Intervenções educacionais de pais ou cuidadores de crianças com seletividade alimentar: uma revisão sistemática

Abstract

Food fussiness is the most prevalent form of feeding difficulty, characterized by limited food preferences, hypersensitivity to textures, flavors, or temperatures, and the refusal of certain food groups, ultimately leading to a less varied diet. This condition can have significant implications for children's nutritional and mental health and can be particularly stressful for parents and caregivers. Numerous studies have demonstrated a direct correlation between caregivers' feeding behaviors and children's eating patterns. Therefore, educational interventions targeting parental feeding practices have been proposed. This systematic review aims to evaluate the effect of educational interventions for parents or caregivers on the feeding behavior and food variety of children with food fussiness. Thus, the guiding question of this review is: Do educational interventions for parents or caregivers improve feeding behavior or increase the variety of foods accepted by children with food fussiness? Searches were conducted in the following databases: Medline via PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), EMBASE (Elsevier), and Scopus. Grey literature was also assessed. Inclusion criteria encompassed intervention studies, including both randomized and non-randomized clinical trials, as well as systematic reviews comparing educational approaches for parents or caregivers of children with food fussiness to other interventions. Studies involving caregivers of children with comorbidities or chronic conditions, or those conducted exclusively with children, were excluded. Language and publication date were not exclusion criteria. After the selection process, 11 studies were retrieved. Eligible studies underwent quality assessment using Risk of Bias tools. Given the nature of the topic, the obtained studies exhibited high variability, resulting in significant heterogeneity, which meant that only a narrative analysis could be conducted. The main findings reveal a considerable variety of definitions and diagnostic tools for food fussiness/feeding difficulties. Additionally, most studies focused on Caucasian populations from developed countries in North America, Oceania, and Europe. It was also demonstrated that caregiver involvement leads to better perception of their children's behavior and the use of less detrimental tactics during meals. The combination of parental educational interventions with sensory-based interventions for children appears to result in less disruptive feeding behaviors and improved dietary variety. However, it is not possible to determine how much of these outcomes are exclusively due to parental interventions. The findings of this review highlight the need for the standardization of diagnostic criteria in the current scenario. Additionally, there is a pressing need for further studies involving populations of diverse ethnicities, social classes, and developing countries.