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The influence of experimental confederate peers on children's food intake: A systematic review and meta-analysis.

ABSTRACT: Confederates influence eating behaviour. Systematic reviews and meta-analyses have been conducted on this topic, however, the majority have examined adults, or a combination of adults and children, therefore, an up-to-date meta-analysis is needed to examine the impact of confederate peers on children's food intake. We systematically reviewed and meta-analysed the influence of confederate peers on children's food intake in research using present and remote-confederates. Six publications summarising findings from seven studies were included in this review. One publication was excluded from the meta-analysis because it was not possible to extract the required data. The meta-analysis showed that children were influenced by confederate peers; eating more when exposed to a high-intake compared to a no or low-intake confederate. Larger effects were observed when children were exposed to a remote-than a present-confederate, and for studies using healthy snacks compared to high fat high sugar (HFHS) snacks. No difference in effect size was observed when children were exposed to a high-vs. low-intake confederate compared to a high-vs. no-intake confederate. In the narrative synthesis, confederate intake influenced children's eating behaviour 24-h later, and possible moderators and a potential mechanism underlying the influence of confederates were identified. Caution is needed when interpreting the results, as the sub-groups were not compared statistically due to high heterogeneity, and a small number of studies were included in this review. Furthermore, all studies using the present-confederate design examined HFHS snack intake, therefore, it is unclear whether observed differences in effect sizes between present- and remote-confederates may be due to confederate or food type. Research is needed to further examine the influence of confederate peers on children's food intake and to examine mechanisms and moderators.

SUBMITTER: Sharps MA

PROVIDER: S-EPMC8748424 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundA growing number of studies suggest that exposure to cues which are associated with weight control can prime or prompt controlled food intake in tempting food environments. However, findings are mixed and understanding which types of cues and for whom such cues may be most effective is needed to inform subsequent research and societal applications. A systematic review and meta-analysis were conducted to evaluate the effects of exposure to weight control cues compared with control cues on food intake.MethodsPsycINFO, Medline, Embase and Web of Science were searched using key terms. Hedge's g was used to calculate effect sizes based on mean food intake, standard deviations and sample sizes extracted from relevant publications and, a random effects model was used for the meta-analysis.ResultsTwenty-five articles consisting of 26 studies were eligible. Data from 25 studies (31 effect sizes) were available for the meta-analysis. Overall, weight control cues reduced food intake, albeit to a trivial effect (ES: -0.149, 95% CI: -0.271 to -?0.027). Subgroup analyses when studies which induced negative affect were removed showed that for individuals with strong weight control goals the effect was small-to-moderate (ES: -0.440, 95% CI: -0.718 to -?0.163), whereas for individuals with weak weight control goals this effect was trivial and non-significant (ES: 0.014, 95% CI: -0.249 to 0.278). Cue type and level of engagement did not significantly moderate the effect; however, specific cues (low-calorie foods and thin models) and attended engagement yielded significant effects. Caution is needed interpreting these findings as most studies were rated with high risk of bias and a number of studies could not be included in the subgroup analyses.ConclusionsBased on the data available, weight control cues reduce food intake in individuals with strong weight control goals. Further research is needed to explore longer term effects of cue exposure and confirm underlying mechanisms. PROSPERO registry#CRD42016052396.

Project description:BackgroundSchool food environment policies may be a critical tool to promote healthy diets in children, yet their effectiveness remains unclear.ObjectiveTo systematically review and quantify the impact of school food environment policies on dietary habits, adiposity, and metabolic risk in children.MethodsWe systematically searched online databases for randomized or quasi-experimental interventions assessing effects of school food environment policies on children's dietary habits, adiposity, or metabolic risk factors. Data were extracted independently and in duplicate, and pooled using inverse-variance random-effects meta-analysis. Habitual (within+outside school) dietary intakes were the primary outcome. Heterogeneity was explored using meta-regression and subgroup analysis. Funnel plots, Begg's and Egger's test evaluated potential publication bias.ResultsFrom 6,636 abstracts, 91 interventions (55 in US/Canada, 36 in Europe/New Zealand) were included, on direct provision of healthful foods/beverages (N = 39 studies), competitive food/beverage standards (N = 29), and school meal standards (N = 39) (some interventions assessed multiple policies). Direct provision policies, which largely targeted fruits and vegetables, increased consumption of fruits by 0.27 servings/d (n = 15 estimates (95%CI: 0.17, 0.36)) and combined fruits and vegetables by 0.28 servings/d (n = 16 (0.17, 0.40)); with a slight impact on vegetables (n = 11; 0.04 (0.01, 0.08)), and no effects on total calories (n = 6; -56 kcal/d (-174, 62)). In interventions targeting water, habitual intake was unchanged (n = 3; 0.33 glasses/d (-0.27, 0.93)). Competitive food/beverage standards reduced sugar-sweetened beverage intake by 0.18 servings/d (n = 3 (-0.31, -0.05)); and unhealthy snacks by 0.17 servings/d (n = 2 (-0.22, -0.13)), without effects on total calories (n = 5; -79 kcal/d (-179, 21)). School meal standards (mainly lunch) increased fruit intake (n = 2; 0.76 servings/d (0.37, 1.16)) and reduced total fat (-1.49%energy; n = 6 (-2.42, -0.57)), saturated fat (n = 4; -0.93%energy (-1.15, -0.70)) and sodium (n = 4; -170 mg/d (-242, -98)); but not total calories (n = 8; -38 kcal/d (-137, 62)). In 17 studies evaluating adiposity, significant decreases were generally not identified; few studies assessed metabolic factors (blood lipids/glucose/pressure), with mixed findings. Significant sources of heterogeneity or publication bias were not identified.ConclusionsSpecific school food environment policies can improve targeted dietary behaviors; effects on adiposity and metabolic risk require further investigation. These findings inform ongoing policy discussions and debates on best practices to improve childhood dietary habits and health.

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The influence of experimental confederate peers on children's food intake: A systematic review and meta-analysis.

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