Parental autonomy-supportive food practices and fruit and vegetable consumption in children: a systematic review and meta-analysis

Abstract

This systematic review synthesizes evidence on the relationship between parental autonomy-supportive food practices and the consumption of fruit and vegetable in children aged 2–12 years. Six electronic databases (PubMed®, EMBASE®, Web of Science™, Scopus™, PsycINFO®, and LILACS®), Google Scholar®, and reference lists were systematically searched for studies published before January 9, 2025. Studies assessing autonomy-supportive food practices (reported by caregivers and/or children) and child consumption of fruit and/or vegetable were included. Data were collected using a standardized form, risk of bias was evaluated using the Joanna Briggs Institute tools. Two authors independently conducted all review steps, and a third reviewer resolved disagreements. A random-effects model was applied, and stratified meta-analyses were performed using R software. A total of 53 studies were included. Although individual study results were inconsistent, a correlation-based meta-analysis found weak but significant associations of verbal and visual encouragement to eat (K = 36; r = 0.17, 95 % confidence interval [CI] [0.13, 0.21]) and involvement (K = 13; r = 0.13, 95 % CI [0.09, 0.16]) with children's fruit and vegetable consumption; significance persisted in the regression-based meta-analysis (encouragement to eat: K = 14; β = 0.07, 95 % CI [0.02, 0.12]; involvement: K = 5; β = 0.10, 95 % CI [0.04, 0.16]). Teachable moments, praise, and negotiation showed weak but significant correlations (r ranging from 0.11 to 0.16). Findings suggest that verbal and visual encouragement to eat and involvement are associated with children's fruit and vegetable intake. Teachable moments, praise, and negotiation show weak positive correlations, although all these associations have small effect sizes and are primarily derived from cross-sectional studies in high-income countries.