Associations Between Caregiver Feeding Practices and Food Neophobia in Children: A Systematic Review and Meta-Analysis Guided by the Vaughn Conceptual Framework.

CONTEXT: Food neophobia limits dietary diversity in childhood and may have lasting implications for growth, development, and health. Caregiver feeding practices are considered a potentially modifiable factor for food neophobia in children, yet evidence regarding their associations remains fragmented and inconsistent. OBJECTIVES: This study aimed to systematically synthesize and quantify the associations between caregiver feeding practices and food neophobia in children. DATA SOURCES: We conducted a systematic search of PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, and PsycINFO for studies published from inception to November 20, 2024. Eligible studies involved children younger than 18 years and were published in English. DATA EXTRACTION: 2 reviewers independently screened titles, abstracts, and full texts. Data on study characteristics, caregiver feeding practice constructs, food neophobia measures, and effect estimates were extracted. Caregiver feeding practices were classified according to the Vaughn conceptual framework. Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality assessment tool. DATA ANALYSIS: Meta-analyses were conducted using pooled correlation coefficients with fixed- or random-effects models as appropriate. 17 studies, with an overall total of 10 102 children with a mean age of approximately 6 years, were included. The "pressure to eat" (r = 0.17; 95% CI, 0.11-0.24) and "restriction" (r = 0.07; 95% CI, 0.01-0.13) were associated with higher food neophobia, while "modeling" was associated with lower food neophobia (r = -0.09; 95% CI, -0.13 to 0.04). Moreover, the association between "pressure to eat" and food neophobia was stronger in non-Asian than Asian populations. CONCLUSION: These findings suggest that caregivers and relevant health professionals should prioritize positive role modeling in caregiver feeding practices rather than relying on coercive feeding strategies, especially for non-Asian populations. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No.[CRD42024602848].