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.

Keywords: Children's food intake; Eating behaviour; Experimental confederates; Food intake; Social influence.

Fig. 1.

PRISMA flowchart.

Fig. 2.

Forest plot for experimental studies comparing food intake when participants ate with a high vs. a low or no intake confederate. The forest plot also compares sub-group analyses to compare the influence of high vs. no and high vs. low intake confederates, present vs. remote confederates, and the intake of healthy snacks vs. HFHS snack foods. Total refers to the number of participants. Bevelander, Anschutz and Engels (2012b) refers to a second comparison within the same paper.