Making Healthy Eating Pleasurable for Children: A Systematic Review and Future Research Agenda

Abstract

Childhood obesity remains a major global public health challenge. Research demonstrates that children's pleasurable food experiences may orient children toward unhealthy options unless children learn, early and consistently, to associate pleasure with healthy foods. This review synthesizes interventions designed to link pleasure with healthy eating and evaluate how these approaches can be strengthened or extended. We conduct a systematic literature review of 52 articles and applied the antecedents-decisions-outcomes (ADO) and theories-contexts-and methods (TCM) frameworks to organize existing knowledge and build understanding. We distinguish four antecedents of pleasurable eating experiences: sensory, interpersonal, psychosocial, and physiological. These antecedents influence six key decisions, including healthy food choice, healthy food consumption, healthy and unhealthy food acceptance or avoidance, gustatory interference, and responses to marketing stimuli. We also identify three outcomes: subjective well-being, objective well-being, and childhood obesity prevention. The review reveals limited theoretical development across the field, constraining cumulative knowledge building. Overall, the review offers comprehensive insight into successful interventions for healthy pleasurable eating for children and provides extensive future research directions.