Assessment of Mealtime Environments and Nutrition Practices in Child Care Centers in Georgia

Abstract

Background:

The amount of time children spend in child care each week has increased in recent years. The aim of this cross-sectional study was to describe the nutritional quality of foods served and the mealtime environment in 24 child care centers in Georgia.

Methods:

Data were collected between April 2010 and September 2010. Each child care center provided a sample 5-day menu (breakfast, lunch, and an afternoon snack) at baseline. Energy and nutrient contents of the menus were analyzed using NutriKids Menu Planning & Nutritional Analysis software (LunchByte Systems, Inc., Rochester, NY). Foods and beverages on the menus were compared to MyPlate food group standards for preschoolers. The child care environment was assessed in each center over 1 full day using the Environment and Policy Assessment and Observation instrument.

Results:

Menus met one half to two thirds of the recommended levels for energy, carbohydrate, protein, and vitamins A and C. However, the menus were high in saturated fat and sodium content and did not meet the recommendations for iron or fiber. The majority of the centers did not meet the recommendations for MyPlate food group standards for preschoolers. On the day of the observation, seven centers did not serve a vegetable and more than half of the centers (n=13) did not serve any whole grains. Nineteen centers served high-sugar and/or high-fat foods and 11 did not have visible water indoors.

Conclusions:

This study identified determinants of the child care environment and nutritional characteristics of the combined meals and snacks offered to children. Findings from this study could inform child care centers how to provide healthier nutrition environments to preschool children.

Get full access to this article

View all access options for this article.

References

Ogden

, Carroll

, Curtin

et al. Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA, 2010; 303:242–249.

Trust for America's Health and the Robert Wood Johnson Foundation. F as in fat: How obesity threatens America's future. http://healthyamericans.org/reports/obesity2010/Obesity2010Report.pdfPublished June 2010.2013 January 10.

Whitaker

, Wright

, Pepe

et al. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med, 1997; 337:869–873.

Dehghan

, Akhtar-Danesh

, Merchant

. Childhood obesity, prevalence and prevention. Nutr J, 2005; 4:24.

Federal Interagency Forum on Child and Family Statistics. America's children: Key national indicators of well-being. 2009. US Government Printing Office: Washington, DC www.childstats.gov/pdf/ac2009/ac_09.pdfPublished July 20092013 January 18

Position of the Academy of Nutrition and Dietetics. Benchmarks for nutrition programs in child care settings. J Am Diet Assoc, 2011; 111:607–615.

United States Department of Agriculture Food and Nutrition Service: Child and Adult Care Food Program (CACFP). www.fns.usda.gov/cnd/care/Updated February 21, 2012.2013 January 25.

United States Department of Agriculture Food and Nutrition Service: Child and Adult Care Food Program (CACFP). Meal patterns. www.fns.usda.gov/cnd/care/ProgramBasics/Meals/Meal_Patterns.htm. 2013 January 25.

US Department of Agriculture and US Department of Health and Human Services. Dietary Guidelines for Americans, 2010, 7th. US Government Printing Office: Washington, DC, December 2010. www.cnpp.usda.gov/Publications/DietaryGuidelines/2010/PolicyDoc/PolicyDoc.pdf. 2013 January 15.

10.

Institute of Medicine. Child and Adult Care Food Program. Aligning Dietary Guidance for All. The National Academies Press: Washington, DC, 2011.

11.

Padget

, Briley

. Dietary intakes at child-care centers in central Texas fail to meet Food Guide Pyramid recommendations. J Am Diet Assoc, 1995; 105:790–793.

12.

Ball

, Benjamin

, Ward

. Dietary intakes in North Carolina child-care centers: Are children meeting current recommendations? J Am Diet Assoc, 2008; 108:718–721.

13.

Oakley

, Bomba

, Knight

et al. Evaluation of menus planned in Mississippi child-care centers participating in the Child and Adult Care Food Program. J Am Diet Assoc, 1995; 95:765–768.

14.

Fleischhacker

, Cason

, Achterberg

. “You had peas today?”: A pilot study comparing a Head Start child-care center's menu with the actual food served. J Am Diet Assoc, 2006; 106:277–280.

15.

Briley

, Buller

, Roberts-Gray

et al.

What is on the menu at the child care center?

J Am Diet Assoc, 1989; 89:771–774.

16.

Drake

. Menu evaluation, nutrient intake of young children, and nutrition knowledge of menu planners in child care centers in Missouri. J Nutr Educ, 1992; 24:145–148.

17.

Sigman-Grant

, Christiansen

, Branen

et al. About feeding children: Mealtimes in child-care centers in four Western states. J Am Diet Assoc, 2008; 108:340–346.

18.

Sigman-Grant

, Christiansen

, Fernandez

et al. Child care provider training and a supportive feeding environment in child care settings in 4 states, 2003. Prev Chronic Dis, 2011; 8:A113.

19.

Erinosho

, Dixon

, Young

et al. Nutrition practices and children's dietary intakes at 40 child-care centers in New York City. J Am Diet Assoc, 2011; 111:1391–1397.

20.

Larson

, Ward

, Neelon

et al. What role can child-care settings play in obesity prevention? A review of the evidence and call for research efforts. J Am Diet Assoc, 2011; 111:1343–1362.

21.

Benjamin Neelon

, Vaughn

, Ball

et al. Nutrition practices and mealtime environments of North Carolina child care centers. Child Obes, 2012; 8:216–223.

22.

Bright from the Start: Georgia Department of Early Care and Learning website. http://decal.ga.gov/Updated 2012.2013 January 18.

23.

Caregivers Promoting Healthy Habits. decal.ga.gov/documents/attachments/RFA_Application.doc. 2013 January 18.

24.

United States Department of Agriculture. Choose MyPlate. Health and nutrition information for preschoolers. www.choosemyplate.gov/preschoolers.html. 2012 July 23.

25.

Benjamin

, Neelon

, Ball

et al. Reliability and validity of a nutrition and physical activity environmental self-assessment for child care. Int J Behav Nutr Phys Act, 2007; 4:29.

26.

Ward

, Hales

, Haverly

et al. An instrument to assess the obesogenic environment of child care centers. Am J Health Behav, 2008; 32:380–386.

27.

National Academy of Sciences, Food and Nutrition Board, National Research Council. Dietary Reference Intakes (DRI) and Recommended Dietary Allowances (RDA) Institute of Medicine of the National Academies: Washington, DC www.iom.edu/Activities/Nutrition/SummaryDRIs/DRI-Tables.aspxUpdated September 12, 2011.2013 January 18.

28.

Bollella

, Spark

, Boccia

et al. Nutrient intake of Head Start children: Home vs. school. J Am Coll Nutr, 1999; 18:108–114.

29.

Briley

, Jastrow

, Vickers

et al.

Dietary intake at child-care centers and away: Are parents and care providers working as partners or at cross-purposes?

J Am Diet Assoc, 1999; 99:950–954.

30.

Bruening

, Passannante

, McClowry

. Dietary intake and health outcomes among young children attending 2 urban day-care centers. J Am Diet Assoc, 1999; 12:1529–1535.

31.

Fisher

, Rolls

, Birch

. Children's bite size and intake of an entree are greater with large portions than with age-appropriate or self-selected portions. Am J Clin Nutr, 2003; 77:1164–1170.

32.

Freedman

, Alvarez

. Early childhood feeding: Assessing knowledge, attitude, and practices of multi-ethnic child-care providers. J Am Diet Assoc, 2010; 110:447–451.

33.

Benjamin Neelon

, Copeland

, Ball

et al. Comparison of menus to actual foods and beverages served in North Carolina child-care centers. J Am Diet Assoc, 2010; 110:1890–1895.