Are Mealtime Best Practice Guidelines for Child Care Centers Associated with Energy, Vegetable, and Fruit Intake?

Abstract

Background: Mealtime best practices for obesity prevention in child care have been developed from experimental studies and expert opinion. Our objective was to describe adherence to best practices in child care centers and to evaluate the association between mealtime practices and children's dietary intake.Methods: We conducted an observational study of 349 preschoolers, ages 36 to 72 months, from 30 child care centers in Cincinnati, Ohio (November 2009 to January 2011). Trained observers recorded providers' behaviors related to six mealtime best practice recommendations and documented children's intake (n = 60 group lunches). General linear mixed models were used to evaluate the association between practice use and children's total energy (caloric consumption) and fruit and vegetable consumption.Results: Adherence to individual mealtime best practices was variable (0%-77%). Staff sitting with children at lunch was associated with lower energy intake and higher vegetable intake. Staff eating some of the same foods was associated with higher energy intake and higher vegetable intake. Staff encouraging children to try new/less-favorite foods more than once was associated with lower fruit intake. Staff having general conversations with children (not addressed in recommendations) was associated with lower vegetable intake. Family-style meal service, staff talking about healthy foods, and staff helping children assess hunger before seconds were not significantly associated with intake.Conclusions: Few mealtime best practices were associated with dietary intake. Given the number of meals children consume in child care and the prevalence of childhood obesity, efforts to identify mealtime practices that improve children's dietary intake are crucial for obesity prevention.

Tribally Affiliated Child-Care Center Environment and Obesogenic Behaviors in Young Children

“…The energy and nutrients consumed were within acceptable distribution ranges for young children and similar to previous reports in the U.S., 25,39 , although lower than childcare centers abroad. 27 A previous report of American Indian preschoolers conducted over the full day reported the same fat consumptionbut higher carbohydrate and lower protein.…”

“…60 However, a high prevalence of centers participated in family-style meal service (36% vs. 8–12%). 25,36 Observations in this study are similar to self-reported practices. 29,61 Given the variation between self-report and researcher observations, it is likely that providers are aware of the best-practice recommendations 3,23 and may be attempting to implement family-style meal service, yet are not fully compliant.…”

“…23 Additional recommendations include eating with children, 24,25 talking about healthy foods, 24 enthusiastic modelling, 26,27 multiple food exposures, 3,28 appropriate portion sizes, 3,29 and serving nutrient-dense food first. 30,31 However, children attending childcare are often served and consume foods high in fat, 34,36 salt, 36 sugar, 36 and excessive protein.…”

“…13,15–19,21,22,25–28,30,31,33,44,45 Little is known about obesogenic practices in centers serving American Indian children, who are vulnerable to health inequalities. 10,46–48 Understanding and improving factors related to the development of obesity by young minority children may improve health disparities.…”

Does family mealtime have a protective effect on obesity and good eating habits in young people? A 2000-2016 review

“…Kharofa et al 35 propose a guide for such interventions with subsidize steps to guide appropriate practices at mealtime. Since family mealtime,is dependent of parental behavioral pattern and socioeconomic conditions, they become the main focus of the interventions and not the children.…”