Child Care Sites Participating in the Federal Child and Adult Care Food Program Provide More Nutritious Foods and Beverages

Gurzó, Klára; Lee, Danielle Louhrine; Ritchie, Kyle; Yoshida, Sallie; Vitale, Elyse Homel; Hecht, Ken; Ritchie, Lorrene D.

doi:10.1016/j.jneb.2020.02.009

Cited by 24 publications

(21 citation statements)

References 17 publications

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“…Studies suggest that childcare sites participating in CACFP reported offering more nutritious foods and healthier beverages than nonparticipating sites did. [18][19][20][21] Similarly, studies in California suggest that the childcare beverage law that went into effect in 2012 resulted in an increase in healthier beverage offerings as reported by childcare sites. [22][23][24] People in lower-income households are more likely to rely on homes than on centers, and the reverse is true for higher-income households.…”

Section: Discussionmentioning

confidence: 99%

Alignment of State Regulations With Breastfeeding and Beverage Best Practices for Childcare Centers and Family Childcare Homes, United States

et al. 2020

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Objectives Childcare is an important setting for nutrition; nearly half of young children in the United States participate in licensed childcare, where they consume up to two-thirds of their daily dietary intake. We compared state regulations for childcare with best practices to support breastfeeding and healthy beverage provision. Methods We reviewed regulations for childcare centers (centers) and family childcare homes (homes) in effect May–July 2016 and rated all 50 states for inclusion (1 = not included, 2 = partially included, 3 = fully included) of 12 breastfeeding and beverage best practices. We calculated average ratings for 6 practices specific to infants aged 0-11 months, 6 practices specific to children aged 1-6 years, and all 12 practices, by state and across all states. We assessed significant differences between centers and homes for each best practice by using McNemar–Bowker tests for symmetry, and we assessed differences across states by using paired student t tests. Results States included best practices in regulations for centers more often than for homes. Average ratings (standard deviations) in regulations across all states were significantly higher in centers than in homes for infant best practices (2.1 [0.5] vs 1.8 [0.5], P < .001), child best practices (2.1 [0.6] vs 1.8 [0.6], P = .002), and all 12 best practices combined (2.1 [0.5] vs 1.8 [0.6], P < .001). Conclusions Although best practices were more consistently included in regulations for centers than for homes, many state childcare regulations did not include best practices to support breastfeeding and the provision of healthy beverages. Findings can be used to inform efforts to improve regulations and to reduce differences between centers and homes.

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Section: Discussionmentioning

confidence: 99%

Alignment of State Regulations With Breastfeeding and Beverage Best Practices for Childcare Centers and Family Childcare Homes, United States

et al. 2020

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“…While this study found that children under the care of Latino FCCPs had higher component diet quality scores for greens/beans, total protein, and seafood and plant protein, this analysis did not take into account the specific types of foods offered and the ethnic differences in the foods provided [24]. While the CACFP is a very important predictor of the nutritional quality of foods served in childcare [30][31][32][33], exploring other factors among FCCHs that care for underserved children is needed. This is particularly important given that children still do not meet recommendations for fruits, vegetables, whole grains and low-fat milk, and are consuming too many sugar-sweetened beverages (SSBs), fruit juice and snacks, with excess sugars, saturated fat and sodium [34][35][36][37][38][39][40][41].…”

Section: Introductionmentioning

confidence: 88%

Dietary Contributors to Food Group Intake in Preschool Children Attending Family Childcare Homes: Differences between Latino and Non-Latino Providers

et al. 2020

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While there are several factors that contribute to the diet quality of children in childcare, one contributing factor in Family Childcare Homes (FCCHs) is the provider’s ethnicity. However, research examining the food items provided in this setting is limited; in particular, with regards to differences between FCCHs of Latino and non-Latino providers. The aim of this study was to identify and describe the food items that contribute to food group intake in preschool-aged children attending FCCHs, and to examine differences by provider ethnicity. This secondary data analysis used baseline data from Healthy Start/Comienzos Sanos: a cluster-randomized trial. Children’s dietary intake was collected using the Dietary Observation in Child Care method and entered into Nutrition Data System for Research software. Food groups were based on the Nutrition Coordinating Center classification. Contribution of food items to their respective food group was calculated as a proportion, using ratio of means and presented as a percentage. Ethnic differences were tested with ANCOVA (p < 0.05) with Bonferroni adjustments for multiple comparisons. All providers (n = 120) were female and 67.5% were Latino. Most fruit consumed by children was in the form of juice (85%), three-fourths of the grains consumed were refined (75%), and half of the sweets consumed were syrup/honey/jelly (50%). Most of the vegetables consumed were non-starchy (61%), nearly three-fourths of dairy consumed was low-fat (71%), and vegetable oils contributed the most to the fats group (89%). Food items differed by provider’s ethnicity, with children cared for by non-Latino providers consuming a higher proportion of fruit juice, animal fats and a lower proportion of legumes (p < 0.001 for all). Children with Latino providers consumed a lower proportion of non-starchy vegetables, low-fat dairy, and nuts/seeds (p < 0.001 for all). FCCH providers could offer more whole fruits and grains and a greater variety of vegetables. Differences by ethnicity suggest providers could benefit from culturally tailored recommendations.

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“…The program was revised for the first time in its existence during 2016, adding requirements for serving a greater variety of fruits and vegetables and protein options, and more whole grains, and healthy beverages 12 . Several research studies focused on the implementation of obesity prevention policies have shown the most effectiveness among programs that participate in CACFP 13‐19 . For example, a study in Mississippi among family child care homes reported that homes participating in CACFP had healthier nutrition practices and served healthier beverages than homes that did not participate in CACFP 14 …”

Section: Introductionmentioning

confidence: 99%

“…A recent multi‐state study (Massachusetts, Rhode Island, North Carolina and South Carolina) found that CACFP participating ECE programs were less likely to report barriers to serving healthy foods than nonparticipants 15 . Similarly, several studies conducted in California have indicated that CACFP participating ECE programs served more fruits and vegetables and fewer sweets and sugary beverages when compared to non‐CACFP participating programs 16‐19 . California is one of the states with a law (Healthy Beverages in Child Care Act‐AB2084), which requires ECE providers to serve healthy beverages 18 .…”

Section: Introductionmentioning

confidence: 99%

Assessing health disparities in foods and beverages served in early care and education programs across Georgia

Kear

Stotz

Love³

et al. 2021

Pediatric Obesity

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Summary Background Obesity disproportionately impacts children who are Black and Hispanic, those who live in rural communities and those who have low income. Predisposition to obesity early in life is profoundly impacted by feeding habits during the preschool years. The early care and education (ECE) setting impacts children's health by providing daily meals. Objective The goal of this study was to identify whether or not health disparities in foods and beverages served in ECE programs in Georgia exist based on socioeconomic, demographic and geographic variables. Methods A random sample was drawn from 3054 ECE programs across the state of Georgia. The likelihood of serving specific foods and beverages in ECE programs in the previous day was measured. Percentages and frequencies, logistic regressions, Spearman's rho and Odds ratio tests determined outcomes. Results A total of 974 surveys were returned. Data were stratified based on the income level of the participant families, race of enrolled children and geographic location of the ECE program. Disparities existed between programs based on race of enrolled children and geographic location. For example, although the odds of providing sweets increased by 0.6% as the percentage of Black children enrolled increased, the provision of healthier foods, such as the odds of providing fruits (P = .001), vegetables (P = .001) and protein (P = .001) also increased. However, after results were adjusted for covariates findings did not remain significant. Conclusions Future research focused on evaluating the foods and beverages provided in ECE programs and the relationship of how income, race and location are related may provide further understanding about the disproportionate childhood obesity rates in America.

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Child Care Sites Participating in the Federal Child and Adult Care Food Program Provide More Nutritious Foods and Beverages

Cited by 24 publications

References 17 publications

Alignment of State Regulations With Breastfeeding and Beverage Best Practices for Childcare Centers and Family Childcare Homes, United States

Alignment of State Regulations With Breastfeeding and Beverage Best Practices for Childcare Centers and Family Childcare Homes, United States

Dietary Contributors to Food Group Intake in Preschool Children Attending Family Childcare Homes: Differences between Latino and Non-Latino Providers

Assessing health disparities in foods and beverages served in early care and education programs across Georgia

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