Children’s food trust ‘Eat Better, Start Better’ programme: outcomes and recommendations

Abstract

Children's early years provide an important foundation for their future health and strongly influence many aspects of wellbeing. Children's tastes and eating habits are also formed early in life with consequences for growth, development, health and academic achievement in later life.1-4 Promoting the initiation and optimal duration of breastfeeding and good nutrition in the early years can reduce the prevalence of later obesity and associated chronic diseases such as cardiovascular disease, diabetes and some cancers.5 Hence, the most cost-effective nutrition interventions focus on this window of opportunity.6 With over 1.3 million registered early years places in England7 and an increasing number of full day-care places,8 early years settings provide an invaluable opportunity to help children to eat well and engage with families to encourage development of healthy eating habits at home. All regulated early years settings in England are required to follow the mandatory standards for learning, development and care of children from birth to five years as set out in the Early Years Foundation Stage (EYFS) framework.9 The framework includes a welfare requirement for the provision of 'healthy, balanced and nutritious' food and drink, but until recently, there was no national guidance in England to explain what this meant in practice.10Development of the 'Eat Better, Start Better' programmeIn April 2011, the Children's Food Trust11 was awarded a Department for Education grant to develop and deliver the 'Eat Better, Start Better' programme. This programme evolved from two recommendations made by the Advisory Panel on Food and Nutrition in Early Years,12 the development of national food and drink guidelines for early years settings and food and nutrition training for the early years and health workforce. The main aims of the programme are to support healthier food provision in early years settings and in families with young children, and increase the food, nutrition and healthy cooking knowledge, skills and confidence of early years and health practitioners and parents.The programme has been implemented over two phases. As part of Phase 1 (2011-2012), the trust developed the Voluntary Food and Drink Guidelines for Early Years Settings in England13 and practical support tools, and worked collaboratively with five local authority areas to develop and pilot an integrated food and nutrition training and evaluation package. Following successful delivery in Phase 1,14 the programme was rolled out to a further 20 targeted local authorities across England between April 2012 and September 2013.The 'Eat Better, Start Better' programme has been designed to support early years and health professionals to confidently cascade age-appropriate, nutrition advice to early years settings and families, helping to ensure that children and parents receive consistent messages around healthy eating.The programme includes two trainthe- trainer courses (how to use the food and drink guidelines; healthy cooking with families), dissemination of guidance and resources, and regular monitoring of impact using standardised evaluation tools. The Trust's training, accredited by the Royal Society for Public Health (RSPH),15 acknowledges the unique role health and early years practitioners have in delivering health and education services.Monitoring the impact of the 'Eat Better, Start Better' programmeEvaluation is an integral part of the programme. Following the training, each local authority undertakes baseline and follow-up audit visits in early years settings to assess the impact of the food and drink guidelines and practical tools on settings' approach to and provision of food. To assess the impact of the cooking sessions delivered to families, early years settings report what food was prepared, the skills developed and how many families were involved in the cooking sessions. This information informs an evaluation report for commissioning in local authorities and can be used as evidence of impact for health and wellbeing boards. …