P113 Diet Quality Assessment in Early Care and Education Centers: A Comparison of Three Common Methods

Abstract

Background Children in Early Care and Education (ECE) centers are not meeting Dietary Guidelines (DG), which could contribute to the onset of diet-related diseases. ECE center diet quality has been assessed using either what is listed on the menu, what children are served and/or what was consumed for the lunch meal. However, it is unclear whether diet quality differs among the three measures, which may be useful to understand patterns that inform nutrition education messaging. Objective Identify if diet quality differs among the menu, served and consumed lunch measures. Diet quality will be assessed using Healthy Eating Index-2015 (HEI) scores, which represent how closely DG are met. Study Design, Settings, Participants ECE centers were located within one southern state, and included rural and urban communities. For each center, three children from a 3-5 year old classroom, were randomly chosen and observed during one lunch meal, per a published protocol. The type and amount of food/beverage served to or by the child (SERVED) and the amount consumed (CONSUMED) was visually estimated and recorded. The menu from the observed lunch (MENU) was collected. For each center, a mean HEI score was calculated for SERVED, CONSUMED and MENU. Measurable Outcome/Analysis Non-parametric ANOVA and Duncan's post-hoc were used to identify statistically significant differences among SERVED, CONSUMED, and MENU HEI scores. Results Lunch observations were completed within 28 ECE centers. The total HEI score was significantly higher (χ2 = 11.7, P = .003) among MENUS, compared to SERVED and CONSUMED. Total HEI scores among SERVED and CONSUMED were not significantly different. Conclusion Diet quality was higher among menus, compared to served and consumed measures. Nutrition education messaging may encourage ECE employees to serve the food/beverage items listed on the lunch menu, in order to improve diet quality. Understanding why diet quality differences exist among lunch measures, is warranted. Funding Nestle S.A. Grant.