Predictors of Nutrition Quality in Early Child Education Settings in Connecticut

Abstract

ObjectiveThis study assessed the dietary quality of lunches and feeding practices (family-style service, teacher role modeling) in Connecticut child care centers and made comparisons by center participation in the federal Child and Adult Care Food Program (CACFP). DesignPlate waste methods and visual observation of lunches served and consumed. SettingA total of 97 randomly selected licensed Connecticut child care centers (53 CACFP and 44 non-CACFP). ParticipantsA total of 838 preschool-aged children. Main Outcome MeasuresTotal energy intake, macronutrient intake, and intake by CACFP meal component as well as use of family-style dining, management of additional helpings, and whether and what teachers consumed in view of children. AnalysisChild dietary intake at lunch was compared with dietary and CACFP recommendations using a mixed linear regression model. ResultsThe CACFP centers were more likely to offer family-style service and have staff eat the same foods as the children. Children in non-CACFP centers consumed more saturated fat (4.1 vs 2.7 g; P < .001) and trans fats (0.1 vs 0.1 g; P = .02) and less milk (3.5 vs 2.7 oz; P < .001) than did children in CACFP centers. Caloric intake and dietary fiber were below recommendations in both groups. Participation in CACFP was a significant predictor of low-fat milk consumption. Conclusions and ImplicationsThe CACFP-participating centers confer some nutritional advantages in terms of provider behavior during meals, characteristics of food offerings, and child intake. Current feeding practices in child care settings require further exploration in the context of serving children at risk for food insecurity and in light of recent work on responsive feeding.