Quality of Nutrition Environments, Menus and Foods Served, and Food Program Achievement in Oklahoma Family Child Care Homes.

Bethany D Williams,Marny Dunlap,Karla Finnell,Hope N Hetrick,Emily L Stinner,Alicia L Salvatore,Jennifer Graef-Downard,Kathrin Eliot,Susan B Sisson

doi:10.3390/nu13124483

Abstract

Child care environments foster children’s healthy eating habits by providing exposure to healthy foods and feeding practices. We assessed the healthfulness of nutrition environments, menu/meal quality, and the achievement of Child and Adult Care Food Program (CACFP) guidelines and best practices in Oklahoma CACFP-enrolled family child care homes (FCCHs) (n = 51). Two-day classroom observations were conducted. Healthfulness of classroom nutrition environments was assessed using the Environment and Policy Assessment and Observation (EPAO). Foods served to and consumed by children were quantified using the Dietary Observations in Child Care (DOCC) tool. Nutrient analysis was performed to determine total energy for foods listed on menus, served to, and consumed by children. Menu and meal food variety and CACFP Guideline Achievement Scores were determined. Average nutrition environment score was 11.7 ± 1.2 (61.5% of maximum possible score). Energy (kcals) from menus and consumed by children was insufficient to meet two-thirds of their daily reference intake. Children were exposed to 1.7 vegetables and 1.3 fruits per meal. CACFP Guideline Achievement Scores were 66.3% ± 7.8 for menus and 59.3% ± 7.6 for mealtimes. Similar to previous research, our findings indicate a need for improved FCCH nutrition practices. Tailored interventions for FCCHs are needed.

Highlights

Childhood is a critical period during which dietary patterns and eating habits are developed by young children [1]
It is vital to consider the quality of family child care homes (FCCHs) nutrition environments, menus, and foods served to and consumed by children to inform resources supporting child and public health, especially in FCCHs in Oklahoma, where residents are at high risk of obesity and related chronic outcomes [33]. This study addresses these gaps in the literature through two primary aims: (1) describe the healthfulness of Oklahoma FCCH overall nutrition environments, including foods/beverages served, staff nutrition behaviors, nutrition learning environment, and classroom healthy lifestyle materials; and (2) describe the quality of Oklahoma FCCH menus, foods served, and foods consumed by children, including nutrient composition, variety, and achievement of Child and Adult Care Food Program (CACFP) requirements and best practices
FCCHs were in business for 10.8 ± 9.6 years, cared for an average number of 9.5 ± 4.2 children, and employed 1.4 ± 1.4 total staff

Summary

Introduction

Childhood is a critical period during which dietary patterns and eating habits are developed by young children [1]. National organizations, including the Academy of Nutrition and Dietetics, American Public Health Association, the National Resource Center for Health and Safety in Child Care and Early Education, and the National Academy of Science (formerly known as the Institute of Medicine), strongly urge that ECE programs achieve recommended benchmarks for nutrition standards to assist public health efforts combatting childhood obesity [16,17,18] In alignment with these goals, the United States Department of Agriculture (USDA) implemented the Child and Adult Care Food Program (CACFP) as a means to reimburse costs of higher-quality, nutritious foods for ECEs that primarily serve low-income children [19]

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Discussion

Conclusion