Dietary Intakes of Children Enrolled in US Early Child Care Programs on Child Care and Non-Child Care Days.

Abstract

BACKGROUND\nEarly child care (ECE) programs may substantially influence child diet quality.\n\n\nOBJECTIVE\nThe Study of Nutrition and Activity in Child Care Settings (SNACS) describes the usual food group intake of preschool-age children attending ECE programs relative to Dietary Guidelines for Americans (DGA) recommendations, comparing intakes on child and non-child care days.\n\n\nDESIGN\nMeal observations and parent-completed food diaries in a cross-sectional nationally representative multi-stage cluster sample of Child and Adult Care Food Program (CACFP)-participating ECE programs.\n\n\nPARTICIPANTS/SETTING\n1,468 children ages 3 to 5 years attending 217 CACFP-participating ECE programs (child care centers, Head Start) in 2017.\n\n\nMAIN OUTCOME MEASURES\nDaily energy intake, daily USDA Food Pattern Food Group intakes, and percentage of daily intakes meeting 2015-2020 DGA Food Pattern recommendations.\n\n\nSTATISTICAL ANALYSES PERFORMED\nRegression-adjusted usual intakes and percentage of children meeting recommendations were estimated using the National Cancer Institute method. Single-day mean intakes were used to test for statistical differences between child care and non-child care days.\n\n\nRESULTS\nMean usual energy intake was 1,524 kcal±19.3 on child care days and exceeded the recommended range at 1,702 kcal±30.2 on non-child care days; single-day means indicated significantly lower energy intake on child care days (p<0.001). The percent of children meeting DGA recommendations on a child care day varied by DGA food group: fruits (51.4%), grains (50.1%), dairy (42.5%), vegetables (6.5%), whole grains (4.6%), and protein foods (0.1%). Recommended limits on calories from added sugar and solid fats were met by 28.2% and 14.6% of children, respectively. Compared to mean food group intakes on a single child care day, non-child care day intakes were similar for fruits and vegetables, lower for dairy and whole grains, and higher for total grains, protein foods, and calories from added sugars and solid fats.\n\n\nCONCLUSIONS\nWhile there is room to increase nutrient density inside and outside of child care, intakes on child care days more closely align to DGAs.