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Dietary Intakes of Children Enrolled in US Early Child-Care Programs During Child-Care and Non-Child-Care Days
Institution:1. Abt Associates, Cambridge, Massachusetts;2. Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan;3. US Department of Agriculture Food and Nutrition Service, Alexandria, Virginia;4. Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;5. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio;6. Mathematica, Cambridge, Massachusetts;7. Westat, Rockville, Maryland;8. Independent Child Nutrition Research Consultant, Massachusetts;1. Mongan Institute Health Policy Center, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA 02114, United States;2. Department of Medicine, Harvard Medical School, United States;3. Division of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA 02114, United States;4. Mathematica Policy Research, 955 Massachusetts Ave, Room 801, Cambridge, MA 02139, United States;5. Disability Policy Consortium, 11 Dartmouth Street, Room 301, Malden, MA 02148, United States;1. Mathematica, 955 Massachusetts Avenue #801, Cambridge, MA, 02139, USA;2. Mathematica, P.O. Box 2393, Princeton, NJ, USA;1. Department of Civil and Environmental Engineering, Tufts University, Medford, MA, USA;2. Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA, USA;3. Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe;4. Blizard Institute, Queen Mary University of London, London, UK;5. Center of International Policy Research and Evaluation, Mathematica Policy Research, Washington, DC, USA;6. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;7. Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya;8. International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh;9. Department of Nutrition, University of California, Davis, CA, USA;10. Department of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA
Abstract:BackgroundEarly-child-care (ECE) programs may substantially influence child diet quality.ObjectiveThe Study of Nutrition and Activity in Child Care Settings describes the usual food group intake of preschool-aged children attending ECE programs relative to Dietary Guidelines for Americans (DGA) recommendations, comparing intakes during child-care and non-child-care days.DesignMeal observations and parent-completed food diaries in a cross-sectional nationally representative multistage cluster sample of Child and Adult Care Food Program-participating ECE programs.Participants/settingOne thousand four hundred sixty-eight children aged 3 to 5 years attending 217 Child and Adult Care Food Program-participating ECE programs (eg, child-care centers and Head Start) during 2017.Main outcome measuresDaily energy intake, daily US Department of Agriculture Food Pattern Food Group intakes, and percentage of daily intakes meeting 2015-2020 DGA Food Pattern recommendations.Statistical analyses performedRegression-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.ResultsMean usual energy intake was 1,524 ± 19.3 kcal during child-care days and exceeded the recommended range at 1,702 ± 30.2 kcal during 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 with mean food group intakes during 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.ConclusionsAlthough there is room to increase nutrient density inside and outside of child care, intakes on child-care days more closely align to DGAs.
Keywords:Dietary intake  CACFP  Dietary Guidelines for Americans  Preschool-aged children
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