title: Child-care environment and dietary intake of 2- and 3-year-old children.
abstract: BACKGROUND
  Previous research has shown that children in child-care do not comply with dietary intake recommendations (i.e. either exceeding or not meeting recommendations), which may be attributable to specific features of the child-care environment. The present study explored the relationship between the social and physical child-care (day-care) environment and dietary intake of 2- and 3-year-olds in Dutch child-care centres.
  
  
  METHODS
  The dietary intake of 135 children, aged 2 and 3 years, who were in child-care was assessed by observing randomly selected children at three meals (morning snack, lunch and afternoon snack) to determine dietary intake (i.e. saturated fat, dietary fibre and energy intake). The environment was observed using the Environment and Policy Assessment and Observation checklist, a structured instrument assessing the physical and social environment.
  
  
  RESULTS
  Children consumed a mean of 486 kJ (116 kcal) during the morning snack, 2043 kJ (488 kcal) during lunch and 708 kJ (169 kcal) during the afternoon snack. There were some gender and age differences in dietary intake. Several environmental factors (e.g. serving style and staff's model dietary behaviour) were significantly associated with the children's dietary intake.
  
  
  CONCLUSIONS
  Overall, energy intake was in the upper range of recommended intake for children in child-care. The associations of several environmental factors with dietary intake stress the importance of the child-care environment for children's dietary behaviour. Intervening in this setting could possibly contribute to the comprehensive prevention of childhood obesity.
authors: NUTRIM School for Nutrition, Toxicology and Metabolism, Department of Health Promotion, Maastricht University Medical Centre+, Maastricht, The Netherlands. jessica.gubbels@gvo.unimaas.nl
authors: J S
authors: JS
authors: Gubbels
authors: S P J
authors: SP
authors: Kremers
authors: A
authors: A
authors: Stafleu
authors: P C
authors: PC
authors: Dagnelie
authors: N K
authors: NK
authors: de Vries
authors: C
authors: C
authors: Thijs
mesh_terms: D000367:Age Factors; D002656:Child Day Care Centers; D002675:Child, Preschool; D004032:Diet; D002149:Energy Intake; D006801:Humans; D009426:Netherlands; D012737:Sex Factors; D012931:Social Environment