title: Academy of Nutrition and Dietetics benchmarks for nutrition in child care 2011: are child-care providers across contexts meeting recommendations?
abstract: The Academy of Nutrition and Dietetics (Academy) recommends feeding practices for child-care providers to establish nutrition habits in early childhood to prevent obesity. With >12 million US children in child care, little is known about child-care providers' feeding practices. The purpose of this study was to examine child-care providers' feeding practices to assess whether providers met the Academy's benchmarks and whether attainment of benchmarks varied across child-care contexts (Head Start, Child and Adult Care Food Program [CACFP], and non-CACFP). Cross-sectional data was collected in 2011 and 2012 from 118 child-care providers who completed self-administered surveys regarding their feeding practices for 2- to 5-year-old children. χ(2) tests and analysis of variance were used to determine variation across contexts. Head Start providers sat more frequently with children during meals (P=0.01), ate the same foods as children (P=0.001), and served meals family style (P<0.0001) more often compared with CACFP and non-CACFP providers. Head Start providers (P=0.002), parents (P=0.001), and children (P=0.01) received more nutrition-education opportunities compared with CACFP and non-CACFP. Head Start providers encouraged more balance and variety of foods (P<0.05), offered healthier foods (P<0.05), modeled healthy eating (P<0.001), and taught children about nutrition (P<0.001) compared with CACFP and non-CACFP providers. Providers across all three contexts used significantly more non-internal than internal mealtime verbal comments (P<0.0001). Head Start providers had greater compliance with the Academy's benchmarks compared with CACFP and non-CACFP providers. Possible reasons for this compliance might be attributed to Head Start nutrition performance standards and increased nutrition-training opportunities for Head Start staff. Head Start programs can serve as a model in implementing the Academy's benchmarks.
authors.forename: Dipti A
authors.initials: DA
authors.lastname: Dev
authors.forename: Brent A
authors.initials: BA
authors.lastname: McBride
mesh_terms: D000047:Academies and Institutes; D000328:Adult; D019985:Benchmarking; D002654:Child Care / Q000592:standards*; D002656:Child Day Care Centers / Q000592:standards; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004046:Dietetics; D018479:Early Intervention, Educational; D005247:Feeding Behavior; D005522:Food Services / Q000592:standards*; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity; D009751:Nutritional Requirements; D009752:Nutritional Status; D009765:Obesity / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014481:United States
keywords: Child and Adult Care Food Program; Child-care nutrition policies; Child-care providers; Feeding practices; Head Start Program