title: Child-care nutrition environments: results from a survey of policy and practice in New Zealand early childhood education services.
abstract: To describe nutrition environments in formal child care for 3- and 4-year-olds.
  
  
  
  Cross-sectional online survey of nutrition-related child-care policy and practice. Written nutrition policies were analysed using the Wellness Child Care Assessment Tool.
  
  
  
  Licensed child-care services in the Auckland, Counties Manukau and Waikato regions of New Zealand.
  
  
  
  Eight hundred and forty-seven services (private and community day care, kindergartens and playcentres).
  
  
  
  Managers/head teachers of 257 child-care services completed the survey. Of services, 82·4 % had a written food, nutrition or wellness policy. Most policies did not refer to the national Food and Nutrition Guidelines and lacked directives for staff regarding recommended behaviours to promote healthy eating. Food was provided daily to children in 56·4 % of child-care services, including 33·5 % that provided lunch and at least two other meals/snacks every day. Teachers talked to children about food, and cooked with children, at least weekly in 60 % of child-care services. Nearly all services had an edible garden (89·5 %). Foods/beverages were sold for fundraising in the past 12 months by 37·2 % of services. The most commonly reported barrier to promoting nutrition was a lack of support from families (20·6 %).
  
  
  
  Although the majority of child-care services had a written nutrition policy, these were not comprehensive and contained weak statements that could be difficult to action. Foods served at celebrations and for fundraising were largely high in sugar, salt and/or saturated fat. Most services promoted some healthy eating behaviours but other widespread practices encouraged children to overeat or form unhealthy food preferences.
authors.affiliation: 1School of Population Health, Faculty of Medical and Health Sciences,University of Auckland,Private Bag 92019,Auckland 1142,New Zealand.
authors.forename: Sarah
authors.initials: S
authors.lastname: Gerritsen
authors.affiliation: 2Department of Nutrition, Faculty of Medical and Health Sciences,University of Auckland,Auckland,New Zealand.
authors.forename: Clare
authors.initials: C
authors.lastname: Wall
authors.affiliation: 3Centre for Longitudinal Research-He Ara ki Mua,University of Auckland,Auckland,New Zealand.
authors.forename: Susan
authors.initials: S
authors.lastname: Morton
mesh_terms: D002656:Child Day Care Centers; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D005522:Food Services; D015438:Health Behavior; D006801:Humans; D009520:New Zealand; D018673:Nutrition Policy; D012574:Schools; D011795:Surveys and Questionnaires
keywords: Child care; Day care; Kindergarten; Nutrition behaviours; Nutrition environment; Obesity prevention; Pre-school