Promoting healthy eating and physical activity in child care: Challenges and opportunities

Compared to schools, childcare has received less research and policy focus on obesity prevention. Yet, a growing body of research highlights the importance of developing healthy habits and combating obesity at the youngest ages. We undertook a multi-method research project to determine the extent to which nutrition and physical activity (PA) practices in childcare meet needs for obesity prevention and to identify challenges and opportunities for policy improvements in this field. A statewide survey of a range of licensed childcare settings revealed that sites participating in the Child and Adult Care Food Program (CACFP) served higher quality nutrition than non-CACFP sites with HeadStart sites generally providing the highest quality nutrition. Lunches brought from home were lower quality than lunches provided by childcare sites. High food costs were identified by providers as the greatest challenge to providing better nutrition. Identified areas for improvement included the provision of water and lower fat milk, more whole grains, and higher quality produce. On average, only 53% of sites reported providing more than 60 minutes per day of PA. Compared to centers, family homes devoted more time to TV watching and had less facilities and equipment, less frequently had written policy on PA, and provided less training for staff and parents on PA. Stakeholders agreed that CACFP standards should be strengthened. Findings from this research and the policy recommendations that emerged could significantly impact national and state efforts to provide healthier nutrition and PA environments to children in childcare.