Wide variability of children's dietary intake in child-care centers

Introduction – As 74% of US children are in child-care settings, they are likely to be an important determinant of children's daily diet and a potential venue to prevent obesity. Since child-care centers have the autonomy to customize menus and nutrition environments within certain broad requirements, we aimed to describe the variability of children's intakes in these settings, and determine the extent to which centers predict this variability.

Methods- Trained observers recorded the foods consumed by 373 children during all meals and snacks over 2 days in 30 randomly selected child-care centers in southwest Ohio. Mean macro and micronutrient intake was calculated by eating occasion and center. Intake was compared across centers using a generalized mixed model to account for the nested design.

Results- The center a child attended was a significant predictor (p<0.0001) of intake for all the following macro and micronutrients except fiber (p=0.3). Mean nutrient intake by eating occasion (range of means by center) and pseudo r² for the effect of center were: Kcals: 244(151 – 370) r²=0.30, % calories from fat: 29(18 – 40) r²=019, % calories from protein: 14(9 – 17) r²=0.18, Vitamin A(IU): 738(255 – 2689) r²=0.43, Vitamin C(mg): 10(3 – 36) r²=0.28, Folate(mcg): 41(24-88) r²=0.27, and Fiber(g): 1.7(1.0-2.1) r²=0.02.

Discussion-Children's caloric and nutrient intake varied widely across child-care centers for all nutrients except fiber, for which intake was low across all centers. Next steps are to determine which aspects of these centers (menus, mealtime environments, center demographics) are driving the observed differences.