266555 Wide variability of children's dietary intake in child-care centers

Monday, October 29, 2012

Kristen Copeland, MD , Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
Jane Khoury, PhD , Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati
Heidi Kalkwarf, PhD , Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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.

Learning Areas:
Epidemiology
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
At the conclusion of this presentation, the learner will be able to: 1) describe children's macro- and micronutrient intake during meals and snacks in child care centers 2) identify the child-care center attended as a significant predictor of the amount of calories and nutrients consumed per meal/snack.

Keywords: Child Care, Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principle investigator on an NIH and Robert Wood Johnson Foundation award focusing on the nutrition and physical activity environments and obesity prevention in child-care centers. I co-authored the revised Caring for our Children National Health and Safety Performance standards for child-care settings (APHA and American Academy of Pediatrics)and have presented the research underlying these standards to numerous audiences nationally.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.