Nutrition practices and policies in CACFP and non-CACFP child care settings

INTRODUCTION: The Child and Adult Care Food Program (CACFP) is a federal program that provides child care settings serving low-income children with subsidies for meals and snacks that meet meal pattern and portion size requirements. CACFP sites also receive annual nutrition education and support. This study compared nutrition practices and policies in CACFP and non-CACFP child care settings. METHODS: A random stratified sample of 350 child care settings (licensed centers, certified family homes) in Columbus, Ohio, was mailed a survey about healthy eating and physical activity practices and policies between May and July 2011. Overall response rate was 74.1% (n=229). Contingency table chi-square tests were used to identify significant differences by CACFP participation. RESULTS: 61.1% of respondents reported CACFP participation. Reported food offerings did not differ by CACFP participation except that CACFP sites were more likely to serve whole grain foods every day (61.2% vs. 49.2%, p=0.026). CACFP sites were also more likely than non-CACFP sites to report that meals are always served family-style (46.0% vs. 30.3%, p=0.033); providers always eat the same foods the children are offered (53.2% vs. 32.1%, p=0.002); posters, books, or pictures about healthy eating or nutrition are displayed (82.9% vs. 69.4%, p=0.019); and that they have at least 5 of 11 written nutrition policies (47.6% vs. 30.7%, p=0.027). DISCUSSION: Food offerings were similar between CACFP and non-CACFP sites; however, CACFP sites exceeded program guidelines in a variety of ways. Regular contact and support from nutritionists may help improve the nutrition environment in child care settings.