Dietary intake at child-care centers and away: are parents and care providers working as partners or at cross-purposes?

OBJECTIVE

To examine how meals and snacks children consume before and after their time at a child-care facility complement the menu at the facility.

DESIGN

Dietary intake of children at and away from the child-care center was compared with recommended standards for child nutrition. Registered dietitians observed foods consumed at the center during 3 consecutive days. Parents reported foods consumed away from the center during the same 3 days.

SUBJECTS/SETTING

Six nonprofit child-care centers with strong menus (i.e., menus that come close to meeting dietary recommendations) and 6 with menus supplying less than 50% of the Recommended Dietary Allowance were selected for study. Five families at each center were invited to participate. Complete data sets were obtained for 51 children aged 3 to 6 years.

STATISTICAL ANALYSES PERFORMED

Descriptive and inferential statistics were calculated to compare the children's dietary intake during center time and family time and over a full day with recommended standards. Energy and nutrient profiles and food frequencies were included in the analysis.

RESULTS

Children consumed plenty of foods at the center and away from the following groups: meat, poultry, fish, dry beans, eggs, nuts; milk, yogurt, cheese; and fruit, fruit juice. Most children failed to consume enough vegetables. Nearly all the children failed to consume enough bread, cereal, pasta, and rice, especially while at the center. The majority ate more than sparing amounts of fats, oils, and sweets, especially during family time. Average percentage of energy from fat was 33 +/- 4. Intakes of concern for the full day were energy, iron, sodium, and zinc.

APPLICATIONS

Child-care menus are an appropriate target for increasing iron and zinc by serving more cereal and whole grains. Families are an appropriate target for reducing young children's consumption of fats, oils, and sweets. Nutrition education and advocacy are needed to strengthen the partnership between parents and caregivers.

Heart Partners: a strategy for promoting effective diffusion of school health promotion programs

Heart Partners uses a straightforward, interpersonal approach to increase acceptance and use of innovations in school health promotion. In accord with the linkage model of innovation diffusion, developers of a new program or technology (i.e., resource system) simply designate and train selected members to be recruiters and allies of individual advocates at the campus-level (i.e., user system). Linkage is supported by supplying advocates and allies with guidelines and materials that encourage ongoing, interactive, interpersonal partnerships to promote effective implementation of the new technology at the school. Empirical assessment of this simple strategy implemented by the Texas Affiliate of the American Heart Association showed a twofold to fourfold increase in actual use and reach of school health promotion packages, with an average reported volunteer time of less than three hours per month.

Identification of factors that influence the menu at child care centers: a grounded theory approach

OBJECTIVE

This study was conducted to identify factors that influence what is on the menu at child care centers.

DESIGN

Quantitative and qualitative data on menus, food preparation, and foodservice were collected during site visits to child care centers. Grounded theory methods were used to develop an explanation of child care menu planning that is "grounded" in data.

SAMPLE AND SETTING

Three child care centers were selected in each of three communities representing different ethnic cultures in Texas.

MAIN OUTCOME MEASURE

Quality of child care menus, as measured by nutrient content and variety and amount of food served, constituted the core category or main phenomenon.

ANALYSES

Open and axial coding of the qualitative data were performed to identify significant themes and concepts and to explore their interrelationships in order to produce an explanation of the quality of child care menus.

RESULTS

The patterns of strengths and weaknesses in the menus were similar in all three ethnic/geographic regions that were visited and were similar to findings in other states. The factors that have the most direct influence on the menus are food program requirements, staff perceptions of children's food preferences, history of the food program at the center, and cost.

APPLICATIONS/CONCLUSIONS

The data and theory support three broad conclusions: (a) child care menus need to be improved; (b) training for child care staff needs to be sensitive to the missions and cultures of different kinds of child care centers; and (c) because lack of staff knowledge has only an indirect influence on the menus, changes in program requirements and strategies for assisting and monitoring food programs in child care centers may also be needed.

What can children learn from the menu at the child care center?

As a result of studies in Texas that indicated menus in child care centers may be depriving children of nutrients, a study was conducted to determine the prevalence of similar problems in 7 states. Menus for breakfast or morning snack, lunch, and afternoon snack for 10 consecutive program days were obtained from 171 child care centers. Results of nutrient analysis of the menus were compared against the Recommended Dietary Allowances (RDA) for children aged 1 to 3 and 4 to 6. Menus typically provided at least 100 percent of the RDA for protein and the vitamins A, ascorbic acid, B12, and riboflavin. The menus offered an average of only 42 percent of the iron needed by both the younger and older children. In all 7 states the menus provided less than 56 percent of the kilocalories recommended and less than 64 percent of niacin for the 1 to 3 year olds. Mean value for kilocalories for the 3-5 year old averaged 40 percent of recommendation while niacin averaged 48 percent. These findings indicate that attention should be directed toward careful assessment of nutritional adequacy of meals and snacks actually served at child care centers, the children's nutritional intake at the center, and the nutritional content of meals and snacks eaten away from the center.

Tools to measure sensory appeal of menus planned for children

The Menu Variety Checklist and Score Sheet is a tool to facilitate evaluation of sensory appeal. Comparisons made across evaluators and across menus show it to be more reliable and more readily diagnostic than subjective summary ratings. Although further research and development are needed to make it more precise and test its criterion validity, the checklist has sufficient advantages to make it a useful starting place or backup tool in research and clinical applications.

Age, familiarity, and visual processing schemes

In a partial-report task adults and 5-yr.-old children identified stimuli of two types (common objects and familiar common objects) in two representations (black-and-white line drawings or full color photographs). It was hypothesized that familiar items and photographic representation would enhance the children's accuracy. Although both children and adults were more accurate when the stimuli were from the familiar set, children performed more accurate when the stimuli were from the familiar set, children performed poorly in all stimulus conditions. Results suggest that the age difference in this task reflects the "concrete" nature of the perceptual process in children.

A musical conservation problem

7 piano pupils (8 to 16 yr.) judged which of two printed musical passages required more playing time. It was hypothesized that younger pupils would not conserve the indicated rhythm. Results support the hypothesis, showing that these children based their judgments on spatial/perceptual characteristics rather than on implied quantitative dimensions of the stimuli. Implications for developing non-traditional teaching methods are discussed.