Provider reported implementation of nutrition-related practices in childcare centers and family childcare homes in rural and urban Nebraska

Approximately 15 million children under age 6 are in childcare settings, offering childcare providers an opportunity to influence children's dietary intake. Childcare settings vary in organizational structure - childcare centers (CCCs) vs. family childcare homes (FCCHs) - and in geographical location - urban vs. rural. Research on the nutrition-related best practices across these childcare settings is scarce. The objective of this study is to compare nutrition-related best practices of CCCs and FCCHs that participate in the Child and Adult Care Food Program (CACFP) in rural and urban Nebraska. Nebraska providers (urban n = 591; rural n = 579) reported implementation level, implementation difficulty and barriers to implementing evidence-informed food served and mealtime practices. Chi-square tests comparing CCCs and FCCHs in urban Nebraska and CCCs and FCCHs in rural Nebraska showed sub-optimal implementation for some practices across all groups, including limiting fried meats and high sugar/ high fat foods, using healthier foods or non-food treats for celebrations and serving meals family style. Significant differences (p < .05) between CCCs and FCCHs also emerged, especially with regard to perceived barriers to implementing best practices. For example, CCCs reported not having enough money to cover the cost of meals for providers, lack of control over foods served and storage problems, whereas FCCHs reported lack of time to prepare healthier foods and sit with children during mealtimes. Findings suggest that policy and public health interventions may need to be targeted to address the unique challenges of implementing evidence-informed practices within different organizational structures and geographic locations.

Nutritional management and autism spectrum disorder: A systematic review

BACKGROUND

Autism spectrum disorder (ASD) presents unique challenges related to feeding and nutritional management. Children with ASD often experience feeding difficulties, including food selectivity, refusal, and gastrointestinal issues. Various interventions have been explored to address these challenges, including dietary modifications, vitamin supplementation, feeding therapy, and behavioral interventions.

AIM

To provide a comprehensive overview of the current evidence on nutritional management in ASD. We examine the effectiveness of dietary interventions, vitamin supplements, feeding therapy, behavioral interventions, and mealtime practices in addressing the feeding challenges and nutritional needs of children with ASD.

METHODS

We systematically searched relevant literature up to June 2024, using databases such as PubMed, PsycINFO, and Scopus. Studies were included if they investigated dietary interventions, nutritional supplements, or behavioral strategies to improve feeding behaviors in children with ASD. We assessed the quality of the studies and synthesized findings on the impact of various interventions on feeding difficulties and nutritional outcomes. Data extraction focused on intervention types, study designs, participant characteristics, outcomes measured, and intervention effectiveness.

RESULTS

The review identified 316 studies that met the inclusion criteria. The evidence indicates that while dietary interventions and nutritional supplements may offer benefits in managing specific symptoms or deficiencies, the effectiveness of these approaches varies. Feeding therapy and behavioral interventions, including gradual exposure and positive reinforcement, promise to improve food acceptance and mealtime behaviors. The findings also highlight the importance of creating supportive mealtime environments tailored to the sensory and behavioral needs of children with ASD.

CONCLUSION

Nutritional management for children with ASD requires a multifaceted approach that includes dietary modifications, supplementation, feeding therapy, and behavioral strategies. The review underscores the need for personalized interventions and further research to refine treatment protocols and improve outcomes. Collaborative efforts among healthcare providers, educators, and families are essential to optimize this population's nutritional health and feeding practices. Enhancing our understanding of intervention sustainability and long-term outcomes is essential for optimizing care and improving the quality of life for children with ASD and their families.

The influence of early and current feeding practices, eating behaviors, and screen time on dietary patterns in Polish toddlers - A cross-sectional study

Early nutrition has an important influence on a child's proper health and development, and understanding factors that may be related to desirable dietary patterns is key to improving the diet of future generations. The aim of this study was to assess whether early and current feeding practices, eating behaviors, and screen time viewing are associated with toddlers' dietary patterns. A cross-sectional sample of 467 mothers of toddlers (aged 1 year to 3) was surveyed between 2020 and 2022. Food consumption was evaluated by the Food Frequency Questionnaire (FFQ). The k-means algorithm was used to define dietary patterns on the basis of data collected from the FFQ and mealtime environment patterns, based on the data about practices during meals consumption. The odds of following a prohealth dietary pattern among early feeding factors were lower when infants ate commercial complementary foods more often. Distracted mealtime environment pattern increased the odds of following a non-eaters pattern, and commercial complementary foods pattern increased the odds of following a processed pattern. Currently, the odds of following a processed dietary pattern were higher when children were not breastfed and had higher screen time. Toddlers who ate during distraction and were more fussy had lower odds of following a prohealth dietary pattern, whereas higher enjoyment of food and satiety responsiveness increased the odds. The results indicate the need to increase parents' awareness about the importance of early factors in establishing dietary patterns.