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Implementation of Minimum Nutrition Standards and Best Practices in Childcare Centers

      Abstract

      Background

      The federal Child and Adult Care Food Program (CACFP) provides reimbursable meals to 4.6 million children annually and sets nutrition standards for foods served. Licensing regulations in many states extend these rules to nonparticipating programs.

      Objective

      To evaluate the quality of meals and snacks served in Connecticut licensed childcare centers in 2019 and assess implementation of a state licensing requirement to adhere to CACFP minimum nutrition standards in all centers.

      Design

      Cross-sectional survey.

      Participants/setting

      Two hundred licensed childcare centers in Connecticut in 2019.

      Main outcome measures

      Meal/snack quality was assessed based on menus. Foods/beverages listed were compared to the minimum CACFP nutrition standards and optional best practices. Surveys completed by center directors measured center characteristics.

      Statistical analysis

      Logistic and linear multivariable regression models tested differences in centers’ adherence to nutrition standards and best practices by CACFP participation status.

      Results

      CACFP centers complied with more required nutrition standards than non-CACFP centers (an adjusted mean of 4.7 vs 3.4 standards among programs serving meals, P < 0.001), with particularly large mean differences for whole grains and low-fat milk. Implementation of optional best practices, except for beverages, was relatively low among all centers, especially for snacks. Compliance (adjusted mean number of minimum nutrition standards met) was greater among centers accredited by the National Association for the Education of Young Children and those using a registered dietitian or a sponsoring agency to prepare menus and receiving food from a vendor. Recent completion of nutrition training was associated with greater mean implementation of best practices.

      Conclusions and implications

      Better adherence to minimum nutrition standards and best practices among CACFP-participating childcare centers contributed to higher nutritional quality of meals and snacks offered. Snack quality would benefit most from greater compliance with nutrition standards. Providers outside of CACFP need additional supports in the implementation of licensing regulations to improve the food environment for young children.

      Keywords

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      Biography

      T. Andreyeva is an associate professor, Department of Agricultural and Resource Economics, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, CT.

      Biography

      X. Sun is a PhD Candidate, Department of Agricultural and Resource Economics, University of Connecticut, Storrs, CT.

      Biography

      M. Cannon is a research technician, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, CT.

      Biography

      E. L. Kenney is an assistant professor, Harvard T.H. Chan School of Public Health, Boston, MA.