Abstract
OBJECTIVES: Childcare centres (CCs) typically offer one meal and snacks daily. This study compared what is served in CCs with what the nutritional recommendations are; described and compared the nutritional composition of lunches served in CCs in New Brunswick and Saskatchewan; and examined differences between French and English, and urban and rural centres.
METHODS: The study involved 61 randomly selected CCs in New Brunswick and Saskatchewan, Canada. Lunch content was measured on two consecutive days by weighing each food item served to children and by visually documenting the food items using digital photography. Food items were categorized into food groups according to Health Canada’s Eating Well with Canada’s Food Guide, and nutrients were analyzed using a nutritional analysis software. One- sample t tests compared lunch content with nutritional recommendations. Independent t tests compared the nutrient and food group content of lunches in New Brunswick and Saskatchewan, French and English, and urban and rural CCs.
RESULTS: On average, CCs did not meet provincial recommendations. Lunches in both provinces were low in calories (<517 kcal) and fibre (<7 g). Overall, Saskatchewan centres served greater amounts of food than New Brunswick centres (p < 0.05). French-speaking centres provided less fat (p = 0.047), less saturated fat (p = 0.01), and fewer servings of meat and alternatives (p = 0.02), and more trans fat (p = 0.03) than English-speaking centres. There were no differences between rural and urban centres.
CONCLUSIONS: Few CC lunches met nutritional recommendations. Interventions are required to improve the quality of foods offered in CCs. Reviewing or developing comprehensive nutrition guidelines is warranted.
Key Words: Child day care centers; food quality; lunch; nutritional value
Key Words: Child day care centers, food quality, lunch, nutritional value
Mots Clés: garderies d’enfants, qualité alimentaire, déjeuner, valeur nutritionnelle
Résumé
OBJECTIFS : Les centres de la petite enfance (CPE) offrent généralement un repas par jour et des collations. Dans cette étude, nous avons: comparé ce qui est servi dans les CPE aux recommandations nutritionnelles; décrit et comparé la composition nutritionnelle des déjeuners servis dans les CPE au Nouveau-Brunswick et en Saskatchewan; et examiné les différences entre les centres francophones et anglophones, urbains et ruraux.
MÉTHODE : Ont participé à l’étude 61 CPE sélectionnés au hasard au Nouveau-Brunswick et en Saskatchewan, au Canada. Le contenu des déjeuners a été mesuré deux jours de suite en pesant chaque produit alimentaire servi aux enfants et en consignant visuellement les produits alimentaires à l’aide de photographies numériques. Les produits alimentaires ont été classés en groupes d’aliments conformément au document Bien manger avec le Guide alimentaire canadien de Santé Canada, et les nutriments ont été analysés à l’aide d’un logiciel d’analyse nutritionnelle. Des tests t à échantillon unique ont permis de comparer le contenu des déjeuners aux recommandations nutritionnelles. Des tests t indépendants ont permis de comparer le contenu nutritionnel et les groupes d’aliments des déjeuners servis dans les CPE francophones et anglophones, urbains et ruraux du Nouveau-Brunswick et de la Saskatchewan.
RÉSULTATS : En moyenne, les CPE ne respectaient pas les recommandations provinciales. Dans les deux provinces, les déjeuners étaient faibles en calories (<517 kcal) et en fibres (<7 g). Dans l’ensemble, les centres de la Saskatchewan servaient de plus grandes quantités de nourriture que ceux du Nouveau-Brunswick (p < 0,05). Les centres francophones offraient moins de matières grasses (p = 0,047), moins de graisses saturées (p = 0,01), moins de portions de viandes et substituts (p = 0,02) et plus de gras trans (p = 0,03) que les centres anglophones. Il n’y avait aucun écart entre les centres ruraux et urbains.
CONCLUSIONS : Peu de déjeuners offerts dans les CPE respectaient les recommandations nutritionnelles. Il faudrait intervenir pour améliorer la qualité des aliments offerts dans les CPE. La révision ou l’élaboration de directives nutritionnelles complètes s’impose.
Mots Clés : garderies d’enfants; qualité alimentaire; déjeuner; valeur nutritionnelle
Footnotes
Acknowledgements: The Healthy Start study is financially supported by a grant from the Public Health Agency of Canada (#6282-15-2010/3381056-RSFS), a research grant from the Consortium national de formation en santé (#2014-CFMF-01) and a grant from the Heart and Stroke Foundation of Canada (#2015-PLNI). SW was supported by a Charles Best Canada Graduate Scholarships Doctoral Award of the Canadian Institutes of Health Research and by the Gérard-Eugène-Plante Doctoral Scholarship. The funders did not play a role in the design of the study, the writing of the manuscript or the decision to submit it for publication.
Conflict of Interest: None to declare.
References
- 1.Bushnik T. Child Care in Canada. Ottawa, ON: Statistics Canada; 2006. [Google Scholar]
- 2.Ministère de l’Éducation et du développement de la petite enfance. Normes visant les responsables d’installations de garderie. Fredericton, NB: Gouvernement du Nouveau-Brunswick; 2012. [Google Scholar]
- 3.Early Years Branch. Child Care Licensee Manual. Regina, SK: Government of Saskatchewan; 2016. [Google Scholar]
- 4.FoodNutrition Support for Licensed Child Care Centres Advisory Group. Manual for Food and Nutrition in Regulated Child Care Settings. Halifax, NS: Government of Nova Scotia; 2011. [Google Scholar]
- 5.Fox M, Glantz F, Endahl J, Wilde J. Early Childhood and Child Care Study. Alexandria, VA: U.S. Department of Agriculture; 1997. [Google Scholar]
- 6.Frisvold DE, Lumeng JC. Expanding exposure: Can increasing the daily duration of Head Start reduce childhood obesity? J Hum Resour. 2011;46(2):373–402. [Google Scholar]
- 7.Ball SC, Benjamin SE, Ward DS. Dietary intakes in North Carolina child-care centers: Are children meeting current recommendations? J Am Diet Assoc. 2008;108(4):718–21. doi: 10.1016/j.jada.2008.01.014. [DOI] [PubMed] [Google Scholar]
- 8.Padget A, Briley ME. Dietary intakes at child-care centers in central Texas fail to meet Food Guide Pyramid recommendations. J Am Diet Assoc. 2005;105(5):790–93. doi: 10.1016/j.jada.2005.02.002. [DOI] [PubMed] [Google Scholar]
- 9.Government of Prince Edward Island. Healthy Living Guidelines for Early Learning and Child Care Centres on Prince Edward Island. 2012. [Google Scholar]
- 10.Nahikian-Nelms M. Influential factors of caregiver behavior at mealtime: A study of 24 child-care programs. J Am Diet Assoc. 1997;97(5):505–9. doi: 10.1016/S0002-8223(97)00130-2. [DOI] [PubMed] [Google Scholar]
- 11.New Brunswick Medical Society. Make Menus Matter — Menu Assessments. 2015. [Google Scholar]
- 12.Addison CC, Jenkins BW, White MS, Young L. Examination of the food and nutrient content of school lunch menus of two school districts in Mississippi. Int J Environ Res Public Health. 2006;3(3):278–85. doi: 10.3390/ijerph2006030034. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Bélanger M, Humbert L, Vatanparast H, Ward S, Muhajarine N, Chow AF, et al. A multilevel intervention to increase physical activity and improve healthy eating and physical literacy among young children (ages 3–5) attending early childcare centres: The Healthy Start-Départ Santé cluster randomised controlled trial study protocol. BMC Public Health. 2016;16:313–22. doi: 10.1186/s12889-016-2973-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.J Ext. 2007.
- 15.Wolper C, Heshka S, Heymsfield S. Measuring food intake: An overview. In: Allison D, editor. Handbook of Assessment Measures for Eating Behaviors and Weight-Related Problems. Thousand Oaks, CA: Sage Publishing; 1995. pp. 215–40. [Google Scholar]
- 16.Garriguet D. Overview of Canadians’ Eating Habits. Ottawa, ON: Statistics Canada; 2006. [Google Scholar]
- 17.Health Canada. What is a Food Guide Serving? Ottawa, ON: Health Canada; 2007. [Google Scholar]
- 18.Community Information Database. Metropolitan Influence Zones (MIZ) Typology. 2006. [Google Scholar]
- 19.Nishida C, Uauy R, Kumanyika S, Shetty P. The joint WHO/FAO expert consultation on diet, nutrition and the prevention of chronic diseases: Process, product and policy implications. Public Health Nutr. 2004;7(1A):245–50. doi: 10.1079/PHN2003592. [DOI] [PubMed] [Google Scholar]
- 20.FoodAgriculture Organization of the United Nations, World Health Organization, United Nations University. Energy and Protein Requirements — 6.3 Infants, Children and Adolescents. Geneva, Switzerland: WHO; 1991. [Google Scholar]
- 21.Institute of Medicine. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC: The National Academies Press; 2006. [Google Scholar]
- 22.Briley ME, Roberts-Gray C, Simpson D. Identification of factors that influence the menu at child care centers: A grounded theory approach. J Am Diet Assoc. 1994;94(3):276–81. doi: 10.1016/0002-8223(94)90368-9. [DOI] [PubMed] [Google Scholar]
- 23.Minister of Health. Nutrient Value of Some Common Foods. Ottawa, ON: Health Canada; 2008. [Google Scholar]
- 24.United States Department of Agriculture. Tips for Using the Food Guide Pyramid for Young Children 2 to 6 Years Old. 1999. [Google Scholar]
- 25.Erinosho TO, Ball SC, Hanson PP, Vaughn AE, Ward DS. Assessing foods offered to children at child-care centers using the Healthy Eating Index-2005. J Acad Nutr Diet. 2013;113(8):1084–89. doi: 10.1016/j.jand.2013.04.026. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 26.Crawford D, Timperio A, Telford A, Salmon J. Parental concerns about childhood obesity and the strategies employed to prevent unhealthy weight gain in children. Public Health Nutr. 2005;9(7):889–95. doi: 10.1017/PHN2005917. [DOI] [PubMed] [Google Scholar]
- 27.World Health Organization. Sugars Intake for Adults and Children. Geneva, Switzerland: WHO; 2015. [PubMed] [Google Scholar]
- 28.Batal M, Makvandi E, Imbeault P, Gagnon-Arpin I, Grenier J, Chomienne MH, et al. Comparison of dietary intake between Francophones and Anglophones in Canada: Data from CCHS 2.2. Can J Public Health. 2013;104(6Suppl1):S31–38. doi: 10.17269/cjph.104.3501. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Bender R, Lange S. Adjusting for multiple testing — When and how? J Clin Epidemiol. 2001;54(4):343–49. doi: 10.1016/S0895-4356(00)00314-0. [DOI] [PubMed] [Google Scholar]