Table 2.
Relevant best practices from nutrition and physical activity self-assessment for child care (NAPSACC) [45–47].
| Domain | Best practices |
|---|---|
| Water | (i) Make drinking water available for children at all times |
| (ii) Prompt children to drink water during each indoor and outdoor playtime | |
|
| |
| Juice | (i) Limit 100% fruit juice to no more than two 4–6 oz servings per week |
| (ii) Only serve 100% fruit juice that has no sugar added | |
|
| |
| Milk | (i) Children of ages 2 and older should only be served skim or 1% milk |
| (ii) Never serve flavored milk (milk with chocolate or strawberry syrup or with added sugar) | |
|
| |
| Vegetables | (i) Offer children vegetables two or more times a day |
| Fruit | (i) Offer children fruit two or more times a day |
| Whole grains | (i) Offer children high-fiber, whole grain foods two or more times a day |
| Snack foods | (i) Limit offering children sugary, salty, or fatty foods to less than 1 time per week or never |
| Mealtime environment | (i) Always sit at the table and eat with the children |
| (ii) Teach children how to serve themselves or, in the case of older children, allow them to serve themselves | |
|
| |
| Self-regulation | (i) Always ask children if they are full before removing an unfinished meal or snack plate |
| (ii) Always ask children if they are hungry before serving more food | |
| (iii) Never pressure children to eat more food than they want | |
| (iv) Do not use food or sweets as a reward or reward children for finishing their plate | |
|
| |
| Role modeling | (i) Enthusiastically role model eating and drinking healthy foods |
| Encouragement | (i) Always prompt and praise children for trying new or less preferred foods |
| Nutrition education | (i) Talk with children informally about nutrition and healthy eating as often as possible |
| Physical activity | (i) Provide children with ≥90 minutes of PA each day |
| Outdoor play | (i) Provide children with ≥60 minutes of outdoor play each day |
| Adult-led physical activity | (i) Provide children with ≥45 minutes of adult-led PA each day |
| Physical activity education | (i) Lead ≥1 planned PA lesson each week |
| Screen time | (i) Limit screen time to < 30 minutes or none per week |
| Participate in indoor PA with kids | (i) Always participate in indoor PA with children |
| Participate in outdoor PA with kids | (i) Always participate in outdoor PA with children |
| Parent communication PA | (i) Provide families with information on children's physical activity |
1 Ammerman AS, Ward DS, Benjamin SE, et al. An intervention to promote healthy weight: Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) theory and design. Prev Chronic Dis. 2007; 4 (3):A67. doi:A67 [pii], 2 Benjamin SE, Ammerman A, Sommers J, Dodds J, Neelon B, Ward DS. Nutrition and Physical Activity Self-assessment for Child Care (NAP SACC): Results from a Pilot Intervention {A figure is presented}. J Nutr Educ Behav. 2007; 39 (3): 142–149. doi:10.1016/j.jneb.2006.08.027, 3 Benjamin SE, Neelon B, Ball SC, Bangdiwala SI, Ammerman AS, Ward DS. Reliability and Benjamin SE, Neelon B, Ball SC, Bangdiwala SI, Ammerman AS, Ward DS. Reliability and validity of a nutrition and physical activity environmental self-assessment for child care. Int J Behav Nutr Phys Act. 2007;4(1):29. doi: 10.1186/1479-5868-4-29 m.