While the growing trends in obesity among the general population are concerning, the rapid increase and early onset among young children in recent decades is particularly alarming. About a quarter of children 2–5 years old are overweight or obese with a greater likelihood of becoming obese in adulthood. Thus, developing healthy eating and activity habits earlier in life is critical to reversing the obesity epidemic. The purpose of this study by Dr. Patricia Markham Risica, assistant professor of epidemiology and behavioral and social sciences, was to assess the current state of food served and physical activity practices of Rhode Island childcare centers to identify potential areas for improvement in the DCYF regulations and implementation, by comparing centers with and without USDA Child and Adult Care Food Program (CACFP) participation to assess the potential influence of guidelines in the environments of child-care centers.
[Photo: Dr. Patricia Markham Risica]
Key informant interviews were conducted with child-care stakeholders from across the state including center directors and state agency representatives during Fall 2010 to gather information and guidance on the content of the survey. Previous literature on similar evaluation instruments was also reviewed. A survey instrument was developed to administer to directors of childcare centers. Overall, differences were found between reports of CACFP and non-CACFP center directors that could not be accounted for by the economic requirements of that program. Nutritional quality of food served across all centers, regardless of CACFP status, was not strong. Though non-CACFP center directors are better able to access and identify healthy foods to prepare, their centers still serve less nutritious foods than CACFP centers.
Rhode Island childcare centers also have room for improvement when it comes to achieving recommended amounts of both structured and unstructured physical activity. Best-practice guidelines recommend that preschool aged children accumulate at least 60 min of unstructured and 60 min of structured physical activity each day. The majority of directors reported less than 45 min of structured physical activity during the previous day. A narrower portion of directors reported that children engage in less than 45 min of unstructured physical activity. The results suggest that children should receive more opportunities for physical activity, specifically in the form of adult-led activities. There were few significant differences between CACFP and non-CACFP centers when it came to physical activity. The findings highlight the importance of improving policies that would affect the physical activity standards of all centers regardless of participation in CACFP.
Overall, more nutritious foods were provided in CACFP centers, compared with non-CACFP centers, but no differences in physical activity were identified. Although non-CACFP directors were better able to access and identify healthy foods, they did not necessarily serve these in centers. The guidelines requiring specific menu plans in CACFP centers might explain a difference found for food provided, but no difference in physical activity between CACFP v. non-CACFP centers. Across the board, staff training and education in nutrition and physical activity could be a way to mediate change in behaviors such as increasing structured physical activity, modeling healthy eating behavior, and communicating with parents regarding nutrition. Finally, stronger guidelines supporting both food and activity would bolster actual policies for childcare centers in Rhode Island and improve the nutrition and physical activity environments in this setting.
The study was published June in BMC Nutrition.