Nutrition Environment and Practices in Twenty-Four Child-Care Centers in Georgia

Background: The amount of time children spend in child care (CC) each week has increased in recent years. As a result children consume a large proportion of their daily energy intake at CC facilities. The purpose of this study is to describe the baseline dietary practices in preschool-aged children attending CC centers in Southwest Georgia before the implementation of a one-year wellness policy implementation program. Additionally, the study will determine the relationship between the social and nutrition environment in childcare centers and dietary practices in child-care centers. Methods: The data is the baseline data of a pilot study evaluating nutrition and physical activity wellness policy implementation in twenty four licensed CC in rural Georgia. Each CC provided a sample one week menu (three meals/day: breakfast, lunch and afternoon snacks). The energy and nutrient contents of 360 meals were analyzed using NutriKids. Food groups were assessed using a menu rubric. Menus were compared to the Dietary Reference Intakes, the Dietary Guidelines for Americans and MyPyramid food group recommendations for children 3 to 5 years of age. Results: Children were served a mean of 883 kcal at three meals. The menus content met the requirements for energy, macro-nutrients, vitamins A and C. However, the menus were high in saturated fat, and sodium content and did not meet the requirements for iron, fiber and calcium. The majority of the centers did not meet the requirements of the Food Guide Pyramid for pre-schoolers. With the exception of milk, children at all participating centers were served less than the recommended amounts for grains, vegetables, meat/beans and fresh fruits. Conclusions: Child care settings provide a unique opportunity to influence children's dietary behaviors and health. Our data suggests that children are not consuming recommended amounts of whole grains, fruits or vegetables while attending full-time childcare. Instead, children are consuming excessive amounts of added sugars from sweet snacks, sodium, and saturated fat from whole milk and high-fat or fried meats. We anticipate that by the end of the one-year implementation of the wellness policies, daycare centers in Southwest Georgia will be better equipped to improve the quality of food served to this population of children. Findings from this study and the policy recommendations that emerge could significantly impact efforts to provide healthier nutrition environments to children in child care centers. Index Words: Nutrition assessment, child-care centers, pre-school, nutrition environment, Georgia iii ACKNOWLEDGEMENTS I would like to thank my thesis advisor Dr. Rodney Lyn and my thesis committee member, Dr. Frances McCarty for providing the guidance, support and encouragement needed to complete the process. I would like to thank the faculty and staff at Georgia State University‘s Institute of Public Health for the wonderful experience I have had over the past two years. My decision to work towards my Master‘s in Public Health has been one of the most enriching experiences in my life so far. I have felt that the support and education I have received have prepared me well for any career in public health. Over the past year two years, I have worked at the Institute of Public Health under the direction of Dr. Rodney Lyn and Dr. Michael Eriksen. Their academic and professional guidance cannot be overstated and I owe them much gratitude. My recognition and gratitude for my friends, colleagues and family for their moral support. A special thanks to my mother, who helped me reach my goal and for her ever-lasting patience and support throughout my education