Staff Food-Related Behaviors and Children’s Tastes of Food Groups during Lunch at Child Care in Oklahoma

doi:10.1016/j.jand.2017.07.023

Journal of the Academy of Nutrition and Dietetics

Volume 118, Issue 8, August 2018, Pages 1399-1407

https://doi.org/10.1016/j.jand.2017.07.023 Get rights and content

Abstract

Background

Young children should consume a variety of nutrient-dense foods to support growth, while limiting added fat and sugar. A majority of children between the ages of 3 and 5 years attend child care in the United States, which makes this environment and the child-care staff influential at meals.

Objective

The aim was to determine the association between best-practice food-related behaviors and young children’s tastes of fruit, vegetable, low-fat dairy, and high-fat/high-sugar foods at child care.

Design

This was a cross-sectional study.

Participants

A community-based study with 201 children ages 3 to 5 years from 25 early care and education centers, including 11 tribally affiliated centers and two Head Start programs across Oklahoma. Data collection occurred from fall 2011 to spring 2014.

Main outcome measures

Classroom observations used the Environmental Policy Assessment Observation tool to measure the staff behaviors and environment. Staff behavior was compared at three different levels: the composite score of staff nutrition behavior, each constituent staff behavior, and staff behaviors grouped into broader feeding behaviors. Tasted food was measured through the Dietary Observation in Child Care method. The children’s meals were categorized into the following food groups: fruit, vegetable, low-fat dairy, fried vegetable, fried meat, high-fat meat, and high-fat/high-sugar food.

Statistical analysis performed

Descriptive statistics were calculated for relevant variables. Relationships between the constituent staff behaviors and food groups that children tasted were compared using multilevel mixed-model analysis.

Results

The mean number of tasted fruit or vegetable items was higher and the mean number of tasted high-fat/high-sugar food items was lower when staff: 1) determined fullness before plate removal when less than half of food was eaten, 2) ate with the children, 3) and talked about healthy food.

Conclusions

The utilization of the three staff behaviors and their association with higher mean tastes of nutrient-dense items and lower mean tastes of high-fat/high-sugar food items among exposed children demonstrated support for the use of the best practices in early care and education centers.

Section snippets

Study Design

This was a cross-sectional study with data collection from fall 2011 to spring 2014. Licensed ECE centers that provided full-time child care to 3- to 5-year-old children were contacted via telephone in a convenience sampling for the opportunity to participate. Twenty-five of the 56 centers that were contacted participated in the study. ECE centers were located in urban and rural settings across all regions in the state of Oklahoma. The study represents 3.3% of all ECE centers in Oklahoma. All

Results

Fifty-one percent of the 201 participating children were male. The sample was 39% American Indian, 36% white, 18.6% African American, 3.5% Hispanic, 2.0% Asian, and 0.5% Native Hawaiian or Pacific Islander. The mean number of children in each classroom was 12.6, and most (86%) classes were supervised by a single staff member. Meal service style was 1) delivered in bulk and served on prepared trays (40%), 2) delivered in bulk and portioned by staff (35%), and 3) family-style meal service (21%).

Discussion

This study expanded limited research on the influence of child-care staff’s nutrition-related behaviors on children’s frequency of tasting nutrient-dense fruit, vegetable, and low-fat dairy, as well as fried vegetable, fried meat, high-fat meat, and high-fat/high-sugar food during the lunch meal. Best-practice recommendations are 1) determine fullness before plate removal with half of the food uneaten, 2) eat the same food as children, and 3) talk about healthy food with children. In contrast

Conclusions

Child-care staff best-practice behaviors supported by outcomes were: 1) staff “determine fullness before plate removal,” 2) staff “eat the same food as children,” and 3) staff “talk about healthy food.” The most frequent behaviors, staff “sit with children at meal times” and staff “encourage a ‘picky eater’ to try a food,” were not associated with desirable outcomes, such as children tasting nutrient-dense foods more frequently and unhealthy foods less frequently. These findings suggest that

Acknowledgements

The authors would like to extend our appreciation to all of the child-care centers and families who contributed to this study. The authors would also like to thank all student members of the Behavioral Nutrition and Physical Activity Laboratory who participated in data collection for this project.

K. Anundson is a clinical registered dietitian nutritionist, Avera Queen of Peace Hospital, Mitchell, SD; at the time of the study, she was a graduate research assistant, Department of Nutritional Science, University of Oklahoma Health Sciences Center, Oklahama City.

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S. B. Sisson is an associate professor, Department of Nutritional Science, University of Oklahoma Health Sciences Center, Oklahoma City.

L. Hoffman is an assistant professor, Department of Nutritional Science, University of Oklahoma Health Sciences Center, Oklahoma City.

M. Anderson is an assistant professor, Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City.

D. Horm is director of the Early Childhood Education Institute, University of Oklahoma, Tulsa.

J. Soto is assistant director for the Center for Early Childhood Development Center, University of Oklahoma, Tulsa.

: STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

: FUNDING/SUPPORT This study was supported by the Gretchen Swanson Center for Nutrition and the Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, as well as the University of Oklahoma Health Sciences Center, Department of Nutritional Sciences.

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ResearchOriginal ResearchStaff Food-Related Behaviors and Children’s Tastes of Food Groups during Lunch at Child Care in Oklahoma

Abstract

Background

Objective

Design

Participants

Main outcome measures

Statistical analysis performed

Results

Conclusions

Section snippets

Study Design

Results

Discussion

Conclusions

Acknowledgements

J Acad Nutr Diet

J Acad Nutr Diet

Appetite

J Acad Nutr Diet

Prev Med

J Nutr Educ Behav

J Nutr Educ Behav

J Acad Nutr Diet

Appetite

Appetite

Appetite

J Acad Nutr Diet

Vital signs: Fruit and vegetable intake among children—United States, 2003-2010

MMWR Morb Mortal Wkly Rep

Research
Original Research
Staff Food-Related Behaviors and Children’s Tastes of Food Groups during Lunch at Child Care in Oklahoma