Dietary Guidelines Are Not Met by In-Home Child Care Providers in Low-Income Areas

Objective: The goals of this study were to describe (1) the dietary quality of foods and beverages served by in-home child care providers in low-income areas in Michigan and (2) the extent to which they align with the Dietary Reference Intakes and food group recommendations.

Design: Cross-sectional, observational. Food and beverages served were examined using direct diet observation.

Setting: Child care provider homes.

Participants: In-home child care providers (n = 116) from rural and urban Michigan counties (n = 24) were recruited from the Great Start to Quality child care database.

Main outcome measures: Dietary quality (food groups and nutrients) of food and beverages served by 116 providers to 378 children, aged 2-5 years, for 1 lunch and a snack.

Analysis: Average food group and nutrient scores were compared with Dietary Reference Intakes and food group thresholds using the Wilcoxon rank sum test (significance at <.05).

Results: Findings indicate overserving of refined grains, protein, carbohydrates, added sugars, and sodium and underserving of whole grains and vegetables. Nutrients exceeding recommendations included vitamins A, C, and D, folate, calcium, zinc, and magnesium, whereas iron and potassium were underserved.

Conclusions and implications: Tailored efforts are needed to address shortcomings in meeting dietary recommendations among in-home child care providers to enhance child nutrition.