The family child care home environment and children's diet quality.
The family child care home environment and children's diet quality.
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DOI：
10.1016/j.appet.2018.03.024
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发表时间：
2018-07-01
期刊：
影响因子：
5.4
通讯作者：
Ward DS
中科院分区：
文献类型：
--
作者：
Benjamin-Neelon SE;Vaughn AE;Tovar A;Østbye T;Mazzucca S;Ward DS
在儿童早期发展健康的饮食行为和食物偏好可能有助于建立未来的健康饮食。大量的儿童花时间在儿童保育上，但很少有研究评估家庭儿童保育院的膳食和零食的营养质量。因此，重要的是要评估所提供的食品和饮料，与营养和喂养儿童有关的政策，以及供应商和儿童在用餐期间的互动。我们研究了家庭儿童保育院的营养环境和儿童的饮食质量之间的关联。我们使用环境与政策评估与观察（EPAO）（评分范围：0-21）评估了166个家庭幼儿园的营养环境。我们还记录了496名儿童在护理中消耗的食物和饮料，并计算了健康饮食指数（HEI）（得分范围：0-100）。我们使用混合效应线性回归模型来检查EPAO营养环境（和EPAO分量表）和儿童HEI之间的关联，控制潜在的混杂因素。家庭儿童保育院的平均（标准差，SD）为7.2（3.6）名儿童，74.1%的提供者是黑人或非裔美国人，儿童的平均（SD）年龄为35.7（11.4）个月。在调整后的多变量模型中，EPAO营养评分越高，儿童HEI评分越高（1.16; 95% CI：0.34，1.98; p = 0.006）。在EPAO分量表中，提供的食物得分较高（8.98; 95% CI：3.94，14.01; p = 0.0006），营养教育（5.37; 95% CI：0.80，9.94; p = 0.02）和营养政策（2.36; 95% CI：0.23，4.49; p = 0.03）都与更高的儿童HEI评分相关。食品和饮料服务，除了营养教育和营养政策，在家庭儿童保育院，可能是有前途的干预目标，以改善儿童的饮食质量。
Developing healthy eating behaviors and food preferences in early childhood may help establish future healthy diets. Large numbers of children spend time in child care, but little research has assessed the nutritional quality of meals and snacks in family child care homes. Therefore, it is important to assess foods and beverages provided, policies related to nutrition and feeding children, and interactions between providers and children during mealtimes. We examined associations between the nutrition environments of family child care homes and children’s diet quality. We assessed the nutrition environments of 166 family child care homes using the Environment and Policy Assessment and Observation (EPAO) (scores range: 0-21). We also recorded foods and beverages consumed by 496 children in care and calculated healthy eating index (HEI) (scores range: 0-100). We used a mixed effects linear regression model to examine the association between the EPAO nutrition environment (and EPAO sub-scales) and child HEI, controlling for potential confounders. Family child care homes had a mean (standard deviation, SD) of 7.2 (3.6) children in care, 74.1% of providers were black or African American, and children had a mean (SD) age of 35.7 (11.4) months. In adjusted multivariable models, higher EPAO nutrition score was associated with increased child HEI score (1.16; 95% CI: 0.34, 1.98; p = 0.006). Higher scores on EPAO sub-scales for foods provided (8.98; 95% CI: 3.94, 14.01; p = 0.0006), nutrition education (5.37; 95% CI: 0.80, 9.94; p = 0.02), and nutrition policy (2.36; 95% CI: 0.23, 4.49; p = 0.03) were all associated with greater child HEI score. Foods and beverages served, in addition to nutrition education and nutrition policies in family child care homes, may be promising intervention targets for improving child diet quality.
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