May 27, 2008
Photograph, Dr. Dianne Ward

Photograph, Dr. Dianne Ward

Young children in child care centers are not eating the recommended amounts of whole grains, fruits or vegetables during their time at such centers, according to a study from the University of North Carolina at Chapel Hill. Dianne Ward, EdD, professor of nutrition, is one of the study’s authors.

In a study published recently in the Journal of the American Dietetic Association, researchers at UNC’s Center for Health Promotion and Disease Prevention examined the food eaten for breakfast, lunch and snacks by 117 randomly selected children age 2 to 5 years old at 20 North Carolina child care centers.

After calculating the amount of food the children consumed and comparing this to current dietary recommendations, researchers found that on average, children consumed less than 13 percent of the daily recommended amounts of whole grains and 7 percent of dark green and orange vegetables while they were at child care.

They also found that although children drank the recommended amount of milk, it was most often whole milk instead of the recommended 1 percent or non-fat milk for children ages 2 to 5.

“Child care centers have a wonderful opportunity to help young children develop life-long healthy eating behaviors. Preschool-age children often eat what is served; they are dependent upon the adults around them to provide a variety of healthy options,” said Sarah Ball, lead author of the study and a research associate at the Center.

Ball and her colleagues compared children’s intake to the new MyPyramid dietary recommendations developed by the U.S. Department of Agriculture. Eighty percent of the centers in the study participate in the Child and Adult Care Food Program, a nutrition program run by the department that provides oversight and reimbursement to child care providers for meals and snacks.

The researchers found that a center could be compliant with the program’s guidelines and still not provide the recommended daily amounts of MyPyramid food groups (adjusted for a full day in child care) to children in its care. While the MyPyramid guidelines were recently revised, the program’s guidelines have not been updated in recent years.

“We hope these data can be helpful to policymakers when recommending revisions to the program’s existing guidelines,” Ball said.

The child care centers that were looked at in the study were also taking part in an initiative based at UNC’s Center for Health Promotion and Disease Prevention that is working to go beyond minimal standards to create healthier eating environments. The Nutrition and Physical Activity Self-Assessment program works with interested child care facilities to improve their policies, practices and environments, providing self-assessment, goal-setting and technical assistance.

This training was recently made available online through the Center for Excellence in Training and Research Translation, which is also based at the Center for Health Promotion and Disease Prevention.

Researchers recommend simple, cost-neutral improvements such as substituting whole fruit or vegetables for 100 percent fruit juice and substituting whole-grain items such as crackers and bread for cookies and other sweet snacks.

Other authors of the study were Sara E. Benjamin, PhD, a postdoctoral research fellow in the department of ambulatory care and prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass.; and Dianne S. Ward, EdD, a research fellow in the Center for Health Promotion and Disease Prevention, professor and director of the intervention and policy division in the nutrition department at the UNC School of Public Health, and a fellow at the UNC Highway Safety Research Center.



Nutrition and Physical Activity Self-Assessment program online training:

School of Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or



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