Impact of a nutrition award scheme on the food and nutrient intakes of 2- to 4-year-olds attending long day care

Abstract

Objective Early childhood settings are promising avenues to intervene to improve children's nutrition. Previous research has shown that a nutrition award scheme, Start Right - Eat Right (SRER), improves long day care centre policies, menus and eating environments. Whether this translates into improvements in children's dietary intake is unknown. The present study aimed to determine whether SRER improves children's food and nutrient intakes. Design Pre-post cohort study. Setting Twenty long day care centres in metropolitan Adelaide, South Australia, Australia. Subjects Children aged 2-4 years (n 236 at baseline, n 232 at follow-up). Methods Dietary intake (morning tea, lunch, afternoon tea) was assessed pre- and post-SRER implementation using the plate wastage method. Centre nutrition policies, menus and environments were evaluated as measures of intervention fidelity. Comparisons between baseline and follow-up were made using t tests. Results At follow-up, 80 % of centres were fully compliant with the SRER award criteria, indicating high scheme implementation and adoption. Intake increased for all core food groups (range: 0·2-0·4 servings/d, P<0·001) except for vegetable intake. Energy intake increased and improvements in intakes of eleven out of the nineteen nutrients evaluated were observed. Conclusions SRER is effective in improving children's food and nutrient intakes at a critical time point when dietary habits and preferences are established and can inform future public health nutrition interventions in this setting.