Young Children's Dietary Quality in Family Child Care and in Their Own Home

Abstract

Background: Some evidence suggests that children may have higher quality dietary intake in early care and education settings, compared with their respective homes, but no studies have explored these differences among children in less formal family child care.

Objective: The purpose of this study was to compare dietary quality via the Healthy Eating Index 2015 among children in family child care and in their own home.

Design: This was a cross-sectional analysis of baseline dietary intake data from the Childcare Home Eating and Exercise Research study, a natural experiment, using directly observed dietary data in child care and 24-hour recall data in homes among children in South Carolina.

Participants/setting: Participants were 123 children in 52 family child-care homes between 2018 and 2019.

Main outcome measure: The main outcome was total and component Healthy Eating Index 2015 scores.

Statistical analysis: The analysis was a hierarchical linear regression of children nested within family child care homes adjusting for child, provider, facility, and parent characteristics, including sex, age, race, ethnicity, and income, with parameters and SEs estimated via bootstrap sampling.

Results: Children had a mean ± SD Healthy Eating Index 2015 score of 60.3 ± 12.1 in family child-care homes and 54.3 ± 12.9 in their own home (P < 0.001). In adjusted analysis and after accounting for clustering of children in family child care homes, total HEI-2015 scores were lower at home than in care (β = -5.18 ± 1.47; 95% CI -8.05 to -2.30; P = 0.003).

Conclusions: Children had healthier dietary intake in family child-care homes vs their respective homes.

Keywords: Childcare; Dietary quality; ECE; Healthy Eating Index; Nutrition; Preschool.