Characterization of snack servings in childcare programs from Southeast Georgia

Background:

In the US, children’s main energy intake comes from high-sodium ultra-processed foods (UPF). Childcare programs (CCP) offer a unique opportunity to offer healthy foods to minoritized children whose minimally-processed fresh fruit and vegetable (FFV) intake is low, and who are heavily burdened by cardiovascular disease in adulthood, relative to non-minorities. The objective of this study is to characterize FV offerings in CCP serving 2–5-year-old children attending CCPs primarily serving marginalized populations.

Methods:

A total of 14 CCP directors from South-East Georgia responded to an online survey that assessed CCP characteristics, and current practices/barriers to offering FV and physical activity. Observation of snack-times was performed in n=13 CCP to observe morning and afternoon snacks. Score variables with total servings of fresh fruit (fruit), fresh vegetables (vegetables), canned fruit, canned vegetables and UPF were created for the observation days and weekly menus and aggregated into medians and interquartile ranges (IQR).

Results:

Total weekly servings from menus offered in CCP were: medians(IQRs) for fresh fruit=8; IQR(7-11); fresh vegetables=4(2-6); canned fruit=2;IQR(1-4); canned vegetables=3;IQR(2-5), and UPF=20;IQR(14-27). The proportion of CCP who offered an UPF item as snack was 85%; and only 1 CCP (7.7%) offered fresh vegetables as part of a snack. Between 46%-54% of CCP served what was scheduled on the menu for that day. Bananas, carrots, apple sauce and green beans are the most common fresh fruits, vegetables, canned fruit and vegetables, respectively.

Conclusion:

There is an opportunity to increase fresh fruits and especially vegetables during snack times in CCP. Snacks are composed of seldom food items which will increase the likelihood of children trying new foods. Replacing UPF with fresh FV may be a strategy to increase intake of FV in young minoritized children.