Date of Award

2020

Degree Type

Thesis

Degree Name

Master of Science in Nutrition and Food Science

Department

Nutrition and Food Sciences

First Advisor

Alison Tovar

Abstract

Statement of the Problem: Exposing preschool aged children to a variety of healthy food is essential for the development of healthy eating patterns. Therefore, ensuring healthy environments are necessary. This includes Family Childcare Homes (FCCH), a specific type of childcare in which non-relative providers care for the children in their own home. Unfortunately, during childcare, children are not meeting recommendations for fruits, vegetables, whole grains and low-fat milk; and on the contrary, are consuming too many sugar-sweetened beverages, fruit juice and energy-dense snacks. Most studies have been conducted in childcare centers, and even though FCCH provide care for nearly 2 million preschoolers, studies exploring what children are consuming in FCCH are limited. In addition, FCCH providers are often ethnically diverse; including Latino providers, which are expected to increase due to demographic changes. Previous studies have shown that the providers’ Latino culture influences the foods they serve; however, differences in foods offered by Latino and non-Latino providers in the FCCH have been unexplored. The aim of this study was to identify and describe the food sources that contribute to food group intake in preschool children attending FCCH in Rhode Island, and to examine differences by provider ethnicity. Methods: Baseline data (n=120 FCCH and n=370 children) from Healthy Start, a cluster-randomized trial, were used. Providers were classified as Latino or non-Latino according to their answer to the question referent to ethnicity on the demographics survey completed. Information about foods and beverages consumed by the children was collected using the Dietary Observation in Child Care technique; observations were done twice, either on consecutive or non-consecutive days. The Nutrition Data System for Research food group classification was used to define food groups and sources. A home-level analysis was conducted to determine the children’s food group intake, this was then averaged overall and by the provider’s ethnicity. The contribution of each food source to its respective major food group was calculated as a proportion, using ratio of means. Differences in mean ratios between Latino and non-Latino providers were tested with ANOVA and ANCOVA (p<0.05) and Bonferroni adjustments were made for multiple comparisons. Summary of results: The analysis included 120 FCCH providers, all female, 67.5% were Latino, with mean age of 48.9 ± 9.0 years; and 370 preschool children, 57.6% were Latino, mean age of 3.4 ± 0.9 years. There is room for improvement in the foods consumed at the FCCH, specifically regarding fruit juice, refined grains and dark-green vegetables. Juice contributed the highest proportion of fruits consumed (0.85 ± 0.24) across all FCCH, and most vegetables consumed were non-starchy (0.61 ± 0.34). Of the total dairy consumed, nearly, three-fourths was low-fat (0.71 ± 0.30), and most milk/yogurt was unsweetened (0.85 ± 0.20). Of the total grains, three fourths of the servings consumed were refined (0.75 ± 0.22). The major contributor to the fats group were vegetable oils (0.89 ± 0.20). Syrup and jelly contributed more than half (0.50 ± 0.41) to the total sweets consumed. Foods sources differed by the provider ethnicity. Children in non-Latino vs Latino FCCH consumed a significantly higher proportion of fruit juice (0.90 ± 0.16 vs 0.82 ± 0.26, p<0.0001), animal fats (0.37 ± 0.36 vs 0.11 ± 0.20, p<0.0001) and a lower proportion of legumes (0.05 ± 0.19 vs 0.33 ± 0.31, p<0.0001). Children attending Latino vs. non-Latino FCCH consumed a lower proportion of non-starchy vegetables (0.52 ± 0.34 vs 0.82 ±0.24, p<0.0001), low-fat dairy (0.68 ± 0.31 vs 0.77 ± 0.24, p<0.0001), and nuts and seeds (0.05 ± 0.13 vs 0.21 ± 0.34, p=0.0020). These differences suggest that Latino and non-Latino FCCH could benefit from tailored recommendations. Findings support that the ethnicity of the provider influences the foods offered in the FCCH and highlight the importance of addressing cultural differences.

Available for download on Thursday, October 29, 2020

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