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Study of Nutrition and Wellness Quality in Child Care Settings


  • USDA needs to address concerns about meal quality and physical activity in child care.
  • Abt conducted a multi-year Study of Nutrition and Wellness Quality in Child Care Settings.
  • The results inform policymaking on nutrition and wellness in child care settings.
The Challenge

Abt Global conducted a five-year Study of Nutrition and Wellness Quality in Child Care Settings for the U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS). Congress asked the USDA to conduct the study in response to concerns about meal quality and physical activity in child-care identified by the Institute of Medicine and other experts. The study included child-care centers, family day care homes, and after-school programs that participated in the Child and Adult Care Food Program, and also non-participating providers.

The Approach

Abt partnered on the study with the Cincinnati Children’s Hospital Medical Center, the Momentum Center of the University of Michigan, and several independent consultants. The study provided a comprehensive description of:

  • Meals and snacks served in child-care settings
  • Providers’ nutrition and wellness policies and practices
  • Children’s food consumption in and out of child-care
  • Meal costs
  • Plate waste.
The Results

The work resulted in a series of interim reports and a comprehensive final report along with methods and detailed results tables to help inform policymaking on potential improvements to nutrition and wellness in child care settings. Public use data files are available from USDA FNS.

The study included a survey and full-day, in-person observations of hundreds of child-care centers, Head Start programs, and family child-homes. Key findings recently released in peer-reviewed journals included:

  • Menu quality. Results published in the Journal of Nutrition Education and Behavior confirmed quality of CACFP meal and snack menus. Most breakfasts (97%), lunches (88%), and afternoon snacks (97%) included all required CACFP meal components, aligning with national dietary guidance. But there is room for improvement, particularly for increasing vegetables served and limiting foods high in added sugar and fat.
  • Child nutrition. An article in the Journal of the Academy of Nutrition and Dietetics found higher quality diets of U.S. children in CACFP programs on days they were in care. However, dietary intake continues to fall short of Dietary Guidelines for Americans on both child care days and non-child care days. Average intake of vegetables, whole grains, dairy, and oils falls below recommendations, while intake of solid fats and added sugar is higher than recommended.
  • Physical activity. An article in Pediatrics found room for improvement in physical activity opportunities while in care. While 74 percent of programs met national guidance on sufficient number of outdoor opportunities, weather permitting, just 50 percent met guidance of at least 60 to 90 minutes of physical activity, and only 43 percent met both standards. Weather and staff not joining in outdoor play were associated with 74 and 31 fewer minutes devoted to physical activity, respectively.

Since 60% of preschool-aged children in the U.S. attend formal child-care, nutrition and physical activity practices in these settings can have a substantial influence on overall child wellness. SNACS findings confirm the positive contribution of CACFP-participating child-care programs to child dietary quality and nutrition, while highlighting areas where additional improvement is needed.

Learn more:

Study of Nutrition and Activity in Childcare Settings in USDA’s Child and Adult Care Food Program (SNACS)