This research synthesis by two Robert Wood Johnson Foundation national programs—Healthy Eating Research and Active Living Research—reviews studies that have examined approaches for preventing obesity in child-care settings, including preschools, Head Start programs, child-care centers and family child-care homes.
The synthesis identifies many opportunities for improving the nutritional quality of foods provided to children, increasing physical activity among children and providing better support to help caregivers promote healthy behaviors. It also highlights key strategies for preventing obesity in child-care settings, including:
- modifying food service practices;
- integrating opportunities for physical activity into the classroom curriculum;
- providing classroom-based nutrition education; and
- engaging parents through educational newsletters or activities.
The authors conclude that regulations regarding nutrition and physical activity practices in child-care settings are limited and vary widely among and within U.S. states. Policy recommendations from the report include those that focus on implementing changes to the Child and Adult Care Food Program (CACFP) as directed by the Healthy, Hunger-Free Kids Act of 2010, as well as other changes at the federal, state and local level. For example:
- The U.S. Department of Agriculture (USDA) should work with state agencies and other stakeholders to promote and expand participation in CACFP through program simplification, paperwork reduction, and other strategies.
- USDA should update nutrition standards and meal patterns and swiftly issue a proposed rule to improve nutrition in participating child-care centers and family child-care homes; this update should include a review of the associated costs with adjustments to reimbursement rates as necessary.
- USDA should encourage participating child-care centers and family child-care homes to provide opportunities for structured and unstructured daily physical activity, and to limit screen time.
- USDA and the U.S. Department of Health and Human Services (HHS) should encourage state licensing entities to include criteria for nutrition and wellness standards in licensing determinations.
- Congress should preserve and promote funding for obesity prevention by supporting the Prevention and Public Health Fund, CACFP investments (study, technical assistance and training), Community Transformation Grants, and other effective prevention programs at USDA and HHS.