Better nutrition policies needed for children

Most early childhood education services strive to encourage healthy eating among children, but need stronger and more detailed nutrition policies to support change in everyday staff and parent behaviours.

These findings are revealed in new doctoral research from the University of Auckland's Centre for Longitudinal Research.

An online survey of 257 licensed Early Childhood Education (ECE) services was carried out in 2014 in Auckland, Manukau and the Waikato.

The survey found that most services promoted healthy eating behaviours by maintaining edible gardens (90 percent), not using food in punishments and rewards (96 and 95 percent respectively), and serving family-style meals with adults seated alongside children (80 percent).

The survey showed other common practices may encourage children to eat too much or develop preferences for unhealthy foods.

These included serving more than the recommended amount of sugary, salty and fatty foods at celebrations (26 percent), selling unhealthy food at fundraisers (37 percent), hurrying children to finish eating (61 percent), and not checking with children if they are full before offering more food (60 percent).

Forty percent of ECE services said they faced barriers to promoting healthy nutrition to children. The most commonly reported barriers were a lack of support from parents and families (21 percent) and concerns about food intolerances and allergies (10 percent).

"Eating behaviours and preferences for certain foods, such as those high in salt and sugar or vegetables and fruits, develop early in life, so early childhood is an opportune time to teach the basics of nutrition and healthy eating", says PhD student Sarah Gerritsen, who conducted the survey with the support of GRAVIDA and the University of Auckland's Centre for Longitudinal Research.

"Day care centres, kindergartens and playcentres play an important role in this process," she says. "Nearly all New Zealand children attend early childhood education for two years before starting school, the majority for three or four full days a week."

"Most ECE services provide some, if not all, of the food children eat while at the service, and therefore have a large impact on a child's diet. Other services, where children bring a lunchbox from home, should be promoting healthy food, as directed by the ECE legislation," says Ms Gerritsen.

Her online survey, titled 'Kai time in ECE', targeted all licensed ECE services for children aged three and four years in the Auckland, Counties Manukau and Waikato areas which together contain one-third of New Zealand's pre-schoolers.

A total of 257 services (30 percent of all licensed services in the areas) participated in the survey which was the first ever in New Zealand to analyse the statements in written ECE nutrition policies. The findings were published in Public Health Nutrition.

The survey found that 56 percent of ECE services provided some food daily to children, with 34 percent providing lunch and at least two other snacks every day. Forty-seven percent required children to bring all their food for the day/session from home.

Four out of five services (82 percent) had a written healthy food, nutrition or wellness/hauora policy. Encouragingly, many of these policies strongly supported nutrition education for children, teachers and/or parents.

While two thirds (66 percent) of services had specific written nutrition guidelines for food brought from home, statements about the standard of food provided by the service or brought from home were usually phrased only as suggestions rather than as requirements.

Less than one in six ECE services with nutrition guidelines (18 percent) reported that 'all' of their families complied with the policy, 73 percent said 'most' complied, 9 percent said 'some' complied, and one service said 'none' of the families complied.

"Most policies could be improved by adding a statement that the food provided by centres and parents should follow the Ministry of Health's Food and Nutrition Guidelines and by giving examples of lunches and snacks that meet the guidelines", says Ms Gerritsen.

"Policies should also include specific recommended practices for staff and parents to follow. This way we can create an environment in ECE centres that assists children to want to make healthy food choices, while also encouraging families to reassess the food they provide for their children," she says.

The results in brief:

• Although the majority of child-care services (82 percent) had a written nutrition policy, many were not comprehensive and contained statements that could be difficult to action.
• Most services promoted some healthy eating behaviours by maintaining edible gardens (90 percent), not using food in punishments and rewards (96 percent and 95 percent respectively), and serving family-style meals, with adults seated alongside children (80 percent).
• Other widespread practices may encourage children to overeat or form unhealthy food preferences. These included serving sugary, salty and fatty foods at celebrations (26 percent), selling unhealthy food at fundraisers (37 percent), hurrying children to finish eating (61 percent), and not checking with children if they are full before offering more food (60 percent).