Background The Academy of Nutrition and Dietetics recommends children attending full-time child care obtain 1/2 – 2/3 of daily nutrient needs, leaving 1/3-1/2 to be consumed away from the center. While there are guidelines to optimize dietary intake of children attending child care, little is known about what these children consume away from the center. Objective To describe the dietary intake away from the child care center for preschool-aged children relative to the expected 1/3-1/2 proportion of recommended intake, and to examine the relationships between energy intake away from the center with weight status, food group consumption and low-income status. Design Cross-sectional study conducted between November 2009 and January 2011. Participants/Setting Participants (n=339) attended 30 randomly selected, licensed, full-time child-care centers in Hamilton County, Ohio. Main Outcome Measures Child weight status and dietary intake (food/beverages consumed outside the child-care setting from the time of pickup from the center to the child’s bedtime) including energy and servings of fruits, vegetables, milk, 100% juice, sugar sweetened beverages and snack foods. Statistical Analyses Generalized linear mixed models were used to examine independent associations of food group servings and low income status to energy intake; and energy intake to child weight status. Results The mean energy intake consumed away from the center (685 ± 17 kcal) was more than the recommended target range (433–650 kcal). Intake of fruits, vegetables, and milk were less than recommended. Food group servings and overweight/obesity status were positively associated with energy intake while away from the center. Conclusion Preschool children consumed more energy and less fruits, vegetables, and milk outside of child-care center than recommended. Overweight status was associated with children’s dietary intake after leaving the child-care center. It may be beneficial to include parents in obesity prevention efforts targeting children attending child-care centers.

Background Parents' diets are believed to influence their children's diets. Previous studies have not adequately and simultaneously assessed the relation of parent and child total diet quality and energy intake. Objective To investigate if parent and child diet quality and energy intakes are related. Design A cross-sectional analysis using baseline dietary intake data from the Neighborhood Impact on Kids (NIK) study collected in 2007-2009. Participants/setting Parents and 6-12 year old children from households in King County (Seattle area), WA and San Diego County, CA, targeted by NIK were recruited. Eligible parent-child dyads (n=698) with two or three 24-hour dietary recalls were included in this secondary analysis. Main Outcome Measures Child diet quality (Healthy Eating Index-2010 [HEI-2010], Dietary Approaches to Stop Hypertension [DASH] score, and energy density (for food-only) and energy intake were derived from the dietary recalls using Nutrition Data Systems for Research. Statistical Analyses Performed Multiple linear regression models examined the relationship between parent diet quality and child diet quality, and the relationship between parent energy intake and child energy intake. In both analyses, we controlled for parent characteristics, child characteristics, household education and neighborhood type. Results Parent diet quality measures were significantly related to corresponding child diet quality measures: HEI-2010 (standardized beta [β] = 0.39, p<0.001); DASH score (β = 0.33, p<0.001); energy density (β = 0.32, p<0.001). Parent daily average energy intake (1763 ± 524 kilocalories) also was significantly related (β = 0.30, p<0.001) to child daily average energy intake (1751 ± 431 kilocalories). Conclusion Parent and child intakes were closely related across various metrics of diet quality and for energy intake. Mechanisms of influence are likely to be shared food environments, shared meals, and parent modeling.

Clinicaltrials.gov NCT01546727.

This study sought to understand barriers and facilitators for preparing and eating dinner at home in families who report eating dinner away from home ≥3 per week. Cross-sectional, mixed methods (focus groups, questionnaires) study. Twenty-seven parents with a child 3–10 years-old who reported eating dinner away from home ≥3 times per week from a pediatric medical center in the Midwest participated. The key concepts analytic framework guided focus group analysis. Descriptive statistics were used to characterize parent demographics, anthropometrics, attitudes and confidence toward cooking, perceptions of dinner costs and portions, and parent and child dinners. Parents reported confidence in cooking a home prepared meal, but that eating away from home was reinforcing because it provided quality family time and diminished barriers such as picky eating and perceived costs. Home cooking was also hindered by early school lunch and after-school sports as children were not hungry or home at the typical dinner hour and parents did not want to cook after 8pm. Parents estimated preparing and eating a meal at home took significantly more time than driving and eating out (80.7 minutes vs. 30.3 minutes, p<0.001). Parents significantly (F (3, 104) = 8.80, p<0.001) overestimated the cost of home-prepared meals compared to take-out and frozen meals. Portion size was also overestimated for a protein serving. Findings are limited to predominantly married, female parents whom are highly educated and working. To reduce eating out, interventions should address family factors (e.g., time management, quality time) and child behavior (e.g., picky eating). Innovative interventions that include experiential cooking opportunities that incorporate time management, address picky eating and enthusiasm for cooking with education on decreasing costs may be particularly beneficial for middle- to high-income families.