Home-based child care meeting nutritional standards; widespread use of TV a concern

A study of about 300 home-based child care providers by Oregon State University's Stewart Trost, an internationally-recognized expert on childhood obesity issues, sheds light on both positive and negative aspects of family daycare providers. The findings are published in the December issue of the American Journal of Preventive Medicine.

Trost, who directs the obesity prevention research core at the new Hallie Ford Center for Healthy Children at Oregon State, said a big concern was television exposure in such a young age group. The providers surveyed were caring for young children up to age 5, and two-thirds of providers said they had the TV on most of the day. The American Academy of Pediatrics recommends no more than two hours of television per day for children between the ages of 2 and 5, and discourages any television viewing for children younger than 2.

In addition, while many providers (78 percent) reported offering more than an hour of time for active play daily, 41 percent said children sat for extended parts of the day. Also of concern to the researchers: A majority (63 percent) restricted active play or exercise as punishment for kids.

"Would you withhold fruits and vegetables for kids who misbehave and negatively affect their health?" Trost said. "All the research shows that restricting physical activity makes children more, not less, likely to misbehave. So it's not even an effective means of punishment."

Trost said the most eye-opening result of the study was that less than half of the providers had received any training in physical activity. Trost's past research has shown that children in family daycare get an average of only seven minutes of physical activity per hour. Group this with the 114 percent rise in childhood obesity in the last 30 years, and Trost said it is time to act on this crisis facing American children.

He said providers did "pretty well" in supporting healthy eating habits. Very few reported serving fried foods or high-fat foods, and a low percentage of providers served sweets or chips as snacks.

One area of nutritional concern was the use of whole milk and an over-reliance on fruit juice. More than 50 percent of providers reported serving juice every day, and less than 14 percent served low-fat milk regularly.

"There is a misconception that whole milk is what should be served to youngsters," Trost said. "Low-fat or skim milk has just as much vitamins, and is much healthier. And fruit juice, even 100 percent juice, is mainly sugar and is not what we recommend."

Trost said weaning American children off juice is not an easy task, and child care providers are probably doing what they think is best for kids.

"Juice boxes are part of the culture, and it is hard to break those habits and the heavy influence of marketing, on both parents and child care providers," he said.

Trost and colleagues at OSU Extension Service, in response, have begun a four-year intervention study called the Healthy Home Child Care Project with family daycare providers in a five-county area from Portland to Eugene. The largest intervention of its kind, this $1.2 million project is funded by the U.S. Department of Agriculture. It will collect data on what Oregon family care providers are doing, as well as seek to improve nutritional and physical activity standards through Extension-based training.

"We've got an epidemic that affects the future of our children, and we need to act," Trost said. "We need to put the research into the hands of the people caring for our youth and start getting results."