BACKGROUND Parents and early care and education (ECE) are the key influencers of young children's diets, but there is limited information about how each contribute to children's overall diet quality. OBJECTIVE This study aimed to determine what proportion of children's dietary intake occurs within the ECE setting and whether diet quality is higher at ECE centers and, consequently, on weekdays than weekends. DESIGN This cross-sectional analysis of a larger cluster randomized controlled trial used multiple 24-hour dietary intakes measured through a combination of the Dietary Observation in Child Care protocol and parent-reported food diaries. PARTICIPANTS/SETTING Participants (N=840) included children aged 3 to 4 years enrolled in ECE centers in central North Carolina for whom 24-hour dietary intake was captured via observation of meals and snacks consumed at ECE and parent-report of all remaining meals and snacks. Data were collected from 2015 to 2016. MAIN OUTCOME MEASURES Diet quality at ECE and elsewhere was evaluated using the Healthy Eating Index 2015. STATISTICAL ANALYSES PERFORMED Mixed-effects models were used to determine differences in mean Healthy Eating Index 2015 component and total scores. Models were adjusted for children's age and sex and accounted for clustering within ECE centers and families. RESULTS Children consumed approximately 40% of daily energy, nutrients, and food groups at ECE centers. The mean total Healthy Eating Index 2015 score was higher for foods and beverages consumed at ECE centers (58.3±0.6) than elsewhere (52.5±0.6) (P<0.0001). The mean total Healthy Eating Index 2015 score was also higher on weekdays (58.5±0.5) than on weekends (51.3±0.5) (P<0.0001). CONCLUSIONS Children consume a majority of dietary intake away from ECE centers. Overall, diet quality is low, but the quality of foods consumed by children at ECE centers is higher than that consumed elsewhere. ECE centers remain an important source of nutrition and further investigation is warranted to identify ways to support both ECE centers and families to provide healthier eating environments.

中文翻译：

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早期护理和教育计划对北卡罗来纳州中部 3 至 4 岁儿童饮食质量的贡献

背景 父母和早期护理与教育 (ECE) 是幼儿饮食的主要影响因素，但关于它们如何影响儿童整体饮食质量的信息有限。目的 本研究旨在确定在 ECE 环境中儿童膳食摄入量的比例，以及 ECE 中心的膳食质量是否更高，因此，工作日比周末更高。设计 这项对更大的整群随机对照试验的横断面分析使用了多个 24 小时膳食摄入量，通过儿童保育中的膳食观察方案和家长报告的食物日记相结合进行测量。参与者/环境 参与者 (N=840) 包括在北卡罗来纳州中部 ECE 中心注册的 3 至 4 岁儿童，他们通过观察在 ECE 消耗的膳食和零食以及所有剩余膳食的家长报告来记录他们 24 小时的膳食摄入量和小吃。数据收集时间为 2015 年至 2016 年。 主要结果指标 使用 2015 年健康饮食指数评估 ECE 和其他地方的饮食质量。执行的统计分析 混合效应模型用于确定 2015 年健康饮食指数平均成分和总分的差异。模型根据儿童的年龄和性别进行了调整，并考虑了 ECE 中心和家庭内的聚类。结果 儿童在 ECE 中心消耗了大约 40% 的日常能量、营养素和食物组。在 ECE 中心消费的食品和饮料的 2015 年健康饮食指数平均总分 (58.3±0.6) 高于其他地方 (52.5±0.6) (P<0.0001)。平日 (58.5±0.5) 的平均健康饮食指数 2015 总分也高于周末 (51.3±0.5) (P<0.0001)。结论 儿童在远离 ECE 中心的地方消耗大部分膳食摄入量。总体而言，饮食质量较低，但儿童在 ECE 中心食用的食物质量高于其他地方。ECE 中心仍然是重要的营养来源，需要进一步调查以确定支持 ECE 中心和家庭提供更健康饮食环境的方法。5±0.5) 比周末 (51.3±0.5) (P<0.0001)。结论 儿童在远离 ECE 中心的地方消耗大部分膳食摄入量。总体而言，饮食质量较低，但儿童在 ECE 中心食用的食物质量高于其他地方。ECE 中心仍然是重要的营养来源，需要进一步调查以确定支持 ECE 中心和家庭提供更健康饮食环境的方法。5±0.5) 比周末 (51.3±0.5) (P<0.0001)。结论 儿童在远离 ECE 中心的地方消耗大部分膳食摄入量。总体而言，饮食质量较低，但儿童在 ECE 中心食用的食物质量高于其他地方。ECE 中心仍然是重要的营养来源，需要进一步调查以确定支持 ECE 中心和家庭提供更健康饮食环境的方法。