NPI study: Law improves beverage environment in California childcare

Obesity among preschoolers is a serious health problem, with one in four obese or overweight by the time the child is ready for kindergarten. Given that well over half of preschool age children are in childcare, UC ANR Nutrition Policy Institute researchers decided to investigate whether healthy beverage standards in childcare could improve their nutrition. Another reason to focus on this age group is that young children are still developing their eating habits. Those who get an early start at eating a nutritious diet will likely have better health outcomes than children who get in the habit of eating junk food and drinking sugary beverages.

In 2008 and 2012, NPI researchers conducted a survey of more than 400 randomly selected California licensed childcare facilities to look at beverages in childcare before and after California's Healthy Beverages in Child Care Act (AB 2084) took effect in January 2012. Under this law, only fat-free or low-fat (1 percent) unsweetened, plain milk for children two years of age or older is allowed, and no more than one serving per day of 100 percent juice. No sugary drinks are allowed at all. Also, drinking water must be readily available throughout the day, including at all meal, snack and play times.

NPI Director Lorrene Ritchie presented NPI's research findings on June 30 at the 8^th Biennial Childhood Obesity Conference in San Diego. The NPI study found that the policy was effective at improving the beverage environment in California childcare. Provision of whole milk dropped from nearly 30 percent of childcare facilities in 2008 to less than 9 percent of facilities 2012. The provision of other beverages also improved. In 2008, 27 percent of facilities offered juice more than once a day, compared to just 20 percent in 2012. Facilities offering any sugar-sweetened beverages dropped from 7.6 percent in 2008 to 6.9 percent in 2012.

“We know the beverages children consume can put a child at risk for overweight and obesity,” said Ritchie. “The good news is that the healthy beverage standards did improve the beverage environment in California childcare. This law impacts potentially a million young children in our state.”

Despite the improved beverage environment, NPI found that only 60 percent of childcare facilities were aware of the law, and only 23 percent were in full compliance with all provisions.

“We need to do more to improve the beverage environment,” said Ritchie. “Based on our findings, we recommend that all childcare providers have access to nutrition training so that more understand and are able to comply with California's childcare beverage standards.”

The NPI study also looked at the effects of serving water at the table with meals and snacks.  While this was not a provision of the California law, it is a best practice for teaching children to reach for water first for thirst. Putting water on the table did not have an impact on children's intake of milk and other foods, which was a common concern of providers caring for young children. However, the study found the law didn't make much of a difference in increasing children's water intake either.

“Simply serving water at the table with meals and snacks is not likely to interfere with intake of other healthy things,” said Ritchie. “But we don't know what would happen if water were provided in such a way as to substantively increase water intake.”

The University of California Global Food Initiative aims to put the world on a path to sustainably and nutritiously feed itself. By building on existing efforts and creating new collaborations among UC's 10 campuses, affiliated national laboratories and the Division of Agriculture and Natural Resources, the initiative will develop and export solutions for food security, health and sustainability throughout California, the United States and the world.