Diet Quality in Early Care and Education Centers: A Comparison of Menu, Served, and Consumed Lunch Measures

Abstract

Objective: Assess if diet quality (DQ) differs among 3 lunch measures commonly used to assess DQ in early care and education (ECE) centers, which include what is listed on the menu, served, and consumed.

Design: This quantitative observational study measured DQ of food and beverage items listed on the menu, what children were served, and what they consumed during one lunch meal.

Setting: Alabama ECE centers.

Participants: ECE centers (n = 28) with attendance of ≥10 children ages 3 to 5 years and provided lunch daily.

Main outcome measure(s): DQ measured through Healthy Eating Index-2015 (HEI) scores, which were calculated for the menu, served, and consumed lunch measures.

Analysis: Menu, served, and consumed HEI scores compared using either Kruskal-Wallis or ANOVA. Dunn Bonferroni or Duncan post hoc tests identified which group differed.

Results: Total HEI scores were significantly higher among menus, compared with served and consumed (P = .001). Served and consumed total HEI scores were not different.

Conclusions and implications: Menu DQ differed from both the served and consumed lunch measures. These findings support the need for nutrition education on the importance of menu adherence in ECE centers.

Keywords: Healthy Eating Index; children; diet quality; early care and education; nutrition.