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HOME/Childhood Obesity/All snacks are not created equal

All snacks are not created equal

All snacks are not created equal
July 16, 2013
2 Comments
By: Dr. Kristen Copeland

I realized the need for a research study as I was picking up my youngest daughter from child care. She was three years old at the time, and like many her age, a very picky eater.  As a conversation starter, I asked her what she would like for dinner.  She promptly quipped, “I don’t want dinner. I want a snack!”

It was that very statement, from a three-year-old, that made me realize there might be a problem.  Why would she want a snack instead of dinner? And then I thought about the types of things she ate for snacks in child care—goldfish, pretzels, juice—and the types of nutritious things she was served at meals (but never ate) – meat and green vegetables.  From the viewpoint of a three-year-old, I could see why she might want to forgo a dinner, which was likely to be full of “yucky” nutritious foods, in lieu of a meal of snack foods, which were unlikely to be nutritious but very likely to be appetizing.  And then I started to wonder how her caregivers in child-care (and her parents at home) might be training her to prefer snacks over meals, just by serving tasty foods at snack times and saving the nutritious foods for mealtimes.  So, as a mom and a researcher, I set out to better understand what our kids were being served at meals versus snacks in child care, and how big of a problem this might be.

In order to do this, we surveyed 258 full-day licensed child-care centers in Southwestern Ohio about their lunch and snack menus, and unfortunately we found that my daughter’s experience was not unique. We found that 87 percent of the centers served sweet and salty foods— gummy snacks, pretzels, and crackers—at snack time more than three times per week, but rarely at lunch.  Similarly, 100% fruit juice was on snack menus over two times per week in 37 percent of centers, but in only one center as a regular component of lunch.  Conversely, those dreaded but very nutritious non-starchy vegetables were on lunch menus over three times per week in 67 percent of centers, but rarely on snack menus in most centers. (Non-starchy vegetables include carrots, squash, sweet potatoes, broccoli, and dark greens. “Starchy” vegetables are generally less nutritious than non-starchy vegetables but very popular with preschoolers: corn, green peas, and white potatoes.)

In essence we found a big difference between the nutritional value of foods and beverages served at meals versus snack time. Foods served at meals were rich with nutrients but those at snack time were not.

In theory, there is no reason for snacks to look different from meals in child care. Snacks are generally smaller and provide fewer calories than meals, but collectively snacks comprise 26 percent of preschooler’s daily caloric intake. Practically, they may differ because meals are usually prepared in a child care facility’s kitchen or through a catering service, but kitchen prep/catering services are not available at snack times. Snacks therefore must be non-perishable items that require no special preparation or handling; in other words, open and serve. According to the USDA’s Child and Adult Care Food Program (CACFP) which operates in most local child-care centers and family child care homes, snacks only have to contain two of the four recommended food groups, while meals must contain all four (fruit/vegetable, milk, meat, and grain).  In our study we found the most typical pairing at snack time to be a fruit and grain, usually juice and crackers.

It seems reasonable that if children are going to get over a quarter of their daily energy from snacks, these “mini-meals” could also provide a similar proportion of their nutrients. Our findings suggest this is not happening. With 75 percent of kids ages 3-5 in child care, improving snacks in these settings could help address the growing obesity problem. At minimum, snacks are a missed opportunity for improving child health and nutrition.

So, what can be done? Meals and snacks served in child care must meet state licensing standards for food safety. Most states have minimum or no nutrient standards for the foods and beverages served, however. Yet individual facilities can choose to offer more nutritious foods and beverages. All it takes is some advocacy. Child-care facilities want parent involvement and feedback.  If you as a parent want or demand something, they will try to adapt.  In the end, child care facilities are businesses, and you and your children are their customers.  Ask to speak to the parent advisory committee.  Or start a parent advisory committee if your center does not have one. Speak with the director and administrative staff about your concerns.  Suggest the following tips for healthier snacking:

  1. Offer whole fruit instead of juice
  2. Offer water or skim milk instead of juice or 2% milk
  3. Offer lean protein at snacks, such as yogurt, eggs, beans,  peanut butter or  lean meat
  4. Offer whole grains and vegetables at snacks
  5. For celebrations, choose either non-food activities, or require that nutritious foods such as fresh fruits be served. Consider a ‘sundae’ made of fresh raspberries and light cream.

Preschoolers in child care are at the perfect age to develop healthy eating habits that can last them a lifetime. And they’re already in the right environment to learn.  Why not take the opportunity to teach them about healthy snacking in addition to their A-B-Cs and 1-2-3s?

 
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About the author: Dr. Kristen Copeland

Kristen Copeland is pediatrician in the division of General and Community Pediatrics at Cincinnati Children’s. She is also a researcher, focusing on how the childcare environment affects children’s health. She has 10 years of research experience in the childcare setting and currently serves on several national committees related to childcare settings, such as the American Academy of Pediatrics Section on Early Education and Child Care.

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Comments

Karen Case July 16, 2013 at 3:52 pm

First off I would like to thank you for doing the research on the snacks/meals, my son is 3 an I work 3rdI shift an my husband 1st so we never leave him with anyone. He is the pickiest eater I have ever seen he is the baby of 7 with my oldest being 24. I have done just about everything, took him to his family Dr, taked to the people at wic….I don’t know what else to do, do you have any suggestions? …..please help ….:'(

    Dr. Kristen Copeland July 17, 2013 at 2:05 pm

    Karen, I sympathize with your situation and I suspect several other readers are in your shoes or have been there before. First, I would say, hang in there. The pickiness phase is fortunately a short one, and peaks around the age 3. As children get older, they typically expand the numbers and types of foods they will eat. Second, don’t give up on trying to expose your son to new types of foods. Research suggests that children must be exposed (and actually try) new foods over 10 times before they will start to accept them. Third, don’t become a short-order cook. Serve your son everything that the rest of the family is eating. You can serve him very small quantities of foods you suspect he may not like. Just seeing the rest of the family eating and enjoying the food that they are served may encourage him to try everything. If you see he is avoiding something even though he has had plenty of time to try it, gently encourage him to “try” everything on his plate. (He can spit out after he puts it in his mouth.) Praise him for trying and ask him what he thought about it. If he doesn’t like it, you can remind him that it’s always good to keep trying things as our tastes buds change over time. You can say something like, “I’m proud of you for trying that. You may not be OLD enough to like it yet. But I bet you will one day.” After that, just leave it. Don’t make food a battle or a struggle, as it just makes things worse. Last, be sure you’re not using food as a reward, restricting foods as punishment, or requiring that he eat certain foods to get other foods (for instance, eating his vegetables to get dessert). This tends to make children desire the restricted foods (like dessert) more, and the foods they have to eat to get the reward (like vegetables) less. Good luck!

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