This issue of the UC ANR Nutrition Policy Institute's Research to Action examines child nutrition in the preschool years, which influences the development of food preferences, dietary patterns, and health outcomes later in life.
Research to Action - The Nutrition Policy Institute news brief

November 2018 | Vol. 2, No. 4

Improving Access to Nutritious Food in Early Care and Education Settings: A Research to Policy Approach

What is the issue?
Nutrition in the preschool years influences the development of food preferences, dietary patterns, and health outcomes later in life. With the growing prevalence of childhood overweight, obesity, and type 2 diabetes, there is need for increased attention to what and how infants and young children are fed. Child care is an ideal environment to support healthy eating and healthy beverage consumption, as nearly two-thirds of children age five years and younger regularly spend time in child care, where they receive up to two-thirds of their daily dietary intake.

Why is this important?
Racial, ethnic, and socioeconomic disparities exist both in child health and in what and how preschool age children are fed. Child care is expensive, and high-quality care can be out of reach for many, particularly working low-income families. State and federal policies can improve the child care nutrition environment, thus making higher quality child care more accessible for all families regardless of race, ethnicity, and income.
Improving nutrition in child care settings through research-informed policy
The federal Child and Adult Care Food Program (CACFP) provides reimbursement for meals and snacks served to more than 4.2 million children in the United States at participating public and private child care centers and family child care homes. In October 2017, CACFP updated the nutrition standards for eligible foods for infants and children as mandated by the 2010 Healthy Hunger Free Kids Act—the first updates since the program started in 1968. These changes support breastfeeding mothers; increase and diversify servings of fruits, vegetables, and whole grains; and limit added sugar and saturated fat.
States have primary oversight in regulating child care settings through licensing, and several have included healthy eating policies in licensing regulations. For example, many states, including California, require licensed child care centers not participating in CACFP to follow the CACFP nutrition standards. However, this is not required for licensed family child care homes in California and many other states, primarily out of concern that such standards would be too much of a burden for home providers, who tend to have more limited resources compared to child care centers.
The Nutrition Policy Institute (NPI) collaborated with child care stakeholders, state administrators, California Food Policy Advocates, and the Sarah Samuels Center for Public Health Research & Evaluation to conduct statewide assessments of which foods and beverages were served to children in licensed child care sites across California. Findings from these assessments – conducted in 2008, 2012, and 2016 – informed both federal and California state policies for child care nutrition, including:
  • 2010 Healthy Beverages in Child Care Act (AB 2084), implemented in 2012, requires sites serve low-fat or non-fat milk to children two years and older, provide no more than one serving of 100% juice each day, make clean and safe drinking water available and accessible for children to consume throughout the day, and not serve beverages with added sugar (artificial or natural).
  • 2013 Child Day Care: Nutrition Training Act (AB 290), implemented in 2016, requires all newly licensed child care providers to complete one hour of nutrition training.
Nutrition Policy Institute's research on licensed California child care sites found that: Upcoming: online training for healthy beverages in child care
  • NPI collaborated with the UCSF California Childcare Health Program and UC Cooperative Extension in 2016 to develop and evaluate a 30-minute, interactive online training in English and Spanish for child care providers on the importance of serving healthy beverages. The training will be made publicly available by early 2020.
What can I do? To learn more about NPI’s child care projects, contact

Research to Action is a periodic news brief from the Nutrition Policy Institute. Please share Research to Action with colleagues who would be interested in receiving it, and please subscribe if you haven't already done so.


November 11, 2018
APHA 2018 Annual Meeting
San Diego, CA

John Pugliese, Lauren Whetstone, Wendi Gosliner, Gail Woodward-Lopez, and Sridharshi Hewawitharana on Trends in Nutritional Quality among SNAP-Eligible Mothers and their Children in California

November 13, 2018   
APHA 2018 Annual Meeting
San Diego, CA

Janice Kao, Gail Woodward-Lopez, Christina Becker, and Lauren Whetstone on What SNAP-Ed PSE strategies do communities use to improve health equity for low-income Californians?

November 14, 2018
APHA 2018 Annual Meeting
San Diego, CA

John Pugliese, Lauren Whetstone, Wendi Gosliner, Gail Woodward-Lopez, and Sridharshi Hewawitharana on Mother-Child Differences in Nutritional Quality among Low-Income Latinos

November 14, 2018
APHA 2018 Annual Meeting
San Diego, CA

Tracy Delaney, Stephanie Caldwell, Joyce Lee, and Wendi Gosliner on Raising Public Awareness about Food Waste: The Development, Implementation, and Evaluation of California's Inaugural Food Waste Prevention Week

November 29, 2018
University of Missouri
Child care Nutrition in California: Conducting Research to Inform Policy
Lorrene Ritchie will give an invited talk about conducting research to inform policy about child care nurition in California.

November 29 - December 2, 2018
Kellogg Fellows Leadership Alliance
Global Summit on Food Security and Thriving Communities
Atlanta, GA

Lorrene Ritchie will participate in an international, interdisciplinary gathering of more than  200 Kellogg Foundation  Leadership  Fellows, community leaders, changemakers, funders, and experts who will examine food as the gateway  to address  the complex, cross-sector challenges that communities face today.


Read the latest news from the National Drinking Water Alliance to access helpful resources on drinking water, including fact sheets, toolkits, webinars, workshops and much more. 


New York Times
Where ‘Yes! to affordable groceries’ really means No to a soda tax

University of Kansas
Largest study of its kind gauges community efforts to combat childhood obesity, a key risk factor for later chronic disease

Modern Wellness Guide
How can society fight childhood obesity?

New York Times (op-ed)
More scare tactics from the Trump administration

California Agriculture
Research Highlights: Fresh produce in low-income areas: High cost and low quality

California Health Report
Food banks at California colleges help keep students from going hungry

Sacramento Bee
Starving students

A new report from presents evidence-based policy solutions that community and tribal leaders, government officials, public health professionals, health care providers, lawyers, and social service providers can use in their own communities. The report, The Role of Law and Policy in Achieving the Healthy People 2020 Nutrition and Weight Status Goals of Increased Fruit and Vegetable Intake in the United States, documents policy solutions that can help communities increase access to and intake of fruits and vegetables in support of Healthy People 2020 nutrition objectives. The UC ANR Nutrition Policy Institute's Pat Crawford is an author of the seminal report.


Martinez S, Tschann JM, Butte N, Gregorich SE, Penilla C, Flores E, Pasch L, Greenspan L, Deardorff J. Sleep durantion in Mexican American children: Do mothers' and fathers' parenting and family practices play a role? Journal of Sleep Research, November 5, 2018. DOI:


Au LE, Gurzo K, Paolicelli C, Whaley SE, Weinfield NS, Ritchie LD. Diet Quality of U.S. Infants and Toddlers 7-24 Months Old in the WIC Infant and Toddler Feeding Practices Study-2. The Journal of Nutrition, Nov 1, 2018, 148(11):1786-1793. DOI: 10.1093/jn/nxy192.


The Healthy Communities Study: Examining Community Programs, Policies and Other Characteristics in Relation to Child Weight, Diet and Physical Activity. Guest Editor: Shiriki K. Kumanyika. Pediatric Obesity, Volume 13, Issue S1, October 21, 2018. 

[Full Text]

Tan ML, Laraia B, Madsen K, Au LE, Ritchie LDChild Food Insecurity Is Associated with Energy Intake among Fourth- and Fifth-Grade Girls. Journal of the Academy of Nutrition and Dietetics, Oct 11, 2018. DOI: 10.1016/j.jand.2018.07.011


Au LE, Crawford PB, Woodward-Lopez G, Gurzo K, Kao J, Webb KL, Ritchie LD. School Wellness Committees Are Associated With Lower Body Mass Index Z-Scores and Improved Dietary Intakes in US Children: The Healthy Communities Study. Journal of School Health, Sep 2018. DOI: 10.1111/josh.12664


Cates S, Blitstein J, Sallack L, Deehy K, Ritchie L, Rosen N, Karns S, Kosa K, Kilpatrick G, Bell S, Rains C. Project Officer: Karen Castellanos-Brown. U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support. WIC Nutrition Education Study: Phase II Final Report. Alexandria, VA: September 2018.

[Abstract]  [Full Text]  [Website]

Crawford P, Dunning L, Kappagoda M, O’Connor JC. The Role of Law and Policy in Achieving the Healthy People 2020 Nutrition and Weight Status Goals of Increased Fruit and Vegetable Intake in the United States. Rockville (MD). Department of Health and Human Services, Office of Disease Prevention and Health Promotion (ODPHP); 2018 Sept 13. 

[Full Text]

For a complete list of NPI publications, please visit

The Nutrition Policy Institute (NPI) conducts research on the impact of nutrition and physical activity on public health. NPI translates research findings into recommendations to provide a basis for effective decision-making, particularly related to the federal nutrition assistance programs.

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