Preschool Children in Childcare Settings Do Not Consume a Healthy Diet Despite Menus that Meet Recommended Dietary Standards


  • Stacie M. Kirk Department of Teaching and Learning, Southern Illinois University Edwardsville, Edwardsville, Illinois, 62026, Founders Hall 1108, Campus Box 1147
  • Erik P. Kirk Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, Illinois, 62026, adalabene Center, Suite 2616, Campus Box 1126



Dietary Intake, Early Childhood, Served, Food Preference.


Purpose/Objective: To compare preschool lunch menus that meet dietary guidelines to what is actually served and consumed.

Methods: Fifty-two preschool children (mean±SD, age 3y and 10m ± 8m) from a university early childhood center participated in the 10-week study. Dietary intake was measured by a registered dietitian using direct observation for pre and post meal analysis. Energy and nutrient content was completed using Food Processor Nutrition Analysis by ESHA.

Results: There was a significant (p<0.05) difference for total kilocalories (kcals) between what was on the menu (448 ± 130) and to what was served to the children (523 ± 148) compared to what was consumed (361 ± 178) by the children.There was a significant (p<0.05) difference for grams of fat between what food was listed on the menu (16.0 ± 8.7g), the food served to the children (21.2 ± 9.7g), and the food consumed (14.5 ± 10.0g) by the children. There was a significant (p<0.05) difference for grams of carbohydrate between what food was listed on the menu (55.3 ± 18.9g) and the food served to the children (56.5 ± 20.5g) compared to what was consumed (38.5 ± 21.7g) by the children. Children consumed only 46.9% of the vegetables, 88.9% of dairy products, 82.0% of fruits, 81.8% of grains and 72.8% of meats served, and 77.9% of all fats/sweets served to them at lunch.

Conclusion: The results indicated that menus that meet recommended dietary standards do not translate into what children are served or consumed, in particular, for vegetables.


[1] US Department of Agriculture, Food and Nutrition Service. Child and Adult Care Food Program. The Child and Adult Care Food Program. Accessed July 19, 2018; Available from: http: //
[2] Head Start Program Performance Standards. 45 CFR 1304.23 Child Nutrition. 98-115. Department of Health and Human Services Administration for Children and Families Head Start Program Performance Standards Web site. Accessed July 19, 2018.
[3] Dev DA, McBride BA. Academy of Nutrition and Dietetics benchmarks for nutrition in child care 2011: are child-care providers across contexts meeting recommendations? J Acad Nutr Diet 2013; 113(10): 1346-53.
[4] Fleischhacker S, Cason KL, Achterberg C. ""You had peas today?"": a pilot study comparing a Head Start child-care center's menu with the actual food served. J Am Diet Assoc 2006; 106(2): 277-80.
[5] Crepinsek MK, Gordon AR, McKinney PM, Condon EM, Wilson A. Meals offered and served in US public schools: do they meet nutrient standards? J Am Diet Assoc 2009; 109(2 Suppl): S31-43.
[6] Benjamin Neelon SE, Briley ME. Position of the American Dietetic Association: benchmarks for nutrition in child care. J Am Diet Assoc 2011; 111(4): 607-15.
[7] Ball SC, Benjamin SE, Ward DS. Dietary intakes in North Carolina child-care centers: are children meeting current recommendations? J Am Diet Assoc 2008; 108(4): 718-21.
[8] Benjamin Neelon SE, Copeland KA, Ball SC, Bradley L, Ward DS. Comparison of menus to actual foods and

beverages served in North Carolina child-care centers. J Am Diet Assoc 2010; 110(12): 1890-5.
[9] Sigman-Grant M, Christiansen E, Branen L, Fletcher J, Johnson SL. About feeding children: mealtimes in child-care centers in four western states. J Am Diet Assoc 2008; 108(2): 340-6.
[10] Trevino RP, Vasquez L, Shaw-Ridley M, Mosley D, Jechow K, Pina C. Outcome of a food observational study among low-income preschool children participating in a family-style meal setting. Health Educ Behav 2015; 42(2): 240-8.
[11] Archer E, Pavela G, Lavie CJ. The Inadmissibility of What We Eat in America and NHANES Dietary Data in Nutrition and Obesity Research and the Scientific Formulation of National Dietary Guidelines. Mayo Clin Proc 2015; 90(7): 911-26.
[12] Ptomey LT, Willis EA, Honas JJ, Mayo MS, Washburn RA, Herrmann SD, et al. Validity of energy intake estimated by digital photography plus recall in overweight and obese young adults. J Acad Nutr Diet 2015; 115(9): 1392-9.
[13] Sievert YA, Schakel SF, Buzzard IM. Maintenance of a nutrient database for clinical trials. Control Clin Trials 1989; 10(4): 416-25.
[14] Nelson M, Atkinson M, Darbyshire S. Food photography II: use of food photographs for estimating portion size and the nutrient content of meals. Br J Nutr 1996; 76(1): 31-49.
[15] Donnelly JE, Sullivan DK, Smith BK, Jacobsen DJ, Washburn RA, Johnson SL, et al. Alteration of dietary fat intake to prevent weight gain: Jayhawk Observed Eating Trial. Obesity (Silver Spring) 2008; 16(1): 107-12.
[16] 2015–2020 Dietary Guidelines for Americans. In: Agriculture United States Department of Health and Human Resources, editor.December 2015.
[17] Frampton AM, Sisson SB, Horm D, Campbell JE, Lora K, Ladner JL. What's for lunch? An analysis of lunch menus in 83 urban and rural Oklahoma child-care centers providing all-day care to preschool children. J Acad Nutr Diet 2014; 114(9): 1367-74.
[18] Nowicka P, Sorjonen K, Pietrobelli A, Flodmark CE, Faith MS. Parental feeding practices and associations with child weight status. Swedish validation of the Child Feeding Questionnaire finds parents of 4-year-olds less restrictive. Appetite 2014; 81: 232-41.
[19] Savage JS, Fisher JO, Birch LL. Parental influence on eating behavior: conception to adolescence. J Law Med Ethics 2007 Spring; 35(1): 22-34.
[20] Ranjit N, Wilkinson AV, Lytle LM, Evans AE, Saxton D, Hoelscher DM. Socioeconomic inequalities in children's diet: the role of the home food environment. Int J Behav Nutr Phys Act 2015; 12(Suppl 1): S4.
[21] Kiefner-Burmeister AE, Hoffmann DA, Meers MR, Koball AM, Musher-Eizenman DR. Food consumption by young children: a function of parental feeding goals and practices. Appetite 2014; 74: 6-11.






General Articles