Child Care Sites Participating in the Federal Child and Adult Care Food Program Provide More Nutritious Foods and Beverages.

OBJECTIVE: To compare food/beverage provisions between child care sites participating and not participating in the Child and Adult Care Food Program (CACFP). DESIGN: Cross-sectional survey administered in 2016. SETTING: Licensed child care centers and homes. PARTICIPANTS: Child care providers (n = 2,400) randomly selected from California databases (30% responded). Respondents (n = 680) were primarily site directors (89%) at child care centers (83%) participating in CACFP (70%). MAIN OUTCOME MEASURES: Meals/snacks served, and food/beverage provisions provided to children of age 1-5 years on the day before the survey. ANALYSIS: Odds ratios unadjusted and adjusted for the number of meals/snacks using logistic regression. RESULTS: Compared with CACFP sites, non-CACFP sites provided fewer meals/snacks; had lower odds of providing vegetables, meats/poultry/fish, eggs, whole grains, and milk; and had higher odds of providing candy, salty snacks, and sugary drinks. After adjusting for the number of meals/snacks, differences were attenuated but remained significant for meats/poultry/fish, milk, candy, salty snacks (centers only), and sugary drinks. Differences emerged in favor of CACFP for flavored/sugar-added yogurt, sweet cereals, frozen treats, and white grains. CONCLUSIONS AND IMPLICATIONS: Child care sites participating in CACFP are more likely to provide nutritious foods/beverages compared with non-CACFP sites. Child care sites are encouraged to participate in or follow CACFP program guidelines.