Document Type
Article
Publication Date
11-21-2023
Identifier
DOI: 10.1186/s12889-023-17179-1; PMCID: PMC10664465
Abstract
BACKGROUND: The food and beverages served in family childcare homes (FCCHs) may play an important role in the development of childhood overweight and obesity. This analysis examines whether children's diet quality mediates the relationship between foods and beverages served in FCCHs and preschool-aged children's weight status.
METHODS: Trained and certified staff conducted observations for two days in each FCCH, using the Environment and Policy Assessment and Observation (EPAO) measure to determine the foods and beverages served to children (N = 370) in FCCHs (N = 120). They also used the Dietary Observation in Child Care (DOCC) protocol to assess children's food and beverage intake during childcare, from which we calculated the Healthy Eating Index-2015 (HEI), a measure of diet quality. Height and weight were measured for each child with parent consent from which the child's body mass index (BMI) z-scores were calculated. A multilevel mediation analysis was conducted to indicate whether children's diet quality mediates the relations between food and beverage served in FCCHs and preschool-aged children's weight status.
RESULTS: Children's total HEI scores significantly mediated the relationship between the EPAO subscale Food Provided and children's BMI z-scores (B=-0.01, p < .05, 95% CI = [-0.03, - 0.002]). Further, the EPAO subscale Food Provided was positively associated with the total HEI score (B = 0.75, p < .01, 95% CI = [0.32, 1.18]). Total HEI scores were negatively associated with BMI z-score (B=-0.01, p < .05, 95% CI = [-0.02, - 0.001]).
CONCLUSION: Children's diet quality did significantly mediate the relationship between the food served in FCCHs and children's weight status. More longitudinal studies with longer follow-up periods need to be conducted to confirm these relationships. Further, future studies need to examine the relationships between a broader spectrum of FCCH environmental characteristics and home environment with children's weight status, as well as other mediators including physical activity.
Journal Title
BMC public health [electronic resource]
Volume
23
Issue
1
First Page
2301
Last Page
2301
MeSH Keywords
Humans; Child, Preschool; Child; Child Care; Diet; Body Mass Index; Pediatric Obesity; Multilevel Analysis
Keywords
Childhood obesity; Diet quality; Early childcare; Family childcare homes
Recommended Citation
Jiang Q, Risica PM, Tovar A, et al. Mediation of the association between social environmental characteristics of family childcare home and weight status in children by diet quality. BMC Public Health. 2023;23(1):2301. Published 2023 Nov 21. doi:10.1186/s12889-023-17179-1
Comments
Grants and funding
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Publisher's Link: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-17179-1