Impact of a worksite wellness program on the nutrition and physical activity environment of child care centers.

PURPOSE: To test whether implementing a staff wellness program affects the nutrition and physical activity environment at child care centers. DESIGN: Quasi-experimental controlled trial. SETTING: Child care centers in low income neighborhoods in California. SUBJECTS: Eighty-two staff members at 13 centers completed the study. INTERVENTION: Intervention and control groups received training and education about nutrition and physical activity. The intervention group also participated in a worksite wellness program. MEASURES: Staff members' personal health habits, self-efficacy in working with families on nutrition and physical activity, and changes in children's food and physical activity environments were assessed. ANALYSIS: Statistical software was used to analyze change scores for pre-post measures and to test differences for end point-only measures. RESULTS: Although significant differences in staff members' personal health behaviors were not observed, staff from intervention sites exhibited more positive changes in their comfort level in talking to parents about nutrition and physical activity. Intervention sites reported providing more fresh fruits (p = .004) and vegetables (p = .03) to children as part of regular meals and snacks and serving more fresh fruits (p = .05) at children's celebrations. Control sites reported greater increases in sweetened foods (p = .02) and sweetened beverages (p = .05) at children's celebrations. CONCLUSION: The wellness intervention shows promise in improving the children's food environment in a child care setting.

Sugar-Sweetened Beverage and Water Intake in Relation to Diet Quality in U.S. Children.

INTRODUCTION: Sugar-sweetened beverages (SSBs) are a major contributor to children's added sugar consumption. This study examines whether children's SSB and water intakes are associated with diet quality and total energy intake. METHODS: Using data on children aged 2-18 years from the 2009-2014 National Health and Nutrition Examination Survey, linear regression models were used to analyze SSB and water intake in relation to Healthy Eating Index 2010 (HEI-2010) scores and total energy intake. Generalized linear models were used to analyze SSB and water intake in relation to the HEI-2010 scores. Analyses were conducted including and excluding caloric contributions from SSBs and were conducted in 2016-2017. RESULTS: SSB intake was inversely associated with the HEI-2010 total scores (9.5-point lower score comparing more than two servings/day with zero servings/day, p-trend<0.0001) and positively associated with total energy intake (394 kcal higher comparing more than two servings/day with zero servings/day, p-trend<0.0001). The associations between SSB and HEI-2010 total scores were similar when SSBs were excluded from HEI-2010 calculations. Water intake was positively associated with HEI-2010 total scores, but not associated with total energy intake. SSB intake was inversely associated with several HEI-2010 component scores, notably vegetables, total fruit, whole fruit, greens and beans, whole grains, dairy, seafood and plant proteins, and empty calories. Water intake was positively associated with most of the same HEI-2010 component scores. CONCLUSIONS: Children who consume SSBs have poorer diet quality and higher total energy intake than children who do not consume SSBs. Interventions for obesity and chronic disease should focus on replacing SSBs with water and improving other aspects of diet quality that correlate with SSB consumption.