Food consumption and nutrient intake in children on day-care days: results from the nationwide German KiESEL study.

BACKGROUND: Day-care (DC) centers are relevant nutritional environments for young children in Germany. Yet, little is known about food consumption and nutrient intake at DC centers. OBJECTIVES: To characterize meal consumption at DC centers, compare food consumption and nutrient intake on DC days versus non-DC days, and explore the contribution of foods consumed at DC centers to the total daily food consumption (TFC) and nutrient intake. METHODS: The analysis is based on questionnaire and food record data (3 + 1 day) collected within the representative KiESEL study. The present subsample includes 1-5-year-old children with at least one DC day and one non-DC day (n = 570). DC days and non-DC days were compared using a mixed linear model. RESULTS: 93.7% of the children ate at least one breakfast and 45.5% ate three meals a day at DC centers regularly. On DC days, more beverages, vegetables, and less meat/sausages and unfavorable foods (e.g., sweets, soft drinks) (as %TFC) were consumed, and intakes of protein (% of energy intake, E%), fiber, calcium (mg/MJ) were higher, while fat intake (E%) was lower than on non-DC days. The diet at DC centers was higher in some favorable foods (e.g., vegetables, fruit, starchy side dishes), but lower in milk/milk products and unfavorable foods, resulting in higher intakes of fiber and lower intakes of mono-/disaccharides and calcium compared to the reference shares (i.e., share of TFC or energy intake at DC centers). CONCLUSION: DC days showed more characteristics of a healthy diet than did non-DC days, considerably owing to foods eaten at DC centers. The role of DC centers in Germany as important nutritional environments should be strengthened further by public health measures, e.g., obligatory quality standards for meals at DC centers, targeted support for health-minded public procurement, or increased access to meals at DC centers.