Field Notes

Nutritionist Looks at Proposed Changes
to Child Care Meal Guidelines

The guidelines for meal requirements in child care settings are being revised for the first time since 1968, something a Kansas State University nutritionist says is a victory for both children’s nutrition and business owners.

Similar to the school lunch guidelines, the Child and Adult Care Feeding Program regulates the type of meals provided to both children in child care settings and adults in care settings. The USDA is updating those guidelines to better align the meal patterns with the 2010 Dietary Guidelines for Americans. It’s unclear when the rule will be finalized.

“The current rule these providers follow means serving meals that are less nutritious by regulation than what you may want your child to be served,“ says Sandy Procter, PhD, a Kansas State University assistant professor of human nutrition and an Expanded Food and Nutrition Education Program coordinator in Kansas. “Parents are really becoming more nutritionally aware and we know it’s important that the feeding guidance keeps up with what the rest of the country is living by as far as dietary guidelines.”

The following are the proposed changes:

  • requiring fruits and vegetables as part of snacks provided;
  • incorporating more whole grains;
  • reducing sugar and fat in meals served;
  • no longer offering fruit juice to children younger than age 1; and
  • more support for breast-feeding in child care settings.

“We know breast-feeding is really the most nutritious meal that a baby can have up to 6 months of age,” Procter says. “Before, it was actually counterproductive if a mother wanted to breast-feed a child. The center actually lost money. This new guidance would reimburse the center for providing a nutritionally adequate meal to a breast-fed baby, so it really encourages the centers to be financially able to do the right thing for the baby—which is a really great change.”

More than 3 million children receive meals each day through the Child and Adult Care Feeding Program. Procter says these changes won’t only improve the health of those being served, but also give the providers a healthy bottom line.

“They’re able to receive reimbursement for healthy meals that are the right thing to be serving these kids,” Procter adds. “It really has a double positive effect. It improves the health of our young children, and also makes it economically feasible for these caretakers to provide nutritious food.”

— Source: Kansas State University


Early Treatment of Type 2 Diabetes May Reduce Heart Disease

Screening to identify type 2 diabetes followed by early treatment could result in substantial health benefits, according to new research published in Diabetes Care that combined large scale clinical observations and innovative computer modeling.

The study, led by researchers at the University of Michigan and the MRC Epidemiology Unit, University of Cambridge, used data from the ADDITION-Europe study of diabetes screening and treatment, which it combined with a computer simulation model of diabetes progression.
This approach revealed that screening followed by treatment led to a reduced risk of cardiovascular disease or death within a five-year follow-up period when compared to patients having no screening.

“Diabetes can be debilitating for patients and costly for health care,” says William Herman, MD, lead author of the paper and a professor at the University of Michigan Medical School. “This research shows that the early identification of diabetes has major health benefits, and supports the introduction of measures such as screening to reduce the time between development of Type 2 diabetes and its treatment.”

Professor Nick Wareham, senior author on the paper and director of the MRC Epidemiology Unit at the University of Cambridge, adds: “This work shows the value of public health modeling to assess impacts and interventions for diseases such as type 2 diabetes that pose an increasing public health challenge.”

At 10 years after baseline, the simulations predicted that with a delay of three years in diagnosis and treatment, 22.4% of those with type 2 diabetes would experience a cardiovascular disease event, such as stroke or heart bypass surgery. This rose to 25.9% with a diagnosis delay of six years.

However, if screening and routine care had been implemented, the simulation predicted only 18.4% would experience a cardiovascular disease event at 10 years after baseline. The simulated incidence of all-cause mortality was 16.4% with a delay of three years and 18.2% with a delay of six years, compared to 14.6% for screening and treatment.

This means that over 10 years, the model predicts that for people with undiagnosed type 2 diabetes, screening would be associated with a 29% reduction in relative risk of a cardiovascular disease event, compared with a delay of six years in diagnosis and treatment.
This amounts to a 7.5% reduction in the absolute risk of adverse cardiovascular outcome in this population. The comparable change in all-cause mortality was 20% relative risk and 3.6% absolute risk reduction.

— Source: University of Michigan Health System