Diet Quality in Early Care and Education Centers: A Comparison of Menu, Served, and Consumed Lunch Measures

Abstract Objective Assess if diet quality (DQ) differs among 3 lunch measures commonly used to assess DQ in early care and education (ECE) centers, which include what is listed on the menu, served, and consumed. Design This quantitative observational study measured DQ of food and beverage items listed on the menu, what children were served, and what they consumed during one lunch meal. Setting Alabama ECE centers. Participants ECE centers (n = 28) with attendance of ≥10 children ages 3 to 5 years and provided lunch daily. Main Outcome Measure(s) DQ measured through Healthy Eating Index–2015 (HEI) scores, which were calculated for the menu, served, and consumed lunch measures. Analysis Menu, served, and consumed HEI scores compared using either Kruskal-Wallis or ANOVA. Dunn Bonferroni or Duncan post hoc tests identified which group differed. Results Total HEI scores were significantly higher among menus, compared with served and consumed (P = .001). Served and consumed total HEI scores were not different. Conclusions and Implications Menu DQ differed from both the served and consumed lunch measures. These findings support the need for nutrition education on the importance of menu adherence in ECE centers.