State Quality Rating and Improvement Systems: Analysis of Strategies to Support Achievement of Healthy Eating and Physical Activity Best Practices in Early Care and Education Settings

In the 1990s, states began developing Quality Rating and Improvement Systems (QRIS) as a structural approach to improve the quality of early care and education (ECE) programs. Nemours’ experience implementing obesity prevention efforts in nine states has demonstrated that QRIS systems may be leveraged to promote childhood obesity prevention in addition to school readiness and More

Evaluating Industry Self-Regulation of Food Marketing to Children

In response to growing concern about children’s exposure to unhealthy food advertising, the food industry adopted a program of self-regulation – the Children’s Food and Beverage Advertising Initiative (CFBAI) – with participating companies pledging to limit child-targeted advertising to healthier products. This study assesses the efficacy of industry self-regulation by comparing advertising content on children’s More

Built Environment Assessment and Interventions for Obesity Prevention: Moving the Field Forward

The American Journal of Preventive Medicine published a special theme issue highlighting discussions and recommendations from the July 2013 Built Environment Assessment Training (BEAT) Institute meeting. The BEAT Institute was developed to train investigators to use observational and self-reported measures of nutrition and activity environments, integrating the disciplines of nutrition, physical activity, obesity prevention, urban More

Monitoring the Uptake of National AfterSchool Association Healthy Eating Standards and Best Practices in Out-of-School-Time Programs

This project builds upon previous work conducted to develop, disseminate, and promote adoption and implementation of the National AfterSchool Association (NAA) Healthy Eating and Physical Activity (HEPA) standards in out-of-school-time programs (OST). The HEPA standards have been adopted by several major national service organizations that represent thousands of OST sites, but no periodic, cross-organization effort More

Potential Population-Level Nutritional Impact of Replacing Whole and Reduced-Fat Milk With Low-Fat and Skim Milk Among US Children Aged 2-19 Years

This study aimed to evaluate the population-level impact of substituting low-fat and skim milk for whole, reduced-fat, and flavored milk (milk eligible for replacement [MER]) on energy, macronutrient and nutrient intakes, and diet cost. Analyses were based on data from 8,112 children and adolescents (ages 2-19) who completed a 24-hour dietary recall through the National More

Influence of School Competitive Food and Beverage Policies on Obesity, Consumption, and Availability

In 2013, the U.S. Department of Agriculture issued an interim final rule containing nationwide standards for all competitive foods and beverages (CF&Bs). This review examines the influence of state laws and school district-level CF&B policies on student body mass index (BMI) and weight outcomes, consumption, and availability of CF&Bs in order to provide insight into More

Policy Improves What Beverages are Served to Young Children in Child Care

In 2011, the U.S. Department of Agriculture began requiring that child-care sites participating in the Child and Adult Care Food Program (CACFP) make drinking water available throughout the day and serve only low-fat or non-fat milk to children ages 2 years and older. In 2012, the California Healthy Beverages in Child Care law additionally required More

Food Marketing: Using Toys to Market Children’s Meals

Nearly $2 billion is spent yearly by U.S. food and beverage companies to market products to children, with the majority of expenditures promoting less healthful foods and drinks. For restaurants, including toys with children’s meals is the leading form of food marketing directed at children. The practice of child-directed marketing by pairing toys with children’s More

Impact of San Francisco’s Toy Ordinance on Restaurants and Children’s Food Purchases, 2011-2012

In December 2011, San Francisco enacted the first citywide ordinance–the Healthy Food Incentives Ordinance– prohibiting restaurants in the city from giving away free toys or other incentives with children’s meals or with foods and beverages not meeting minimal nutritional criteria. This paper examines the impact of the ordinance on restaurant response (e.g., toy-distribution practices, changes More