University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute, Berkeley, California.
Stockholm University, Department of Public Health Sciences, Stockholm, Sweden.
Prev Chronic Dis. 2020 Apr 9;17:E30. doi: 10.5888/pcd17.190296.
Since 2012, licensed California child care centers and homes, per state policy, are required to serve only unflavored low-fat or nonfat milk to children aged 2 years or older, no more than one serving of 100% juice daily, and no beverages with added sweeteners, and they are required to ensure that drinking water is readily accessible throughout the day. We evaluated adherence to the policy after 4 years in comparison to the adherence evaluation conducted shortly after the policy went into effect.
Licensed California child care sites were randomly selected in 2012 and 2016 and surveyed about beverage practices and provisions to children aged 1-5 years. We used logistic regression to analyze between-year differences for all sites combined and within-year differences by site type and participation in the federal Child and Adult Care Food Program (CACFP) in self-reported policy adherence and beverage provisions.
Respondents in 2016 (n = 680), compared with those in 2012 (n = 435), were more adherent to California's 2010 Healthy Beverages in Child Care Act overall (45.1% vs 27.2%, P < .001) and with individual provisions for milk (65.0% vs 41.4%, P < .001), 100% juice (91.2% vs 81.5%, P < .001), and sugar-sweetened beverages (97.4% vs 93.4%, P = .006). In 2016, centers compared with homes (48.5% vs 28.0%, P = .001) and CACFP sites compared with non-CACFP sites (51.6% vs 27.9%, P < .001) were more adherent to AB2084 overall.
Beverage policy adherence in California child care has improved since 2012 and is higher in CACFP sites and centers. Additional policy promotion and implementation support is encouraged for non-CACFP sites and homes. Other states should consider adopting such policies.
自 2012 年起，根据州政策规定，加利福尼亚州获得许可的儿童保育中心和家庭必须向 2 岁及以上的儿童提供无调味低脂或脱脂牛奶，每日不超过一份 100%果汁，且不得提供添加甜味剂的饮料，并确保全天提供饮用水。我们评估了在该政策实施 4 年后的执行情况，并与该政策生效后不久进行的执行情况评估进行了比较。
2012 年和 2016 年随机选择加利福尼亚州获得许可的儿童保育场所，并对 1-5 岁儿童的饮料使用情况和供应情况进行调查。我们使用逻辑回归分析所有场所的年度间差异以及按场所类型和参与联邦儿童和成人照顾食品计划（CACFP）的情况进行的年度内差异，以评估自我报告的政策遵守情况和饮料供应情况。
2016 年（n=680）的受访者比 2012 年（n=435）的受访者总体上更遵守加利福尼亚州 2010 年《儿童保健中的健康饮料法案》（45.1%比 27.2%，P<.001）和个别牛奶（65.0%比 41.4%，P<.001）、100%果汁（91.2%比 81.5%，P<.001）和含糖饮料（97.4%比 93.4%，P=.006）的供应规定。2016 年，与家庭（48.5%比 28.0%，P=.001）相比，中心（与家庭相比，中心（48.5%比 28.0%，P=.001）和 CACFP 地点（与非 CACFP 地点相比，51.6%比 27.9%，P<.001）总体上更遵守 AB2084。
自 2012 年以来，加利福尼亚州儿童保育中的饮料政策遵守情况有所改善，并且在 CACFP 地点和中心更高。应鼓励为非 CACFP 地点和家庭提供更多的政策推广和实施支持。其他州也应考虑采取此类政策。
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