Do Early Learning Service Menus Meet Healthy Food and Drink and Choking Guidance in New Zealand? ^†

Abstract

Healthy food and drink guidance for early learning services (ELS) provided by the Ministry of Health (MoH) assists ELS to develop policies and practices to promote healthy eating habits in childhood. This study aimed to assess alignment of food and drinks served to NZ children in ELS with the MoH Healthy Food and Drink and choking guidance. Menus (n = 271) collected remotely from 148 ELS between November 2020 and March 2021 were analysed for their nutritional quality (percentage of ‘green’, ‘amber’, and ‘red’ menu items) using a scoring system based on the MoH guidance. Points were awarded based on the availability of healthy (green) menu items and the exclusion of unhealthy (red) menu items. Overall, of all menus, 2.6% met the MoH Healthy Food and Drink guidance and one-fifth (18.5%) met the MoH choking guidance. Menus for children over two-year-olds (over-2s) scored, on average, 12% higher than menus for children under two-year-olds (under-2s; p < 0.01). Services with a Health Heart Award from the NZ Heart Foundation provided more green items to over-2s (p = 0.04) and under-2s (p = 0.01) and less red items to over-2s (p = 0.04). Providing more green menu items was inversely correlated with providing less high-choking-risk foods (p < 0.01, r = −0.347 over-2s, r = −0.504 under-2s, respectively). Menu scores did not vary by service location, neighbourhood socioeconomic deprivation or type (services operating independently versus those part of an education group chain). Alignment with MoH nutritional guidance is low, particularly in ELS caring for very young children (under-2s). Service characteristics, except for Healthy Heart Award status, are a poor predictor of nutritional quality of menus at ELS. Greater uptake of the Healthy Heart Award scheme could assist ELS to provide healthier food and drinks, which may also reduce food-related choking risk.