There appears to be variation in food provision in childcare settings across England, as well as variation in the healthy eating guidelines available and/or used by childcare settings, and this is likely to lead to differences in food provision and nutritional health in under-fives. Given the nutritional vulnerability of under-5 year-olds, sub-par nutrition in early years can lead to differences in nutrition-related diseases in later life, as well as considerable health and socio-economic inequalities. Diet at the earliest stages of life plays a crucial role in determining the major chronic diseases currently faced by the English population, including cardiovascular disease, diabetes and certain cancers.
A majority of young children are cared for either part-time or full time by a form of childcare service in England, and so early years’ settings have a fundamental role in establishing good nutritional health in the 0-5 age group. While there are representative data on children aged 18 months and over in the National Diet and Nutrition Survey and since 2011 data on dietary intake of infants, there are relatively few studies on, and no nationally representative data on, nutritional intake or provision in early years’ settings caring for children under-5 years of age in England. This research provides an opportunity to analyse the role of early years’ settings in food provision and nutrition in England, and inequalities in toddlers’ access to healthy food, in the context of suboptimal diets and existence of nutritional ill-health in young children in England.
This project sets out to analyse food provision in early years’ settings across England, how it is decided and to identify ways to reduce any potential inequalities in uptake of guidance, food provision and indirectly, child health. It has three objectives:
- To understand food provision practices in early years’ settings across England, including assessing awareness and uptake of dietary guidance via stakeholder interviews, a national survey of food provision in early years settings, and focused case studies;
- To analyse the mechanisms by which inequalities, if present, are introduced into the current system of food provision in early years settings;
- To co-create (with key stakeholders) a strategy to reduce inequalities in food provision in early years’ settings, based on areas which require change, as indicated by the findings.
There will be three main stages to this research:
- A review of practice and evidence in England comprising (1) stakeholder interviews to understand food provision in early years settings and to inform a nationally representative survey; (2) a nationally representative survey of food provision in early years’ settings to capture data on food provision approaches, menu planning, differences in awareness, understanding, uptake of early years dietary guidelines; and (3) in-depth case studies of sub-sample of early years settings to allow for greater exploration, according to types of setting and area of deprivation, of factors such as menu planning and food provision.
- System mapping sessions using Group Model Building method, with key stakeholders to explore any issues raised in the stage 1 of the research, for example analysing the mechanisms within which inequalities (for example in guidelines on food provision) are manifested in the current system of early years’ settings, and potential practical solutions to these problems.
- “Transformation labs” with key stakeholders building on the previous stages of research, to co-create a change strategy (to be defined based on need).
Through a range of presentations and publications, it is expected that the findings from this research will contribute to achieving several current policy commitments including:
- the Government's vision for putting prevention at the heart of the nation's health, as expressed in the policy paper “Prevention is better than cure”;
- the Childhood Obesity Plan which has a specific focus on early years’ settings and the need to support them to contribute to healthy weight via healthy food provision and nutritional guidance; and
- Public Health England’s ambitious programme on sugar reduction, which will as of 2019 focus on product ranges aimed exclusively at babies and young children.