Knowledge and use of voluntary food and drink guidelines in English nurseries? Results from a nationally representative cross-sectional study

Good nutrition in early life is vital for healthy development, and sets the stage for good health throughout the life-course. Most children aged 0–4 years old in the UK spend at least some time each week in an early years’ setting (EYS), such as a nursery or childminder. Unlike schools which serve older children, there are no statutory standards for the food and drinks served to the youngest children in EYS, despite the potential for greater public health gains due to early intervention. Two comprehensive, age-appropriate voluntary guidelines were developed, one called the Example Menus for Early Years Settings in England by the government and another, called Eat Better, Start Better by a charity. Both are seen as standard across the sector. To assess nurseries’ awareness and use of voluntary guidelines, including how they are used and how they can be improved upon, and examine how these vary by socioeconomic deprivation and setting types (private nurseries and voluntary, community and charity nurseries), we conducted the first nationally representative cross-sectional survey of nurseries in England via an online survey. Using frequency distributions and binomial multivariate logistic regression models, considerable discrepancies between awareness (82.6 %) and use (48.8 %) of available EYS dietary guidelines were found. A key reason for not using guidelines was ‘I know what is healthy without them.’ The question about whether following food and drink guidelines should be voluntary or statutory generated mixed findings. More research is required to understand the factors influencing nurseries’ views on whether guidelines should be voluntary or statutory.