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Young children's food in Liverpool day-care settings: a qualitative study of pre-school nutrition policy and practice

  • Ffion Lloyd-Williams (a1), Katie Bristow (a1), Simon Capewell (a1) and Modi Mwatsama (a2)

To explore nutrition and food provision in pre-school nurseries in order to develop interventions to promote healthy eating in early years settings, especially across deprived communities.


An ethnographic approach was used combining participant observation with semi-structured interviews. Research participants were selected purposively using convenience sampling.


Community pre-school nurseries.


Nursery managers (n 9), cooks (n 6), staff (n 12), parents (n 12) and children at six nurseries (four private and two attached to children's centres) in Liverpool, UK.


Private nurseries had minimal access to information and guidelines. Most nurseries did not have a specific healthy eating policy but used menu planning to maintain a focus on healthy eating. No staff had training in healthy eating for children under the age of 5 years. However, enthusiasm and interest were widespread. The level and depth of communication between the nursery and parents was important. Meal times can be an important means of developing social skills and achieving Early Years Foundation Stage competencies.


Nurseries are genuinely interested in providing appropriate healthy food for under-5s but require support. This includes: improved mechanisms for effective communication between all government levels as well as with nurseries; and funded training for cooks and managers in menu planning, cost-effective food sourcing and food preparation. Interventions to support healthy eating habits in young children developed at the area level need to be counterbalanced by continued appropriate national-level public health initiatives to address socio-economic differences.

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1. Bundred P, Kitchiner D & Buchan I (2001) Prevalence of overweight and obese children between 1989 and 1998: population based series of cross sectional studies. BMJ 322, 326328.
2. Goran MI (2001) Metabolic precursors and effects of obesity in children: a decade of progress, 1990–1999. Am J Clin Nutr 73, 158171.
3. Kotani K, Nishida M, Yamashita S et al. (1997) Two decades of annual medical examinations in Japanese obese children: do obese children grow into obese adults? Int J Obes Relat Metab Disord 21, 912921.
4. Whitaker RC, Wright JA, Pepe MS et al. (1997) Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 337, 869873.
5. Caballero B (2001) Early nutrition and risk of disease in the adult. Public Health Nutr 2, 335336.
6. Jacobi C, Agras WS, Bryson S et al. (2003) Behavioral validation, precursors, and concomitants of picky eating in childhood. J Am Acad Child Adolesc Psychiatry 42, 7684.
7. Liem DG & Mennella JA (2002) Sweet and sour preferences during childhood: role of early experiences. Dev Psychobiol 41, 388395.
8. Mennella JA, Ziegler P, Briefel R et al. (2006) Feeding Infants and Toddlers Study: the types of foods fed to Hispanic infants and toddlers. J Am Diet Assoc 106, Suppl. 1, S96S106.
9. Thomas J, Sutcliffe K, Harden A et al. (2003) Children and Healthy Eating: A Systematic Review of Barriers and Facilitators. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London; available at
10. Foresight (2007) Tackling Obesity: Future Choices – Project Report, 2nd ed. London: Government Office for Science, Department of Innovation Universities and Skills; available at
11. Welsh Assembly Government (2007) Schools in Wales: General Statistics 2007. Cardiff: Welsh Assembly Government; available at
12. Pre-school Learning Alliance (2006) Act Now to bridge the early years nutrition gap says Alliance, as it launches new training scheme for practitioners. Press release, 26 January. (accessed May 2010).
13. Department for Education and Skills (2005) Healthy School Lunches for Pupils in Nursery Schools/Units. Guidance for School Caterers on Implementing National Nutrition Standards. Nottingham: DfES Publications; available at
14. Crawley H (2006) Eating Well for Under-5s in Child Care: Practical Nutritional Guidelines, 2nd ed. St Austell: Caroline Walter Trust; available at
15. Organix & Soil Association (2008) Georgie Porgie Pudding and Pie: Exposing the Truth about Nursery Food. Bristol: Organix & Soil Association; available at
16. Sharp L, Mucavele P & Nelson M (2010) Preliminary Review of Early Years Food, Nutrition and Healthy Eating Guidance in England: A Summary. London: School Food Trust.
17. Heart of Mersey (2006) Nursery Food Provision, Policy and Practice across Cheshire and Merseyside. Report of a Survey of Food Provision in Nurseries across Cheshire and Merseyside to Support the Big Noise Social Marketing Project. Liverpool: Heart of Mersey; available at,_Po.pdf
18. Sefton Council (2007) Food and Nutrition in Nursery Settings: Project Report 2006–2007. Southport: Sefton Council, Environmental Protection; available at
19. Shaw J & Mindlin M (2006) Are Children in Childcare Given Snacks which Comply with National Guidelines?. Teddington: Richmond and Twickenham PCT, St Georges University of London.
20. Moore H, Nelson P, Marshall J et al. (2005) Laying foundations for health: food provision for under 5s in day care. Appetite 44, 207213.
21. East Sussex County Council (2007) Nipper's Nutrition: A Study into the Nutritional Quality of Meals Provided by Local Nurseries for Children Less Than Five Years Old. Lewes: East Sussex County Council Trading Standards Service; available at
22. Local Authorities Government Co-ordinators of Regulatory Services (2010) Councils working with nurseries to improve nutritional standards. London: LACORS; available at
23. School Food Trust (2010) Advisory Panel on Food and Nutrition in Early Years. (accessed May 2010).
24. Lambert H & McKevitt C (2002) Anthropology in health research: from qualitative methods to multidisciplinarity. BMJ 325, 210213.
25. Ritchie J, Lewis J & Elam G (2003) Designing and selecting samples. In Qualitative Research and Practice: A Guide for Social Science Students and Researchers, pp. 77108 [J Ritchie and J Lewis, editors]. London: Sage Publications.
26. Kuper A, Reeves S & Levinson W (2008) An introduction to reading and appraising qualitative research. BMJ 337, a288.
27. Seale C (editor) (2004) Coding and analysing data. In Researching Society and Culture, pp. 305321. London: Sage Publications.
28. Parker M, Dexter N, Kelly A et al. (2010) Nursery Nutrition and Food Provision in Liverpool Final Report. Liverpool: Liverpool First For Health and Wellbeing Partnership.
29. Segal DG & Sanchez JC (2001) Childhood obesity in the year 2001. Endocrinologist 11, 296306.
30. Dinsdale H & Ridler C (2010) National Child Measurement Programme: Change in Children's Body Mass Index between 2006/07 and 2008/09. Oxford: National Obesity Observatory.
31. Department of Health (2004) Choosing Health: Making Healthier Choices Easier. London: The Stationery Office; available at
32. Department for Education and Skills & Department of Health (2006) National Service Framework for Children, Young People and Maternity Services: The Mental Health and Psychological Wellbeing of Children and Young People. London: DH Publications; available at
33. Swanton K & Frost M (2007) Lightening the Load: Tackling Overweight and Obesity. A Toolkit for Developing Local Strategies to Tackle Overweight and Obesity in Children and Adults. London: National Heart Forum in association with the Faculty of Public Health; available at
34. Cross-Government Obesity Unit, Department of Health & Department of Children, Schools and Families (2008) Healthy Weight, Healthy Lives: A Cross-Government Strategy for England. London: DH Publications; available at
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Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
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