Comparison of Preventing Childhood Obesity (PCO, 2010) with Caring For Our Children 3rd Edition (CFOC3, 2011)

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Comparison of Preventing Childhood Obesity (PCO, 2010) with
Caring For Our Children 3rd Edition (CFOC3, 2011)

Since the publication of Preventing Childhood Obesity in 2010, new information has become available and is featured in Caring for Our Children, 3rd Ed., 2011! The COMPARISON OF PCO 2010 AND CFOC3, 2011 will help you identify the differences between the two documents. The differences are highlighted! Updated language, enhancements, and clarifications are included.

Standards Related to Nutrition and Infant Feeding

Topic & Location	PCO	CFOC3
*Section 4.1* Nutrition Introduction Last Paragraph	Page 12 Dietary Guidelines for Americans, 2005 and My Pyramid for Kids are designed to support lifestyle behaviors that promote health, including a diet composed of a variety of healthy foods and physical activity at two years of age and older.	Page 52 2010 Dietary Guidelines for Americans and the U.S. Department of Agriculture's ChooseMyPlate.gov are designed to support lifestyle behaviors that promote health, including a diet composed of a variety of healthy foods and physical activity at two years of age and older.
*Standard 3.1.2.1* Routine health supervision and growth monitoring Standard Paragraph 1	Page 14 For children younger than twenty-four months of age, health supervision includes documentation and plotting of charts on standard sex-specific length, weight, weight for length, and head circumference and assessing diet and activity.	Page 89 For children younger than twenty-four months of age, health supervision includes documentation and plotting of sex-specific charts on child growth standards from the World Health Organization (WHO), available at http://www.who.int/childgrowth/ standards/en/, and assessing diet and activity.
*Standard 4.2.0.4* Categories of Foods Additional Resources Following food chart (See chart comparison at end of this document)	Page 18 U.S. Department of Health and Human Services, U.S. Department of Agriculture. 2005. Dietary guidelines for Americans, 2005. 6th ed. Washington, DC: U.S. Government Printing Office. http:// www.health.gov/dietaryguidelines/ dga2005/document/pdf/DGA2005.pdf. U.S. Department of Agriculture. 2008. MyPyramid for Kids. www.mypyramid.gov.	Page 155 U.S. Department of Health and Human Services, U.S. Department of Agriculture. 2011. Dietary guidelines for Americans, 2010. 7th ed. Washington, DC: U.S. Government Printing Office. http://www.health.gov/dietaryguidelines/ dga2010/DietaryGuidelines2010.pdf. U.S. Department of Agriculture. 2011. MyPlate. http://www .choosemyplate.gov.
*Standard 4.2.0.4* Categories of Foods Rationale Paragraph 1 Following food chart (See chart comparison at end of this document)	Page 19 Both the Dietary Guidelines for Americans, 2005 and the U.S. Department of Agriculture (USDA) identify and suggest use of food groups as a basis for making wise choices of nutritious foods from each of the five food groups.	Page 155 The Dietary Guidelines for Americans, 2010 and "The Surgeon General's Call to Action to Support Breast Feeding" support feeding nutritious foods and healthy lifestyles to prevent the onset of overweight and obesity and chronic diseases (1,2). From the very first feeding of an infant begins setting the stage for lifetime eating behavior.
*Standard 4.2.0.4* Categories of Foods Comments Paragraph 1 Following food chart (See chart comparison at end of this document)	Page 19 For more information on portion sizes and types of food, see CACFP Guidelines at http://www.fns.usda.gov/cnd/care/ ProgramBasics/Meals/Meal_Patterns.htm.	Page 156 Early Care and education settings should encourage mothers to breastfeed their infants. Scientific evidence documents and supports the nutritional and health contributions of human milk (2). For more information on portion sizes and types of food, see CACFP Guidelines at http://www.fns.usda.gov/cnd/care/ ProgramBasics/Meals/Meal_ Patterns.htm.
*Standard 4.3.1.1* General Plan for Feeding Infants Rationale Paragraph 4	Page 26 Except in the presence of rare genetic diseases, the clear advantage of human milk over any formula should lead to vigorous efforts . . .	Page 163 Except in the presence of rare medical conditions, the clear advantage of human milk over any formula should lead to vigorous efforts . . .
*Standard 4.3.1.5* Preparing, Feeding, and Storing Infant Formula Comments Paragraph 2	Page 32 The bottles must be sanitary, properly prepared and stored, and must be the same brand in the early care and education program and at home.	Page 168 Parents/guardians should supply enough clean and sterilized bottles to be used throughout the day. The bottles must be sanitary, properly prepared and stored, and must be the same brand in the early care and education program and at home.
*Standard 4.3.1.11* Introduction of Age-Appropriate Solid Foods to Infants Standard Paragraph 3	Page 35 One new food should be introduced at a time, followed by waiting a couple of days before introducing another new food.	Page 172 Evidence for introducing complementary foods in a specific order or rate is not available. The current best practice is that the first solid foods should be single-ingredient foods and should be introduced one at a time at two- to seven-day intervals (1).
*Standard 4.3.1.11* Introduction of Age-Appropriate Solid Foods to Infants Comments Paragraph 4	Page 35 This schedule of introducing new foods one at a time with at least a two-day trial period enables parents and caregivers/teachers to pinpoint any problems a child might have with any specific food.	Page 172 This schedule of introducing new foods one at a time, followed by waiting two to seven days before intro ducing another new food, enables parents and caregivers/teachers to pinpoint any problems a child might have with any specific food.
Appendices	Pages 60-62 My Pyramid for Preschoolers\ My Pyramid for Kids Enjoy Moving: Be Physically Active Every Day	Pages 459-460 Appendix Q – Getting Started with MyPlate Appendix R – Choose MyPlate Appendix S – Physical Activity: How Much is Needed

Standard 4.2.0.4 *If this chart is difficult to read in you browser, click here to view a clear, printable pdf

Food Charts

PCO Page 18

CFOC3 Page 155

Standards Related to Physical Activity and Screen Time

Topic & Location	PCO	CFOC3
Standard 3.1.3.1 Active Opportunities for Physical Activity Standard Paragraph 1	Page 51 The facility should promote children's active play every day. Children should have ample opportunity to do vigorous activities such as running, climbing, dancing, skipping, and jumping. All children, birth to six years, should participate daily in:	Page 90 The facility should promote children's active play every day. Children should have ample opportunity to do moderate to vigorous activities such as running, climbing, dancing, skipping, and jumping. All children, birth to six years, should participate daily in:
Standard 3.1.3.1 Active Opportunities for Physical Activity Standard Paragraph 2	Page 51 The total time allotted for outdoor play and vigorous indoor or outdoor physical activity can be adjusted for the age group and weather conditions.	Page 90 The total time allotted for outdoor play and moderate to vigorous indoor or outdoor physical activity can be adjusted for the age group and weather conditions.
Standard 3.1.3.1 Active Opportunities for Physical Activity Standard Paragraph 2b	Page 51 b) Total time allotted for vigorous activities: Toddlers should be allowed sixty to ninety minutes per eight-hour day for vigorous physical activity, including running;	Page 91 b) Total time allotted for moderate to vigorous activities: Toddlers should be allowed sixty to ninety minutes per eight-hour day for moderate to vigorous physical activity, including running;
Standard 3.1.3.1 Active Opportunities for Physical Activity Standard Paragraph 7	Page 52 Children should not be seated for more than fifteen minutes at a time, except during meals or naps. Infant equipment such as swings, stationary activity centers (ex. exersaucers), infant seats (ex. bouncers), molded seats, etc. if used should only be used for short periods of time. A least restrictive environment should be encouraged at all times. (5,6, 26).	Page 91 Infants should not be seated for more than fifteen minutes at a time, except during meals or naps. Infant equipment such as swings, stationary activity centers (ex. exersaucers), infant seats (ex. bouncers), molded seats, etc. if used should only be used for short periods of time. A least restrictive environment should be encouraged at all times (5,6,26).
Standard 3.1.3.1 Active Opportunities for Physical Activity Comments Paragraph 2	Page 53 • "How to Lower Your Risk for Type 2 Diabetes "National Diabetes Education Program http://ndep.nih.gov/media/kids-tips-lower-risk.pdf.	Page 92 f) "How to Lower Your Risk for Type 2 Diabetes: National Diabetes Education Program" – http://ndep.nih .gov/media/kids-tips-lower-risk.pdf; g) "Motion Moments" – http://nrckids.org/Motion _Moments/.
Standard 3.1.3.1 Active Opportunities for Physical Activity Comments Paragraph 3	Page 53 Experts disagree about the appropriate amount of physical activity for toddlers and preschoolers, what proportion of children's physical activity should be structured, and to what extent structured activities are effective in producing children's physical activity. Researchers do agree that toddlers and preschoolers generally accumulate vigorous physical activity over the course of the day in very short bursts (fifteen to thirty seconds) (23). For additional recommendations by other national groups and experts, see:	Page 92 Experts disagree about the appropriate amount of physical activity for toddlers and preschoolers, what proportion of children's physical activity should be structured, and to what extent structured activities are effective in producing children's physical activity. Researchers do agree that toddlers and preschoolers generally accumulate moderate to vigorous physical activity over the course of the day in very short bursts (fifteen to thirty seconds) (23). For additional recommendations by other national groups and experts, see:
Standard 3.1.3.1 Active Opportunities for Physical Activity Comments Paragraph 3	Page 53 2) U.S. Department of Health and Human Services and the U.S. Department of Agriculture's Dietary Guidelines for Americans, 2005 at http://www.health.gov/ dietaryguidelines/dga2005/document/default.htm.	Page 92 c) U.S. Department of Health and Human Services and the U.S. Department of Agriculture's Dietary Guidelines for Americans, 2010 at http://www.cnpp.usda .gov/DGAs2010-DGACReport.htm.
Standard 3.1.3.2 Playing Outdoors Standards and Comments	In order to make this standard more reader friendly, content was significantly rearranged but was not changed. Read the standards for comparison. Pages 54-55 in PCO Pages 93-94 in CFOC3
Standard 3.1.3.3 Protection from Air Pollution While Children are Outside All	New since PCO Not in PCO Pages 94-95 in CFOC3
Standard 3.1.3.4 Caregivers'/ Teachers' Encouragement of Physical Activity Standard Paragraph 1	Page 55 g) Limit screen time (TV, DVD, computer).	Pages 93-94 g) Limit screen time (TV, DVD, computer, etc.), except for 1) school-age children completing homework assignments and 2) children with special health care needs who require and consistently use assistive and adaptive computer technology.
Standard 3.1.3.4 Caregivers'/ Teachers' Encouragement of Physical Activity References	No references in PCO	Pages 95-96 REFERENCES: 1. Ward, D. S., A. Vaughn, C. McWilliams, D. Hales. 2010. Interventions for increasing physical activity at child care. Med Sci Sports Exercise 42:526-34. 2. Copeland, K. A., S. N. Sherman, C. A. Kendeigh, B. E. Saelens, H. J. Kalkwarf. 2009. Flip-flops, dress clothes and no coat: Clothing barriers to children's physical activity in child-care centers. Int J Behav Nutr Activ 74(6). 3. Trost, S. G., D. S. Ward, M. Senso. 2010. Effects of child care policy and environment on physical activity. Med Sci Sports Exercise 42:520-25. 4. Brown, W. H., K. A. Pfeiffer, K. L. McIver, M. Dowda, C. L. Addy, R. R. Pate. 2009. Social and environmental factors associated with preschoolers' nonsedentary physical activity. Child Devel 80:45-58.
Standard 9.2.3.1 Policies and Practices that Promote Physical Activity Standard Paragraph 1b	Page 56 b) Duration: children will spend sixty to ninety minutes each day outdoors depending on their age, weather permitting. Policies will describe what will be done to ensure physical activity on days with more extreme temperatures (either very hot or very cold);	Page 353 b) Duration: children will spend sixty to one hundred and twenty minutes each day outdoors depending on their age, weather permitting. Policies will describe what will be done to ensure physical activity and provisions for gross motor activities indoors on days with more extreme conditions (i.e., very wet, very hot, or very cold);
Standard 2.2.0.3 Limiting Screen Time – Media, Computer Time Standard Paragraph 1	Page 58 In early care and education settings, media (television [TV], video, and DVD) viewing and computer use should not be permitted for children younger than two years. For children two years and older in early care and early education settings, total media time should be limited to not more than thirty minutes once a week, and for educational or physical activity use only. During meal or snack time, TV, video, or DVD viewing should not be allowed (1). Computer use should be limited to no more than fifteen-minute increments except for school-age children completing homework assignments (2).	Page 67 In early care and education settings, media (television [TV], video, and DVD) viewing and computer use should not be permitted for children younger than two years. For children two years and older in early care and early education settings, total media time should be limited to not more than thirty minutes once a week, and for educational or physical activity use only. During meal or snack time, TV, video, or DVD viewing should not be allowed (1). Computer use should be limited to no more than fifteen-minute increments except for school-age children completing homework assignments (2) and children with special health care needs who require and consistently use assistive.