Early care and education (ECE) settings represent an important point of intervention for childhood obesity prevention efforts. The objective of this paper was to compare ECE licensing regulations for each Canadian province and territory to evidence-based, obesity prevention standards related to nutrition, physical activity, and screen time. While previous reviews of ECE regulations in the U.S. have been conducted, little is known about the Canadian context.
In 2019, existing ECE regulations were identified for each of the 13 provinces and territories in Canada. Using a detailed coding protocol, two authors systematically reviewed the regulations and examined whether the regulatory text supported each of the standards for nutrition (n=11), physical activity (n=5), and screen time (n=4). The standards were identified by obesity prevention experts as important benchmarks to promote healthy behaviors in ECE settings. Provinces and territories were evaluated on the strength of each standard (i.e., fully, partially, or not addressed), as well as a total comprehensiveness score (i.e., number of standards at least partially addressed, with a maximum score of 20). ECE centers and homes were examined separately.
Total comprehensiveness scores averaged 5.6 for centers and 5.2 for homes. The majority of provinces and territories required providers to follow Canada’s Food Guide, but few had regulations for specific foods or beverages (e.g., sugary drinks). Most provinces and territories included standards related to written menus and drinking water, but the strength of these standards was weak. A high proportion of provinces and territories required physical activity and outdoor opportunities to be provided daily, but few included a time requirement. Standards related to screen time were limited, with only two provinces including any standards.
Canadian ECE have few obesity-related regulations. These regulatory gaps highlight a strategy to prevent obesity among young Canadians.