ABC Grow Healthy Practices and Obesity-Related Health Behaviours in Family Child Care Homes in South Carolina.

Data were collected before ABC homes were required to implement Grow Healthy standards, so the study cannot show what the standards would do. Sleep was parent-reported, and the paper notes parents often overestimate children's sleep duration. Parent diet and health behaviors were self-reported and may be subject to response bias. The sample was limited to South Carolina family child care homes, so results may not apply to other child care settings or states. Children's BMI z-scores were high, and BMI is not the best indicator of body fatness in children. ABC and non-ABC homes differed in race/ethnicity and parent income, which may make the groups hard to compare. The comparison was observational, not randomized, so differences cannot be attributed to ABC enrollment.

The authors declared no conflicts of interest.

Do not read the lower fat and higher protein calorie shares as proof that ABC enrollment improved child health behaviors. Data were collected before the homes had to meet the standards, and there were no significant differences in physical activity, sedentary behavior, or sleep.