Family Style Meal Service is Associated with Reduced Plate Waste in Nebraska Family Child Care Homes

<b><i>Background:</i></b> Family style meal service is a nationally endorsed best practice. However, implementation in family child care homes (FCCHs) is low because child care providers are worried that it could increase plate waste. To examine this perceived barrier, the study aims to investigate the association between family style meal service and plate waste in FCCHs in Nebraska. <b><i>Methods:</i></b> In this cross-sectional study, the participants included FCCH providers (<i>n</i> = 46) in Nebraska and 3-5-year-old children attending these FCCH settings (<i>n</i> = 146). Providers were given a family style meal service score using 11 items from the Mealtime Observation in Child Care tool. Children's plate waste data over the observed lunchtime were collected using the Dietary Observation in Child Care method. We conducted multivariate, multilevel regression analyses in SAS (v9.4) to assess the relationship between family style meal service score and children's plate waste, while controlling for child-level characteristics and accounting for FCCH setting-level effects (ICCs 11.3%-31.2%). <b><i>Results:</i></b> Increase in family style meal service score was associated with a decrease in vegetable waste (<i>B</i> = -4.7, <i>p</i> = 0.03), fruit waste (<i>B</i> = -3.6, <i>p</i> = 0.03), and protein waste (<i>B</i> = -4.2, <i>p</i> = 0.02). Dairy and grain waste were not associated with family style meal service score. <b><i>Conclusions:</i></b> A higher family style meal service score was associated with a 3%-5% reduction in plate waste for three food groups. These findings warrant further research examining the effect of interventions promoting family style meal service in child care on improving children's dietary intake and reducing plate waste.