A Scoping Review of Nutritional Guidelines and Practices in Day Care Centers

The first 3 years of life represent a critical period for shaping long-term health patterns, with day care centers offering strategic settings for implementing early nutritional interventions. This scoping review aimed to analyze existing guidelines and recommendations for food provision in day care centers, identifying common principles, existing gaps, and inconsistencies. Searches were performed in Google Scholar and on the official websites of national/regional health ministries from December 2024 to January 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Checklist. Twenty-nine official documents from 17 countries were included from the gray literature. Findings revealed wide heterogeneity in age ranges, portion sizes, and recommended food frequencies. Most guidelines recommend the daily inclusion of breast milk, meat, fish, eggs, vegetables, fruits, and dairy products. There was broad consensus on limiting added sugars and salt. Nonetheless, several gaps were identified: Common inclusion of red and processed meat, insufficient emphasis on fish and plant-based protein sources, underpromotion of whole grains, and some permissiveness toward fruit juices and ultraprocessed foods. Also, quantitative recommendations were often incomplete, and few guidelines addressed vegetarian diets and texture progression. The review highlights the urgent need for harmonized, evidence-based, and contextually nutritional guidelines tailored to day care centers. Standardized frameworks could improve food provision quality, contribute to healthier eating habits in early childhood, and support long-term benefits for public health outcomes. This scoping review is registered in the Open Science Framework (DOI: 10.17605/OSF.IO/CWG8E).