Child and Adult Care Food Program Aligning Dietary Guidance for All (2011) / Chapter Skim
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To ensure that the meals and snacks provided by this crucial food program are of the highest quality possible, the USDA asked the Institute of Medicine (IOM) to review and recommend improvements, as necessary, to the Meal Requirements for CACFP.
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TASK AND APPROACH USDA requested that the IOM convene a panel of experts to undertake a study to review and recommend revisions to the CACFP Meal Requirements. The major objective was to develop practical recommendations that would bring CACFP meals and snacks into alignment with current dietary guidance.
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To address its task, the committee formulated a strategy that included the review of published literature and other available evidence, consideration of information from public workshop presentations, analyses of relevant data, and deliberations on topics relevant to its charge. Prior to proposing revisions to the CACFP Meal Requirements, the committee developed criteria to guide its deliberations.
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See Table S-1 for the recommended age groups. RECOMMENDATIONS As structured by the committee, the recommended Meal Requirements encompass two distinct elements: meal patterns and food specifications.
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Recommendations for Revised Meal Requirements: Meal Patterns and Food Specifications In order to bring the Meal Requirements into alignment with the best available dietary guidance and to improve consistency with the requirements of other FNS programs, the committee recommends that the FNS of USDA take the following steps: Meal Requirement Recommendation 1: USDA should adopt the recommended Meal Requirements for healthy infants up to 1 year of age. Key elements of this recommendation are the provision of only breast milk or formula for infants under 6 months of age; the gradual introduction of baby meats, cereals, fruits, and vegetables beginning at age 6 months; and the omission of fruit juice of any type before the age of 1 year.
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Fruit 2 per week ½ to 1 cup Vegetable 2 per week 1/8 to 1 cup Grains/breads 2 per week ½ to 2 ounce equivalent Lean meat/meat alternate 2 per week ½ to 1 ounce equivalent Milk 2 per week ½ cup aServing sizes vary by age group approximately the same level as for children 5–13 years of age. In addition, for several of the food groups, the amounts of food within the group are similar to those specified for the current meal patterns.
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As a result, the committee notes that weekly menu planning would help providers achieve the specified variety and adopt efficient new shopping patterns and ways to control costs. As shown in Table S-2, the recommended Meal Requirements differ in many important ways from those in the current regulations.
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8 CHILD AND ADULT CARE FOOD PROGRAM TABLE S-2 Comparison of Current Requirements with Recommended Meal Requirements and Specifications Recommended Requirements Eating Occasion Current Requirements and Specifications All Must meet daily pattern Must meet daily and weekly patterns to provide more flexibility and better alignment with the Dietary Guidelines Breakfast 3 meal components 4 or 5 meal components Lunch or supper 4 meal components 5 meal components Snack Any 2 of 4 components Variety specified for the week Choice between 2 small snacks or 1 enhanced snack Meal Component Fruit Fruits and vegetables are Fruits are a separate combined as a category category, and servings are increased; juice is not provided for infants and is limited for children; fruits containing added sugars are limited Vegetable Vegetables are a separate category from fruit, and servings are increased; must provide variety including dark green leafy, bright yellow/orange, legumes; sodium content is limited; starchy vegetables are limited Grain Enriched or whole grain, At least half must be proportions not specified whole grain-rich; additional whole grains are encouraged; grain products high in solid fats and added sugars are limited to control calories and saturated fat; high sodium grain products are also limited Meat/alternate None at breakfast Included in weekly breakfast No restrictions on high-fat, pattern highly processed meats Some types are limited to help control calories, solid fat, and sodium
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; food specifications limit highly processed and high fat meats and foods; moderate use of healthy fats is encouraged Sodium No restriction No salt at the table Recommendations to choose commercial foods low in sodium and to prepare foods with less salt NOTE: DRI 5 Dietary Reference Intake.
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The CACFP National Professional Association and the Child and Adult Care Food Program Sponsor's Association would be key partners. Several aspects of the existing monitoring and reimbursement processes will need to be revised to enable states to efficiently administer the CACFP program with the new recommended Meal Requirements in place.
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Program Evaluation Recommendation 1: USDA, in collaboration with relevant agencies, should provide support for research to evaluate the impact of the Meal Requirements on participants' total and program-related dietary intake and consumption patterns, on the food and nutrient content of the meals and snacks served, on demand from eligible providers to participate in CACFP, and on program access by participants. This evaluation would determine: (a)
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Review of the meal patterns and menus developed from the recommended Meal Requirements shows improved alignment with Dietary Guidelines (see Box S-3)
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Reduced use of pre-prepared foods and increased in-house food preparation would be helpful in reducing sodium, solid fats, added sugars, and cost; technical assistance would help develop the skills needed. Criterion 3: Appeal to Diverse Age Groups and Cultures The meal patterns allow broad flexibility in planning menus.
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CONCLUSION The new recommended Meal Requirements (meal patterns and food specification standards) will result in menus that are more closely aligned with the Dietary Guidelines for Americans and the DRIs than are the menus based on the current regulations.
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