November 4th, 2010

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Meals and snacks served to children and adults at day care facilities through a federally supported food program should contain increased amounts and varieties of vegetables and fruits and less fat, salt, and added sugars, says a new report from the Institute of Medicine.  The report’s recommendations will bring the nutrition standards of the Child and Adult Care Food Program (CACFP) in line with the latest nutrition science and dietary guidelines used in other federal food programs, including the National School Lunch and School Breakfast programs.

CACFP is a U.S. Department of Agriculture food program that helps facilities such as family day care homes, traditional child care centers, places that offer care outside of school hours, adult care facilities, and emergency shelters provide nutritious meals and snacks to children and adults from low-income families.  The program reimburses sites for the foods they serve if they meet CACFP standards.  Roughly 3 million children and 114,000 functionally impaired adults and other adults over age 60 received meals and snacks through the program in fiscal year 2010.

The report builds on existing CACFP requirements for meals, such as specifying a minimum amount of foods in each meal and excluding soft drinks and candy.  The report also calls for each meal to include one serving of fruit and two of vegetables and for the amount of dark green and orange vegetables served each week to increase while limiting starchy vegetables to no more than twice a week.  Fresh, frozen, canned, and dried forms are all acceptable.  Vegetables may be cooked any way except fried.  Juice should be 100 percent fruit juice without added sugars, should not be given to children less than a year old, and should be limited to once a day for older day care participants.

In addition, at least half of the grain products served should be rich in whole grains.  Baked or fried grain products that are high in fat and added sugars would be allowed only once a week.  Day care facilities should limit their use of foods and ingredients that are high in sodium, saturated fat, trans fat, and added sugars; controlling fats and added sugars will help keep calories in check.  Sites should use vegetable oils and limited amounts of salt when preparing meals.  Meats should be lean; soy products, beans, eggs, nuts, and other meat alternatives may be used.

Healthy infants should receive only breast milk or formula until they reach six months, when day care sites should gradually introduce baby foods.  Children should be given whole milk until age 2.  Milk provided to participants age 2 and older should contain no more than 1 percent fat.

Day care providers will need resources and assistance to comply with the changes, noted the committee that wrote the report.  USDA personnel should work with state agencies and health professionals to help participating sites plan menus and purchase and prepare foods.  USDA will need to re-evaluate and streamline the way CACFP monitors facilities’ compliance with the standards and reimburses them.

“The meals and snacks made possible through the Child and Adult Care Food Program are an important source of nutrition for millions of children and tens of thousands of adults,” said committee chair Suzanne P. Murphy, researcher, professor, and director of the Nutrition Support Shared Resource, Cancer Research Center of Hawaii, University of Hawaii, Honolulu.  “This report points the way to updating the program’s meal requirements so that they reflect the latest nutrition science.  The changes recommended will help program beneficiaries get more of the nutrients they need without getting too many calories and will promote lifelong healthy eating habits.”

The study was sponsored by the U.S. Department of Agriculture.  Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public.  The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.