The Child and Adult Care Food Program (CACFP) is a federally-funded program designed to provide healthy meals and snacks to children and adults while receiving day care at participating family day care homes, traditional child care centers, afterschool facilities, adult care facilities, and emergency shelters. CACFP has the broadest scope of any of the U.S. Department of Agriculture (USDA) food program, serving more than 3 million children and 114,000 adults across the nation. To receive reimbursement for the foods served, participating programs must abide by requirements set by the USDA.

Child and Adult Care Food Program assesses the nutritional needs of the CACFP population based on Dietary Guidelines for Americans and the Dietary Reference Intakes (DRIs) and makes recommendations for revisions to the CACFP meal requirements. The book outlines meal requirements that include food specifications that could be used for specific meals and across a full day, covering all age groups from infants to older adults and meal patterns designed for use in a variety of settings, including in-home care and in large centers. By implementing these meal requirements, consumption of fruits, vegetables, and whole-grain rich foods will increase while consumption of solid fats, added sugars, and sodium will decrease. Not only will this address the high prevalence of childhood obesity, it will also help to achieve consistency with the standards and regulations of other USDA nutrition assistance programs, particularly the Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the National School Lunch and School Breakfast programs.

Child and Adult Care Food Program makes practical recommendations that would bring CACFP meals and snacks into alignment with current dietary guidance. The book will serve as a vital resource for federal and state public health officials, care providers working in child and adult day care facilities, WIC agencies, officials working with the National School Lunch and School Breakfast programs, and other organizations serving at-risk populations.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE TO REVIEW CHILD AND ADULT CARE FOOD PROGRAM MEAL REQUIREMENTS
• Reviewers
• Preface
• Summary
• 1. Introduction
  • THE COMMITTEE’S TASK
  • RATIONALE FOR REVISING THE MEAL REQUIREMENTS
  • ORGANIZATION OF THE REPORT
  • REFERENCES
• 2. The Child and Adult Care Food Program
  • PROGRAM OVERVIEW
  • PROGRAM SETTINGS
  • CLIENT CHARACTERISTICS
  • HISTORY AND GROWTH OF THE PROGRAM
  • ADMINISTRATION AND REGULATIONS
  • MONITORING THE QUALITY OF CACFP MEALS
  • CACFP AS PART OF THE FOOD AND NUTRITION SAFETY NET
  • SUMMARY
  • REFERENCES
• 3. Methods for Examining Food and Nutrient Intakes
  • FOOD AND NUTRIENT DATA SOURCES
  • STANDARDS USED TO REVIEW FOOD INTAKES
  • THE DETERMINATION OF AGE GROUPS, BODY WEIGHTS AND HEIGHTS, AND ESTIMATED CALORIE REQUIREMENTS
  • FOOD INTAKE EVALUATION
  • NUTRIENT INTAKE EVALUATION
  • SUMMARY
  • REFERENCES
• 4. Nutritional Considerations for Infants and Children
  • FOOD INTAKES
  • NUTRIENT INTAKES
  • SPECIAL NUTRITIONAL CONSIDERATIONS
  • REFERENCES
• 5. Nutritional Considerations for Adults
  • FOOD INTAKES
  • ENERGY AND NUTRIENT INTAKES
  • SPECIAL NUTRITIONAL CONSIDERATIONS
  • FOODS AND NUTRIENTS TO BE ENCOURAGED OR LIMITED
  • REFERENCES
• 6. Process for Developing Recommendations for Meal Requirements
  • CRITERIA
  • OVERALL APPROACH TO DEVELOPING RECOMMENDATIONS
  • ESTABLISHING CALORIE AND NUTRIENT TARGETS
  • DEVELOPING MEAL REQUIREMENTS
  • SUMMARY
  • REFERENCES
• 7. Recommendations for Meal Requirements
  • RECOMMENDED MEAL REQUIREMENTS
  • RECOMMENDED MEAL AND SNACK PATTERNS
  • FOOD SPECIFICATIONS
  • TRANSLATING MEAL REQUIREMENTS INTO MENUS
  • COMPARISON BETWEEN CURRENT AND RECOMMENDED MEAL REQUIREMENTS
  • SUMMARY
  • REFERENCES
• 8. Meal Cost Implications
  • PROJECTED CHANGES IN FOOD COSTS
  • NON-FOOD MEAL COSTS
  • SUMMARY
  • REFERENCES
• 9. Implementation
  • PROMOTING THE IMPLEMENTATION OF KEY ELEMENTS OF THE RECOMMENDED MEAL REQUIREMENTS
  • RECOMMENDATIONS TO SUPPORT THE IMPLEMENTATION OF THE REVISED MEAL REQUIREMENTS
  • SUMMARY
  • REFERENCES
• 10. Consistency of Recommendations for Meal Requirements and Implementation Strategies with the Committee’s Criteria
  • OVERVIEW
  • RECOMMENDATIONS FOR MEAL REQUIREMENTS ARE CONSISTENT WITH THE CRITERIA
  • RECOMMENDATIONS FOR IMPLEMENTATION STRATEGIES ARE CONSISTENT WITH THE CRITERIA
  • SUMMARY
  • REFERENCES
• 11. Evaluation and Research Recommendations
  • RECOMMENDATIONS FOR EVALUATION
  • RECOMMENDATIONS FOR RESEARCH
  • SUMMARY
  • REFERENCES
• A Acronyms, Abbreviations, and Glossary
• B Biographical Sketches of Committee Members
• C Workshop Agenda: February 2010
• D Critical Issues for Consideration by the Committee to Review Child and Adult Care Food Program Meal Requirements, as Submitted by the U.S. Department of Agriculture
• E Current CACFP Meal Patterns
• F Selected Food Program Descriptions and Websites
• G Data Sources and Analytical Methods
• H MyPyramid Food Groups and Subgroups
• I Food Cost Approach and Methods
• J Nutrient Targets by Meal and Age Group and Comparison of MyPyramid Food Group and Nutrient Targets with Recommended Meal Patterns
• K Sample Menus
• L Options for Breastfeeding Incentives
• M Potential Partnerships to Assist with Technical Training for CACFP

This study was supported by Contract No. AG-3198-C-08-0001 between the National Academy of Sciences and the U.S. Department of Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine). 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.