Advertisement
Research Article| Volume 54, ISSUE 7, P610-620, July 2022

Download started.

Ok

Foods Served in Child Care Programs Participating in the Child and Adult Care Food Program and Alignment with Program Meal Patterns

Published:April 28, 2022DOI:https://doi.org/10.1016/j.jneb.2022.01.005

      Abstract

      Objective

      Assess Child and Adult Care Food Program (CACFP) program compliance with meal component requirements for children aged 3-5 years by program type, and describe foods and beverages most commonly served.

      Design

      Cross-sectional analysis of 1-week menu surveys during winter/spring 2017.

      Setting

      US CACFP-participating child care programs.

      Participants

      Nationally representative multistage cluster sample of 664 programs: 222 child care centers, 247 Head Start programs, 195 family child care homes.

      Main Outcome Measure(s)

      Percentage of meals including required components; frequently served foods and beverages.

      Analysis

      Mean percentages; 2-tailed t tests; alpha = 0.05 significance level.

      Results

      Most breakfasts (97%), lunches (88%), and afternoon snacks (97%) included all required CACFP meal components. Most breakfasts included fruits (96%), but not vegetables; 16% included a meat/meat alternate. Most lunches (81%) included both fruits and vegetables. Afternoon snacks were mostly grains/breads (80%) and fruits (57%). Most frequently served foods included 1% unflavored milk and fresh fruits such as apples and bananas. Most menus limited juice, offered low-sugar cereal, and did not include flavored milk; very few menus included noncreditable foods with added sugar.

      Conclusions and Implications

      Most CACFP meals provided required components, but there is room for improvement, particularly for increasing vegetables served and limiting foods high in added sugar and fat.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access

      SNEB Member Login

      SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.

      Subscribe:

      Subscribe to Journal of Nutrition Education and Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Savage JS
        • Fisher JO
        • Birch LL.
        Parental influence on eating behavior: conception to adolescence.
        J Law Med Ethics. 2007; 35: 22-34
        • Birch LL.
        Development of food preferences.
        Annu Rev Nutr. 1999; 19: 41-62
        • Birch LL
        • Savage JS
        • Ventura A.
        Influences on the development of children's eating behaviours: from infancy to adolescence.
        Can J Diet Pract Res. 2007; 68: s1-s56
        • Anzman-Frasca S
        • Ventura AK
        • Ehrenberg S
        • Myers KP.
        Promoting healthy food preferences from the start: a narrative review of food preference learning from the prenatal period through early childhood.
        Obes Rev. 2018; 19: 576-604
        • Benjamin-Neelon SE.
        Position of the Academy of Nutrition and Dietetics: benchmarks for nutrition in child care.
        J Acad Nutr Diet. 2018; 118: 1291-1300
        • Spill MK
        • Johns K
        • Callahan EH
        • et al.
        Repeated exposure to food and food acceptability in infants and toddlers: a systematic review.
        Am J Clin Nutr. 2019; 109: 978S-989S
        • Ritchie LD
        • Boyle M
        • Chandran K
        • et al.
        Participation in the child and adult care food program is associated with more nutritious foods and beverages in child care.
        Child Obes. 2012; 8: 224-229
        • Sisson SB
        • Kiger AC
        • Anundson KC
        • et al.
        Differences in preschool-age children's dietary intake between meals consumed at childcare and at home.
        Prev Med Rep. 2017; 6: 33-37
        • Korenman S
        • Abner KS
        • Kaestner R
        • Gordon RA.
        The Child and Adult Care Food Program and the nutrition of preschoolers.
        Early Child Res Q. 2013; 28: 325-336
        • Zaltz DA
        • Hecht AA
        • Neff RA
        • et al.
        Healthy eating policy improves children's diet quality in early care and education in South Carolina.
        Nutrients. 2020; 12: 1753
        • Benjamin-Neelon SE
        • Vaughn AE
        • Tovar A
        • Østbye T
        • Mazzucca S
        • Ward DS.
        The family child care home environment and children's diet quality.
        Appetite. 2018; 126: 108-113
        • Snyder TD
        • de Brey C
        • Dillow SA.
        Digest of Education Statistics 2018 (NCES 2020-009).
        National Center for Education Statistics, Institute of Education Sciences, U.S. Department of Education, 2020 (Accessed February 16, 2022)
      1. Food and Nutrition Service, United States Department of Agriculture. Why CACFP is important. Food and Nutrition Service, United States Department of Agriculture; 2013.https://www.fns.usda.gov/cacfp/why-cacfp-important. Accessed February 16, 2022.

      2. Food and Nutrition Service, United States Department of Agriculture. Child nutrition tables. Food and Nutrition Service, United States Department of Agriculture; 2022.https://www.fns.usda.gov/pd/child-nutrition-tables. Accessed August 11, 2021.

        • U.S. Department of Health and Human Services and U.S. Department of Agriculture
        2015–2020 Dietary Guidelines for Americans.
        8th ed. 2015 (U.S. Department of Health and Human Services and US Department of Agriculture; 2015.) (Accessed January 15, 2022)
      3. US Department of Agriculture. Child and Adult Care Food Program: Best Practices. US Department of Agriculture.https://fns-prod.azureedge.net/sites/default/files/cacfp/CACFP_factBP.pdf. Accessed January 15, 2022.

        • Dave JM
        • Cullen KW.
        Foods served in child care facilities participating in the Child and Adult Care Food Program: menu match and agreement with the new meal patterns and best practices.
        J Nutr Educ Behav. 2018; 50: 582-588
        • Erinosho T
        • Vaughn A
        • Hales D
        • Mazzucca S
        • Gizlice Z
        • Ward D.
        Participation in the child and adult care food program is associated with healthier nutrition environments at family child care homes in Mississippi.
        J Nutr Educ Behav. 2018; 50: 441-450
        • Schwartz MB
        • Henderson KE
        • Grode G
        • et al.
        Comparing current practice to recommendations for the Child and Adult Care Food Program.
        Child Obes. 2015; 11: 491-498
        • Gurzo K
        • Lee DL
        • Ritchie K
        • et al.
        Child care sites participating in the federal Child and Adult Care Food Program provide more nutritious foods and beverages.
        J Nutr Educ Behav. 2020; 52: 697-704
      4. Fox MK, Glantz FB, Geitz L, Burstein N. Early Childhood and Child Care Study: Nutritional Assessment of the CACFP: Final Report Volume II. US Government Printing Office; US Department of Agriculture, Food and Consumer Service, Office of Analysis and Evaluation Publication; 1997.

        • Logan CW
        • Connor P
        • LeClair LB
        • et al.
        Study of Nutrition and Activity in Child Care Settings: Appendix A.
        US Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 2021 (Accessed January 15, 2022)
      5. The American Association for Public Opinion Research. Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. 9th ed. AAPOR; 2016.https://www.aapor.org/AAPOR_Main/media/publications/Standard-Definitions20169theditionfinal.pdf. Accessed January 15, 2022.

        • Crepinsek MK
        • Burstein N
        • Lee EB
        • Kennedy SD
        • Hamilton WL.
        Meals Offered by Tier 2 CACFP Family Child Care Providers—Effects of Lower Meal Reimbursements: A Report to Congress on the Family Child Care Homes Legislative Changes study.
        Economic Research Service, US Department of Agriculture, 2002 (Accessed January 15, 2022)
        • Fox MK
        • Condon E
        • Crepinsek MK
        • et al.
        School Nutrition Dietary Assessment Study IV, Vol. I: School Foodservice Operations, School Environments, and Meals Offered and Served.
        US Department of Agriculture, Food and Nutrition Service, Office of Research and Analysis, 2012
        • United States Department of Agriculture, Food and Nutrition Service
        Crediting Handbook for the Child and Adult Care Food Program.
        US Department of Agriculture, 2014
        • Benjamini Y
        • Hochberg Y.
        Controlling the false discovery rate: a practical and powerful approach to multiple testing.
        J R Stat Soc B. 1995; 57: 289-300
      6. Food and Nutrition Service, United States Department of Agriculture. Nutrition Standards for CACFP Meals and Snacks. Food and Nutrition Service, United States Department of Agriculture; 2013. https://www.fns.usda.gov/cacfp/meals-and-snacks. Accessed March 3, 2022.

        • Mandal B
        • Powell LM.
        Child care choices, food intake, and children's obesity status in the United States.
        Econ Hum Biol. 2014; 14: 50-61
      7. Administration for Children and Families. Head Start Policy and Regulations: 1302.44 Child nutrition.https://eclkc.ohs.acf.hhs.gov/policy/45-cfr-chap-xiii/1302-44-child-nutrition. Accessed January 15, 2022.

        • United States Department of Agriculture
        Child and Adult Care Food Program: meal pattern revisions related to the Healthy, Hunger-Free Kids Act of 2010; final rule.
        Federal Register. 2016; 81 (Accessed January 15, 2022): 24348-24383
      8. United States Department of Agriculture. Child meal pattern. https://fns-prod.azureedge.net/sites/default/files/cacfp/CACFP_childmealpattern.pdf. Accessed January 15, 2022.

      9. United States Department of Agriculture. Updated child and adult care food program meal patterns: child and adult meals.https://fns-prod.azureedge.net/sites/default/files/cacfp/CACFP_MealBP.pdf. Accessed January 15, 2022.

        • Birch LL
        • Johnson SL
        • Fisher JA
        Pennsylvania State University, University P. Children's eating: the development of food-acceptance patterns.
        Young Child. 1995; 50: 71-78
        • Dixon LB
        • Breck A
        • Kettel Khan L
        Comparison of children's food and beverage intakes with national recommendations in New York City child-care centres.
        Public Health Nutr. 2016; 19: 2451-2457
        • Benjamin Neelon SE
        • Vaughn A
        • Ball SC
        • McWilliams C
        • Ward DS.
        Nutrition practices and mealtime environments of North Carolina child care centers.
        Child Obes. 2012; 8: 216-223
        • Logan CW
        • Connor P
        • LeClair LB
        • et al.
        Summary of Findings: The Study of Nutrition and Activity in Child Care Settings.
        US Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 2021 (Accessed January 15, 2022)
        • Ritchie LD
        • Sharma S
        • Gildengorin G
        • Yoshida S
        • Braff-Guajardo E
        • Crawford P.
        Policy improves what beverages are served to young children in child care.
        J Acad Nutr Diet. 2015; 115: 724-730
        • Copeland KA
        • Benjamin Neelon SE
        • Howald AE
        • Wosje KS.
        Nutritional quality of meals compared to snacks in child care.
        Child Obes. 2013; 9: 223-232
        • Chriqui JF
        • Leider J
        • Schermbeck RM.
        Early childhood education centers’ reported readiness to implement the updated Child and Adult Care Food Program meal pattern standards in the United States, 2017.
        Child Obes. 2018; 14: 412-420
        • Zaltz DA
        • Hecht AA
        • Pate RR
        • Neelon B
        • O'Neill JR
        • Benjamin-Neelon SE
        Participation in the Child and Adult Care Food Program is associated with fewer barriers to serving healthier foods in early care and education.
        BMC Public Health. 2020; 20: 856
        • Zaltz DA
        • Pate RR
        • O'Neill JR
        • Neelon B
        • Benjamin-Neelon SE
        Barriers and facilitators to compliance with a state healthy eating policy in early care and education centers.
        Child Obes. 2018; 14: 349-357
        • Chriqui JF
        • Leider J
        • Schermbeck RM
        • Sanghera A
        Pugach O. Changes in Child and Adult Care Food Program (CACFP) practices at participating childcare and Education Centers in the United States following updated national standards, 2017–2019.
        Nutrients. 2020; 12
      10. USDA Food and Nutrition Service. Child and Adult Care Food Program National Data Bank Version 8.2: Internal Report for FY19. USDA-FNS National Data Bank; 2021.

      11. US Government. 7 CFR 226.16 Sponsoring organization provisions 2021.https://www.govinfo.gov/content/pkg/CFR-2021-title7-vol4/pdf/CFR-2021-title7-vol4-part226.pdf. Accessed November 30, 2021.