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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions (2008)

Chapter: Appendix K Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating

« Previous: Appendix J MyPyramid Calorie Levels and Food Intake Patterns
Suggested Citation:"Appendix K Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating." Institute of Medicine. 2008. Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Washington, DC: The National Academies Press. doi: 10.17226/12512.
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Suggested Citation:"Appendix K Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating." Institute of Medicine. 2008. Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Washington, DC: The National Academies Press. doi: 10.17226/12512.
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Page 168
Suggested Citation:"Appendix K Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating." Institute of Medicine. 2008. Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Washington, DC: The National Academies Press. doi: 10.17226/12512.
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Page 169
Suggested Citation:"Appendix K Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating." Institute of Medicine. 2008. Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Washington, DC: The National Academies Press. doi: 10.17226/12512.
×
Page 170
Suggested Citation:"Appendix K Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating." Institute of Medicine. 2008. Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Washington, DC: The National Academies Press. doi: 10.17226/12512.
×
Page 171
Suggested Citation:"Appendix K Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating." Institute of Medicine. 2008. Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Washington, DC: The National Academies Press. doi: 10.17226/12512.
×
Page 172
Suggested Citation:"Appendix K Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating." Institute of Medicine. 2008. Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Washington, DC: The National Academies Press. doi: 10.17226/12512.
×
Page 173
Suggested Citation:"Appendix K Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating." Institute of Medicine. 2008. Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Washington, DC: The National Academies Press. doi: 10.17226/12512.
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Page 174

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Appendix K Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating The following tables include the Dietary Reference Intakes (DRIs) for schoolchildren. 167

168 TABLE K-1 DRIs: Estimated Average Requirements for Groups Life- Vitamin Vitamin Vitamin Ribo- Vitamin Vitamin Magnes- Molyb- Phos- Sele- Stage CHO Protein A C E Thiamin flavin Niacin B6 Folate B12 Copper Iodine Iron ium denum phorus nium Zinc Group (g/d) (g/d) (μg/d)a (mg/d) (mg/d)b (mg/d) (mg/d) (mg/d)c (mg/d) (μg/d)d (μg/d) (μg/d) (μg/d) (mg/d) (mg/d) (μg/d) (mg/d) (μg/d) (mg/d) Children 4–8 yr 100 15 275 22 6 0.5 0.5 6 0.5 160 1.0 340 65 4.1 110 17 405 23 4.0 Males 9–13 yr 100 27 445 39 9 0.7 0.8 9 0.8 250 1.5 540 73 5.9 200 26 1,055 35 7.0 14–18 yr 100 44 630 63 12 1.0 1.1 12 1.1 330 2.0 685 95 7.7 340 33 1,055 45 8.5 Females 9–13 yr 100 28 420 39 9 0.7 0.8 9 0.8 250 1.5 540 73 5.7 200 26 1,055 35 7.0 14–18 yr 100 38 485 56 12 0.9 0.9 11 1.0 330 2.0 685 95 7.9 300 33 1,055 45 7.3 Pregnant 14–18 yr 135 50 530 66 12 1.2 1.2 14 1.6 520 2.2 785 160 23 335 40 1,055 49 10.5 Lactating 14–18 yr 160 60 885 96 16 1.2 1.3 13 1.7 450 2.4 985 209 7 300 35 1,055 59 10.9 NOTE: This table presents Estimated Average Requirements (EARs), which serve two purposes: they are used to assess the adequacy of population intakes and as the basis for calculation of the Recommended Dietary Allowances for individuals for those nutrients. EARs have not been established for vitamin D, vitamin K, pantothenic acid, biotin, choline, calcium, chromium, fluoride, manganese, or other nutrients not yet evaluated by the DRI process. CHO = carbohydrates; g/day = grams per day; mg/day = milligrams per day; μg/d = micrograms per day. a As retinol activity equivalents (RAEs). 1 RAE = 1 μg retinol, 12 μg β-carotene, 24 μg α-carotene, or 24 μg β-cryptoxanthin. The RAE for dietary provitamin A carotenoids is two-fold greater than retinol equivalents (RE), whereas the RAE for preformed vitamin A is the same as RE. b As α-tocopherol. α-Tocopherol includes RRR-α-tocopherol, the only form of α-tocopherol that occurs naturally in foods, and the 2R-stereoisomeric forms of α-tocopherol (RRR-, RSR-, RRS-, and RSS-α-tocopherol) that occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of α-tocopherol (SRR-, SSR-, SRS-, and SSS-α-tocopherol), also found in fortified foods and supplements. c As niacin equivalents; 1 mg of niacin = 60 mg of tryptophan. d As dietary folate equivalents (DFE); 1 DFE = 1 µg food folate = 0.6 µg of folic acid from fortified food or as a supplement consumed with food = 0.5 µg of a supplement taken on an empty stomach. SOURCE: IOM, 2006.

TABLE K-2 DRIs: Recommended Dietary Allowances and Adequate Intakes, Vitamins Panto- Life- Vitamin Vitamin Vitamin Vitamin Vitamin Ribo- Vitamin Vitamin thenic Stage A C D E K Thiamin flavin Niacin B6 Folate B12 Acid Biotin Choline Group (μg/d)a (mg/d) (μg/d)b,c (mg/d)d (μg/d) (mg/d) (mg/d) (mg/d)e (mg/d) (μg/d)f (μg/d) (mg/d) (μg/d) (mg/d)g Children 4–8 yr 400 25 5* 7 55* 0.6 0.6 8 0.6 200 1.2 3* 12* 250* Males 9–13 yr 600 45 5* 11 60* 0.9 0.9 12 1.0 300 1.8 4* 20* 375* 14–18 yr 900 75 5* 15 75* 1.2 1.3 16 1.3 400 2.4 5* 25* 550* Females 9–13 yr 600 45 5* 11 60* 0.9 0.9 12 1.0 300 1.8 4* 20* 375* 14–18 yr 700 65 5* 15 75* 1.0 1.0 14 1.2 400h 2.4 5* 25* 400* Pregnant 14–18 yr 750 80 5* 15 75* 1.4 1.4 18 1.9 600i 2.6 6* 30* 450* Lactating 14–18 yr 1,200 115 5* 19 75* 1.4 1.6 17 2.0 500 2.8 7* 35* 550* NOTE: This table presents Recommended Dietary Allowances (RDAs) in boldface type and Adequate Intakes (AIs) in ordinary type followed by an asterisk. RDAs and AIs may both be used as goals for individual intakes. An RDA is set to meet the needs of almost all (97 to 98 percent) individuals in a group. It is calculated from an Estimated Average Requirement (EAR). If sufficient scientific evidence is not available to establish an EAR and, thus, to calculate an RDA, an AI is usually developed. For healthy breast-fed infants, the AI is the mean intake. The AI for other life-stage and gender groups is believed to cover the needs of all individuals in the group, but a lack of data or uncertainty in the data prevent the percentage of individuals covered by this intake from being able to be specified with confidence. mg/day = milligrams per day; μg/d = micrograms per day. a As retinol activity equivalents (RAEs). 1 RAE = 1 μg retinol, 12 μg β-carotene, 24 μg α-carotene, or 24 μg β-cryptoxanthin. The RAE for dietary provitamin A carotenoids is twofold greater than the retinol equivalents (RE), whereas the RAE for preformed vitamin A is the same as the RE. b As cholecalciferol. 1 µg cholecalciferol = 40 international units of vitamin D. c In the absence of adequate exposure to sunlight. d As α-tocopherol. α-Tocopherol includes RRR-α-tocopherol, the only form of α-tocopherol that occurs naturally in foods, and the 2R-stereoisomeric forms of α-tocopherol (RRR-, RSR-, RRS-, and RSS-α-tocopherol) that occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of α-tocopherol (SRR-, SSR-, SRS-, and SSS-α-tocopherol), also found in fortified foods and supplements. e As niacin equivalents (NE); 1 mg of niacin = 60 mg of tryptophan; for ages 0–6 months = preformed niacin (not NE) is counted. f As dietary folate equivalents (DFE); 1 DFE = 1 µg food folate = 0.6 µg of folic acid from fortified food or as a supplement consumed with food = 0.5 µg of a supplement taken on an empty stomach. g Although AIs have been set for choline, there are few data to assess whether a dietary supply of choline is needed at all stages of the life cycle, and it may be that the choline requirement can be met by endogenous synthesis at some of these stages. h In view of evidence linking folate intake with neural tube defects in the fetus, it is recommended that all women capable of becoming pregnant consume 400 micrograms from supplements or fortified foods, in addition to the intake of food folate from a varied diet. i It is assumed that women will continue consuming 400 micrograms from supplements or fortified food until their pregnancy is confirmed and they enter prenatal care, which ordinarily occurs after the end of the periconceptional period—the critical time for the formation of the neural tube. SOURCE: IOM, 2006. 169

170 TABLE K-3 DRIs: Recommended Dietary Allowances and Adequate Intakes, Elements Life- Magnes- Man- Molyb- Phos- Selen- Chlori Stage Calcium Chromium Copper Fluoride Iodine Iron ium ganese denum phorus ium Zinc Potassium Sodium de Group (mg/d) (μg/d) (μg/d) (mg/d) (μg/d) (mg/d) (mg/d) (mg/d) (μg/d) (mg/d) (μg/d) (mg/d) (g/d) (g/d) (g/d) Children 4–8 yr 800* 15* 440 1* 90 10 130 1.5* 22 500 30 5 3.8* 1.2* 1.9* Males 9–13 yr 1,300* 25* 700 2* 120 8 240 1.9* 34 1,250 40 8 4.5* 1.5* 2.3* 14–18 yr 1,300* 35* 890 3* 150 11 410 2.2* 43 1,250 55 11 4.7* 1.5* 2.3* Females 9–13 yr 1,300* 21* 700 2* 120 8 240 1.6* 34 1,250 40 8 4.5* 1.5* 2.3* 14–18 yr 1,300* 24* 890 3* 150 15 360 1.6* 43 1,250 55 9 4.7* 1.5* 2.3* Pregnant 14–18 yr 1,300* 29* 1,000 3* 220 27 400 2.0* 50 1,250 60 12 4.7* 1.5* 2.3* Lactating 14–18 yr 1,300* 44* 1,300 3* 290 10 360 2.6* 50 1,250 70 13 5.1* 1.5* 2.3* NOTE: This table presents Recommended Dietary Allowances (RDAs) in boldface type and Adequate Intakes (AIs) in ordinary type followed by an asterisk. RDAs and AIs may both be used as goals for individual intakes. An RDA is set to meet the needs of almost all (97 to 98 percent) individuals in a group. It is calculated from an Estimated Average Requirement (EAR). If sufficient scientific evidence is not available to establish an EAR and, thus, to calculate an RDA, an AI is usually developed. For healthy breast-fed infants, the AI is the mean intake. The AI for other life stage and gender groups is believed to cover the needs of all individuals in the group, but a lack of data or uncertainty in the data prevent the percentage of individuals covered by this intake from being able to be specified with confidence. g/d = grams per day; mg/day = milligrams per day; μg/d = micrograms per day. SOURCE: IOM, 2006.

TABLE K-4 DRIs: Tolerable Upper Intake Levels, Vitamins Panto- Life- Vitamin Vitamin Vitamin Vitamin Vitamin Vitamin Ribo- Vitamin thenic Stage A D K Folate B12 Biotin C E Thiamin flavin Niacin B6 Acid Choline Carot- Group (μg/d)a (mg/d) (μg/d) (mg/d)b,c (μg/d) (mg/d) (mg/d) (mg/d)c (mg/d) (μg/d)c (μg/d) (mg/d) (μg/d) (mg/d) enoidsd Children 4–8 yr 900 650 50 300 ND ND ND 15 40 400 ND ND ND 1.0 ND Males 9–13 yr 1,700 1,200 50 600 ND ND ND 20 60 600 ND ND ND 2.0 ND 14–18 yr 2,800 1,800 50 800 ND ND ND 30 80 800 ND ND ND 3.0 ND Females 9–13 yr 1,700 1,200 50 600 ND ND ND 20 60 600 ND ND ND 2.0 ND 14–18 yr 2,800 1,800 50 800 ND ND ND 30 80 800 ND ND ND 3.0 ND Pregnant 14–18 yr 2,800 1,800 50 800 ND ND ND 30 80 800 ND ND ND 3.0 ND Lactating 14–18 yr 2,800 1,800 50 800 ND ND ND 30 80 800 ND ND ND 3.0 ND NOTE: A Tolerable Upper Intake Level (UL) is the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. Unless otherwise specified, the UL represents total intake from food, water, and supplements. Because of a lack of suitable data, ULs could not be established for vitamin K, thiamin, riboflavin, vitamin B12, pantothenic acid, biotin, and carotenoids. In the absence of a UL, extra caution may be warranted in consuming levels above the recommended intakes. Members of the general population should be advised not to routinely consume amounts in excess of the UL. The UL is not meant to apply to individuals who are treated with the nutrient under medical supervision or to individuals with predisposing conditions that modify their sensitivity to the nutrient. mg/day = milligrams per day; ND = not determinable because of a lack of data on adverse effects in this age group and concern over the lack of an ability to handle excess amounts. The source of the intake should be from food only to prevent high levels of intake; μg/d = micrograms per day. a As preformed vitamin A only. b As α-tocopherol; applies to any form of supplemental α-tocopherol. c The ULs for vitamin E, niacin, and folate apply to synthetic forms obtained from supplements, fortified foods, or a combination of the two. d β-Carotene supplements are advised only to serve as a provitamin A source for individuals at risk of vitamin A deficiency. SOURCE: IOM, 2006. 171

172 TABLE K-5 DRIs: Tolerable Upper Intake Levels, Elements Cal- Copp- Fluo- Mag- Man- Phos- Selen- Sod- Chlo- Life Stage cium Chro- er ride Iodine Iron nesium ganese Molybdenum phorus Potass- ium Zinc ium ride Group (g/d) mium (μg/d) (mg/d) (μg/d) (mg/d) (mg/d)a (mg/d) (μg/d) (g/d) ium (μg/d) (mg/d) (g/d) (g/d) Children 4–8 yr 2.5 ND 3,000 2.2 300 40 110 3.0 600 3.0 ND 150 12 1.9 2.9 Males 9–13 yr 2.5 ND 5,000 10 600 40 350 6.0 1,100 4.0 ND 280 23 2.2 3.4 14–18 yr 2.5 ND 8,000 10 900 45 350 9.0 1,700 4.0 ND 400 34 2.3 3.6 Females 9–13 yr 2.5 ND 5,000 10 600 40 350 6.0 1,100 4.0 ND 280 23 2.2 3.4 14–18 yr 2.5 ND 8,000 10 900 45 350 9.0 1,700 4.0 ND 400 34 2.3 3.6 Pregnant 14–18 yr 2.5 ND 8,000 10 900 45 350 9.0 1,700 3.5 ND 400 34 2.3 3.6 Lactating 14–18 yr 2.5 ND 8,000 10 900 45 350 9.0 1,700 4.0 ND 400 34 2.3 3.6 NOTE: A Tolerable Upper Intake Level (UL) is the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. Unless otherwise specified, the UL represents total intake from food, water, and supplements. Because of a lack of suitable data, In the absence of a UL, extra caution may be warranted in consuming levels above the recommended intakes. Members of the general population should be advised not to routinely consume amounts in excess of the UL. The UL is not meant to apply to individuals who are treated with the nutrient under medical supervision or to individuals with predisposing conditions that modify their sensitivity to the nutrient. mg/day = milligrams per day; ND = not determinable because of a lack of data on adverse effects in this age group and concern over the lack of an ability to handle excess amounts. The source of the intake should be from food only to prevent high levels of intake; μg/d = micrograms per day. a The ULs for magnesium represent intake from a pharmacological agent only and do not include intake from food and water. SOURCE: IOM, 2006.

APPENDIX K 173 TABLE K-6 DRIs: Recommended Dietary Allowances and Adequate Intakes, Total Water and Macronutrient Total Carbo- Total a Life-Stage Water Hydrate Fiber Fat Linoleic α-Linoleic Proteinb Group (L/d) (g/d) (g/d) (g/d) Acid (g/d) Acid (g/d) (g/d) Children 4–8 yr 1.7* 130 25* ND 7* 0.9* 19 Males 9–13 yr 2.4* 130 31* ND 12* 1.2* 34 14–18 yr 3.3* 130 38* ND 16* 1.6* 52 Females 9–13 yr 2.1* 130 26* ND 10* 1.0* 34 14–18 yr 2.3* 130 26* ND 11* 1.1* 46 Pregnant 14–18 yr 3.0* 175 28* ND 13* 1.4* 71 Lactating 14–18 yr 3.8* 210 29* ND 13* 1.3* 71 NOTE: This table presents Recommended Dietary Allowances (RDAs) in boldface type and Adequate Intakes (AIs) in ordinary type followed by an asterisk. RDAs and AIs may both be used as goals for individual intakes. An RDA is set to meet the needs of almost all (97 to 98 percent) individuals in a group. It is calculated from an Estimated Average Requirement (EAR). If sufficient scientific evidence is not available to establish an EAR and, thus, to calculate an RDA, an AI is usually developed. For healthy breast-fed infants, the AI is the mean intake. The AI for other life-stage and gender groups is believed to cover the needs of all individuals in the group, but a lack of data or uncertainty in the data prevent the percentage of individuals covered by this intake from being able to be specified with confidence. g/d = grams per day; L/d = liters per day; ND = not determined. a Total water includes all water contained in food, beverages, and drinking water. b On the basis of the number of grams protein per kilograms of body weight for the reference body weight, for example, for adults 0.8 grams per kilogram of body weight for the reference body weight. SOURCE: IOM, 2006. TABLE K-7 Acceptable Macronutrient Distribution Ranges Range (percent of energy) for the Following Age Groupsa: Macronutrient 1–3 yr 4–18 yr Fat n-6 Polyunsaturated fatty acidsb 30–40 25–35 (linoleic acid) n-3 Polyunsaturated fatty acidsb 0.6–1.2 0.6–1.2 (α-linolenic acid) Carbohydrate 45–65 45–65 Protein 5–20 10–30 a The Acceptable Macronutrient Distribution Range is the percentage of energy intake that is associated with a reduced risk of chronic disease yet that provides adequate amounts of essential nutrients. b Approximately 10 percent of the total can come from longer-chain n-3 or n-6 fatty acids. SOURCE: IOM, 2006.

174 NUTRITION STANDARDS AND MEAL REQUIREMENTS TABLE K-8Additional Macronutrient Recommendations Macronutrient Recommended Intake As low as possible while consuming a nutritionally Dietary cholesterol adequate diet As low as possible while consuming a nutritionally Trans fatty acids adequate diet As low as possible while consuming a nutritionally Saturated fatty acids adequate diet Limit to a maximum intake of no more than 25% of total Added sugars energya a Not a recommended intake. A daily intake of added sugars that individuals should aim for to achieve a healthful diet was not set. SOURCE: IOM, 2006. TABLE K-9 Estimated Energy Requirements Group Equation Used to Estimate Energy Requirement Males 3–8 yr EER = 88.5 – (61.9 age [yr]) + PA [(26.7 weight [kg]) + (903 height [m])] + 20 9–18 yr EER = 88.5 – (61.9 age [yr]) + PA [(26.7 weight [kg]) +(903 height [m])] + 25 Females 3–8 yr EER = 135.3 – (30.8 age [yr]) + PA [(10.0 weight [kg]) + (934 height [m])] + 20 9–18 yr EER = 135.3 – (30.8 age [yr]) + PA [(10.0 weight [kg]) + (934 height [m])] + 25 NOTE: Estimated energy requirement (calories per day) = total energy expenditure + energy deposition; kg = kilograms; m = meters; PA = physical activity coefficient (see Table J-10). These equations provide an estimate of energy requirement. Relative body weight (i.e., loss, stable, gain) is the preferred indicator of energy adequacy. SOURCE: IOM, 2006. TABLE K-10 Physical Activity Coefficients for Use in Estimated Energy Requirement Equations Physical Activity Coefficients for the Following Levels of Activity: Sedentary Low Active Active Very Active (PAL 1.0–1.39) (PAL 1.4–1.59) (PAL 1.6–1.89) (PAL 1.9–2.5) Typical daily living Typical daily living activities plus at least 60 activities plus 30– Typical daily living minutes of daily moderate Typical daily living 60 minutes of daily activities plus at activity plus an additional 60 activities (e.g., moderate activity least 60 minutes of minutes of vigorous activity household tasks, (e.g., walking at 5– daily moderate or 120 minutes of moderate Group walking to the bus) 7 km/h) activity activity Males, 1.00 1.13 1.26 1.42 3–18 yr Females, 1.00 1.16 1.31 1.56 3–18 yr NOTE: PAL = physical activity level. SOURCE: IOM, 2006.

Next: Appendix L MyPyramid Food Intake Pattern Compared with Meal Requirements for the NSLP »
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The National School Breakfast Program feeds 10 million children each day, and the National School Lunch Program feeds more than 30 million students. Yet the national nutrition standards and meal requirements for these meals were created more than a decade ago, making them out of step with recent guidance about children's diets. With so many children receiving as much as 50 percent of their daily caloric intake from school meals, it is vital for schools to provide nutritious food alongside the best possible education for the success of their students. At the request of U.S. Department of Agriculture (USDA), the Institute of Medicine assembled a committee to recommend updates and revisions to the school lunch and breakfast programs. The first part of the committee's work is reflected in the December 2008 IOM report Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Phase II of the report is expected in Fall 2009. This first report provides information about the committee's approach as it reviews the school lunch and breakfast programs. In the report's second part, the committee will share its findings and recommendations to bring these meals more in line with today's dietary guidelines. The committee welcomes public comments about its intended approach. An open forum will be held January 28, 2009 in Washington, DC to receive input from the public. Please go to http://www.iom.edu/fnb/schoolmeals for details or email FNBSchoolMeals@nas.edu with any input.

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