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Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

Index

A

α-Linolenic acid, 67, 68, 81, 99, 100, 102, 173, 175, 177

Acceptable Macronutrient Distribution Range (AMDR), 54, 55, 57, 68

Added sugars (see Solid fats and added sugars)

Adequate Intakes (AIs), nutrient intake evaluation, 54, 55, 56, 65, 67-68, 81-82, 93, 97, 99, 100, 102, 105

Administration on Aging, 115

Adolecents (see Children and adolescents 2 through 18 years)

Adult day care, 2, 27

administration and regulation, 31, 32

eligibility for CACFP, 28

offer versus serve form of food service, 34

participation in CACFP, 16, 25, 32, 41

reimbursement, 28, 32, 36, 143

Adults

chronic disease, 84-85

EARs, 79-81

energy intakes, 78-79

ethnic and religious considerations, 86

food insecurity, 39

food intakes, 48, 77-78, 79

foods and nutrients to be encouraged or limited, 86

fruits and vegetables, 33, 78, 79, 86, 114, 115, 118-119, 120, 121, 123

functional limitations, 25, 28, 29, 39, 82-83, 85

grains/breads, 5, 33, 34, 78, 79, 86, 114, 115, 118-119, 120, 121, 123, 125-126, 134, 171

meal and snack patterns, 4, 33-35, 116-124

meats and meat alternates, 78, 79, 118-119, 120, 121, 123, 127, 128, 132

milk, 33, 78, 79, 118-119, 120, 121, 123, 132

nutrient intakes, 79-82

obesity, 84

physical activity level, 84

snacks, 10

special nutritional considerations, 82-96

vitamin B12, 83

vitamin D and calcium, 83-84

African Americans/Blacks, 40, 71

Age groups

(see also Adults;

Children and adolescents 2 through 18 years;

Infants and children younger than 2 years)

CACFP beneficiaries, 29

costs of meals by, 143-144

determination for dietary intake estimates, 50-51

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

EERs by, 52

and meal patterns, 5-6

for nutrient intake estimates, 56

recommended, 4

Agricultural Risk Protection Act, 30

Agriculture, Rural Development, FDA, and Related Agencies Appropriations Act, 30

Alcohol intake, 19, 46

American Academy of Pediatrics (AAP), 12, 18, 19, 48, 49, 57, 61, 62, 70, 111, 116, 170, 171, 188

American College of Sports Medicine, 84

American Dietetic Association, 85

Asians, 40

At-risk afterschool care programs, 2, 4, 9, 10, 15, 16, 25, 28-29, 30, 32, 37 n.1, 40-41, 116, 127, 128, 132, 133, 139-140, 143

B

Behavioral Risk Factor Surveillance System, 84

Body mass index (BMI), 52, 70, 71, 72, 78

Bone health, 73

Breastfeeding and breast milk

in child daycare programs, 125, 133-134

current meal patterns, 33

encouraging and supporting, 20, 73, 90, 114, 133-134, 170, 171, 187

and first solid foods, 48, 114, 134, 171

guidance on, 19, 49

intake data, 50, 65

meal and snack patterns, 117

nutrient adequacy, 5, 65, 66, 114

prevalence, 62

recommendatuions, 3, 5, 33, 73, 114, 117, 171

WIC support for, 20, 134

C

Caffeine, 20

Calcium, 65, 67-68, 73, 81, 83-84, 86, 99, 100, 102, 104, 106, 107, 108, 127, 175, 177, 188

Calorie requirements, 51-52, 93-96

(see also Energy intakes)

Carbohydrates, 19, 35, 52, 56, 68

Center-based facilities

nutrition education, 14

participating in CACFP, 16

pricing vs. nonpricing programs, 36

reimbursement for meals, 15, 32, 35-36

Centers for Disease Control and Prevention (CDC), 19, 52, 70, 71, 84

Cereals, 5, 33, 34, 35, 48, 83, 86, 114, 117, 122, 124, 125, 126, 130, 131, 145, 147, 154, 173

Cheese, 5, 33, 63, 79, 117, 127, 128, 130, 131, 156, 172, 179

Child and Adult Care Food Program (CACFP)

(see also Adult day care;

At-risk afterschool care programs;

Child day care;

Meal Requirements for CACFP;

Reimbursement)

administration and regulations, 26-27, 31-37

benefits provided, 15-16

client characteristics, 2, 25, 29, 32

costs of program, 15

current meal patterns, 31, 33-35

ethnic and socioeconomic considerations, 40

history and growth of, 29-31, 32

impact on food and nutrient intake, 39-41

monitoring compliance with, 37-38

National Professional Association, 10, 164

nutrient benchmarks, 35

nutrition safety net role, 38-41

number of participants, 32

number of providers, 15, 16, 32, 39-41

overview, 1, 2, 25-26, 31, 39-40

settings, 2, 15, 26-29, 32

Sponsor’s Association, 10, 164

Child Care Food Program, 30

Child day care, 2, 25

administration and regulation, 31, 32

eligibility for CACFP, 27

ethnic and socioeconomic considerations, 40

meals, 40-41

overview, 39-40

participation in CACFP, 32, 39-41

reimbursement, 27, 29, 32, 36, 143

Child Nutrition and WIC Reauthorization Acts, 30

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

Child Nutrition Reauthorization Act, 30

Childhood obesity

concerns about, 18, 21, 66, 72-73

defined, 70

dietary intake data, 46

extreme, 71

new Meal Requirements and, 188

prevalence, 70-71, 72

Children and adolescents 2 through 18 years

(see also Infants and children younger than 2 years)

alignment of recommendations with dietary guidance, 171-172

energy intakes, 66

food insecurity, 39

food intakes, 48, 63-64

foods and nutrients to be encouraged or limited, 73-74

fruits and vegetables, 33, 34, 38, 49, 63, 64, 73, 114, 115, 118-119, 120, 121, 122, 123, 124, 125, 130-131, 140, 142, 144, 147, 173

grains/breads, 5, 33, 34, 63, 64, 73, 114, 115, 118-119, 120, 121, 122, 123, 124, 125-126, 130-131, 132, 134, 140, 142, 144, 147, 156, 171, 174

meal and snack patterns, 4, 33-35, 116-124

meats and meat alternates, 63, 64, 73, 115, 118-119, 120, 121, 122, 123, 124, 127, 128, 130-131, 132, 140, 142, 144, 147, 174

milk, 5, 7, 13, 33, 34-35, 49, 63, 64, 73, 115, 118-119, 120, 121, 122, 123, 124, 127, 129, 130-131, 132, 140, 144, 173, 174

nutrient intakes, 66-69, 177

prevalence of inadequate intakes, 66-67

special nutritional considerations, 70-74

Cholesterol, dietary, 35, 52, 57, 69, 82, 99, 100, 101, 103, 126

Chronic disease, modified diets, 84-85

Committee on Nutrition Standards for the National School Lunch and Breakfast Program, 50, 52, 89, 93, 96, 97, 102-103, 109, 110

Committee to Review the WIC FoodPackages, 50, 52

Consolidated Appropriations Act of 2001, 30

Continuing Survey of Food Intakes by Individuals, 53, 65

Costs of meals

(see also Reimbursement)

for adults, 141

by age group, 141, 143-144, 147

amounts of foods and, 139-140, 142

baseline foods, 138

for children, 140, 141, 142, 143, 144

component cost ranges, 146

composite costs, 144, 145, 146-147

consistency of committee criteria with, 180

controlling, 7, 10, 152, 155, 159, 160-161, 164

effects of recommendations, 14, 147-148

estimated, 140-142

factors contributing to increases, 144-147

by food group, 14, 138, 139, 140, 142, 144, 145, 146-147, 148, 149, 150, 151, 156, 161, 180

foods representing recommended meal requirements, 138-139

for infants, 141, 142

limitations of analyses, 148-149

methods for estimating, 138-140

non-food costs, 14, 149-151

projected changes in food costs, 14, 137-149

sample menus, 140

scenarios, 147

setting and, 148-149

unit costs, 144, 145, 146-147

D

DASH diet eating plan, 49 n.1

Day care

(see also Adult day care;

Child day care;

Family or group day care homes)

Department of Health and Human Services, 18, 19, 115

Development of recommendations

age group and, 4, 102-103

AIs and, 99

approach, 89-93, 109

calorie targets, 4, 93-96

converting daily TMI to targets, 104-105

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

criteria, 3, 89, 90

EARs and 97-98

food group targets, 4

food specifications, 4

meal patterns, 4, 109-110

for Meal Requirements, 109-111

MyPyramid food patterns compared to TMI, 103-104

nutrient targets, 4, 96-102, 105-109

process, 4, 92

saturated fat, cholesterol, and trans fat, 99-102

sodium, 99

UL considerations, 105-109

vitamin D, 99

Dietary Guidelines Advisory Committee, 63, 69, 70, 78, 82, 188

Dietary Guidelines for Americans

alignment of Meal Requirements with, 2, 3, 4, 5, 8, 10-11, 12-13, 14, 16, 17, 21, 35, 38, 53, 73, 85, 90, 91, 92, 93, 99, 100, 109, 115, 116, 132, 134, 144, 147, 149, 154, 162, 164, 170, 171, 172-173, 174, 180, 182, 183, 184-185, 188-189

applicable population, 19

changes in, 18-19, 114 n.1, 153, 188-189

and dietary intakes, 57, 61, 63, 69, 77, 78, 185

fat and cholesterol limits, 69, 82, 100, 101, 103

food specifications, 78, 79, 161, 172-173, 184-185, 186

infants and young children, 188

and nutrition standards for foods in schools, 20, 21

sodium limits, 82, 99

special considerations, 85

translation into meal patterns, 19, 35, 48, 63, 64, 70, 103, 104, 115, 116, 132, 149, 173

website, 19

weight recommendations, 70

and WIC food packages, 20, 21

Dietary intake data

(see also Estimating dietary intakes)

description, 45-46

Dietary Guidelines, 57, 61, 63, 69, 77, 78, 185

infants and children younger than 2 years, 48, 49

sample sizes for low-income individuals, 47

self-reported, 46-47

standards for reviewing, 48

strengths and limitations, 46-47

Dietary Reference Intakes

(see also specific DRIs)

alignment of Meal Requirements with, 2, 3, 9, 16, 17, 21, 38, 115-116, 173, 175-176

changes in, 18, 19

life-stage groups, 55

and nutrient intake evaluation, 48, 54-57

E

Early Childhood and Child Care Study, 35, 143

Emergency shelters, 2, 4, 15, 16, 25, 29, 32, 37 n.1, 183, 186, 187

Energy intakes

adults, 78-79

children and adolescents, 21, 66

current requirements, 9, 26

Dietary Guidelines, 18

infants, 62

from macronutrients, 57

recommended requirements, 26

Estimated Average Requirements (EARs)

cut-point method, 54, 55

defined, 55

nutrient intake assessments with, 53-54, 55-56, 79-81

setting targets for nutrient intakes with, 97-98

Estimated Energy Requirement (EER), 52, 53, 66, 93, 95, 103

Estimating dietary intakes

AI and, 56

age group determinations, 50-51

Automated Multiple-Pass Method, 47

calorie requirements, 51-52

EAR cut-point method, 55-56

energy intakes from macronutrients, 57

food intake evaluation, 52-53

Iowa State University Foods method,52-53

nutrient intake evaluation, 53-57

risk of excessive intake, 56-57

weight and height determination, 51, 52

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

Ethnic and religious considerations, 86

Evaluation of programs

key components, 184-187

recommendations, 11-12, 183-184

Even Start, 30

Expanded Food and Nutrition Education Program (EFNEP), 157-158, 166

F

Family or group day care homes, 2

administration and regulation, 27, 31, 32, 37

participating in CACFP, 16, 32

provider’s children, 27, 29

reimbursement for meals, 15, 28, 29, 32, 36, 37

sponsoring organization, 31, 32, 37

Fat

(see also Cholesterol, dietary;

Saturated fat;

Solid fats and added sugars;

Trans fat)

intakes from meat, 63, 100, 173

Feeding Infants and Toddlers Study, 46, 62, 65

Fiber, dietary, 67, 68, 81, 86, 99, 100, 102, 104, 147, 175, 177, 179

Folate, 56, 65, 67, 80, 86, 100, 102, 105, 106, 107, 108, 109, 175, 176, 177

Food and Consumer Service, 143

Food and Drug Administration, 19, 126, 127

Food and Nutrition Service (FNS) of USDA, 2, 5, 10, 16, 17, 27, 31, 38, 113, 125, 163

Food components

(see also specific nutrients)

current requirements, 26

Food insecurity, 39

Food intakes

added sugars, 63, 65

children 2 through 18 years, 48, 63-64

evaluation, 52-53

fats (solid), 63, 65

grains/breads, 63, 64, 73, 78, 79, 86, 174, 179, 185, 186

infants and children younger than 2 years, 48, 49, 61-63

meats or meat alternates, 63, 64, 79

milk, 21, 62, 63, 64, 79, 129, 174, 185

MyPyramid recommendations and, 63-65

Food specifications

consistency of committee criteria with, 176, 178-179

Dietary Guidelines, 78, 79, 161, 172-173, 184-185, 186

fruits and vegetables, 49, 115, 120, 121, 122, 123, 124, 125, 130-131

grains/breads, 7, 8, 114-115, 117, 125-126, 130-131, 132, 139, 173, 181

meats and meat alternates, 121, 122, 123, 124, 125, 127, 128, 130-131, 156

milk, 7, 9, 119, 127, 128, 129, 130-131, 132, 172, 173

Formula, infant, 5, 33, 49, 62, 65, 114, 117, 125, 142, 148, 171

Fortified foods, 33, 34, 48, 49, 83, 86, 109, 125, 127, 142

Fresh Fruit and Vegetable Program, 38, 156

Fruit juice, 5, 7, 8, 21, 34, 49, 62, 63, 73, 114, 115, 117, 122, 124, 125, 132,134, 139, 145, 146, 147, 148, 154, 156, 171

Fruits and vegetables

(see also Vegetables)

access to, 149

adults, 33, 78, 79, 86, 114, 115, 118-119, 120, 121, 123

children, 33, 34, 38, 49, 63, 64, 73, 114, 115, 118-119, 120, 121, 122, 123, 124, 125, 130-131, 140, 142, 144, 147, 173

cost estimates, 14, 138, 139, 140, 142, 144, 145, 146, 147, 149, 150, 151, 156, 180

current requirements, 8, 26, 33, 41, 132, 138, 139, 140, 142

Dietary Guidelines, 13, 14, 18, 49, 78, 115, 172, 173, 185, 186

food specifications, 49, 115, 120, 121, 122, 123, 124, 125, 130-131

fostering acceptance of, 155, 156

Fresh Fruit and Vegetable Program, 38, 156

implementation of changes, 154, 156, 157, 160, 161, 163, 180

infants, 5, 33, 49, 62, 73, 114, 117, 118-119, 120, 121, 125, 140, 142, 154, 171

intakes, 62, 63, 64, 78, 79, 86, 185, 186

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

meal and snack patterns, 6, 7, 14, 31, 33, 34, 110, 114, 115, 117, 118-119, 120, 121, 122, 123, 124, 140, 142, 145, 170, 173

menu samples, 122, 124, 130-131

MyPyramid targets, 63, 64, 78, 79, 173

nutrient intakes from, 86

Older Americans Nutrition Program, 115

phytochemicals, 78

recommended changes, 5, 8, 14, 73, 114, 115, 120, 121, 132, 134, 139, 140, 142, 171, 182

separation of vegetable and fruit components, 5, 6-7, 8, 10, 110, 114, 115, 132, 138, 139-140, 142, 146, 147, 188

Functional limitations

fluid requirements, 85

texture modifications, 85

G

Gender differences

energy intakes, 53, 93, 94-95, 103

excessive nutrient intakes, 82, 103, 105, 106-107, 108

nutrient intake adequacy, 55, 56, 66, 67, 68, 74, 80, 81, 82, 83

nutrient needs, 102-103

weight and height, 51, 98

Grains/breads

(see also Cereals)

adults, 5, 33, 34, 78, 79, 86, 114, 115, 118-119, 120, 121, 123, 125-126, 134, 171

children, 5, 33, 34, 63, 64, 73, 114, 115, 118-119, 120, 121, 122, 123, 124, 125-126, 130-131, 132, 134, 140, 142, 144, 147, 156, 171, 174

cost estimates, 14, 139, 140, 142, 144, 145, 146-147, 148, 149, 151, 161, 180

current requirements, 8, 26, 33, 41, 132, 140, 142

Dietary Guidelines, 13, 14, 18, 63, 73, 78, 115, 172, 173, 185, 186

food specifications, 7, 8, 114-115, 117, 125-126, 130-131, 132, 139, 173, 181

fostering acceptance of, 156, 179

implementation of changes, 129, 130-131, 156, 157, 158, 159, 160, 161, 163, 164, 166, 179, 181

intakes, 63, 64, 73, 78, 79, 86, 174, 179, 185, 186

meal and snack patterns, 6, 7, 14, 33, 34, 114-115, 117, 118-119, 120, 121, 122, 123, 124, 140, 142, 147, 151, 157, 158, 170, 173

menu samples and planning, 130-131, 159, 160, 172

MyPyramid targets, 63, 64, 78, 79, 173, 174

nutrient content, 48, 86, 173

provider access to, 13, 149, 163, 179, 180

recommended changes, 5, 7, 8, 14, 73, 114, 115, 120, 132, 134, 139, 140, 142, 144, 171, 174, 182

H

Head Start, 13, 27, 30, 36, 39-40, 180

Healthy Meals for Healthy Americans Act, 30

Hispanics, 40, 65, 61

Home day care (see Family or group day care homes)

Hunger Prevention Act, 30

I

Implementation strategies

baseline database of foods, 11

budgeting/purchasing, 10, 149, 153, 155, 159, 160-161, 162, 164, 165, 181, 188

for clients 1 year and older, 155-158

consistency of committee criteria with recommendations, 181-182

continuous quality improvement, 10, 11, 114-116, 164

evaluation of, 11-12, 183-187

fostering acceptance of change, 155

general measures, 157-158

fruit replacement of juices, 154, 156, 157, 160, 161, 163

for infants, 154-155

low-fat, low-added sugar, and low-sodium foods, 156

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

meat or meat alternatives, 154, 156, 158

mentoring program, 11, 164, 166

menu planning, 7, 10, 13-14, 90, 92, 109, 125, 137, 150, 153, 155, 157, 159-160, 164, 165-166, 172, 179, 181

milk, 163, 178

monitoring for compliance, 10, 11, 12, 13, 18, 27, 37-38, 116, 153, 156, 161, 162-163, 164, 166, 181-182, 186

nutrition education, 14, 37, 38, 125, 151, 158

overview, 154

parental, community, and stakeholder involvement, 157, 159

phasing in changes, 158

preparation of foods in-house, 13

promotion of key elements, 154-163

provider resources and capabilities, 13-14

recommendations, 10-11, 163-166, 181-182

reimbursement processes, 10, 35-37, 116, 164, 181-182

reporting/record-keeping requirements, 10, 11, 37, 38, 150, 153, 159, 162, 164, 165, 182

research recommendations, 11, 187-189

snacks, 156

technical assistance for providers, 10, 13, 14, 19, 27, 37-38, 150, 151, 153, 157, 158-159, 161, 162, 163-164, 165, 166, 181

training agency staff, sponsors, and program providers, 10, 13-14, 27, 37, 133-134, 150-151, 154, 157-158, 159, 161, 162, 163, 164-165, 166, 179, 181

vegetable variety and amounts, 155-156, 158, 159, 164, 166, 178

whole grain-rich foods, 129, 130-131, 156, 157, 158, 159, 160, 161, 163, 164, 166, 179, 181

Infants and children younger than 2 years

(see also Breastfeeding and breast milk)

0 through 5 months, 5, 62

6 months through 1 year, 5, 61-62

cow’s milk, 49, 62, 117, 127, 140, 171

dietary guidance, 50, 188

food intakes, 48, 49, 61-63

foods and nutrients to be encouraged or limited, 73

formula-fed, 5, 33, 49, 62, 65, 114, 117, 125, 142, 148, 171

fruits and vegetables, 5, 33, 49, 62, 73, 114, 117, 118-119, 120, 121, 125, 140, 142, 154, 171

meal and snack patterns, 4, 33, 111, 116, 117

meats and meat alternates, 5, 33, 48, 117, 118-119, 120, 121, 125, 140, 142, 154, 171

nutrient intakes, 62, 65-66

recommendations, 5

solid foods, 48, 114, 117, 142, 148, 171

Institute of Medicine

standards for competitive foods or meals in schools, 20-21

Intakes (see Dietary intake data;

Estimating dietary intakes;

Food intakes;

Nutrient intakes)

Iron, 33, 47, 48, 50, 55, 56, 61, 65-66, 67, 80, 98, 100, 101, 102, 106, 107, 108, 114, 125, 142, 171, 175, 176, 177

L

Linoleic acid, 67, 68, 81, 99, 100, 102, 173, 175, 177

M

Macronutrients, usual intakes, 54, 68

Magnesium, 56, 66, 67, 80, 86, 100, 102, 104, 105, 106, 107, 108, 175

Meal components

(see also specific food groups)

current requirements, 26, 31, 33

Meal patterns

age groups recommended for, 4

calculation, 110

children and adults, 4, 33-35, 116-124

consistency of committee criteria with, 176, 178-179

current CACFP, 6, 31, 33-35

daily patterns, 6, 119, 120

descriptions, 33-35

development of, 109-110

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

Dietary Guidelines and, 12-13, 19, 35, 48, 63, 64, 70, 103, 104, 115, 116, 132, 149, 173

fruits and vegetables, 6, 7, 14, 31, 33, 34, 114, 115, 117, 118-119, 120, 121, 122, 123, 124, 140, 142, 145, 170, 173

grains/breads, 6, 7, 14, 33, 34, 114-115, 117, 118-119, 120, 121, 122, 123, 124, 140, 142, 147, 151, 157, 158, 170, 173

infants, 4, 33, 111, 116, 117

meats and meat alternates, 6, 7, 8, 14, 33, 34, 115, 117, 118-119, 120, 121, 122, 123, 124, 132, 140, 142, 170, 173, 174

menu writing and testing, 110

milk, 6, 7, 31, 33, 34, 115, 117, 118-119, 120, 121, 122, 123, 124, 140, 145, 171-172, 174

recommendations, 6-7, 116-124

snacks, 119-124

weekly patterns, 118-119, 121, 123

Meal Requirements for CACFP

consistency of committee criteria with recommendations, 169-181

current vs. recommended, 5, 8, 9, 14, 26, 33, 34, 41, 130-134, 138, 139, 140, 142

development of, 109-111

Dietary Guidelines alignment, 2, 3, 4, 5, 8, 10-11, 12-13, 14, 16, 17, 21, 35, 38, 53, 73, 85, 90, 91, 92, 93, 99, 100, 109, 115, 116, 132, 134, 144, 147, 149, 154, 162, 164, 170, 171, 172-173, 174, 180, 182, 183, 184-185, 188-189

evaluation of program impacts, 184-187

menu development from, 129-130

rationale for revision, 17-21

reassessment periodically, 188-189

recommendations, 5-10, 113-117

Meats and meat alternates

adults, 78, 79, 118-119, 120, 121, 123, 127, 128, 132

children ages 2 to 18 years, 63, 64, 73, 115, 118-119, 120, 121, 122, 123, 124, 127, 128, 130-131, 132, 140, 142, 144, 147, 174

cost considerations, 14, 142, 144, 145, 147, 148, 151

current requirements, 8, 9, 14, 26, 33, 34, 41, 132, 139, 140

fat intakes from, 63, 100, 173

food specifications, 5, 6, 7, 73, 115, 121, 122, 123, 124, 125, 127, 128, 130-131, 156, 161

implementation of changes, 154, 156, 158

infants, 5, 48, 117, 118-119, 120, 121, 125, 140, 142, 154, 171

intakes, 63, 64, 79

meal and snack patterns, 6, 7, 8, 14, 33, 34, 115, 117, 118-119, 120, 121, 122, 123, 124, 132, 140, 142, 170, 173, 174

menu samples, 122, 124, 130-131

MyPyramid targets, 49, 63, 64, 79, 173, 174

recommended changes, 5, 8, 9, 14, 120, 121, 132, 133, 139, 140, 170

Mentoring program, 11, 164, 166

Menus

(see also Meal patterns)

alignment with Dietary Guidelines, 5, 12, 14, 85, 103, 109, 115, 172, 173, 182

breakfast, 34-35

and compliance monitoring, 37, 38, 162, 163

consistency of committee criteria with, 2, 12, 13-14, 90, 176, 178, 179-180

costs of components, 137, 138, 140, 142, 180

culturally and geographically appropriate, 13, 155, 159, 160, 178, 180

current regulations and, 34-35, 137

cycle menus, 160

development spreadsheets, 110

evaluation of, 91, 93

flexibility in, 13, 33, 178, 181

Meals Menu Analysis program, 173

MyPyramid and, 109

nutrient content estimates, 110, 115-116, 176

phasing in changes, 179

planning, 7, 10, 12, 13-14, 90, 92, 109, 125, 137, 150, 153, 155, 157, 159-160, 164, 165-166, 172, 179, 181

practical considerations, 12, 91, 110, 181, 186

samples, 12, 91, 122, 124, 130-131, 140, 172

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

snacks, 122, 124

translating meal requirements into, 129-131

writing, 110

Micronutrients

(see also specific nutrients)

current vs. recommended, 9, 26

prevalence of inadequacy, 65

Migrant children, 4, 25, 29

Milk

(see also Breastfeeding and breast milk;

Formula, infant)

adults, 33, 78, 79, 118-119, 120, 121, 123, 132

children ages 1 to 18 years, 5, 7, 13, 33, 34-35, 49, 63, 64, 73, 115, 118-119, 120, 121, 122, 123, 124, 127, 129, 130-131, 132, 140, 144, 173, 174

cost considerations, 139, 144, 145

current requirements, 9, 26, 31, 33, 34-35, 41, 140

Dietary Guidelines, 13, 18, 49, 73, 172, 185, 186

flavored, 9, 13, 127, 129, 132, 139, 172, 173

food specifications, 7, 9, 119, 127, 128, 129, 130-131, 132, 172, 173

fostering acceptance of, 178

implementation of changes, 163, 178

infants under 1 year, 49, 62, 117, 127, 140, 171

intakes, 21, 62, 63, 64, 79, 129, 174, 185

meal and snack patterns, 6, 7, 31, 33, 34, 115, 117, 118-119, 120, 121, 122, 123, 124, 140, 145, 171-172, 174

menu samples, 122, 124, 130-131

MyPyramid targets, 48, 63, 64, 79, 171-172, 173, 174

nutrient intakes, 86

recommended changes, 5, 7, 9, 115, 120, 140, 174

substitutes, 9, 127, 128, 132, 133

Monitoring compliance with CACFP, 10, 11, 12, 13, 18, 27, 37-38, 116, 153, 156, 161, 162-163, 164, 166, 181-182, 186

MyPyramid

applicable population, 19

calorie requirements estimated from, 51-52, 79, 95, 100-101

food intake evaluation, 46, 49, 53, 57, 63-65, 77-78, 178, 185

fruits and vegetables, 63, 64, 78, 79, 173, 178

grains/breads, 63, 64, 78, 79, 173, 174

and meal pattern planning 19, 49, 70, 109-110, 117, 171, 173, 174

meat and meat alternate group, 49, 63, 64, 79, 173, 174

milk, 48, 63, 64, 79, 171-172, 173, 174

nutrient intake evaluations, 100-101, 102, 103-104

solid fats and added sugars, 53, 63, 64

MyPyramid Equivalents Database, 46, 49

N

National Adult Day Services Association, 41

National Cancer Institute, 47

National Center for Health Statistics, 45, 70

National Food Service Management Institute (NFSMI), 158, 166

National Health and Nutrition Examination Survey (NHANES), 17, 21, 45, 46, 47, 51, 52, 53, 54, 56-57, 63, 67, 68, 69, 71, 72, 77-78, 80, 81, 82, 93-94, 96, 98, 99, 105, 131, 178

National Institute of Food and Agriculture, 157-158

National Institutes of Health, 19

National Nutrition Monitoring and Related Research Act of 1990, 18

National Professional Association, 164

National Research Council, 54

National School Lunch Act, 31

National School Lunch Program (NSLP), 2, 16-17, 18, 20-21, 38, 40, 50, 52, 89, 117-118, 131

Niacin, 56, 67, 80, 100, 102, 105, 106, 107, 108, 109, 175, 177

Non-nutritive sweeteners, 20

Nutrient intakes

(see also specific nutrients)

children and adolescents, 66-69

DRIs and, 54-57, 67-68, 97-98

effect of recommended Meal Requirements on, 176, 177

evaluation, 53-57

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

infants, 65-66

Iowa State University method, 54

low-nutrient, energy-dense foods, 21

prevalence of inadequacy, 66-67

setting targets, 96-102, 105-109

Software for Intake Distribution Estimation, 54

TMI approach, 97, 100-101, 102-103

usual intakes, 54, 68

Nutrition education, 14, 18, 37, 38, 125, 151, 158

Nutrition standards for foods in schools, 20, 21

Nutritional labels, 7, 9, 103, 115, 128, 133, 159, 179

O

Obesity

(see also Childhood obesity)

and dietary modifications, 84

prevalence, 170

Observing Protein and Energy Nutrition study, 47

Older Americans Act, 30, 31

Older Americans Nutrition Program, 115

Omnibus Budget Reconciliation Act of 1981, 30

Outside school hours care facility, 16, 27, 30, 32, 37

P

Personal Responsibility and Work Opportunity Reconciliation Act, 30, 35, 37

Phosphorus, 56, 65, 66, 67, 80, 100, 102, 106, 107, 108, 175, 177

Physical activity, 18, 52, 66, 70, 73, 84, 157

Phytochemicals, 78

Portion or serving sizes, 5, 6, 34, 78, 125, 132, 133, 139, 140, 141, 146, 164-165

Potassium, 12, 65, 67, 68, 81, 86, 99, 100, 102, 104, 109, 175, 177

Protein, 9, 51, 56, 65, 66, 67, 68, 80, 83, 98, 100, 102, 104, 127, 133, 175, 177

R

Recommendations

(see also Development of recommendations)

adaptability to provider venues, 13-14

breastfeeding, 133-134

children and adults, 5, 114-124, 171-176

consistency with committee criteria, 169-181

cost sensitivity, 4, 14, 147-148

current requirements compared to, 5, 130-134

and dietary guidance, 12, 115-116, 171-173, 174, 175-176

and diversity of food selection, 13

evaluation of programs, 11-12, 183-187

food specifications, 4, 5, 6-7, 124-129, 178-179

fruits and vegetables, 5, 8, 14, 73, 114, 115, 120, 121, 132, 134, 139, 140, 142, 171, 182

grains/breads, 5, 7, 8, 14, 73, 114, 115, 120, 132, 134, 139, 140, 142, 144, 171, 174, 182

implementation strategies, 10-11, 181-182

infants, 5, 114, 116, 170-171

meal patterns, 4, 5, 6-7, 116-124

meal requirements, 5-10, 113-116, 169-181

meats and meat alternates, 5, 8, 9, 14, 120, 121, 132, 133, 139, 140, 170

menu development, 129-130

milk, 5, 7, 9, 115, 120, 140, 174

periodic reassessment, 188-189

practicality, 4, 12-13, 133

research, 11, 187-189

snacks, 10, 116, 180-181

Recommended Dietary Allowances (RDAs), 19, 35, 54-55, 83

Recommended Nutrient Intakes, 19

Reimbursement

(see also Monitoring compliance with CACFP)

adult day care, 28, 32, 36, 143

at-risk afterschool care facility, 32, 143

center-based facilities, 15, 32, 35-36

child day care, 27, 29, 32, 36, 143

emergency shelters, 29

hosme-based day care, 15, 28, 29, 32, 36, 37

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

ineligible foods, 130

non-food costs, 149-151

outside school hours care facility, 32

processes/methods, 10, 35-37, 116, 164, 181-182

and provider acceptance of changes, 14

qualifying meals and components, 10, 26, 31, 33-37, 41, 142

rates, 14, 27, 28, 30, 36, 37, 161, 180, 187

reporting/record-keeping requirements, 10, 11, 37, 38, 150, 153, 159, 162, 164, 165, 182

snacks, 109, 119, 143

statutory basis, 30, 37, 143

Reporting/record-keeping requirements, 10, 11, 37, 38, 150, 153, 159, 162, 164, 165, 182

Research recommendations, 11, 187-189

Riboflavin, 56, 67, 80, 100, 102, 175, 177

S

Saturated fat, 8, 35, 57, 69, 82, 99, 100, 101, 126, 132, 147, 173, 175, 176, 177, 179, 188

School Breakfast Program (SBP), 2, 16-17, 18, 20-21, 38, 40, 50, 52, 89, 117-118, 131

School foods and meals

(see also At-risk afterschool care programs;

National School Lunch Program;

School Breakfast Program)

Dietary Guidelines, 20, 21

nutrition standards for competitive foods/meals, 2, 20-21

recommended requirements for meals, 20-21

School Lunch and Breakfast Cost Study, 149-150

Shelters (see Emergency shelters)

Snacks

consistency of committee criteria with recommendations, 180-181

enhanced, 8, 10, 96, 113, 116, 122-124, 132, 139-140, 142, 143-144, 156, 180-181

patterns, 119-124

recommendations, 116, 119-124, 180-181

regular, 119-122, 123, 139, 140, 142, 143-144, 156

reimbursement, 109, 119, 143

Sodium

age group and, 105, 106-108, 125, 175, 177

current requirements, 9, 16, 132, 133

dietary guidance, 12, 13, 19, 35, 49, 99, 172

food specifications, 8, 125, 128, 129, 130, 132, 133, 138, 156, 170, 178, 179, 188

implementation challenges, 156, 157, 180

intakes, 57, 62, 67, 69, 82, 100, 102, 106-108, 109, 179

limiting/decreasing, 5, 7, 13, 14, 19, 73, 74, 85, 86, 114, 115, 129, 132, 134, 156, 157, 158, 179, 182

meal patterns and, 175, 177

MyPyramid, 100, 102

recommendations, 9, 114, 132, 133, 171

setting targets, 99, 100, 102, 104, 105

UL, 82, 99, 104, 105, 106-108

Solid fats and added sugars

current vs. recommended requirements, 9, 26

Dietary Guidelines, 19

energy benchmarks, 35

food specifications, 9, 126, 128, 129, 132, 138, 170, 177-178, 179

intakes, 19, 46, 53, 62, 63, 64, 65, 68, 78, 79

limiting/decreasing, 5, 7, 8, 9, 13, 14, 19, 73-74, 78, 86, 114, 115, 134, 139, 156, 157, 158, 171, 172, 173, 180, 181, 182

Special Food Service Program for Children, 29, 30, 35

Special nutritional considerations

adults, 82-96

bone health, 73

children and adolescents, 70-74

chronic disease, 84-85

ethnic and religious considerations, 86

fluid requirements, 84

foods and nutrients to be encouraged or limited, 73-74

functional limitations, 85

physical activity level, 84

texture modifications, 85

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
×

vitamin B12, 83

vitamin D and calcium, 83-84

weight status, 70-72

Statement of task, 2, 17

Summer Food Service Program, 30

Supplemental Nutrition Program for Women, Infants, and Children (see WIC)

Survey of Income and Program Participation, 40

T

Target Median Intake (TMI) approach, 97, 100-101, 102-103

Technical assistance for providers, 10, 13, 14, 19, 27, 37-38, 150, 151, 153, 157, 158-159, 161, 162, 163-164, 165, 166, 181

Texture modifications, 85

Thiamin, 56, 67, 80, 100, 102, 175, 177

Tolerable Upper Intake Levels (ULs)

defined, 55

and development of recommendations, 105-109

nutrient intake assessment, 53-54, 56-57, 63, 69, 82

Training agency staff, sponsors, and program providers, 10, 13-14, 27, 37, 133-134, 150-151, 154, 157-158, 159, 161, 162, 163, 164-165, 166, 179, 181

Trans fat, 5, 7, 9, 13, 99, 101, 103, 114, 115, 128, 129, 133, 134, 156, 171, 172, 179

U

U.S. Department of Agriculture

(see also specific services)

Survey Foods, 46

V

Vegetable oils, 64, 79, 99, 119, 125, 127, 128, 173

Vegetables

(see also Fruits and Vegetables)

composite food group, 139

fried or starchy, 62, 65, 114, 125, 132, 158, 178

implementation of recommendations, 155-156, 158, 159, 164, 166, 178

practical considerations, 133

sodium content, 132

Vitamin A, 56, 65, 66, 67, 69, 80, 100, 102, 105, 106, 107, 108, 109, 127, 175, 177

Vitamins B6, 56, 67, 80, 86, 100, 102, 106, 107, 108, 175, 177

Vitamins B12, 56, 65, 67, 77, 80, 83, 86, 100, 102, 175, 177

Vitamins C, 56, 65, 66, 67, 80, 86, 98, 100, 102, 106, 107, 108, 175, 177

Vitamin D, 46, 65, 67, 73, 77, 82, 83-84, 86, 99, 127, 188

Vitamin E, 12, 56, 65, 66, 67, 80, 99, 100, 102, 104, 106, 107, 108, 109, 119, 173-174, 175, 176, 177

W

WIC, 1, 2, 30

breastfeeding support, 20, 134

consistency of CACFP with, 20, 21, 50, 52, 98, 111, 115, 116, 127, 131, 187

dietary intakes of participants, 62, 65, 68, 69

food package standards, 20, 21, 50, 52, 126, 127

Y

Yogurt, 5, 7, 9, 63, 79, 86, 115, 117, 119, 127, 128, 130, 132, 139, 156, 172, 173

Z

Zinc, 48, 50, 56, 65, 67, 69, 80, 100, 102, 105, 106, 107, 108, 171, 175, 177

Suggested Citation:" Index." Institute of Medicine. 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press. doi: 10.17226/12959.
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Child and Adult Care Food Program: Aligning Dietary Guidance for All Get This Book
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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.

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