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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



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Index A fruits and vegetables, 33, 78, 79, 86, 114, 115, 118-119, 120, 121, 123 α-Linolenic acid, 67, 68, 81, 99, 100, 102, functional limitations, 25, 28, 29, 39, 173, 175, 177 82-83, 85 Acceptable Macronutrient Distribution grains/breads, 5, 33, 34, 78, 79, 86, Range (AMDR), 54, 55, 57, 68 114, 115, 118-119, 120, 121, 123, Added sugars (see Solid fats and added 125-126, 134, 171 sugars) meal and snack patterns, 4, 33-35, Adequate Intakes (AIs), nutrient intake 116-124 evaluation, 54, 55, 56, 65, 67-68, meats and meat alternates, 78, 79, 118- 81-82, 93, 97, 99, 100, 102, 105 119, 120, 121, 123, 127, 128, 132 Administration on Aging, 115 milk, 33, 78, 79, 118-119, 120, 121, Adolecents (see Children and adolescents 123, 132 2 through 18 years) nutrient intakes, 79-82 Adult day care, 2, 27 obesity, 84 administration and regulation, 31, 32 physical activity level, 84 eligibility for CACFP, 28 snacks, 10 offer versus serve form of food service, special nutritional considerations, 82-96 34 vitamin B12, 83 participation in CACFP, 16, 25, 32, 41 vitamin D and calcium, 83-84 reimbursement, 28, 32, 36, 143 African Americans/Blacks, 40, 71 Adults Age groups (see also Adults; Children and chronic disease, 84-85 adolescents 2 through 18 years; EARs, 79-81 Infants and children younger than energy intakes, 78-79 2 years) ethnic and religious considerations, 86 CACFP beneficiaries, 29 food insecurity, 39 costs of meals by, 143-144 food intakes, 48, 77-78, 79 determination for dietary intake foods and nutrients to be encouraged or estimates, 50-51 limited, 86 285

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286 CHILD AND ADULT CARE FOOD PROGRAM Carbohydrates, 19, 35, 52, 56, 68 EERs by, 52 Center-based facilities and meal patterns, 5-6 nutrition education, 14 for nutrient intake estimates, 56 participating in CACFP, 16 recommended, 4 pricing vs. nonpricing programs, 36 Agricultural Risk Protection Act, 30 reimbursement for meals, 15, 32, 35-36 Agriculture, Rural Development, FDA, and Centers for Disease Control and Prevention Related Agencies Appropriations (CDC), 19, 52, 70, 71, 84 Act, 30 Cereals, 5, 33, 34, 35, 48, 83, 86, 114, Alcohol intake, 19, 46 117, 122, 124, 125, 126, 130, 131, American Academy of Pediatrics (AAP), 12, 145, 147, 154, 173 18, 19, 48, 49, 57, 61, 62, 70, 111, Cheese, 5, 33, 63, 79, 117, 127, 128, 130, 116, 170, 171, 188 131, 156, 172, 179 American College of Sports Medicine, 84 Child and Adult Care Food Program American Dietetic Association, 85 (CACFP) (see also Adult day care; Asians, 40 At-risk afterschool care programs; At-risk afterschool care programs, 2, 4, 9, Child day care; Meal Requirements 10, 15, 16, 25, 28-29, 30, 32, 37 for CACFP; Reimbursement) n.1, 40-41, 116, 127, 128, 132, 133, administration and regulations, 26-27, 139-140, 143 31-37 benefits provided, 15-16 B client characteristics, 2, 25, 29, 32 costs of program, 15 Behavioral Risk Factor Surveillance System, current meal patterns, 31, 33-35 84 ethnic and socioeconomic Body mass index (BMI), 52, 70, 71, 72, 78 considerations, 40 Bone health, 73 history and growth of, 29-31, 32 Breastfeeding and breast milk impact on food and nutrient intake, in child daycare programs, 125, 39-41 133-134 monitoring compliance with, 37-38 current meal patterns, 33 National Professional Association, 10, encouraging and supporting, 20, 73, 90, 164 114, 133-134, 170, 171, 187 nutrient benchmarks, 35 and first solid foods, 48, 114, 134, 171 nutrition safety net role, 38-41 guidance on, 19, 49 number of participants, 32 intake data, 50, 65 number of providers, 15, 16, 32, 39-41 meal and snack patterns, 117 overview, 1, 2, 25-26, 31, 39-40 nutrient adequacy, 5, 65, 66, 114 settings, 2, 15, 26-29, 32 prevalence, 62 Sponsor’s Association, 10, 164 recommendatuions, 3, 5, 33, 73, 114, Child Care Food Program, 30 117, 171 Child day care, 2, 25 WIC support for, 20, 134 administration and regulation, 31, 32 eligibility for CACFP, 27 ethnic and socioeconomic C considerations, 40 meals, 40-41 Caffeine, 20 overview, 39-40 Calcium, 65, 67-68, 73, 81, 83-84, 86, 99, participation in CACFP, 32, 39-41 100, 102, 104, 106, 107, 108, 127, reimbursement, 27, 29, 32, 36, 143 175, 177, 188 Child Nutrition and WIC Reauthorization Calorie requirements, 51-52, 93-96 (see Acts, 30 also Energy intakes)

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287 INDEX Child Nutrition Reauthorization Act, 30 Continuing Survey of Food Intakes by Childhood obesity Individuals, 53, 65 concerns about, 18, 21, 66, 72-73 Costs of meals (see also Reimbursement) defined, 70 for adults, 141 dietary intake data, 46 by age group, 141, 143-144, 147 extreme, 71 amounts of foods and, 139-140, 142 new Meal Requirements and, 188 baseline foods, 138 prevalence, 70-71, 72 for children, 140, 141, 142, 143, 144 Children and adolescents 2 through 18 component cost ranges, 146 years (see also Infants and children composite costs, 144, 145, 146-147 younger than 2 years) consistency of committee criteria with, alignment of recommendations with 180 dietary guidance, 171-172 controlling, 7, 10, 152, 155, 159, 160- energy intakes, 66 161, 164 food insecurity, 39 effects of recommendations, 14, food intakes, 48, 63-64 147-148 foods and nutrients to be encouraged or estimated, 140-142 limited, 73-74 factors contributing to increases, fruits and vegetables, 33, 34, 38, 49, 144-147 63, 64, 73, 114, 115, 118-119, 120, by food group, 14, 138, 139, 140, 142, 121, 122, 123, 124, 125, 130-131, 144, 145, 146-147, 148, 149, 150, 140, 142, 144, 147, 173 151, 156, 161, 180 grains/breads, 5, 33, 34, 63, 64, 73, foods representing recommended meal 114, 115, 118-119, 120, 121, 122, requirements, 138-139 123, 124, 125-126, 130-131, 132, for infants, 141, 142 134, 140, 142, 144, 147, 156, 171, limitations of analyses, 148-149 174 methods for estimating, 138-140 meal and snack patterns, 4, 33-35, non-food costs, 14, 149-151 116-124 projected changes in food costs, 14, meats and meat alternates, 63, 64, 73, 137-149 115, 118-119, 120, 121, 122, 123, sample menus, 140 124, 127, 128, 130-131, 132, 140, scenarios, 147 142, 144, 147, 174 setting and, 148-149 milk, 5, 7, 13, 33, 34-35, 49, 63, 64, unit costs, 144, 145, 146-147 73, 115, 118-119, 120, 121, 122, 123, 124, 127, 129, 130-131, 132, D 140, 144, 173, 174 nutrient intakes, 66-69, 177 DASH diet eating plan, 49 n.1 prevalence of inadequate intakes, 66-67 Day care (see also Adult day care; Child special nutritional considerations, 70-74 day care; Family or group day care Cholesterol, dietary, 35, 52, 57, 69, 82, 99, homes) 100, 101, 103, 126 Department of Health and Human Services, Chronic disease, modified diets, 84-85 18, 19, 115 Committee on Nutrition Standards for Development of recommendations the National School Lunch and age group and, 4, 102-103 Breakfast Program, 50, 52, 89, 93, AIs and, 99 96, 97, 102-103, 109, 110 approach, 89-93, 109 Committee to Review the WIC Food calorie targets, 4, 93-96 Packages, 50, 52 converting daily TMI to targets, Consolidated Appropriations Act of 2001, 104-105 30

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288 CHILD AND ADULT CARE FOOD PROGRAM criteria, 3, 89, 90 sample sizes for low-income individuals, EARs and 97-98 47 food group targets, 4 self-reported, 46-47 food specifications, 4 standards for reviewing, 48 meal patterns, 4, 109-110 strengths and limitations, 46-47 for Meal Requirements, 109-111 Dietary Reference Intakes (see also specific MyPyramid food patterns compared to DRIs) TMI, 103-104 alignment of Meal Requirements with, nutrient targets, 4, 96-102, 105-109 2, 3, 9, 16, 17, 21, 38, 115-116, process, 4, 92 173, 175-176 saturated fat, cholesterol, and trans fat, changes in, 18, 19 99-102 life-stage groups, 55 sodium, 99 and nutrient intake evaluation, 48, UL considerations, 105-109 54-57 vitamin D, 99 Dietary Guidelines Advisory Committee, E 63, 69, 70, 78, 82, 188 Dietary Guidelines for Americans Early Childhood and Child Care Study, 35, alignment of Meal Requirements with, 143 2, 3, 4, 5, 8, 10-11, 12-13, 14, 16, Emergency shelters, 2, 4, 15, 16, 25, 29, 17, 21, 35, 38, 53, 73, 85, 90, 91, 32, 37 n.1, 183, 186, 187 92, 93, 99, 100, 109, 115, 116, 132, Energy intakes 134, 144, 147, 149, 154, 162, 164, adults, 78-79 170, 171, 172-173, 174, 180, 182, children and adolescents, 21, 66 183, 184-185, 188-189 current requirements, 9, 26 applicable population, 19 Dietary Guidelines, 18 changes in, 18-19, 114 n.1, 153, infants, 62 188-189 from macronutrients, 57 and dietary intakes, 57, 61, 63, 69, 77, recommended requirements, 26 78, 185 Estimated Average Requirements (EARs) fat and cholesterol limits, 69, 82, 100, cut-point method, 54, 55 101, 103 defined, 55 food specifications, 78, 79, 161, 172- nutrient intake assessments with, 53-54, 173, 184-185, 186 55-56, 79-81 infants and young children, 188 setting targets for nutrient intakes with, and nutrition standards for foods in 97-98 schools, 20, 21 Estimated Energy Requirement (EER), 52, sodium limits, 82, 99 53, 66, 93, 95, 103 special considerations, 85 Estimating dietary intakes translation into meal patterns, 19, 35, AI and, 56 48, 63, 64, 70, 103, 104, 115, 116, age group determinations, 50-51 132, 149, 173 Automated Multiple-Pass Method, 47 website, 19 calorie requirements, 51-52 weight recommendations, 70 EAR cut-point method, 55-56 and WIC food packages, 20, 21 energy intakes from macronutrients, 57 Dietary intake data (see also Estimating food intake evaluation, 52-53 dietary intakes) Iowa State University Foods method, description, 45-46 52-53 Dietary Guidelines, 57, 61, 63, 69, 77, nutrient intake evaluation, 53-57 78, 185 risk of excessive intake, 56-57 infants and children younger than 2 weight and height determination, 51, 52 years, 48, 49

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289 INDEX Ethnic and religious considerations, 86 Food specifications Evaluation of programs consistency of committee criteria with, key components, 184-187 176, 178-179 recommendations, 11-12, 183-184 Dietary Guidelines, 78, 79, 161, 172- Even Start, 30 173, 184-185, 186 Expanded Food and Nutrition Education fruits and vegetables, 49, 115, 120, 121, Program (EFNEP), 157-158, 166 122, 123, 124, 125, 130-131 grains/breads, 7, 8, 114-115, 117, 125-126, 130-131, 132, 139, 173, F 181 meats and meat alternates, 121, 122, Family or group day care homes, 2 123, 124, 125, 127, 128, 130-131, administration and regulation, 27, 31, 156 32, 37 milk, 7, 9, 119, 127, 128, 129, 130- participating in CACFP, 16, 32 131, 132, 172, 173 provider’s children, 27, 29 Formula, infant, 5, 33, 49, 62, 65, 114, reimbursement for meals, 15, 28, 29, 117, 125, 142, 148, 171 32, 36, 37 Fortified foods, 33, 34, 48, 49, 83, 86, 109, sponsoring organization, 31, 32, 37 125, 127, 142 Fat (see also Cholesterol, dietary; Saturated Fresh Fruit and Vegetable Program, 38, 156 fat; Solid fats and added sugars; Fruit juice, 5, 7, 8, 21, 34, 49, 62, 63, 73, Trans fat) 114, 115, 117, 122, 124, 125, 132, intakes from meat, 63, 100, 173 134, 139, 145, 146, 147, 148, 154, Feeding Infants and Toddlers Study, 46, 156, 171 62, 65 Fruits and vegetables (see also Vegetables) Fiber, dietary, 67, 68, 81, 86, 99, 100, 102, access to, 149 104, 147, 175, 177, 179 adults, 33, 78, 79, 86, 114, 115, 118- Folate, 56, 65, 67, 80, 86, 100, 102, 105, 119, 120, 121, 123 106, 107, 108, 109, 175, 176, 177 children, 33, 34, 38, 49, 63, 64, 73, Food and Consumer Service, 143 114, 115, 118-119, 120, 121, 122, Food and Drug Administration, 19, 126, 123, 124, 125, 130-131, 140, 142, 127 144, 147, 173 Food and Nutrition Service (FNS) of cost estimates, 14, 138, 139, 140, 142, USDA, 2, 5, 10, 16, 17, 27, 31, 38, 144, 145, 146, 147, 149, 150, 151, 113, 125, 163 156, 180 Food components (see also specific current requirements, 8, 26, 33, 41, nutrients) 132, 138, 139, 140, 142 current requirements, 26 Dietary Guidelines, 13, 14, 18, 49, 78, Food insecurity, 39 115, 172, 173, 185, 186 Food intakes food specifications, 49, 115, 120, 121, added sugars, 63, 65 122, 123, 124, 125, 130-131 children 2 through 18 years, 48, 63-64 fostering acceptance of, 155, 156 evaluation, 52-53 Fresh Fruit and Vegetable Program, 38, fats (solid), 63, 65 156 grains/breads, 63, 64, 73, 78, 79, 86, implementation of changes, 154, 156, 174, 179, 185, 186 157, 160, 161, 163, 180 infants and children younger than 2 infants, 5, 33, 49, 62, 73, 114, 117, years, 48, 49, 61-63 118-119, 120, 121, 125, 140, 142, meats or meat alternates, 63, 64, 79 154, 171 milk, 21, 62, 63, 64, 79, 129, 174, 185 intakes, 62, 63, 64, 78, 79, 86, 185, MyPyramid recommendations and, 186 63-65

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290 CHILD AND ADULT CARE FOOD PROGRAM meal and snack patterns, 6, 7, 14, 31, implementation of changes, 129, 130- 33, 34, 110, 114, 115, 117, 118- 131, 156, 157, 158, 159, 160, 161, 119, 120, 121, 122, 123, 124, 140, 163, 164, 166, 179, 181 142, 145, 170, 173 intakes, 63, 64, 73, 78, 79, 86, 174, menu samples, 122, 124, 130-131 179, 185, 186 MyPyramid targets, 63, 64, 78, 79, 173 meal and snack patterns, 6, 7, 14, 33, nutrient intakes from, 86 34, 114-115, 117, 118-119, 120, Older Americans Nutrition Program, 121, 122, 123, 124, 140, 142, 147, 115 151, 157, 158, 170, 173 phytochemicals, 78 menu samples and planning, 130-131, recommended changes, 5, 8, 14, 73, 159, 160, 172 114, 115, 120, 121, 132, 134, 139, MyPyramid targets, 63, 64, 78, 79, 173, 140, 142, 171, 182 174 separation of vegetable and fruit nutrient content, 48, 86, 173 components, 5, 6-7, 8, 10, 110, 114, provider access to, 13, 149, 163, 179, 115, 132, 138, 139-140, 142, 146, 180 147, 188 recommended changes, 5, 7, 8, 14, 73, Functional limitations 114, 115, 120, 132, 134, 139, 140, fluid requirements, 85 142, 144, 171, 174, 182 texture modifications, 85 H G Head Start, 13, 27, 30, 36, 39-40, 180 Gender differences Healthy Meals for Healthy Americans Act, energy intakes, 53, 93, 94-95, 103 30 excessive nutrient intakes, 82, 103, 105, Hispanics, 40, 65, 61 106-107, 108 Home day care (see Family or group day nutrient intake adequacy, 55, 56, 66, care homes) 67, 68, 74, 80, 81, 82, 83 Hunger Prevention Act, 30 nutrient needs, 102-103 weight and height, 51, 98 I Grains/breads (see also Cereals) adults, 5, 33, 34, 78, 79, 86, 114, 115, Implementation strategies 118-119, 120, 121, 123, 125-126, baseline database of foods, 11 134, 171 budgeting/purchasing, 10, 149, 153, children, 5, 33, 34, 63, 64, 73, 114, 155, 159, 160-161, 162, 164, 165, 115, 118-119, 120, 121, 122, 123, 181, 188 124, 125-126, 130-131, 132, 134, for clients 1 year and older, 155-158 140, 142, 144, 147, 156, 171, 174 consistency of committee criteria with cost estimates, 14, 139, 140, 142, 144, recommendations, 181-182 145, 146-147, 148, 149, 151, 161, continuous quality improvement, 10, 180 11, 114-116, 164 current requirements, 8, 26, 33, 41, evaluation of, 11-12, 183-187 132, 140, 142 fostering acceptance of change, 155 Dietary Guidelines, 13, 14, 18, 63, 73, general measures, 157-158 78, 115, 172, 173, 185, 186 fruit replacement of juices, 154, 156, food specifications, 7, 8, 114-115, 117, 157, 160, 161, 163 125-126, 130-131, 132, 139, 173, for infants, 154-155 181 low-fat, low-added sugar, and low- fostering acceptance of, 156, 179 sodium foods, 156

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291 INDEX meat or meat alternatives, 154, 156, 158 food intakes, 48, 49, 61-63 mentoring program, 11, 164, 166 foods and nutrients to be encouraged or menu planning, 7, 10, 13-14, 90, 92, limited, 73 109, 125, 137, 150, 153, 155, 157, formula-fed, 5, 33, 49, 62, 65, 114, 159-160, 164, 165-166, 172, 179, 117, 125, 142, 148, 171 181 fruits and vegetables, 5, 33, 49, 62, 73, milk, 163, 178 114, 117, 118-119, 120, 121, 125, monitoring for compliance, 10, 11, 12, 140, 142, 154, 171 13, 18, 27, 37-38, 116, 153, 156, meal and snack patterns, 4, 33, 111, 161, 162-163, 164, 166, 181-182, 116, 117 186 meats and meat alternates, 5, 33, 48, nutrition education, 14, 37, 38, 125, 117, 118-119, 120, 121, 125, 140, 151, 158 142, 154, 171 overview, 154 nutrient intakes, 62, 65-66 parental, community, and stakeholder recommendations, 5 involvement, 157, 159 solid foods, 48, 114, 117, 142, 148, 171 phasing in changes, 158 Institute of Medicine preparation of foods in-house, 13 standards for competitive foods or promotion of key elements, 154-163 meals in schools, 20-21 provider resources and capabilities, Intakes (see Dietary intake data; Estimating 13-14 dietary intakes; Food intakes; recommendations, 10-11, 163-166, Nutrient intakes) 181-182 Iron, 33, 47, 48, 50, 55, 56, 61, 65-66, 67, reimbursement processes, 10, 35-37, 80, 98, 100, 101, 102, 106, 107, 116, 164, 181-182 108, 114, 125, 142, 171, 175, 176, reporting/record-keeping requirements, 177 10, 11, 37, 38, 150, 153, 159, 162, 164, 165, 182 L research recommendations, 11, 187-189 snacks, 156 Linoleic acid, 67, 68, 81, 99, 100, 102, technical assistance for providers, 10, 173, 175, 177 13, 14, 19, 27, 37-38, 150, 151, 153, 157, 158-159, 161, 162, 163- 164, 165, 166, 181 M training agency staff, sponsors, and program providers, 10, 13-14, 27, Macronutrients, usual intakes, 54, 68 37, 133-134, 150-151, 154, 157- Magnesium, 56, 66, 67, 80, 86, 100, 102, 158, 159, 161, 162, 163, 164-165, 104, 105, 106, 107, 108, 175 166, 179, 181 Meal components (see also specific food vegetable variety and amounts, 155-156, groups) 158, 159, 164, 166, 178 current requirements, 26, 31, 33 whole grain-rich foods, 129, 130-131, Meal patterns 156, 157, 158, 159, 160, 161, 163, age groups recommended for, 4 164, 166, 179, 181 calculation, 110 Infants and children younger than 2 years children and adults, 4, 33-35, 116-124 (see also Breastfeeding and breast consistency of committee criteria with, milk) 176, 178-179 0 through 5 months, 5, 62 current CACFP, 6, 31, 33-35 6 months through 1 year, 5, 61-62 daily patterns, 6, 119, 120 cow’s milk, 49, 62, 117, 127, 140, 171 descriptions, 33-35 dietary guidance, 50, 188 development of, 109-110

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292 CHILD AND ADULT CARE FOOD PROGRAM Dietary Guidelines and, 12-13, 19, 35, current requirements, 8, 9, 14, 26, 33, 48, 63, 64, 70, 103, 104, 115, 116, 34, 41, 132, 139, 140 132, 149, 173 fat intakes from, 63, 100, 173 fruits and vegetables, 6, 7, 14, 31, 33, food specifications, 5, 6, 7, 73, 115, 34, 114, 115, 117, 118-119, 120, 121, 122, 123, 124, 125, 127, 128, 121, 122, 123, 124, 140, 142, 145, 130-131, 156, 161 170, 173 implementation of changes, 154, 156, grains/breads, 6, 7, 14, 33, 34, 114-115, 158 117, 118-119, 120, 121, 122, 123, infants, 5, 48, 117, 118-119, 120, 121, 124, 140, 142, 147, 151, 157, 158, 125, 140, 142, 154, 171 170, 173 intakes, 63, 64, 79 infants, 4, 33, 111, 116, 117 meal and snack patterns, 6, 7, 8, 14, 33, meats and meat alternates, 6, 7, 8, 14, 34, 115, 117, 118-119, 120, 121, 33, 34, 115, 117, 118-119, 120, 122, 123, 124, 132, 140, 142, 170, 121, 122, 123, 124, 132, 140, 142, 173, 174 170, 173, 174 menu samples, 122, 124, 130-131 menu writing and testing, 110 MyPyramid targets, 49, 63, 64, 79, 173, milk, 6, 7, 31, 33, 34, 115, 117, 118- 174 119, 120, 121, 122, 123, 124, 140, recommended changes, 5, 8, 9, 14, 120, 145, 171-172, 174 121, 132, 133, 139, 140, 170 recommendations, 6-7, 116-124 Mentoring program, 11, 164, 166 snacks, 119-124 Menus (see also Meal patterns) weekly patterns, 118-119, 121, 123 alignment with Dietary Guidelines, 5, Meal Requirements for CACFP 12, 14, 85, 103, 109, 115, 172, 173, consistency of committee criteria with 182 recommendations, 169-181 breakfast, 34-35 current vs. recommended, 5, 8, 9, 14, and compliance monitoring, 37, 38, 26, 33, 34, 41, 130-134, 138, 139, 162, 163 140, 142 consistency of committee criteria with, development of, 109-111 2, 12, 13-14, 90, 176, 178, 179-180 Dietary Guidelines alignment, 2, 3, 4, 5, costs of components, 137, 138, 140, 8, 10-11, 12-13, 14, 16, 17, 21, 35, 142, 180 38, 53, 73, 85, 90, 91, 92, 93, 99, culturally and geographically appropriate, 100, 109, 115, 116, 132, 134, 144, 13, 155, 159, 160, 178, 180 147, 149, 154, 162, 164, 170, 171, current regulations and, 34-35, 137 172-173, 174, 180, 182, 183, 184- cycle menus, 160 185, 188-189 development spreadsheets, 110 evaluation of program impacts, 184-187 evaluation of, 91, 93 menu development from, 129-130 flexibility in, 13, 33, 178, 181 rationale for revision, 17-21 Meals Menu Analysis program, 173 reassessment periodically, 188-189 MyPyramid and, 109 recommendations, 5-10, 113-117 nutrient content estimates, 110, 115-116, Meats and meat alternates 176 adults, 78, 79, 118-119, 120, 121, 123, phasing in changes, 179 127, 128, 132 planning, 7, 10, 12, 13-14, 90, 92, 109, children ages 2 to 18 years, 63, 64, 73, 125, 137, 150, 153, 155, 157, 159- 115, 118-119, 120, 121, 122, 123, 160, 164, 165-166, 172, 179, 181 124, 127, 128, 130-131, 132, 140, practical considerations, 12, 91, 110, 142, 144, 147, 174 181, 186 cost considerations, 14, 142, 144, 145, samples, 12, 91, 122, 124, 130-131, 147, 148, 151 140, 172

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293 INDEX snacks, 122, 124 food intake evaluation, 46, 49, 53, 57, translating meal requirements into, 63-65, 77-78, 178, 185 129-131 fruits and vegetables, 63, 64, 78, 79, writing, 110 173, 178 Micronutrients (see also specific nutrients) grains/breads, 63, 64, 78, 79, 173, 174 current vs. recommended, 9, 26 and meal pattern planning 19, 49, 70, prevalence of inadequacy, 65 109-110, 117, 171, 173, 174 Migrant children, 4, 25, 29 meat and meat alternate group, 49, 63, Milk (see also Breastfeeding and breast 64, 79, 173, 174 milk; Formula, infant) milk, 48, 63, 64, 79, 171-172, 173, 174 adults, 33, 78, 79, 118-119, 120, 121, nutrient intake evaluations, 100-101, 123, 132 102, 103-104 children ages 1 to 18 years, 5, 7, 13, 33, solid fats and added sugars, 53, 63, 64 34-35, 49, 63, 64, 73, 115, 118-119, MyPyramid Equivalents Database, 46, 49 120, 121, 122, 123, 124, 127, 129, 130-131, 132, 140, 144, 173, 174 N cost considerations, 139, 144, 145 current requirements, 9, 26, 31, 33, 34- National Adult Day Services Association, 35, 41, 140 41 Dietary Guidelines, 13, 18, 49, 73, 172, National Cancer Institute, 47 185, 186 National Center for Health Statistics, 45, flavored, 9, 13, 127, 129, 132, 139, 70 172, 173 National Food Service Management food specifications, 7, 9, 119, 127, 128, Institute (NFSMI), 158, 166 129, 130-131, 132, 172, 173 National Health and Nutrition fostering acceptance of, 178 Examination Survey (NHANES), implementation of changes, 163, 178 17, 21, 45, 46, 47, 51, 52, 53, 54, infants under 1 year, 49, 62, 117, 127, 56-57, 63, 67, 68, 69, 71, 72, 77-78, 140, 171 80, 81, 82, 93-94, 96, 98, 99, 105, intakes, 21, 62, 63, 64, 79, 129, 174, 131, 178 185 National Institute of Food and Agriculture, meal and snack patterns, 6, 7, 31, 33, 157-158 34, 115, 117, 118-119, 120, 121, National Institutes of Health, 19 122, 123, 124, 140, 145, 171-172, National Nutrition Monitoring and Related 174 Research Act of 1990, 18 menu samples, 122, 124, 130-131 National Professional Association, 164 MyPyramid targets, 48, 63, 64, 79, 171- National Research Council, 54 172, 173, 174 National School Lunch Act, 31 nutrient intakes, 86 National School Lunch Program (NSLP), 2, recommended changes, 5, 7, 9, 115, 16-17, 18, 20-21, 38, 40, 50, 52, 89, 120, 140, 174 117-118, 131 substitutes, 9, 127, 128, 132, 133 Niacin, 56, 67, 80, 100, 102, 105, 106, Monitoring compliance with CACFP, 10, 107, 108, 109, 175, 177 11, 12, 13, 18, 27, 37-38, 116, 153, Non-nutritive sweeteners, 20 156, 161, 162-163, 164, 166, 181- Nutrient intakes (see also specific nutrients) 182, 186 children and adolescents, 66-69 MyPyramid DRIs and, 54-57, 67-68, 97-98 applicable population, 19 effect of recommended Meal calorie requirements estimated from, Requirements on, 176, 177 51-52, 79, 95, 100-101 evaluation, 53-57

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294 CHILD AND ADULT CARE FOOD PROGRAM R infants, 65-66 Iowa State University method, 54 Recommendations (see also Development of low-nutrient, energy-dense foods, 21 recommendations) prevalence of inadequacy, 66-67 adaptability to provider venues, 13-14 setting targets, 96-102, 105-109 breastfeeding, 133-134 Software for Intake Distribution children and adults, 5, 114-124, Estimation, 54 171-176 TMI approach, 97, 100-101, 102-103 consistency with committee criteria, usual intakes, 54, 68 169-181 Nutrition education, 14, 18, 37, 38, 125, cost sensitivity, 4, 14, 147-148 151, 158 current requirements compared to, 5, Nutrition standards for foods in schools, 130-134 20, 21 and dietary guidance, 12, 115-116, 171- Nutritional labels, 7, 9, 103, 115, 128, 133, 173, 174, 175-176 159, 179 and diversity of food selection, 13 evaluation of programs, 11-12, 183-187 food specifications, 4, 5, 6-7, 124-129, O 178-179 Obesity (see also Childhood obesity) fruits and vegetables, 5, 8, 14, 73, 114, and dietary modifications, 84 115, 120, 121, 132, 134, 139, 140, prevalence, 170 142, 171, 182 Observing Protein and Energy Nutrition grains/breads, 5, 7, 8, 14, 73, 114, 115, study, 47 120, 132, 134, 139, 140, 142, 144, Older Americans Act, 30, 31 171, 174, 182 Older Americans Nutrition Program, implementation strategies, 10-11, 115 181-182 Omnibus Budget Reconciliation Act of infants, 5, 114, 116, 170-171 1981, 30 meal patterns, 4, 5, 6-7, 116-124 Outside school hours care facility, 16, 27, meal requirements, 5-10, 113-116, 30, 32, 37 169-181 meats and meat alternates, 5, 8, 9, 14, 120, 121, 132, 133, 139, 140, 170 P menu development, 129-130 milk, 5, 7, 9, 115, 120, 140, 174 Personal Responsibility and Work periodic reassessment, 188-189 Opportunity Reconciliation Act, 30, practicality, 4, 12-13, 133 35, 37 research, 11, 187-189 Phosphorus, 56, 65, 66, 67, 80, 100, 102, snacks, 10, 116, 180-181 106, 107, 108, 175, 177 Recommended Dietary Allowances (RDAs), Physical activity, 18, 52, 66, 70, 73, 84, 19, 35, 54-55, 83 157 Recommended Nutrient Intakes, 19 Phytochemicals, 78 Reimbursement (see also Monitoring Portion or serving sizes, 5, 6, 34, 78, 125, compliance with CACFP) 132, 133, 139, 140, 141, 146, adult day care, 28, 32, 36, 143 164-165 at-risk afterschool care facility, 32, 143 Potassium, 12, 65, 67, 68, 81, 86, 99, 100, center-based facilities, 15, 32, 35-36 102, 104, 109, 175, 177 child day care, 27, 29, 32, 36, 143 Protein, 9, 51, 56, 65, 66, 67, 68, 80, 83, emergency shelters, 29 98, 100, 102, 104, 127, 133, 175, home-based day care, 15, 28, 29, 32, 177 36, 37

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295 INDEX ineligible foods, 130 regular, 119-122, 123, 139, 140, 142, non-food costs, 149-151 143-144, 156 outside school hours care facility, 32 reimbursement, 109, 119, 143 processes/methods, 10, 35-37, 116, 164, Sodium 181-182 age group and, 105, 106-108, 125, 175, and provider acceptance of changes, 14 177 qualifying meals and components, 10, current requirements, 9, 16, 132, 133 26, 31, 33-37, 41, 142 dietary guidance, 12, 13, 19, 35, 49, 99, rates, 14, 27, 28, 30, 36, 37, 161, 180, 172 187 food specifications, 8, 125, 128, 129, reporting/record-keeping requirements, 130, 132, 133, 138, 156, 170, 178, 10, 11, 37, 38, 150, 153, 159, 162, 179, 188 164, 165, 182 implementation challenges, 156, 157, snacks, 109, 119, 143 180 statutory basis, 30, 37, 143 intakes, 57, 62, 67, 69, 82, 100, 102, Reporting/record-keeping requirements, 10, 106-108, 109, 179 11, 37, 38, 150, 153, 159, 162, 164, limiting/decreasing, 5, 7, 13, 14, 19, 73, 165, 182 74, 85, 86, 114, 115, 129, 132, 134, Research recommendations, 11, 187-189 156, 157, 158, 179, 182 Riboflavin, 56, 67, 80, 100, 102, 175, 177 meal patterns and, 175, 177 MyPyramid, 100, 102 recommendations, 9, 114, 132, 133, 171 S setting targets, 99, 100, 102, 104, 105 UL, 82, 99, 104, 105, 106-108 Saturated fat, 8, 35, 57, 69, 82, 99, 100, Solid fats and added sugars 101, 126, 132, 147, 173, 175, 176, current vs. recommended requirements, 177, 179, 188 9, 26 School Breakfast Program (SBP), 2, 16-17, Dietary Guidelines, 19 18, 20-21, 38, 40, 50, 52, 89, 117- energy benchmarks, 35 118, 131 food specifications, 9, 126, 128, 129, School foods and meals (see also At-risk 132, 138, 170, 177-178, 179 afterschool care programs; National intakes, 19, 46, 53, 62, 63, 64, 65, 68, School Lunch Program; School 78, 79 Breakfast Program) limiting/decreasing, 5, 7, 8, 9, 13, 14, Dietary Guidelines, 20, 21 19, 73-74, 78, 86, 114, 115, 134, nutrition standards for competitive 139, 156, 157, 158, 171, 172, 173, foods/meals, 2, 20-21 180, 181, 182 recommended requirements for meals, Special Food Service Program for Children, 20-21 29, 30, 35 School Lunch and Breakfast Cost Study, Special nutritional considerations 149-150 adults, 82-96 Shelters (see Emergency shelters) bone health, 73 Snacks children and adolescents, 70-74 consistency of committee criteria with chronic disease, 84-85 recommendations, 180-181 ethnic and religious considerations, 86 enhanced, 8, 10, 96, 113, 116, 122-124, fluid requirements, 84 132, 139-140, 142, 143-144, 156, foods and nutrients to be encouraged or 180-181 limited, 73-74 patterns, 119-124 functional limitations, 85 recommendations, 116, 119-124, physical activity level, 84 180-181 texture modifications, 85

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296 CHILD AND ADULT CARE FOOD PROGRAM vitamin B12, 83 fried or starchy, 62, 65, 114, 125, 132, vitamin D and calcium, 83-84 158, 178 weight status, 70-72 implementation of recommendations, Statement of task, 2, 17 155-156, 158, 159, 164, 166, 178 Summer Food Service Program, 30 practical considerations, 133 Supplemental Nutrition Program for sodium content, 132 Women, Infants, and Children (see Vitamin A, 56, 65, 66, 67, 69, 80, 100, WIC) 102, 105, 106, 107, 108, 109, 127, Survey of Income and Program 175, 177 Participation, 40 Vitamins B6, 56, 67, 80, 86, 100, 102, 106, 107, 108, 175, 177 Vitamins B12, 56, 65, 67, 77, 80, 83, 86, T 100, 102, 175, 177 Vitamins C, 56, 65, 66, 67, 80, 86, 98, Target Median Intake (TMI) approach, 97, 100, 102, 106, 107, 108, 175, 177 100-101, 102-103 Vitamin D, 46, 65, 67, 73, 77, 82, 83-84, Technical assistance for providers, 10, 13, 86, 99, 127, 188 14, 19, 27, 37-38, 150, 151, 153, Vitamin E, 12, 56, 65, 66, 67, 80, 99, 100, 157, 158-159, 161, 162, 163-164, 102, 104, 106, 107, 108, 109, 119, 165, 166, 181 173-174, 175, 176, 177 Texture modifications, 85 Thiamin, 56, 67, 80, 100, 102, 175, 177 Tolerable Upper Intake Levels (ULs) W defined, 55 and development of recommendations, WIC, 1, 2, 30 105-109 breastfeeding support, 20, 134 nutrient intake assessment, 53-54, 56- consistency of CACFP with, 20, 21, 50, 57, 63, 69, 82 52, 98, 111, 115, 116, 127, 131, Training agency staff, sponsors, and 187 program providers, 10, 13-14, 27, dietary intakes of participants, 62, 65, 37, 133-134, 150-151, 154, 157- 68, 69 158, 159, 161, 162, 163, 164-165, food package standards, 20, 21, 50, 52, 166, 179, 181 126, 127 Trans fat, 5, 7, 9, 13, 99, 101, 103, 114, 115, 128, 129, 133, 134, 156, 171, Y 172, 179 Yogurt, 5, 7, 9, 63, 79, 86, 115, 117, 119, 127, 128, 130, 132, 139, 156, 172, U 173 U.S. Department of Agriculture (see also specific services) Z Survey Foods, 46 Zinc, 48, 50, 56, 65, 67, 69, 80, 100, 102, 105, 106, 107, 108, 171, 175, 177 V Vegetable oils, 64, 79, 99, 119, 125, 127, 128, 173 Vegetables (see also Fruits and Vegetables) composite food group, 139