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Child and Adult Care Food Program: Aligning Dietary Guidance for All (2011)
Food and Nutrition Board (FNB)

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. "3 Methods for Examining Food and Nutrient Intakes." Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press, 2011.

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Child and Adult Care Food Program: Aligning Dietary Guidance for All

STANDARDS USED TO REVIEW FOOD INTAKES

Infants and Children Younger Than 2 Years of Age

Because the Dietary Guidelines for Americans (HHS/USDA, 2005) excludes children under the age of 2 years, published statements of the American Academy of Pediatrics (AAP) were used as the source of dietary guidance for this age group (see Table 3-1). Nutrient intakes were examined using Dietary Reference Intakes (see later section “Nutrient Intake Evaluation”).

The AAP acknowledges that there is little evidence for order of first foods and states that its preferred first foods are iron-fortified cereal and pureed meat (AAP, 2009). However because iron and zinc are better absorbed from meat than grains, they may be a preferred first food, particularly for breastfed infants (Krebs et al., 2006).

Children Over 2 Years of Age and Adults

The standard used to review food intakes of persons over 2 years of age was the MyPyramid food guidance system.1 MyPyramid provides specific food-based dietary guidance that are consistent with the recommendations in the 2005 Dietary Guidelines for Americans (HHS/USDA, 2005) for all individuals over the age of 2 years. That is, MyPyramid uses food patterns to translate the 2005 Dietary Guidelines into recommendations about the types and amounts of food that will promote health and healthy weight (Marcoe et al., 2006). Extensive information about MyPyramid is available online at www.mypyramid.gov. A key aspect of MyPyramid concerns the forms of foods used to develop the food patterns. In particular, the foods included in each of the MyPyramid food groups are the lowest in fat (e.g., lean meat and fat-free milk), and they are free of added sugars (e.g., water-packed canned fruit).

THE DETERMINATION OF AGE GROUPS, BODY WEIGHTS AND HEIGHTS, AND ESTIMATED CALORIE REQUIREMENTS

Before dietary intakes could be assessed, it was necessary to establish appropriate age groups for CACFP, determine body weights and heights by

1

The DASH diet eating plan (NHLBI, 2010; http://www.nhlbi.nih.gov/hbp/prevent/h_eating/h_eating.htm), which is very similar to the MyPyramid food guide, has been documented to lower blood pressure among adults (Appel et al., 2006; Ard et al., 2004; Sacks et al., 2001); however the committee found that its use for review of food intakes and planning meals for CACFP would present logistical problems. For example, it would not match satisfactorily with the MyPyramid Equivalents Database, 2.0, for USDA Survey Foods, 2003–2004 (MPED 2.0).

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Front Matter (R1-R14)
Summary (1-14)
1 Introduction (15-24)
2 The Child and Adult Care Food Program (25-44)
3 Methods for Examining Food and Nutrient Intakes (45-60)
4 Nutritional Considerations for Infants and Children (61-76)
5 Nutritional Considerations for Adults (77-88)
6 Process for Developing Recommendations for Meal Requirements (89-112)
7 Recommendations for Meal Requirements (113-136)
8 Meal Cost Implications (137-152)
9 Implementation (153-168)
10 Consistency of Recommendationsfor Meal Requirements and Implementation Strategies with the Committee's Criteria (169-182)
11 Evaluation and Research Recommendations (183-190)
Appendix A: Acronyms, Abbreviations, and Glossary (191-196)
Appendix B: Biographical Sketches of Committee Members (197-204)
Appendix C: Workshop Agenda: February 2010 (205-206)
Appendix D: Critical Issues for Consideration by the Committee to Review Child and Adult Care Food Program Meal Requirements, as Submitted by the U.S. Department of Agriculture (207-212)
Appendix E: Current CACFP Meal Patterns (213-222)
Appendix F: Selected Food Program Descriptions and Websites (223-228)
Appendix G: Data Sources and Analytical Methods (229-234)
Appendix H: MyPyramid Food Groups and Subgroups (235-238)
Appendix I: Food Cost Approach and Methods (239-250)
Appendix J: Nutrient Targets by Meal and Age Group and Comparison of MyPyramid Food Group and Nutrient Targets with Recommended Meal Patterns (251-268)
Appendix K: Sample Menus (269-280)
Appendix L: Options for Breastfeeding Incentives (281-282)
Appendix M: Potential Partnerships to Assist with Technical Training for CACFP (283-284)
Index (285-296)