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Child and Adult Care Food Program: Aligning Dietary Guidance for All
tion of a group whose usual intakes do not meet the requirements (Beaton, 1994; Carriquiry, 1999; IOM, 2000). This approach was used to estimate the prevalence of inadequate intakes within each of the CACFP age groups for protein, carbohydrates, nine vitamins (A, B6, B12, C, E, thiamin, riboflavin, niacin, and folate), and three minerals (phosphorus, magnesium, and zinc).
Some of the CACFP age groups contain more than one DRI age group; for example, the age group for children 5 to 10 years contains two: DRI age groups 4–8 years and 9–13 years. The CACFP group for females (or males) ages 19–59 years contains three DRI groups: 19–30, 31–50, and 51–60 years. When mixed CACFP age groups occurred, the committee first estimated usual nutrient intake distributions and the proportion of individuals with usual intakes below the EAR using the DRI groups. The committee then computed the weighted average of the DRI group-specific prevalence of inadequacies, where the weights were given by the proportion of persons that belonged to each DRI group in the mixed CACFP group.
For female adolescents and for women ages 19–59 years, the probability approach (NRC, 1986) was used to assess iron intake, as recommended by the IOM (2000). This more complex approach accounts for both the distribution of iron requirements (which is skewed for these age-gender groups; see IOM, 2000) and the distribution of usual intakes. Moreover, the committee increased the EAR value used for females ages 11–13 years from 5.7 mg of iron per day to 7.5 mg per day, as explained in the School Meals report (IOM, 2010, pp. 65–66). Dietary Reference Intakes: Applications inDietary Assessment (IOM, 2000) provides more detailed information about the EAR cut-point and probability methods.
Evaluating Adequacy for Nutrients with an AI
Groups with mean intakes at or above the AI can generally be assumed to have a low prevalence of inadequacy for the criterion of adequate nutritional status used for that nutrient. Assumptions about the inadequacy of intakes cannot be made when the mean intake is below the AI. As described by the IOM (2000), the inherent limitations of the AI affect the inferences that can be made about the prevalence of inadequacy for nutrients with an AI (IOM, 2000). Data were evaluated by comparing the estimated mean intakes with the AI. For the mixed DRI age groups, the committee proceeded as described above and computed the weighted average of the mean intakes divided by the age-appropriate AIs.
Evaluating the Risk of Excessive Intake
The proportion of a group with intakes above the UL is an estimate of the prevalence of intakes at risk of being excessive. The data from NHANES