Child Care Sites Participating in the Federal Child and Adult Care Food Program Provide More Nutritious Foods and Beverages

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Approximately 1 in 4 US children of age 2−5 years were overweight or obese in 2015−2016.Dietary intakes in early childhood have implications for weight later in life. Moreover, obese children are at increased risk for developing diabetes, coronary heart disease, and other chronic health conditions. Because food habits are largely established early in childhood, it is recommended that obesity prevention measures are taken before children are of school age. Child care settings are an ideal environment for intervening because nearly 3 of 4 children of age 3−5 years in the US are enrolled in child care centers/ preschools or family child care homes.

The federal Child and Adult Care Food Program (CACFP) reaches more young children in child care than any other single program. The CACFP provides full or partial reimbursement for meals and snacks served to more than 4 million children annually. Eligibility varies depending on site type, with the focus on providers and children from low-income households. Participating child care centers and family child care homes can be reimbursed for up to 3 daily meals and snacks. To qualify for reimbursement, each meal/snack must include certain components such as age-specific amounts and types of milk, fruit and vegetables, grains, and meat/ meat alternatives. For example, for a breakfast served to a child of age 3−5 years to be reimbursed, the meal must include 3 components: 6 fluid oz of milk (unflavored, lowor nonfat), half a cup of fruit and/or vegetable, and a whole-grain−rich or enriched grain product (such as half a slice of bread or a quarter cup of breakfast cereal, with grain-based desserts not counting toward the grain component).

Prior studies showed that child care sites participating in CACFP compared with those that do not serve more vegetables,9−11 whole grains12 and healthier beverages,13 and decreased provision of sweetand snack-type foods.10 Having meal-component requirements in place is a likely contributing factor. However, serving more daily meals and snacks also provides more opportunities during the day to serve a wider range of nutritious options. It is possible that the nutritional advantages of CACFP disappear after accounting for the number of eating occasions.

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