rr37
USDA m?zw
Department of
Agriculture
Food and
Consumer
Service
Office of
Analysis*
Evaluation
Jury 1997
Contract No.
53-3198-3-018
Early Childhood and
Child Care Study
Summary of Findings
o?A
Early Childhood and Child Cars Study
Tables of Contents
Background 2
Characteristics of Participating Homes and Centers 6
Characteristics of Children and Their Families 7
Meals and Snacks Offered by CACFP Providers 9
Meals and Snacks Consumed by CACFP Participants 15
Nutrition Knowledge and Practices of CACFP Food Preparers 22
Summary of Findings 1
Early Childhood and ChUd Cam Study
Background
The Child and Adult Care Food Program (CACFP) is a Federal
program that provides meals and snacks in child and adult day care
facilities.The child care component of the CACFP provides Federal
funds for meals and snacks served to children in nonresidential
day care facilities.These include family and proup day care homes
(homes), Head Start centers, and some child care centers. In fiscal
year 1995, the program served an average of 2.3 million children
daily at a cost of $1.5 billion. Forty-two percent of these children
were served through homes; 58 percent through centers.
Home- and center-based child care are fundamentally different.
Because home- and center-based care are so different, the CACFP
applies different rules for reimbursement and administration, as well
as different criteria for participation, to the two types of provide».
Licensed centers may participate in the CACFP independently
or under the aegis of a nonprofit agency that assumes administrative
responsibility for the centers it sponsors (sponsored centers).
Centers receive three different categories of reimbursement for the
meals and snacks they serve, based on children's family income.
Meals and snacks served to children from families with income at or
below 130 percent of poverty are reimbursed at the "free" (highest)
rate; meals served to children from families with income between
130 percent and 185 percent of poverty are reimbursed at the
"reduced-price" (somewhat lower) rate; and meals and snacks served
to children from families with income above 185 percent of poverty
are reimbursed at the "paid" (lowest) rate.The reimbursement rates
in effect in 1994-1995 are shown in (Exhibit 1). Reimbursement is
limited to a maximum of two meals and one snack or one meal and
two snacks for children in care fewer than eight hours per day. At the
time this study was conducted, centers could receive reimburse-ment
for an additional meal or snack for children in care eight or
more hours per day.
2 Summary of Findings
Early Childhood and ChUd Can Study
taMMM
CACPP Reknbwaanwnt Rates for CMM Car* Contort
Ju* 1994-Jtmt 1995
nuffliij rfyniji BTMMMI Lunch/Supper Snack
Rta $0.9750 $1.7575 $0.4625
Raduosd-prica $04)750 $1.3675 $02400
Paid $0.1925 $0.1700 $0.0450
In order to participate in the CACFP, family day care homes must
meet State licensing requirements, where these are imposed, or be
approved by a Federal, State, or local agency. In addition, homes must
be sponsored by an organization that assumes responsibility for en-suring
compliance with Federal and State regulations and that acts as
a conduit for meal reimbursements to family day care providers. At
the time this study was conducted, homes were reimbursed at a flat
rate for each meal or snack served.The 1994-1995 reimbursement
rates for homes were $0.8275 for breakfasts; $1.5050 for lunches and
suppers; and $0.4475 for snacks. Meals served to the provider's own
children were reimbursable only if the provider's income did not
exceed 185 percent of the poverty threshold.
This publication, which is based on the Early Childhood and
Child Care Study, describes the institutions and children that partici-pate
in the CACFP It also describes the nutrient content of meals
and snacks offered by participating sites (CACFP providers) and the
meals and snacks consumed by children while receiving care in
those sites (CACFP participants). Finally, information is presented on
the relative nutrition knowledge of individuals with primary respon-sibility
for preparing CACFP meals and snacks and the extent to
which CACFP providers are using desirable food service practices.
The information presented in this report reflects program operations
before the implementation of changes stemming from the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996
(P.L 104-193). This act mandated several changes to CACFP regula-tions
including changes in the reimbursement structure for homes
and the reduction in the number of meals that CACFP centers may
claim for reimbursement.
Summary otMtH 3
Earfy ChMdhood and CNU Can Study
The Early Childhood and Child Care Study collected information
from nationally representative samples of sponsoring agencies,
participating child care sites, and children.A total of 1,962 CACFP
providers supplied information about all meals and snacks offered
during a one-week period between January and June, 1995. Obser-vers
recorded detailed information about the foods and beverages
consumed by a total of 1,347 children while they were in child
care. Information on household characteristics was obtained
through interviews with 1,951 parents or primary caregivers of
these children.
The study compares the nutrient content of meals and snacks
offered and consumed with several nutrient standards (Exhibit 2).
These standards are used solely for the purpose of providing bench-marks
to facilitate interpretation of the nutrient data. CACFP pro-viders
arc not required to meet these, or any other, nutrient-based
standards.
Exhibit 2
IVUUWIH otarKMTOv UOTG m UN Cany IHIMJIMMMJ MN
Chid Cart Study
ll«llnn«l ^-« nauunai ocnoo'i ILunc«n- fniuyiw■ n■■ ma« ^o-c«n-oo«i ■D»raM»u"s-s-x- rnrogrs»■n■■i
• One-fourth of IheROA for breakfast
• One-third of the RDA for lunch
f
• UrnK intake of toteJ fat to rwnwre than 30 pe^
• Limit intake of saturated fat to lees then 10 percent of total calories
National Reeeercn Counot?o IMef and' rveeffft Roport
increase miaKe or caroonyoraie IO ex least oo percent or total
• Limit cholestefol Intake to 2,400 mg or less per day
• Urn* sooTurn intake to 300 mg or less per day
Apptad only to maaJa offatad to and consumed by cMdran ftva yarn c4 aga und oidar.
4 Summary of Rndhgt
Early Childhood and ChUd Care Study
The Recommended DietaryAllowances (RDA) arc the levels of
intake of essential nutrients that are adequate to meet the known
nutrient needs of practically all healthy persons.They are traditionally
used to plan menus for schools and other group feeding programs.
The National School Lunch Program (NSLP) requires that lunches
provide one-third or more of the RDA.The School Breakfast Program
(SBP) requires that breakfasts provide one-fourth of the RDA. Recent
regulations require that Head Start programs meet these same nutri-tional
requirements (45CFR 1304). Head Start performance standards
further specify that children in part-day programs must receive at
least one-third of the RDA and that children in full-day programs
must receive one-half to two-thirds of the RDA, depending on the
length of the program day. This study examined the contribution of
CACFP meals and snacks to the RDA for calories as well as five key
nutrients targeted by USDA in ongoing efforts to improve the nutri-tional
quality of meals offered in the NSLP and SBP (protein, vitamin
A, vitamin C, calcium, and iron).
The Dietary GuidelinesforAmericans provide broad food-based
recommendations for a healthy diet as well as quantitative goals
for intake of total fat and saturated fat (expressed as a percentage of
total calories).While the quantitative goals for intake of fat and
saturated fat apply only to children five years of age and older, it is
recommended that children between the ages of two and five con-sume
gradually diminishing amounts of fat and saturated fat so that,
by about five years of age, children are consuming a diet that is
consistent with the Dietary Guidelines goals. In keeping with the
Dietary Guidelines recommendation, quantified standards for the
percentage of calories from the various macronutrients have been
applied only to meals offered and consumed by children five years
of age and older.
Because the Dietary Guidelines do not provide quantitative goals
for carbohydrate, sodium or cholesterol intake, the standards used in
this study are based on recommendations of the National Research
Council (NRC), as published in their report, Diet and Health. Quanti-fied
standards for cholesterol and sodium, like those for the percen-tage
of calories for the various macronutrients, have been applied
only to children age five and above.
Summaiy ofFindings 5
Early Childhood and ChUd Can Study
Characteristics of Participating
Homes and Centers
■ ••
CACFP is administered in two different
child care settings-homes and child
care centers, including Head Start
centers. Homes are private, and must
have CACFP sponsors. Centers can be
public or private and do not require
sponsors. If a center is private, it must
be either nonprofit or, if for-profit, at
least 25% of its children must receive
compensation for child care under
Title XX of the Social Security Act.
Homes are much smaller than
centers.
Homes enroll an average of eight child-ren,
including a provider's own children.
After adjusting for absenteeism, an
avenge of seven enrolled children are
in care on a daily basis. Centers are con-siderably
larger than homes.The average
Head Start center enrolls 60 children,
while the average child care center
enrolls 70 children. Average daily atten-dance
is 53 for Head Start centers and
57 for child care centers.
Homes and child care centers offer
full-day care, five days per week;
Head Start centers tend to offer
part-day programs.
The typical home provides care 11
hours per day, five days per week, on a
year-round basis. Child care centers
operate an average of 10 hours per day,
five days per week. Head Start centers,
on the other hand, are open an average
of about eight hours per day, and nearly
one-third (31%) are open fewer than five
days per week. In addition, most Head
Start centers follow school calendars
rather than being open year-round.
Figure 1. Funding Sources Differ by Type of Provider
Hssdtti
CtftftOfs
CNMCsrs
C#crt#rs
Head Start programs do not offer
typical child care services. Rather, these
programs are best viewed as compre-hensive
child development programs
intended to promote social competence
and improve the emotional and cog-nitive
development of low-income
children. While some Head Start centers
combine part-day programs with full-day,
work-related child care programs,
most Head Start centers operate part-day
programs.
Funding sources differ by type of
provider (Figure 1).
More than half (56%) of omify day
care providers are funded exclusively by
parent fees. In contrast, almost all (96%)
Head Start centers are funded exclu-sively
by government subsidies. Nearly
three-quarters (71%) of child care
centers are funded by both parent fees
and government subsidies. Parent fees
are comparable in homes and child care
centers.The average hourly fee for full-time,
unsubsidized cur is $1.90 in
homes and $1.96 in child care centers.
36%
71%
11%
18%
onlyptylng
PuyingOnty
98%serveonry
subsidized families
rpm-.y^wiiny mmnnrut of*ui rufiW■<■<Ju■■W it
71% serve a mix of
paying and subsidized
families
Ml SubsktzedOnly
6 Sunwnefy of FinoinQM
Early ChMhood and Child Care Study
Figure 2. Almost 40% of Family
Day Car* Providers Are
At or Below 186% of
Poverty
At or I
1S5% of poverty
38%
Almost 40% of family day care pro-viders
ar- at or below 105% of
poverty (Figure 2).
For the average family day care pro-vider,
child care is an important source
of household income.Total child-care
income, including CACFP meal reim-bursements,
accounts for 43 percent of
providers' median household income.
For low-income providers, child care
income accounts for more than one-half
(55%) of totai household income. On
average, income from CACFP accounts
for a relatively small proportion (14%)
of providers' child care income.
Characteristics of Children
and Their Families
CACFP benefits were originally targeted
at children from low-income families.
Program coverage expanded in the late
1970s when the elimination of the
means test in participating homes (PL.
95-627) enabled family day care pro-viders
to receive reimbursement for
meals and snacks served to all child-ren
(other than the provider's own
children), regardless of family income.
Most recently, the Personal
Responsibility and Work Opportunity
Reconciliation Act of 1996 (PL 104-193)
seeks to refocus the family day care
portion of the program on low-income
children by targeting benefits to homes
serving children from low-income
families.The characteristics of participat-ing
children and families covered in this
report summary reflect the operation
of the program before the implementa-tion
of this legislation.
Most of the children participating
In the CACFP are preschoolers
between the ages of three and
five (Figure 3).
Virtually all of the children (99%) who
participate in the CACFP through Head
Start centers are between the ages of
three and five. Other child care centers,
and particularly family day care homes,
serve a more varied group of children.
Nonetheless, preschoolers account for
two-thirds of the children in centers and
42 percent of the children in homes.
Figure 3. Most Children Are Preschoolers Between the Ages of
Three and Five
FamayDayCm HMd Start
Canhm
CMdCm
Canlm
\Undf 1 ymr 1 1-2ymrt*t$ 3-5 \6-12y—roU$
Summary ot Findings 7
Early Childhood and ChUd Cam Study
Figure 4. The Majority of Children in Homes Are From Families With
incomes Higher than 185% of Poverty
100%
Children in homes tend to come
from households with higher
incomes than children in centers
(Figure 4).
The median family income of children
receiving care in homes is $40,484.
compared with $10,433 for children in
Head Start centers and $24,022 for
children in child care centers. More
than three-quarters (78%) of the
children in homes are from families
with incomes above 185 percent of the
poverty threshold. By contrast, only
eight percent of children in Head Start
centers and 47 percent of children in
child care centers are from families
with incomes above this threshold.
FMitfyDayCara Head SUrl Ontof* CWCMCMHI
130% of poverty orMM ■ 131% to 185% of poverty mm Over 185% ol poverty
6 Summary of rindinffs
Early Childhood and ChHd Can Study
Meals and Snacks Offered
by CACFP Providers
• ••
The goal of the CACFP is to provide
nutritious meals and snacks to children
in child care programs.To this end,
USDA has established meal pattern
requirements designed to ensure that
meals and snacks offered by CACFP pro-viders
include the kinds and amounts of
food required to meet chiklrei.'s daily
energy and nutrient needs (Exhibit 3).
In addition, program regulations
specify minimum amounts of each
component to be offered to children of
different ages.The average portions
taken at breakfast and lunch are gener-ally
equivalent to or greater than the
minimum portions specified in the
CACFP meal pattern. CACFP providers
are not required to meet specific
nutrient-based standards. The findings
reported below are consistent for
homes, Head Start centers, and child
care centers except when noted.
On an average day, more than nine
out of ten CACFP breakfast menus and
about 87 percent of CACFP lunch
menus comply with all component re-quirements.
The component most often
missing is juke, fruit or vegetable. In
the case of CACFP lunches, it is the
second serving of this component that
is most often omitted.
CACFP providers rarely offer children
choices within a meal component
category, such as a choice between two
types of cereal at breakfast or two main
dishes at lunch. CACFP providers do
offer children a variety of different
foods over the course of a typical week,
however.An average of four different
types of fruit, vegetables, or juice are
offered at breakfast, as well as three to
four different types of bread or
acceptable bread alternates.
Lunches include even more variety.
Over the course of a typical week,
CACFP providers offer children nine to
10 different types of fruit, vegetables, or
full-strength juices; three different types
Figures. Breakfasts Provide Mora Than One-fourth of the RDA for All
Key Nutrients but Not for Calories
100%
Onatarvtaa
• tuatm.
• 100ft Jute. IruR, or
m
i«
OnsseHna
• tuMmft
• mortar
• bandar
IHO SMVfcipji of fcvft endtor
Ateeicl
• tuUmflk
• motor
• bnedor
• iQtJftMoft.lnt.or
of bread or acceptable bread alternates;
and five different meats or meat alter-nates.
The decreased variety of foods
offered in the bread/bread alternate
component at lunch, relative to other
components, is due to frequent use of
sandwiches and a reliance on white
bread and sandwich rolls.
CACFP breakfasts provide more
than one-fourth of die IDA for
all key nutrients, but not for
calories (Figure 5).
On average, breakfasts offered by
CACFP providers supply more than one-half
of the RDA for protein and vitamin
A, about three-quarters of the RDA for
vitamin C, and more than one-third of
the RDA for calcium and iron. By com-parison,
breakfasts are low in calories,
providing, on average, 19 percent of
the RDA.
Summary oi Findings 9
EanyCMdhood and ChtdCara Study
Figure 6. Breakfasts Maat tna DhUtry Guktotlnos Goal for Total Fat
ths NRC Racomm#nda*lon for Carbohydrate, but Not ths
Goal for Saturated Fat
CACFP breakfasts offered to child-ren
five years of age and older
meet the Dietary Guidelines goal
for percent of total calories from
fat and the NRC recommendation
for percent of calories from
carbohydrate but do not meet the
Dietary Guidelines goal for per-cent
of calories from saturated
fat (Figure 6).
The average percentage of calories
from fat in breakfasts offered to child-ren
five years of age and older is 23
percent, a level that is consistent with
the Dietary Guidelines goal of no
more than 30 percent.The percent-age
of calories from carbohydrate
(64 percent) is also consistent with
the NRC recommendation (55 per-cent
or more).The average percent-age
of calories from saturated fat is
11 percent, a level that exceeds the
Dietary Guidelines goal of less than
10 percent. In addition, there is little
evidence of decreasing amounts of
saturated fat in breakfasts offered to
children between the ages of two
and five, as recommended by the
Dietary Guidelines.
100%
Town
\OOOomlorNfK
fkteomrmndtton
Carbohydrate
or C§ton&t In OfQGktMKtt Offend
Figure 7. Breakfasts Mast NRC RacommandatJons for Chotastarol
and Sodium
100%
80%
60%
40%
20%
600%
<eoofn
|446mg
400%
200%
1
Sodium
Akvrao* Amount m
tOfhntd
10 Summary of Fmdmga
Earty Childhood and Chad Can Study
Average amounts of cholesterol
and sodium in CACFP breakfasts
offered to children five years of agi
and older are consistent with NRC
recotamendationa (Figure 7).
The average amount of cholesterol in
CACFP breakfasts offered to children
over the age of five is 51 mg. This is
within the recommended range of
75 mg or less (one-fourth of the sug-gested
dairy iimit of 300 mg). Likewise,
average sodium content of CACFP
breakfasiis, 445 mg, is consistent with
the recommended range of 600 mg
or less (one-fourth of the suggested
daily limit of 2,400 mg).
CACFP lunches provide more
than one-third of die IDA for all
key nutrients except iron and
less than one-third of RDA for
calories (Figure 8).
On average, lunches offered by CACFP
providers supply about 100 percent
of the RDA for protein and vitamin A,
about 50 percent of the RDA for
vitamin C, and more than 40 percent of
the RDA for calcium. CACFP lunches
provide leaser amounts of calories and
iron, averaging fust over 25 percent of
the RDA for each.
Figures. Lunchaa Provtda Mora Than Ona-third of tha RDA,
Excapt for Catortaa i
HW%
Summs/y of Findings 11
Earty CHUhood end CNU Can Study
Figure* Lunch— Do Not Moat Dhtary Gukt-Un— Goals for Total Fat
saiuratso rat or tna ttn\* HOC otnnwnaaiion TOT uaroonyorau
CACFP lunches offered to children
five and older do not meet the
Dtmtmry GuldeUnta goals for per-from
total fat or
I tat or the NIC recommen-i
for percent of calories from
pare 9).
The average percentage of calories from
fat in CACFP lunches offered to child-ren
five and older it 35 percent.The
average percentage of calories from
saturated fat In CACFP lunches is 14
percent.Therc is Httle evidence that
the relative fat and saturated fin' content
of CACFP lunches decreases gradually
in hmrhrs offered to children between
the ages of two and five. Moreover,
CACFP lunches derive too few calories
from carbohydrate.The carbohydrate
level in CACFP lunches, as offered to
children five and older, is 47 percent.
100%
dPSMkS *» Lunctm OUmma
Figure 10. Faw Providers Offar Lunchaa That Maat Dttttty Gukkttlnot
Goals for Total Fat or Saturated Fat
Few CACFP providers oiler I
that asset Dtmmry GnUtUut* \
for percent of calorie* from total
fat or aasarased 1st (Figure 10).
Only 14 percent of all providers offer
hinches to children live years of age
and oider that meet the Dietary
Guidelines goal. One-half of providers
offer lunches that average more than
35 percent of calories from fist.The per-centage
of providers SwPsfgJ lunches
that meet the Dietary Guidelines goal
for calories from saturated Cat is even
lower (4 percent). Close to one-half of
al providers (49%) offer lunches that
derive more than 14 percent of calories
from saturated fat.
100%
OomimmOQQem
12
Earty CMdhood and ChUd Can Study
CACFP lunches offered to children
ftre and oWier meet the NEC recotn-mendatton
for cholesterol, but not
for 10 ill—1 flUpwr 11).
The average amount of cholesterol Li
CACFP lunches offered to children five
and older is 65 mg-TMf it well within
the recommended range of 100 rng or
less (one-third of the suggested dairy
limit of 300 mg) Average sodium con-tent
of CACFP lunches is 919 mg.
This exceeds the recommended range
of 800 mg or less (one-third of the
suggested dairy limit of 2.4O0 mg)
CACFP providers offering low-fat
for most vitamins and minerals but
provide fewer calories.
Lunches that meet the Dietary
Guidelines goal for calories from fat
are slightly lower in calories than
other lunches but provide comparable
or greater amounts of vitamins and
minerals.These low-fat CACFP lunches
also provide less sodium and choles-terol
than other CACFP lunches.
Flflursj 11. LunchM Most tha NRC
but Nc4 tor Sodium
S100
1000%
Providers offering low-fat lunches
tend to offer different types of food
than providers that offer higher-fat
lunches.
Providers offering lunches that meet the
Dietary Guidelines goal of no more
than 30 percent of calories from fat
tend to offer the following foods more
often than providers offering higher-fat
lunches:
• 1% and skim milks;
• fruit, on a dairy basis; and
• rice.
And they tend to offer these foods less
often:
• whole milk;
• french fries and other
processed/fried potatoes;
• breaded, processed or fried meat,
poultry or fish;
• regular (as opposed to lean'• extra
lean) ground beef;
• regular (not low-fat) cheeses;
• regular (not low-fat) hot dogs and
cold cuts;
• high-fat condiments such as hutter,
sour cream, cream cheese, and
regular salad dressings.
Summary or Findnga 13
Earty ChMdhood and CHU Cant Study
Both morning and afternoon
snacks provide 10 percent or more
of the RDA for calories and key
nutrients (Figure 12).
CACFP snacks provide an average of
more than 10 percent of the RDA for
calories and equivalent or substantially
larger percentages of the RDA for all
key nutrients. Snacks are especially
rich in vitamin C, providing, on aver-age,
about one-third (afternoon snacks)
to 40 percent (morning snacks) of
the RDA.
The full complement of meals and
snacks ottered by most CACFP pro-viders
supplies more man one-half
of the RDA for calories and sub-stantially
more than two-thirds of
the IDA for key nutrients.
Forty-three percent of CACFP providers
offer breakfast, lunch and one snack
and 26 percent offer breakfast, lunch
and two snacks. Both of these meal and
snack combinations provide, on average,
more than 60 percent of the RDA for
calories. Both combinations also pro-vide
100 percent or more of the RDA
for protein, vitamin A, and vitamin C.
Calcium levels approximate 100 per-cent
of the RDA, and iron is provided
at levels that exceed 70 percent of
the RDA.
The full complement of meals and
snacks offered by most CACFP
providers mrcts or approximates
the Dietcry Guidelines goal for
percent ofcalories from fat as well
as the NBC recommrndation for the
percent of calories from carbohy-drate,
but does not meet the Dietary
Guidelines goal for percent of
calories from saturated fat.
The combination of breakfast, lunch,
and one snack, as offered to children
five years of age and older, supplies an
average of 31 percent of calories from
fat and 55 percent of calorics from
carbohydrate.The combination of break-out,
lunch, and two snacks supplies an
average of 30 percent of calories from
fat and 56 percent of calories from car-bohydrate.
Both combinatio s exceed
the Dietary Guidelines goal for calories
from saturated fat, averaging 13 percent.
Figure 12. Snacks Provide 10 Percent o< More of the RDA for Calories
and Key Nutrients
100%
80%
I eos
■8
40%
20%
0%
40%
Pro** VMmkiA VtanlnC CUchim
UonHngSnm*$ I AlfmoonSnackt
14 Summary ofFMnga
Early Childhood and Child Can Study
Meals and Snacks Consumed
by CACFP Participants
The nutrient profile of meals and snacks
actually consumed by participating
children may differ from what is offered.
For example, children may decline one
or more of the foods offered; children
may select portions that differ from the
avenge portion; or children may waste
(not consume) some of the food they
take. It is therefore important to examine
CACFP meals and snacks as actually
consumed by children.
Breakfasts consumed by CACFP
participants provide one-fourth
or more of the RDA for all key
nutrients except Iron and less
than one-fourth of the RDA for
calories (Figure 13).
On a typical day, children receiving
CACFP breakfasts consume about three-quarters
of the food they take. Different
types of food are consumed in approxi-mately
equal proportions. On average,
breakfasts consumed by CACFP parti-cipants
provide 40 percent or more of
the RDA for protein, vitamin A, and
vitamin C, and just over one-fourth of
the RDA for calcium. Intake of iron
from CACFP breakfasts is almost one-fourth
of the RDA (24%). Caloric intake
averages 15 percent of the RDA.
Figure 13. Breakfasts Consumed Provide One-fourth or More of the
RDA Except tor Calories and Iron
100%
(Mortm PraMn VanHnA VtamlnC CaMum
Summary of Findings 15
Early Childhood andChMd Can Study
Figure 14. Breakfasts Consumed Meet the Dhtary Guidelines Goal for
Total Fat and the NRC Recommendation for Carbohydrate,
but Not the Goal for Saturated Fat
Breakfasts consumed by CACFP
participants five years of age and
older meet the Dietary Guidelines
goal for percent of calories from
total fat and die NIC recommen-dation
for percent ofcalories from
carbohydrate, but not the Dietary
Guidelines goal for percent of calo-ries
from saturated Cat (Figure 14).
On average, 24 percent of die calories
in breakfasts consumed by CACFP par-ticipants
five years of age and older
come from fat, a level that is consistent
with the Dietary Guidelines goal of no
more than 30 percent.The average per-centage
of calories from carbohydrate
is 64 percent, which is consistent with
the NRC recommendation of 55 percent
or more.The average percentage of
calorics from saturated fat, 11 percent,
exceeds the Dietary Guidelines goal of
less than 10 percent.
100%
80%
eo%
40%
20%
04%
430%
ToMFat
OQQomlorNfK
HKOrWFMfldWtofl
Saturated Fat Carbohydrate
lAtmagaPmcammji
IctCaloritinBr—ktattaConHjmtd
Figure 15. Breakfasts Consumed Meet NRC Recommendations for
Cholesterol and Sodium
Breakfasts consumed by CACFP
participants five years erf age and
older meet NRC recommendations
for cholesterol and sodium Intake
(Figure 15).
The average amount of cholesterol in
CACFP breakfasts consumed by children
five years of age and older is 38 mg,
which meets the recommendation of
75 mg or less (one-fourth of die sug-gested
daily limit of 300 mg). Likewise,
children's average sodium intake from
CACFP breakfasts, 356 mg, meets the
recommendation of 600 mg or less
(one-fourth of the suggested daily limit
of 2,400 rag).
100% 000%
■00%
600%
400%
200%
Sodium
/bwapMate
16 sartwisfy of FwMMiQa
Early Childhood and ChHd Can Study
Figure 16. Lunches Consumed Provide One-third or More of the RDA
■Ewxicvewoirti f■ o*■•■r C^•*^aswlvoa*r* iwe^sp #a■«n■%d■ I■r■%a*»n■
100%
Catortaa PreWn
Figure 17. Lunches Consumed Do Not Meet Dietary Guidelines Goals
for Total Fat or Saturated Fat or the NRC Recommendation
for Carbohydrate
100%
TflMPM
DOQotJorNRC
Saturated Fat Carbohydrate
\Aimmg$P*ommg$
I of Catortaa *i Lunehm Conumad
Lunches consumed by CACFP par-ticipants
provide one-third or more
of the RDA for all key nutrients
except iron and less than one-third
of the RDA for calories (Figure 16).
Children consume, on average, about 70
percent of the food they take at lunch.
The average proportion of milk con-sumed
is substantially higher (83%) and
the average proportion of vegetables
consumec' s substantially lower (59%).
Lunches consumed by CACFP partici-pants
provide more than three-quarters
of the RDA for protein and more than
one-half of the RDA for vitamin A.
Intakes of viuurin C and calcium from
CACFP lunches approximate, on aver-age,
one-third of the RDA. Intakes of
calories and iron average 23 percent
and 22 percent of the RDA, respectively.
Lunches consumed by CACFP par-ticipants
five years of age and older
do not meet the Dietary Guidelines
goals for percent of calories from
total fat or saturated fat or the
NRC recommendation for percent
of calories from carbohydrate
(Figure 17).
The average percentage of calories from
fat in lunches consumed by CACFP par-ticipants
five years of age and older is
35 percent, whkh exceeds the Dietary
Guidelines goal.The average percent-age
of calories from saturated fat, 15
percent, also exceeds the Dietary
Guidelines goal. Finally, the average per-centage
of calories from carbohydrate is
46 percent, an amount that is lower
than the NRC recommendation.
Summary of Flndhos 17
Eariy CNMhood and ChUd Can Study
Figure 18. Lunches Consumed MMI NRC Recommendations for
Cholesterol and Sodium
Lunches consumed by CACFP
participants five years of age and
older meet NRC recommendations
for cholesterol and sodium intake
(Figure 18).
Children five years of age and older
consume an average of 55 mg of choles-terol
from CACFP lunches, an amount
which meets the recommendation of
100 mg or less (one-third of the sugges-ted
daily limit of 300 mg). Children's
average sodium intake from CACFP
lunches, 772 mg, also meets the recom-mendation
of 800 mg or less (one-third
of the suggested daily limit of
2,400 mg).
Snacks consumed by CACFP partici-pants
provide, on average, at least
10 percent of the IDA for calories
and most key nutrients (Figure 19).
Bom morning and afternoon snacks
consumed by CACFP participants pro-vide
10 percent or more of the RDA for
calories, vitaminA and calcium and
more than 20 percent of the RDA for
protein CACFP snacks provide at least
30 percent of the RDA for vitamin C.
CACFP snacks, as consumed, provide
nine percent of the RDA for iron.
100%
80%
90%
£100
40%
20%
1000%
800%
000%
400%
200%
Sodium
AvtnQ9 Inttkt Frotii
CACFPLunchm
Figure 19. Snacks Consumed Provide At Least 10 Percent of the RDA for
Calories and Most Key Nutrients
100%
80%
00%
40%
20%
44%
Ctfortat PreWn VtaminA
I UommgSmda An$fnOOH SHACKS
18 Summary of FnMngt
Earty Childhood and ChUd Can Study
With the exception erf calories and
iron, children in part-day care
consume more than one-half of the
■DA from CACFP meals and snacks
and children in full-day care con-sume
more than two-thirds of
the RDA (Figure 20).
On a typical day, children in care at least
four but less than eight hours per day
(part-day care) consume, from CACFP
meals and snacks, an average of about
one-third of the RDA for calorics and
iron. Intakes of other nutrients exceed
one-half of the RDA and, in some cases,
are substantially higher, avenging 102
percent of the RDA for protein, 78 per-cent
of trie RDA for vitaminAand 82
percent of the RDA for vitamin C. Mean
intake of part-day children receiving
care in child care centers are markedly
lower than part-day children receiving
care in homes. This is not unexpected,
given that 36 percent of part-day child-ren
in centers receive only one meal
or snack.
Children in care eight or more
hours per day (full-day care) consume
an average of about 90 percent of the
RDA for calories and iron. Intakes of
other nutrients exceed two-thirds of the
RDA often by a substantial margin.
Average intakes of protein, vitaminA
and vitamin C, for example, exceed
100 percent of the RDA.
Figure 20. Except for Calories and Iron, Children In Part-day Care
Coiiaunialll^Tr^Ona-han'oftna RDA White Full-day
Children Consuma More Than Two-thirds of tha RDA
nvCHalmmFi+dayOam
Summary of FinOnot 19
Eeriy Chsuhood MHO Cfmd Cuf Study
The iwfi|t intake of five-year-olds
In part-day care meets the Dietary
Guidelines goal for percent of
calories from total fat and the NRC
recommendation for percent of
calories from carbohydrate, but not
the Dietary Guidelines goal for per-cent
ot calories from saturatea tat
■ he average infafc^ of ctiudreri in
full-day care does not meet any of
these standards (Figure 21).
The average percentage of calories from
fat in CACFP meals and snacks con-sumed
by five-year-olds in part-day care
is 29 percent, which meets the Dietary
Guidelines goal.The average percent-age
of calories from carbohydrate, 56
percent, is also in line with the NRC
recommendation. However, the average
percentage of calories from saturated fat
(12 percent) exceeds the Dietary
Guidelines goal of less than 10 percent
The average intake of five-year olds
in full-day care provides 32 percent of
calories from fat and 12 percent of
calories from saturated fat Both of these
levels exceed Dietary Guidelines goals.
Likewise, the average percentage of
calories from carbohydrate, 53 percent,
is less than the NRC-recommended level
of 55 percent or more.
Figure 21. Tha Average Intake of Part-day Children Differs from Full-day
Children for Total Fat, Saturated Fat, and Carbohydrate
100%
dChUmm
Pml-dtyCan
\otCNktwi*
asayOM
20 Summary at FMng*
IllA
Earfy Childhood and ChUd Can Study
On
about one-fowth to one-third of the
I daily Hm* of cholesterol
: forty to fifty percent of
I only Hnwt of sodium
i CACIV meals and snacks
(Figure 22).
CACFP meals and snacks consumed by
five-year-olds in part-day care provide
70 mg of cholesterol, winch is equiva-lent
to approximately 23 percent of the
suggested daily limit of 300 mg or less.
Five-year-olds in full-day care consume
an average of 96 mg of cholesterol,
equivalent to approximately 33 percent
of the suggested daily limit.
Five-year-olds in part-day care con-sume
an average of 893 mg of sodium
from CACFP meals and snacks.This is
equivalent to approximately 37 percent
of the recommended daily limit of
2,400 mg uf teas. Five-year-olds in full-day
care consume an average of 1,244
mg of sodium, equivalent to approxi-mately
52 percent of the suggested
daily limit.
Figure 22. Children's Intate of Chotostsrol MB Sodium front CACFP
to Not
Summary of FnMnga 21
Eany ChUhood and ChU Can Study
Nutrition Knowledge and Practices
of CACFP Food Preparers
■ ••
Individuals with primary responsibility
for preparing CACFP meals and snacks
were interviewed to assess levels of
nutrition knowledge as well as the
extent to which desirable food service
practices arr being used in the CACFP
For family day care homes, the provider
was almost always the respondent. For
most centers, the respondent was the
center cook. In cases where meals were
prepared off-site, whether for homes or
for centers, the respondent was the
responsible cook in the off-site prepara-tion
facility.
The average CACFP food preparer
is familiar with many principles of
On average, CACFP food preparers
answered almost three-quarters (73%) of
the nutrition knowledge items correctly.
Food preparers are more knowledgeable
about ways to implement the Dietary
Guidelines than they are about general
nutrition facts, however.The average
score for items dealing with general
nutrition knowledge (for example, good
sources of vitamins A, C and iron) was
69 percent", compared to a scot? of 77
percent for Items hiving to do with
i for hnplrmrnttag the Dietary
Some CACFP good preparers have
misconceptions about food sources
of hey nutrients.
Almost all CACFP food preparers are
aware that dietary intake can influence
disease risk and most arc familiar with
the Food Guide Pyramid. Food pre-parers
liave some misconceptions,
however, about food sources of key
nutrients, particularly vitamin A.Almost
all food preparers are aware that child-ren
need to consume a variety of foods
and that new foods should be offered
to picky eaters. One-third of all food
preparers are misinformed about the
importance of carbohydrate, however,
believing that children's intake of
"starchy" foods should be limited
because these foods are "fattening."
CACFP food preparers arc familiar
with many strategies for imple-menting
the Dietary GuideUmer.
CACFP food preparers are knowledge-able
about techniques that can be used
to implement the Dietary Guidelines.
In general, food preparers are most
knowledgeable about ways to decrease
sodium. Most arc also aware of tech-niques
that can be used to increase
fiber and to decrease fat, satinated fat,
and sugar. Food preparers are least
knowledgeable about techniques for
kyre sakig carbohydrate content of
child care meals.
According to food preparers, CACFP
sites are implementing many food
service practices that are consistent
with Dietary Guidettnet principles.
Overall, CACFP providers reportedly
use, at least some of the time, dose to
three-quarters of the desired food ser-vice
practices assessed in this study.
Approximately 80 percent or more of
all providers keep sugar bowls, butter/
margarine, and salt shakers off the
tables where children eat; avoid use of
sweetened cereals; offer foods made
with dried beans or peas; offer lean
meat, chicken or fish; remove skin from
chicken before cooking; offer low-fat
or skim milk to children over the age
of three; and use herbs and spices rather
than salt to flavor foods.
CACFP food preparers with respon-sibility
for food purchasing make
frequent use of nutrition labefe.
More than nine out of ten CACF? food
preparers reported that they always
or sometimes read the nutrition infor-mation
on food package labels and
consider nutrient content when making
food purchasing decisions Almost all
food preparers compare the nutrkmt
content of different brands and review
ingredient lists.
Earty ChOdhood and ChUd Can Study
When
CACFPfood
to the need to
children with a variety of
When making food purchasing deci-sions,
more than two-thirds of all CACFP
food prepare! s consider children's feed-ing
and eating abilities, food preferences,
and the need to introduce children to
new foods. Sanitation considerations
are also important to food purchasing
decisions. More than three-quarters of
all food preparers consider possible
sanitation/cleanliness problems when
deciding whether or not to purchase a
particular food item. Required prepara-tion
time is also a consideration for 62
percent of CACFP food preparers.
With regard to nutrient content,
sugar is a major concern of CACFP food
preparers. Cited by 81 percent of all
respondent*, sugar content is the second
stoat common purchasing ronajderation
(the need to provide a variety of foods is
the most common consideration). Other
aspects of nutrient content receive less
focus, particularly fiber and vitamin C.
Cost ha comparatively la
i in CACFP food]
— nnr half of al food
prepwus included coat on the list of
Home Economics and Household Collection
