Contribution of Meals and Snacks Provided Through the Child and Adult Care Food Program on Young Children's Total...

Several federal food assistance programs support children's nutrition. However, evidence is limited on how the Child and Adult Care Food Program (CACFP), specifically, contributes to children's dietary intake.

The study objective was to understand how CACFP meals and snacks contribute to young children's overall dietary intake on a given day.

A within-person, observational study design was used.

Participants were children aged from 1 to 6 years (n = 1004) attending CACFP-participating early care and education (ECE) programs participating in the 2017 US Department of Agriculture Study of Nutrition and Activity in Childcare Settings.

Daily energy-adjusted food group and specific nutrient intakes were the primary outcome measures, standardized by kilocalories consumed.

Paired t tests evaluated how a child's energy-adjusted dietary intake at a CACFP-participating ECE program compared with elsewhere on the same day, and analyses were stratified by duration of attendance at an ECE program and household food security status.

Children attending an ECE program for a full day consumed most of their fruit (mean [SE], 54% [0.02%]), whole grains (mean [SE], 67% [0.03%]), and dairy (mean [SE], 61% [0.02%]) from CACFP meals and snacks. When children ate at full-day ECE programs, they consumed significantly more energy-adjusted dairy (0.3 cup-equivalent [c-eq]/1000 kcal; 95% CI, 0.12 to 0.40 c-eq/1000 kcal) and whole grains (0.1 ounce-equivalent [oz-eq]/1000 kcal; 95% CI, 0.03 to 0.25 oz-eq/1000 kcal), and less vegetables (-0.1 c-eq/1000 kcal; 95% CI, -0.21 to -0.08 c-eq/1000 kcal), protein foods (-0.4 oz-eq/1000 kcal; 95% CI, -0.60 to -0.26 oz-eq/1000 kcal), sodium (-211 mg/1000 kcal; 95% CI, -283.1 to -139.8 mg/1000 kcal), saturated fat (-2.1 g/1000 kcal; 95% CI, -2.91 to -1.28 g/1000 kcal), and added sugars (-6.8 g/1000 kcal; 95% CI, -10.15 to 3.54 g/1000 kcal) than when they were not at an ECE program. Patterns in energy-adjusted intake differences remained for those experiencing food security compared with food insecurity, except for whole grains; children experiencing food security had significantly higher consumption of whole grains at a full-day ECE program compared with elsewhere (0.2 oz-eq/1000 kcal; 95% CI, 0.05 to 0.26 oz-eq/1000 kcal), whereas there was no difference for children experiencing food insecurity.

CACFP meals and snacks support nutritious diets for young children by contributing to higher energy-adjusted intakes of dairy and whole grains, and lower energy-adjusted intakes of sodium, saturated fat, and added sugars compared with what children consume elsewhere. Future research should examine how CACFP can further support nutritious diets for children.