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Changes in the Nutritional Quality of Child and Adult Care Food Program Meals and Snacks Served in Early Child Care
Rebecca L Franckle1, Elizabeth C Gearan2, Jodie Davis3
1School of Health Sciences, Regis College, Weston, Massachusetts.
Background:
Updates to the meal pattern requirements for the Child and Adult Care Food Program (CACFP) took effect in 2017. The updates were designed to align CACFP meals and snacks with the 2015-2020 Dietary Guidelines for Americans and represented the first major revision of the CACFP meal patterns since the program's inception in 1968.
Objective:
The aim of the study was to examine changes in the nutritional quality of CACFP meals and snacks served to children aged 3 to 5 years in early child care programs before and after the updated meal patterns were implemented.
Design:
The US Department of Agriculture's Study of Nutrition and Activity in Child Care Settings (SNACS-I) collected data in program year 2016-2017, and SNACS-II collected data in program year 2022-2023 from nationally representative samples of CACFP programs and the children they served. Both studies used a menu survey to collect detailed descriptions and recipes for all foods and beverages served in CACFP meals and snacks during a 1-week period, and on-site measurements of reference portions to estimate portion sizes for the foods and beverages served.
Participants/Setting:
The analysis included data from 664 early child care programs in SNACS-I and 759 early child care programs in SNACS-II.
Outcome Measures:
Mean Healthy Eating Index 2015 (HEI-2015) scores were calculated for all CACFP meals and snacks served combined, in addition to separate HEI-2015 scores for breakfast, lunch, morning snack, and afternoon snack.
Statistical Analysis:
Differences in the mean HEI-2015 scores between the 2 time periods were estimated, and 2-tailed Welch's t tests were conducted to test for statistical significance.
Results:
After the meal pattern updates, mean total HEI-2015 scores significantly improved for CACFP breakfasts by 6.1 points (P < .001), lunches by 5.4 points (P < .001), afternoon snacks by 4.7 points (P < .05), and all meals and snacks combined by 5.1 points (P < .001).
Conclusions:
Results of this analysis showed that CACFP meals and snacks served in early child care programs were more consistent with the 2015-2020 Dietary Guidelines for Americans after updated CACFP meal pattern requirements were implemented in 2017. This work underscores the importance of updating meal pattern requirements for nutrition assistance programs such as the CACFP to ensure meals provided to children are aligned with the Dietary Guidelines for Americans.
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