The federally supported meals and snacks served to some children and adults at day care centers should be changed to include more vegetables and fruits, and less saturated fats, trans fat, salt and added sugars says a new report from the Institute of Medicine.

In a news release, the IOM said current requirements are based, in part, on information that is two decades old and in that time scientists have gained a better understanding of how improved nutrition can lead to better health.

“This report points the way to updating the program’s meal requirements so that they reflect the latest nutrition science,” said committee chair Suzanne P. Murphy, researcher, professor, and director of the Nutrition Support Shared Resource, Cancer Research Center of Hawaii, University of Hawaii, Honolulu.

“The changes recommended will help program beneficiaries get more of the nutrients they need without getting too many calories and will promote lifelong healthy eating habits.”

The report’s recommendations would align the nutrition standards of the Child and Adult Care Food Program (CACFP) with the latest nutrition science and dietary guidelines used in other federal food programs, including the National School Lunch and School Breakfast programs, the IOM said.

The report calls for building on existing CACFP requirements for meals, such as specifying a minimum amount of foods in each meal and excluding soft drinks and candy.  Among the recommendations:

–Each meal should include one serving of fruit and two of vegetables.

–The amount of dark green and orange vegetables (fresh, frozen, canned or dried) served each week should increase, while starchy vegetables should be limited to no more than twice a week.

— Vegetables can be cooked any way except fried.

— Juice should be 100 percent fruit juice without added sugars, but should not be given to children less than a year old, and should be limited to once a day for older day care participants.


— At least half of the grain products served should be rich in whole grains.  Baked or fried grain products that are high in fat and added sugars should be allowed only once a week.

— Vegetable oils and limited amounts of salt should be used in preparing meals.

— Meats should be lean and soy products, beans, eggs, nuts, and other meat alternatives should be encouraged.

— Healthy infants should receive only breast milk or formula until they reach six months of age, then day care sites should gradually introduce baby foods. 

— Children should be given whole milk until age 2.  Milk provided to participants age 2 and older should contain no more than 1 percent fat.

The study was sponsored by USDA, which asked the IOM to evaluate the nutritional needs of the day care program’s participants and then make recommendations to revise meal requirements.

Authors of the report acknowledged that day care providers will need resources and assistance to comply with the changes, and said USDA personnel should work with state agencies and health professionals to help day care operators plan menus and purchase and prepare foods.

USDA will need to re-evaluate and streamline the way CACFP monitors facilities’ compliance with the standards and reimburses them, the report said.


In 2010, federally supported meals and snacks serve approximately 3 million children and 114,000 functionally impaired adults and other adults over age 60 in day care programs.