Changes in Foods Served and Meal Costs in Boston Family Child Care Homes after One Year of Implementing the New Child and Adult Care Food Program Nutrition Standards.

Mary Kathryn Poole,Erica L Kenney,Angie L Cradock

doi:10.3390/nu12092817

Abstract

This study aimed to determine the impact of 2017 revisions to the Child and Adult Care Food Program (CACFP) nutrition standards on foods and beverages served and meal costs in family child care homes (FCCHs). Our pre–post study utilized four weeks of menus and food receipts from 13 FCCH providers in Boston, MA prior to CACFP nutrition standards changes in 2017 and again one year later, resulting in n = 476 menu observation days. We compared daily servings of food and beverage items to the updated standards. Generalized estimating equation models tested for changes in adherence to the standards and meal costs. FCCHs offered more whole grains and less juice and refined grains from baseline to follow-up. FCCHs were more likely to meet the revised whole grain standard at follow-up (OR = 2.7, 95% CI: 1.4, 5.2, p = 0.002), but rarely met all selected standards together. Inflation-adjusted meal costs increased for lunch (+$0.27, p = 0.001) and afternoon snack (+$0.25, p = 0.048). FCCH providers may need assistance with meeting CACFP standards while ensuring that meal costs do not exceed reimbursement rates.

Highlights

Over 60% of children between the ages of 3 and 5 years in the United States (U.S.) are cared for in early care and education settings [1]
Twenty-nine family child care homes (FCCHs) providers, representing 11% of those contacted by our team and 7% of all Boston FCCH providers, agreed to participate in the study at baseline
While studies assessing readiness to the meet the new Child and Adult Care Food Program (CACFP) nutrition standards have found mixed levels of preparedness in child care settings [11,12,31], our results indicate that FCCHs may still not be meeting certain nutrition standards

Summary

Introduction

Over 60% of children between the ages of 3 and 5 years in the United States (U.S.) are cared for in early care and education settings [1] These settings influence the dietary habits of young children since some children may consume up to two-thirds of their daily food intake during program attendance [2,3]. These were designed to be cost-neutral for providers. The updated nutrition standards went into effect on 1 October 2017 and required that participating programs across the U.S.: (1) serve a fruit and vegetable with lunch; (2) limit

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