Impact of the institute of medicine's recommendations to the child and adult care food program on preschoolers' intake

Introduction: The US Department of Agriculture is preparing to release the first update to the Child and Adult Care Food Program (CACFP) nutrition standards since the 1980s. The new standards are expected to closely mirror the recommendations of the Institute of Medicine (IOM), and include increased offerings of whole grains, fruits and vegetables, and decreases in sodium and saturated fat. This study aimed to assess the impact of IOM's proposed changes on the dietary intake of preschoolers. Methods: A within-subjects randomized design was used to collect meal consumption data (plate waste) on 57 children from one racially/ethnically diverse preschool in southern CT. Consumption of meal components was compared across conditions, with the control meal meeting current CACFP regulations and the IOM meal reflecting IOM's recommendations. Paired t-tests were used to test for differences. Results: There was a significant increase in fiber intake (+2.03g; p=<0001), while significant reductions were made in total calories (-31.80; p=<0001), total and saturated fat (total: -2.93g; p=<0001; sat fat: -1.08 p=<0001), sodium (-301.26mg; p=<0001) and protein (-7.21g; p=<0001). Fruit intake nearly doubled (6.7% to 30% of calories, control vs IOM) and vegetable intake more than doubled (4.9% to 14.2% of calories, control vs IOM). During the IOM meal, 81% consumed a full CACFP serving of fruit, compared to 51% (control); 69% consumed a full CACFP serving of vegetable, compared to 51% (control). Discussion: Study findings suggest that the IOM's proposed changes to CACFP nutrition standards would improve nutrition quality for children in child care.