BACKGROUND The US Department of Agriculture Child and Adult Care Food program (CACFP) recently (October 2017) updated requirements for meal reimbursement and best practice recommendations for serving nutritious meals and beverages, and minimum age-specific serving sizes for five food groups. It is not known whether CACFP-funded child-care centers are meeting the updated meal pattern requirements and best practice recommendations, and whether children are meeting nutrition recommendations based on the current 2015-2020 Dietary Guidelines for Americans (DGA). OBJECTIVE This study assessed whether the recruited CACFP-funded child-care centers in this study were meeting the updated (2017) CACFP requirements regarding foods served for lunch and whether children attending these child-care centers were meeting age- and sex-specific DGA recommendations regarding foods consumed. DESIGN This was a cross-sectional study using the Dietary Observation for Child Care method. PARTICIPANTS AND SETTINGS: Children aged 3 to 5 years (n=108) from 10 classrooms in three CACFP-funded child-care centers in Lincoln, NE, were recruited by convenience sampling during spring 2018. MEASURABLE OUTCOMES Food served and consumed during observed lunches in comparison with updated CACFP requirements and DGA, respectively. STATISTICAL ANALYSIS Adjusted mean amounts of foods served from each food group were compared with age specific minimum CACFP serving size requirements. Adjusted mean amounts of foods consumed from each food group were then compared with age- and sex-specific DGA recommendations. RESULTS The recruited child-care centers were meeting the updated CACFP requirements regarding foods served but showed limited adherence to the best practice recommendations during the observed lunches. However, the overall mean intake for grains, fruits, and vegetables was significantly lower (P<0.01) than DGA recommendations. In addition, approximately 25% of the children did not consume any vegetables during their meal. CONCLUSIONS: Although child-care centers were meeting the updated CACFP requirements by serving the recommended amounts of foods, children were not meeting DGA-recommended intakes. Future studies are needed to explore ways to improve adherence to best practice recommendations to improve children's consumption of healthy foods in child-care centers.

中文翻译：

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参与 CACFP 确保了托儿中心学龄前儿童午餐时营养食品的供应，但不保证其摄入量

背景 美国农业部儿童和成人护理食品计划 (CACFP) 最近（2017 年 10 月）更新了膳食补偿要求和提供营养膳食和饮料的最佳实践建议，以及五个食物组的最低年龄特定份量。目前尚不清楚 CACFP 资助的托儿中心是否满足更新的膳食模式要求和最佳实践建议，以及儿童是否满足基于当前 2015-2020 美国人膳食指南 (DGA) 的营养建议。目标 本研究评估了本研究中招募的 CACFP 资助的托儿中心是否符合更新的（2017 年）CACFP 对午餐食品的要求，以及就读这些托儿中心的儿童是否满足特定年龄和性别的 DGA 建议关于食用的食物。设计 这是一项横断面研究，使用儿童保育饮食观察方法。参与者和环境：在 2018 年春季通过便利抽样招募了来自内布拉斯加州林肯市三个 CACFP 资助的托儿中心 10 个教室的 3 至 5 岁儿童（n=108）。 可衡量的结果 观察午餐期间提供和消费的食物分别与更新的 CACFP 要求和 DGA 进行比较。统计分析 将调整后的每个食物组提供的食物平均量与特定年龄的最低 CACFP 份量要求进行比较。然后将每个食物组的调整后平均食物消耗量与特定年龄和性别的 DGA 建议进行比较。结果 招募的儿童保育中心在所提供的食物方面符合最新的 CACFP 要求，但在观察到的午餐期间对最佳实践建议的遵守程度有限。然而，谷物、水果和蔬菜的总体平均摄入量显着低于 DGA 建议的 (P<0.01)。此外，大约 25% 的儿童在用餐期间没有食用任何蔬菜。结论：虽然托儿中心通过提供推荐量的食物来满足更新的 CACFP 要求，儿童未达到 DGA 推荐的摄入量。未来的研究需要探索如何提高对最佳实践建议的依从性，以改善儿童在托儿中心的健康食品消费。