1. health and fitness
2. disease
3. cholesterol

Nutrition Policies and Guidance for
Adult Day Care Centers in the
Child and Adult Care Food Program (CACFP)
5
Planning Healthy Meals
ADULT DAY CARE CENTERS
September 2011
Connecticut State Department of Education
Bureau of Health/Nutrition, Family Services and Adult Education
25 Industrial Park Road
Middletown, CT 06457
PLANNING HEALTHY MEALS
CONTENTS
About This Guide .................................................................................................................................................. iii
Abbreviations and Acronyms .............................................................................................................................. iv
1 — Nutrition Guidelines..............................................................................................................1
Dietary Guidelines for Americans .............................................................................................................. 2
Nutrient-Dense Foods ............................................................................................................................ 2
MyPlate............................................................................................................................................................ 3
Dietary Reference Intakes ............................................................................................................................ 3
Key Recommendations of the Dietary Guidelines for Americans ........................................................ 4
State Nutrition Recommendations ............................................................................................................. 6
2 — Increasing Iron in CACFP Meals. ........................................................................................ 7
Iron Requirements ......................................................................................................................................... 7
Sources of Iron .............................................................................................................................................. 7
Increasing Iron Absorption ......................................................................................................................... 7
Iron Content of Foods ................................................................................................................................. 8
3 — Increasing Vitamins A and C in CACFP Meals .................................................................. 11
Vitamin A Requirements ............................................................................................................................ 11
Sources of Vitamin A .................................................................................................................................. 12
Vitamin A Content of Fruits and Vegetables.......................................................................................... 12
Vitamin C Requirements ............................................................................................................................ 13
Sources of Vitamin C .................................................................................................................................. 13
Vitamin C Content of Fruits and Vegetables .......................................................................................... 14
4 — Decreasing Fat, Saturated Fat, Trans Fat and Cholesterol in CACFP Meals..................... 17
Sources of Fat............................................................................................................................................... 17
Sources of Saturated Fat ............................................................................................................................. 17
Sources of Trans Fat ................................................................................................................................... 18
Sources of Cholesterol ................................................................................................................................ 18
Improving Menus ........................................................................................................................................ 19
Menu Planning to Decrease Fat .......................................................................................................... 19
Purchasing to Decrease Fat .................................................................................................................. 20
Meal Preparation to Decrease Fat ....................................................................................................... 21
Modifying Recipes to Decrease Fat .................................................................................................... 22
5 — Decreasing Sodium in CACFP Meals ................................................................................ 23
Sources of Sodium....................................................................................................................................... 23
Range of Sodium Content for Selected Foods.................................................................................. 24
Improving Menus ........................................................................................................................................ 25
Menu Planning to Decrease Sodium .................................................................................................. 25
Purchasing to Decrease Sodium .......................................................................................................... 25
Meal Preparation to Decrease Sodium ............................................................................................... 26
Modifying Recipes to Decrease Sodium ............................................................................................ 26
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
i
PLANNING HEALTHY MEALS
6 — Decreasing Sugars in CACFP Meals .................................................................................. 27
Sources of Sugars ......................................................................................................................................... 27
Sugars and Sweeteners .......................................................................................................................... 27
Improving Menus ........................................................................................................................................ 28
Menu Planning to Decrease Sugars..................................................................................................... 28
Purchasing to Decrease Sugars ............................................................................................................ 28
Meal Preparation to Decrease Sugars ................................................................................................. 29
Modifying Recipes to Decrease Sugars .............................................................................................. 29
7 — Increasing Fiber in CACFP Meals ...................................................................................... 31
Fiber Requirements ..................................................................................................................................... 31
Sources of Fiber ........................................................................................................................................... 32
Dietary Fiber ........................................................................................................................................... 32
Fiber Content of Foods .............................................................................................................................. 33
Improving Menus ........................................................................................................................................ 35
Menu Planning to Increase Fiber ........................................................................................................ 35
Purchasing to Increase Fiber................................................................................................................ 36
Meal Preparation to Increase Fiber ..................................................................................................... 36
Modifying Recipes to Increase Fiber .................................................................................................. 37
8 — Food Labels ........................................................................................................................ 39
Using Food Labels in the CACFP ............................................................................................................ 39
Food Label Information ............................................................................................................................. 39
Ingredients Statement............................................................................................................................ 39
Nutrient Content Claims ...................................................................................................................... 39
Health Claims ......................................................................................................................................... 40
Serving Sizes ........................................................................................................................................... 40
Nutrients Listed...................................................................................................................................... 41
Daily Reference Values ......................................................................................................................... 41
Label Rounding ...................................................................................................................................... 41
How to Read a Food Label ........................................................................................................................ 42
Label Language ............................................................................................................................................ 43
9 — Resources ........................................................................................................................... 45
Resources ...................................................................................................................................................... 45
Web Sites....................................................................................................................................................... 46
References .............................................................................................................................................................. 47
Glossary .................................................................................................................................................................. 49
ii
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
ABOUT THIS GUIDE
Planning Healthy Meals is the fifth in a series of five guides that comprise the Connecticut State
Department of Education’s (CSDE) publication Nutrition Policies and Guidance for Adult Day Care Centers
in the Child and Adult Care Food Program (CACFP). These guides assist adult day care centers in meeting
CACFP requirements. The complete set of guides is available online at http://www.sde.ct.gov/
sde/cwp/view.asp?a=2626&q=322694 and contains four additional documents:
•
•
Meal Pattern Requirements
Crediting Foods
•
•
Accommodating Special Dietary Needs
Sanitation and Food Safety
Planning Healthy Meals contains information on healthy menu planning, the Dietary Guidelines for
Americans and food labels, with suggestions for improving the nutritional quality of CACFP meals. For
questions regarding this information, please contact the CACFP staff in the CSDE’s Bureau of
Health/Nutrition, Family Services and Adult Education:
•
•
•
Susan Boyle, 860-807-2074, susan.boyle@ct.gov
Celia Cordero, 860-807-2076, celia.cordero@ct.gov
Benedict Onye, 860-807-2080, benedict.onye@ct.gov
For more information on Planning Healthy Meals, contact:
Susan S. Fiore, M.S., R.D., Nutrition Education Coordinator
Connecticut State Department of Education
Bureau of Health/Nutrition, Family Services and Adult Education
25 Industrial Park Road
Middletown, CT 06457
Phone: 860-807-2075
E-mail: susan.fiore@ct.gov
Original Publication Date: October 2002
Current Revision Date: September 2011
In accordance with federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin,
sex, age, or disability. To file a complaint of discrimination, write USDA, Director, Office of Adjudication, 1400 Independence Avenue, SW, Washington, D.C.
20250-9410 or call toll free 866-632-9992 (Voice). Individuals who are hearing impaired or have speech disabilities may contact USDA through the Federal Relay
Service at 800-877-8339 or 800-845-6136 (Spanish). USDA is an equal opportunity provider and employer.
The State of Connecticut Department of Education is committed to a policy of equal opportunity/affirmative action for all qualified persons. The Department of
Education does not discriminate in any employment practice, education program, or educational activity on the basis of race, color, religious creed, sex, age, national
origin, ancestry, marital status, sexual orientation, disability (including, but not limited to, mental retardation, past or present history of mental disability, physical
disability or learning disability), genetic information, or any other basis prohibited by Connecticut state and/or federal nondiscrimination laws. The Department of
Education does not unlawfully discriminate in employment and licensing against qualified persons with a prior criminal conviction. Inquiries regarding the Department
of Education’s nondiscrimination policies should be directed to: Levy Gillespie, Equal Employment Opportunity Director, Title IX /ADA/Section 504
Coordinator, State of Connecticut Department of Education, 25 Industrial Park Road, Middletown, CT 06457, 860-807-2071.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
iii
PLANNING HEALTHY MEALS
ABBREVIATIONS AND ACRONYMS
CACFP
Child and Adult Care Food Program
CFR
Code of Federal Regulations
CN
Child Nutrition
CNP
Child Nutrition Programs
CSDE
Connecticut State Department of Education
DRI
Dietary Reference Intake
DV
Daily Value
FDA
Food and Drug Administration
FNS
Food and Nutrition Service, U.S. Department of Agriculture
HDL
high-density lipoprotein
LDL
low-density lipoprotein
MSG
monosodium glutamate
RDA
Recommended Dietary Allowance
USDA
United States Department of Agriculture
iv
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Nutrition Guidelines  1
1 — NUTRITION GUIDELINES
The goal of the Child and Adult Care Food Program (CACFP) is
The CSDE strongly encourages
to improve and maintain participants’ health and nutrition while
CACFP facilities to serve meals
promoting healthy eating habits. The CACFP meal patterns allow
and snacks that meet the CSDE’s
and encourage a variety of foods within each of the food
recommended nutrition standards
components. The Connecticut State Department of Education
(see State Nutrition
(CSDE) strongly encourages CACFP menu planners to make
Recommendations in this section).
choices that reflect the principles of the Dietary Guidelines for
Americans. Meals and snacks should provide nutrient-rich foods, such as fruits, vegetables, whole grains,
low-fat and nonfat dairy, lean meats and legumes.
The CSDE strongly encourages adult day care centers to use meals and snacks to set the standard of
nutrition by serving a variety of healthy foods and eliminating or limiting low-nutrient choices. Each
local program determines the quality of food choices for CACFP meals and snacks. Menu planners
should keep in mind that the choices within each CACFP meal pattern component can vary greatly in
nutrient content, for example:
•
whole-grain bread and enriched-flour croissants both meet the requirements for the
grains/breads component but the whole-grain bread provides fiber, more nutrients and less
fat;
•
100 percent fruit punch juice and fruit salad both meet the requirements for the
vegetables/fruits component, but the fruit salad provides fiber and more nutrients; and
•
salami (without meat byproducts, cereals, binders or extenders) and skinless turkey breast both
meet the requirements for the meat/meat alternates component, but the turkey breast contains
less fat and sodium and more nutrients.
The food components of the CACFP Meal Pattern for Adults include some foods that are less
nutritious choices. For example, enriched cakes, brownies, doughnuts and high-sugar breakfast cereals
are allowable as a grains/breads component. However, these foods provide few nutrients and are
generally high in fat, added sugars and sodium. When meals and snacks regularly include less nutritious
foods, participants fill up without getting all the nutrients needed.
Menu planners should pay particular attention to the nutrition quality of snacks served in the CACFP.
Snacks might meet the CACFP meal pattern requirements but not be nutrient-rich choices. For
example, apple juice and graham crackers meet the CACFP snack requirements, but provide few
nutrients. The CSDE strongly encourages menu planners to choose snack foods that consist primarily
of whole grains, vegetables, fruits, legumes, lean meats and low-fat or nonfat dairy products.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
1
1  Nutrition Guidelines
PLANNING HEALTHY MEALS
DIETARY GUIDELINES FOR AMERICANS
The Dietary Guidelines for Americans is developed by the U.S. Department of Agriculture (USDA) and the
U.S. Department of Health and Human Services (HHS). It was first published in 1980, and is updated
by the USDA and HHS every five years to incorporate advances in medical and scientific research. The
most recent edition of the Dietary Guidelines was released in 2010.
The Dietary Guidelines for Americans provides general diet and
lifestyle recommendations to help people attain and maintain a
healthy weight, reduce their risk of chronic disease and promote
overall health. The recommendations are intended for people ages
2 and older, including those at risk of chronic disease.
The Dietary Guidelines focuses on healthy food choices and physical
activity. Poor diet and a sedentary lifestyle are major causes of
disease and death in the United States. They are the most
important factors contributing to the increase in overweight and
obesity for children and adults in this country. Even in the absence
of overweight, poor diet and physical inactivity are associated with
major causes of morbidity and mortality. These include
cardiovascular disease, hypertension, type 2 diabetes, osteoporosis
and some types of cancer.
The Dietary Guidelines promotes the consumption of nutrient-dense
foods and beverages and call for moderation and avoidance of
extremes in the diet. Recommendations focus on choosing a diet
with most of the calories from whole grains, vegetables, fruits,
low-fat and nonfat milk products, lean meats, fish, poultry and dry
beans. They also emphasize fewer calories from fats and sweets.
The Dietary Guidelines describes food choices that will help people
meet their nutritional needs, as specified by the Dietary Reference
Intakes (see Dietary Reference Intakes on the next page).
The recommendations of the 2010 Dietary Guidelines encompass
two main concepts.
NUTRIENT-DENSE FOODS
Nutrient-dense foods and
beverages provide substantial
amounts of naturally occurring
vitamins, minerals and other
nutrients with relatively few
calories. They include lean sources
of protein and complex
carbohydrates that are low in total
fat and saturated fats, such as
fruits, vegetables, whole grains,
low-fat and nonfat dairy products,
lean meat, skinless poultry, fish,
eggs and beans.
Foods and beverages that are not
nutrient dense supply calories
(from fat, added sugars and
processed carbohydrates) but
relatively small amounts of
nutrients (and sometimes none at
all), unless fortified. The greater
the consumption of foods or
beverages that are low in nutrient
density, the more difficult it is to
consume enough nutrients without
gaining weight, especially for
sedentary individuals.
•
Maintain calorie balance over time to achieve and sustain a healthy weight. People who
are most successful at achieving and maintaining a healthy weight do so through continued
attention to consuming only enough calories from foods and beverages to meet their needs
and by being physically active. To curb the obesity epidemic and improve their health, many
Americans must decrease the calories they consume and increase the calories they expend
through physical activity.
•
Focus on consuming nutrient-dense foods and beverages. Americans currently consume
too much sodium and too many calories from solid fats, added sugars and refined grains.
These replace nutrient-dense foods and beverages and make it difficult for people to achieve
recommended nutrient intake while controlling calorie and sodium intake. A healthy eating
pattern limits intake of sodium, solid fats, added sugars and refined grains and emphasizes
nutrient-dense foods and beverages — vegetables, fruits, whole grains, fat-free or low-fat milk
and milk products, seafood, lean meats and poultry, eggs, beans and peas, and nuts and seeds.
A basic premise of the Dietary Guidelines is that nutrient needs should be met primarily through
consuming foods. For more information on the Dietary Guidelines, see Key Recommendations of the Dietary
Guidelines for Americans in this section and http://health.gov/dietaryguidelines/.
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Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Nutrition Guidelines  1
MYPLATE
MyPlate is the USDA’s food guidance system that translates the Dietary Guidelines into a healthy eating
plan. It focuses on recommendations for daily servings of the food groups, and emphasizes consuming
more fruits, vegetables, whole grains and low-fat dairy. Additional information and resources are
available at http://www.choosemyplate.gov/.
DIETARY REFERENCE INTAKES
The Dietary Reference Intakes (DRIs) are a set of nutrient reference values that are intended to serve
as a guide for good nutrition and provide the scientific basis for the development of national food
guidelines. They expand upon and replace the former Recommended Dietary Allowances (RDAs) in
the United States and the Recommended Nutrient Intakes (RNIs) in Canada. They are developed by
the Institute of Medicine of the National Academies, a nonprofit organization that provides sciencebased health policy advice.
The DRIs include four reference values related to both adequate intakes and safe upper levels of
nutrient intakes.
•
Recommended Dietary Allowance (RDA): The average daily dietary intake level that is
sufficient to meet the nutrient requirement of most healthy individuals in a particular life stage
and gender group.
•
Adequate Intake (AI): A recommended intake value based on observed or experimentally
determined approximations or estimates of nutrient intake by a group (or groups) of healthy
people, that are assumed to be adequate. AI is used when an RDA cannot be determined.
•
Tolerable Upper Intake Level (UL): The highest level of daily nutrient intake that is likely to
pose no risk of adverse health effects for almost all individuals in the general population. As
intake increases above the UL, the potential risk of adverse effects increases.
•
Estimated Average Requirement (EAR): A daily nutrient intake value that is estimated to
meet the requirement of half of the healthy individuals in a life stage and gender group. The
EAR is used to assess dietary adequacy and as the basis for the RDA.
For more information on the DRIs, go to the Institute of Medicine of the National Academies
(http://www.iom.edu/) and search for “Dietary Reference Intakes.”
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
3
1  Nutrition Guidelines
PLANNING HEALTHY MEALS
KEY RECOMMENDATIONS OF THE
DIETARY GUIDELINES FOR AMERICANS
BALANCING CALORIES TO MANAGE WEIGHT
• Prevent and/or reduce overweight and obesity through improved eating and physical activity
behaviors.
• Control total calorie intake to manage body weight. For people who are overweight or obese,
this will mean consuming fewer calories from foods and beverages.
• Increase physical activity and reduce time spent in sedentary behaviors.
• Maintain appropriate calorie balance during each stage of life—childhood, adolescence,
adulthood, pregnancy and breastfeeding and older age.
FOODS AND FOOD COMPONENTS TO REDUCE
• Reduce daily sodium intake to less than 2,300 milligrams (mg) and further reduce intake to
1,500 mg among persons who are 51 and older and those of any age who are African
American or have hypertension, diabetes, or chronic kidney disease. The 1,500 mg
recommendation applies to about half of the U.S. population, including children and the
majority of adults.
• Consume less than 10 percent of calories from saturated fatty acids by replacing them with
monounsaturated and polyunsaturated fatty acids.
• Consume less than 300 mg per day of dietary cholesterol.
• Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic
sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.
• Reduce the intake of calories from solid fats and added sugars.
• Limit the consumption of foods that contain refined grains, especially refined grain foods that
contain solid fats, added sugars, and sodium.
• If alcohol is consumed, it should be consumed in moderation—up to one drink per day for
women and two drinks per day for men—and only by adults of legal drinking age.1
Dietary Guidelines for Americans. U.S. Department of Agriculture and U.S. Department of Health and Human
Services, 2010. http://health.gov/dietaryguidelines/
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Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Nutrition Guidelines  1
KEY RECOMMENDATIONS OF THE DIETARY GUIDELINES FOR AMERICANS, continued
FOODS AND NUTRIENTS TO INCREASE
Individuals should meet the following
recommendations as part of a healthy eating
pattern while staying within their calorie needs.
• Increase vegetable and fruit intake.
• Eat a variety of vegetables, especially darkgreen and red and orange vegetables and
beans and peas.
• Consume at least half of all grains as whole
grains. Increase whole-grain intake by
replacing refined grains with whole grains.
• Increase intake of fat-free or low-fat milk and
milk products, such as milk, yogurt, cheese or
fortified soy beverages.2
• Choose a variety of protein foods, which
include seafood, lean meat and poultry, eggs,
beans and peas, soy products and unsalted
nuts and seeds.
• Increase the amount and variety of seafood
consumed by choosing seafood in place of
some meat and poultry.
• Replace protein foods that are higher in solid
fats with choices that are lower in solid fats
and calories and/or are sources of oils.
• Use oils to replace solid fats where possible.
• Choose foods that provide more potassium,
dietary fiber, calcium, and vitamin D, which
are nutrients of concern in American diets.
These foods include vegetables, fruits, whole
grains, and milk and milk products.
RECOMMENDATIONS FOR SPECIFIC
POPULATION GROUPS
Women capable of becoming pregnant3
• Choose foods that supply heme iron,
which is more readily absorbed by the
body, additional iron sources, and
enhancers of iron absorption such as
vitamin C-rich foods.
• Consume 400 micrograms (mcg) per day
of synthetic folic acid (from fortified
foods and/or supplements) in addition to
food forms of folate from a varied diet.4
Women who are pregnant or breastfeeding3
• Consume 8 to 12 ounces of seafood per
week from a variety of seafood types.
• Due to their high methyl mercury
content, limit white (albacore) tuna to 6
ounces per week and do not eat the
following four types of fish: tilefish,
shark, swordfish, and king mackerel.
• If pregnant, take an iron supplement, as
recommended by an obstetrician or other
health care provider.
Individuals ages 50 years and older
• Consume foods fortified with vitamin B12,
such as fortified cereals, or dietary
supplements.
BUILDING HEALTHY EATING PATTERNS
• Select an eating pattern that meets nutrient needs over time at an appropriate calorie level.
• Account for all foods and beverages consumed and assess how they fit within a total healthy
eating pattern.
• Follow food safety recommendations when preparing and eating foods to reduce the risk of
foodborne illnesses.
1
2
3
4
See “Chapter 3 Foods and Food Components to Reduce” in the Dietary Guidelines for Americans for additional recommendations on
alcohol consumption and specific population groups. There are many circumstances when people should not drink alcohol.
Fortified soy beverages have been marketed as “soymilk,” a product name consumers could see in supermarkets and consumer
materials. Since FDA’s regulations do not contain provisions for the use of the term soymilk, the term “fortified soy beverage”
includes products that may be marketed as soymilk.
Includes adolescent girls.
“Folic acid” is the synthetic form of the nutrient. “Folate” is the form found naturally in foods.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
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1  Nutrition Guidelines
PLANNING HEALTHY MEALS
STATE NUTRITION RECOMMENDATIONS
All CACFP meals and snacks must meet the CACFP meal pattern
requirements as specified by the USDA. In addition, the CSDE
strongly encourages adult day care centers to provide meals and
snacks that comply with the CSDE’s recommended nutrition
standards.
For information on the CACFP
adult meal pattern requirements,
see Nutrition Policies and
Guidance for Adult Day Care
Centers: Meal Pattern
Requirements.
The CSDE’s recommended nutrition standards provide the healthiest choices in the CACFP by
promoting whole or minimally processed, nutrient-rich foods that are low in fat, added sugars and
sodium. The standards reflect current nutrition science and national health recommendations from the
Dietary Guidelines for Americans and national organizations, such as the National Academy of Sciences
Institute of Medicine, American Academy of Pediatrics, American Dietetic Association and American
Heart Association. For more information, see State Nutrition Recommendations in each meal component
section of Nutrition Policies and Guidance for Adult Day Care Centers: Crediting Foods.
It is important for participants’ health that CACFP menus provide a variety of nutrient-rich foods
while minimizing choices that are high in fat, added sugars and sodium. The CSDE encourages CACFP
facilities to use menu planning strategies that incorporate more nutritious choices in CACFP menus.
The following sections provide ideas to assist programs in planning healthy meals and implementing
the Dietary Guidelines through menu planning, purchasing, meal preparation and modifying recipes. The
strategies addressed include:
•
•
•
•
•
increasing iron, vitamin A and vitamin C;
decreasing fat, saturated fat, trans fat and cholesterol;
decreasing sugars;
decreasing sodium; and
increasing fiber and complex carbohydrates, e.g., whole grains, fruits and vegetables.
The CSDE strongly encourages CACFP facilities to develop policies that ensure the provision of
nutrient-rich foods throughout the adult day care environment.
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Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Increasing Iron  2
2 — INCREASING IRON IN CACFP MEALS
The USDA recommends that meals and snacks include several iron-rich foods each day. Menu
planners should choose foods carefully to ensure that enough iron-rich foods are included in CACFP
menus. A good source of iron (such as meat, poultry, fish, dried fruits, enriched or whole-grain breads
and dry beans) should be served in at least one meal or snack daily.
IRON REQUIREMENTS
The Recommended Dietary Allowance (RDA) for iron is 8 milligrams per day for adults ages 51 and
older.
SOURCES OF IRON
Good sources of iron include lean meats, fish, poultry, organ
meats (liver, kidney and heart), legumes (dry beans and peas), nuts
and seeds, dried fruits, whole grains and leafy green vegetables.
Breakfast cereals can be an excellent source of iron if they are
enriched or fortified. Menu planners should read food labels to
determine the iron content of packaged foods (see How to Read a
Food Label in section 8).
For more information on
determining whether a cereal is
enriched or fortified, see
Understanding Terms for
Grains/Breads in Nutrition Policies
and Guidance for Adult Day Care
Centers: Crediting Foods —
Grains/Breads.
INCREASING IRON ABSORPTION
On average, the body absorbs only about 10 percent of the iron contained in foods. Iron from animal
sources (such as red meat) is better absorbed than iron from plant sources (such as cooked kidney
beans). However, the body’s absorption of iron increases when nonmeat sources are combined with
meat sources, such as chili made with kidney beans and hamburger or a burrito made with chicken and
black beans.
Iron is also best absorbed if accompanied by a food source of vitamin C, for example, orange wedges
with a turkey sandwich on whole-wheat bread. Adding a vitamin C-rich food to a meal increases the
absorption of iron from both animal and plant foods.
To increase the iron content of CACFP meals, menu planners should incorporate iron-rich foods into
menus as frequently as possible. The chart on the following two pages, Iron Content of Foods, indicates
the iron content of foods in each group from most to least. It also provides each food’s contribution to
the daily iron requirement for ages 50 and older, based on the RDAs. This helps CACFP menu
planners to identify the best sources of iron. For more information on the DRIs, see Dietary Reference
Intakes in section 1.
For more information on iron, see the following resources:
•
•
Dietary Supplement Fact Sheet: Iron. National Institutes of Health, Office of Dietary Supplements.
http://ods.od.nih.gov/factsheets/iron.asp
Iron. Medline Plus. http://www.nlm.nih.gov/medlineplus/ency/article/002422.htm
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
7
2  Increasing Iron
PLANNING HEALTHY MEALS
IRON CONTENT OF FOODS1
Iron
Contribution of
Serving to Adults’
RDA for Iron (8 mg)
1.5 ounces
1.5 ounces
1.5 ounces
1.5 ounces
1 ounce
½ cup
11.88
7.62
4.94
4.55
4.24
3.92
149%
95%
62%
57%
53%
Oysters, cooked
Liverwurst
Lentils, cooked
Beef liver, cooked
Black beans, canned
Soybeans, green, cooked
1.5 ounces
1.5 ounces
½ cup
1.5 ounces
½ cup
½ cup
3.91
3.76
3.3
2.62
2.28
2.25
Calf liver
Pinto beans, canned
Kidney beans, canned
Chickpeas (garbanzo beans), canned
Pine nuts (pignolias)
Shrimp, cooked, moist heat
1.5 ounces
½ cup
½ cup
½ cup
1 ounce
1.5 ounces
2.17
1.75
1.63
1.62
1.57
1.31
Peanuts, raw
Split peas, cooked
Beef, pot roast, braised
Beef, ground, 95% lean, broiled
Tongue, braised
Sunflower seeds, dry roasted
Almonds, blanched
1 ounce
½ cup
1.5 ounces
1.5 ounces
1.5 ounces
1 ounce
1 ounce
1.3
1.26
1.29
1.21
1.11
1.08
1.05
Beef, round steak, broiled
Turkey, dark meat, roasted, no skin
Mackerel, canned
Trout, cooked
Beef brisket, corned, cooked
Turkey, breast, roasted, no skin
1.5 ounces
1.5 ounces
1.5 ounces
1.5 ounces
1.5 ounces
1.5 ounces
1.04
0.99
0.87
0.82
0.79
0.65
2 tablespoons
1 large
1.5 ounces
1.5 ounces
0.60
0.59
0.44
0.41
Food
Serving Size2
Meat and Meat Alternates3
Clams, canned, drained
Pork liver, cooked
Chicken liver, cooked
Turkey liver, cooked
Pumpkin or squash seeds, roasted
White beans, canned
Peanut butter, smooth
Egg, large, hard-boiled
Chicken, breast meat, roasted
Tuna, white, water packed
Milligrams (mg)
per Serving
49%
49%
47%
41%
33%
29%
28%
27%
22%
20%
20%
20%
16%
16%
16%
16%
15%
14%
14%
13%
13%
12%
11%
10%
10%
8%
8%
7%
6%
5%
The use of brand name products does not constitute approval or endorsement by the CSDE or the USDA. Product names are used solely for
clarification regarding nutrient content.
2 These serving sizes are used to illustrate the comparative nutrient content of foods. The actual serving sizes required in the CACFP Meal
Pattern for Adults may be different.
3 Iron from nonmeat sources (vegetables, fruits and grains) is not as well absorbed as iron from animal sources. Iron absorption increases by
serving nonmeat sources with meat, fish or poultry or a food rich in vitamin C.
1
8
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Increasing Iron  2
IRON CONTENT OF FOODS1, continued
Food
Apricots, dried
Prune juice, canned
Raisins, seedless
Peas, green, canned
Prunes, dry, cooked
Beans, lima, canned
Swiss chard, chopped, cooked
Spinach, frozen, chopped or leaf, cooked
Kale, chopped, cooked
Collard greens, chopped, boiled
Asparagus, cooked
Broccoli, chopped, boiled
Post Raisin Bran
Quaker Oat Life
General Mills Cheerios
Kellogg’s Corn Flakes
Bran flakes, ready-to-eat
Oatmeal, instant, fortified
Muffin, oat bran, small
Wheat germ, toasted, ready-to-eat
Pretzel, soft, small, enriched
Bagel, plain, enriched
Noodles, egg, enriched, cooked
Rice, white, long grain, enriched, cooked
Bread, white, enriched
Pita bread, whole-wheat
Bread, whole wheat
Rice, brown, medium grain, cooked
Iron
Contribution of
Serving to Adults’
RDA for Iron (8 mg)
½ cup
½ cup
1.73
1.51
22%
½ cup
½ cup
½ cup
1.36
0.81
0.81
½ cup
½ cup
2.18
1.98
½ cup
½ cup
½ cup
½ cup
½ cup
1.86
1.17
1.10
0.82
0.52
1 cup
¾ cup
1 cup
1 cup
¾ cup
½ cup
14.16
8.99
8.9
8.2
8.1
6.97
2.3 ounces
1 ounce
2.3 ounces
2 ounces
½ cup
½ cup
2.77
2.58
2.42
2.02
1.18
0.95
1 ounce
1 small
1 ounce
½ cup
0.98
0.86
0.68
0.52
Serving Size*
Milligrams (mg)
per Serving
Fruits3
Vegetables3
Grains and Breads3
19%
17%
10%
10%
27%
25%
23%
15%
14%
10%
7%
177%
112%
111%
103%
101%
87%
35%
32%
30%
25%
15%
12%
12%
11%
9%
7%
The use of brand name products does not constitute approval or endorsement by the CSDE or the USDA. Product names are used solely for
clarification regarding nutrient content.
2 These serving sizes are used to illustrate the comparative nutrient content of foods. The actual serving sizes required in the CACFP Meal
Pattern for Adults may be different.
3 Iron from nonmeat sources (vegetables, fruits and grains) is not as well absorbed as iron from animal sources. Iron absorption increases by
serving nonmeat sources with meat, fish or poultry or a food rich in vitamin C.
1
Nutrient values were obtained from the USDA National Nutrient Database for Standard Reference, Release 23,
http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
9
2  Increasing Iron
10
PLANNING HEALTHY MEALS
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Increasing Vitamins A and C  3
3 — INCREASING VITAMINS A AND C IN CACFP MEALS
The USDA encourages CACFP facilities to incorporate a variety of vitamin A and vitamin C sources
into CACFP menus. Some fruits and vegetables are good sources of both nutrients, such as broccoli,
peppers and mango.
VITAMIN A REQUIREMENTS
The RDA for vitamin A is expressed as micrograms (mcg) of retinol activity equivalents (RAE), a
measure of vitamin A activity. There are 1,000 mcg in 1 milligram. For adults ages 51 and older, the
RDA for vitamin A is 900 mcg per day for males and 700 mcg per day for females.
The Food and Drug Administration (FDA) uses another measure of vitamin A, International Units
(IU), as the basis for food and supplement labels and to calculate the percent Daily Value. For more
information on percent Daily Value, see How to Read a Food Label in section 8.
SOURCES OF VITAMIN A
Good plant sources of vitamin A include carrots, pumpkin, sweet
potatoes, winter squashes, cantaloupe, apricots, broccoli, spinach
and most dark green, leafy vegetables. Generally, color is a good
guide to vitamin A content; dark orange and green fruits and
vegetables contain the most. CACFP menu planners should
include a good source of vitamin A in a meal or snack at least
three times a week.
The chart on the following page, Vitamin A Content of Fruits and
Vegetables, indicates the vitamin A content of foods in each group
from most to least. It also provides each food’s contribution to
the daily vitamin C requirement for ages 50 and older, based on
the RDAs. This helps CACFP menu planners to identify the best
sources of vitamin A. For more information on the RDAs, see
Dietary Reference Intakes in section 1.
Additional information on vitamin A can be found in the following resources:
•
•
Dietary Supplement Fact Sheet: Vitamin A and Carotenoids. National Institutes of Health, Office of
Dietary Supplements. http://ods.od.nih.gov/factsheets/vitamina.asp
Vitamin A. MedlinePlus. http://www.nlm.nih.gov/medlineplus/ency/article/002400.htm
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
11
3  Increasing Vitamins A and C
PLANNING HEALTHY MEALS
VITAMIN A CONTENT OF FRUITS AND VEGETABLES
Serving
Size1
Food
Vitamin A
Micrograms
(mcg) RAE
per Serving
Fruits
Contribution of Serving to
Adults’ RDA for Vitamin A
Males
Females
Ages 51 and
older (900 mcg)
Ages 51 and
older (700 mcg)
Cantaloupe, diced
½ cup
169
19%
24%
Apricots, dried, uncooked
Apricots, canned, juice pack
Apricots, dried, stewed, no added sugar
Melon balls, frozen
Plums, purple, canned, juice pack
Mandarin oranges, juice pack
½ cup
½ cup
½ cup
½ cup
½ cup
½ cup
117
104
80
77
63
54
13%
12%
9%
9%
7%
6%
17%
15%
11%
11%
9%
8%
½ cup
½ cup
½ cup
½ cup
1 medium
½ cup
50
38
34
31
24
21
6%
4%
4%
3%
3%
2%
7%
5%
5%
4%
3%
3%
½ cup
961
573
572
509
443
107%
64%
64%
57%
49%
137%
82%
82%
73%
63%
386
381
306
274
221
276
43%
42%
34%
30%
25%
31%
55%
54%
44%
39%
32%
39%
268
180
180
102
72
36
30%
20%
20%
11%
8%
4%
38%
26%
26%
15%
10%
5%
35
30
28
4%
3%
3%
5%
4%
4%
Cherries, red sour, fresh
Papaya, cubes
Prunes, dried
Mango, sliced
Nectarine
Watermelon, diced
Sweet potato, baked
Spinach, frozen, chopped or leaf, cooked
Squash, butternut, cubes, cooked
Carrots, raw, strips*
Kale, chopped, cooked
Vegetables
½ cup
½ cup
½ cup
½ cup
Collards, cooked, chopped
Peas and carrots, frozen, cooked
Pumpkin, cooked, mashed
Turnip greens, chopped, cooked
Mustard greens, cooked, chopped
Beet greens, pieces, cooked
½ cup
Swiss chard, chopped, cooked
Bok choy, shredded, cooked
Dandelion greens, chopped, cooked
Romaine lettuce, shredded
Peppers, sweet red, raw, sliced
Red chili peppers, raw, chopped or diced
½ cup
Plantain, cooked, sliced
Broccoli, cooked, chopped
½ cup
Tomato juice, canned
½ cup
½ cup
½ cup
½ cup
½ cup
½ cup
½ cup
½ cup
½ cup
½ cup
½ cup
½ cup
1 These
serving sizes are used to illustrate the comparative nutrient content of foods. The actual serving sizes required in the
CACFP Meal Pattern for Adults may be different.
Nutrient values were obtained from the USDA National Nutrient Database for Standard Reference, Release 23,
http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00.
12
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Increasing Vitamins A and C  3
VITAMIN C REQUIREMENTS
For adults ages 51 and older, the RDA for vitamin C is 90 milligrams (mg) per day for males and 75 mg
per day for females.
SOURCES OF VITAMIN C
The USDA recommends incorporating vitamin C-rich sources into CACFP menus. Foods that are
high in vitamin C include citrus fruits and juices, kiwi, strawberries, cantaloupe, tomatoes, broccoli,
peppers, cabbage, potatoes and leafy greens, such as romaine lettuce, turnip greens and spinach. A
good source of vitamin C should be served in at least one meal or snack daily.
The chart on the following two pages, Vitamin C Content of Fruits and Vegetables, indicates the vitamin C
content of foods in each group from most to least. It also provides each food’s contribution to the
daily vitamin C requirement for ages 50 and older, based on the RDAs. This helps CACFP menu
planners to identify the best sources of vitamin C. For more information on the RDAs, see Dietary
Reference Intakes in section 1.
Additional information on vitamin C can be found in the following resources:
•
•
Dietary Supplement Fact Sheet: Vitamin C. National Institutes of Health, Office of Dietary
Supplements. http://ods.od.nih.gov/factsheets/VitaminC-QuickFacts/
Vitamin C. MedlinePlus. http://www.nlm.nih.gov/medlineplus/vitaminc.html
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
13
3  Increasing Vitamins A and C
PLANNING HEALTHY MEALS
VITAMIN C CONTENT OF FRUITS AND VEGETABLES
Food
Serving Size1
Vitamin C
Milligrams
(mg) per
Serving
Fruits
Contribution of Serving to
Adults’ RDA for Vitamin C
Males
Females
Ages 51 and
Ages 51 and
older (90 mg) older (75 mg)
Guava, raw
½ cup
188
209%
251%
Strawberries, sliced
½ cup
49
54%
65%
Papaya, cubes
½ cup
43
48%
58%
Mandarin orange sections, canned, juice pack
½ cup
43
47%
57%
Orange juice, chilled or from concentrate
½ cup
41
46%
55%
Papaya, cubes
½ cup
43
48%
58%
½ medium
39
44%
52%
Cantaloupe, diced
½ cup
37
41%
49%
Grapefruit juice, white, canned
½ cup
36
40%
48%
Kiwi, without skin
½ medium
35
39%
47%
Orange
½ medium
35
39%
46%
Tangerine
1 medium
24
26%
31%
Mango, sliced
½ cup
23
25%
31%
Raspberries
½ cup
16
18%
21%
Honeydew, diced
½ cup
15
17%
20%
Blackberries, raw
½ cup
15
17%
20%
Pineapple juice, canned, unsweetened
½ cup
13
14%
17%
Pineapple, canned, juice pack
½ cup
12
13%
16%
1 medium
10
11%
13%
Kumquat
1 fruit
8
9%
11%
Nectarine
1 medium
8
9%
10%
½ cup
7
8%
10%
1 medium
6
7%
8%
½ cup
6
7%
8%
Grapefruit
Peach, fresh, raw
Blueberries, raw
Plum, raw
Watermelon, diced
1 These
serving sizes are used to illustrate the comparative nutrient content of foods. The actual serving sizes required in the
CACFP Meal Pattern for Adults may be different.
Nutrient values were obtained from the USDA National Nutrient Database for Standard Reference, Release 23,
http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00.
14
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Increasing Vitamins A and C  3
VITAMIN C CONTENT OF FRUITS AND VEGETABLES, continued
Food
Serving Size1
Vitamin C
Milligrams
(mg) per
Serving
Vegetables
Contribution of Serving to
Adults’ RDA for Vitamin C
Males
Females
Ages 51 and
Ages 51 and
older (90 mg) older (75 mg)
Peppers, sweet red, raw, sliced
½ cup
59
66%
79%
Broccoli, cooked, chopped
½ cup
51
57%
68%
Brussels sprouts, cooked
½ cup
48
53%
64%
Kohlrabi, cooked, sliced
½ cup
45
50%
60%
Peppers, sweet green, raw, sliced
½ cup
37
41%
49%
Tomato vegetable juice
½ cup
34
38%
45%
Cauliflower, cooked
½ cup
28
31%
37%
Kale, cooked, chopped
½ cup
27
30%
36%
Chili peppers, green, canned
½ cup
24
27%
32%
Tomato juice
½ cup
22
24%
29%
Sweet potato, boiled, mashed
½ cup
21
23%
28%
Bok choy, cooked, shredded
½ cup
22
24%
29%
Snow peas, raw pods
½ cup
19
21%
25%
Mustard greens, cooked, chopped
½ cup
18
20%
24%
Rutabaga, cooked, cubes
½ cup
16
18%
21%
Cabbage, raw, shredded
½ cup
13
14%
17%
Parsnips, cooked, sliced
½ cup
10
11%
13%
½ medium
10
11%
13%
Dandelion greens, cooked, chopped
½ cup
9
10%
12%
Plantain, cooked, sliced
½ cup
8
9%
11%
½ medium
8
9%
11%
Romaine lettuce, raw
½ cup
6
7%
8%
Spinach, raw
½ cup
4
4%
5%
Potato, baked
Tomato, raw
1 These
serving sizes are used to illustrate the comparative nutrient content of foods. The actual serving sizes required in the
CACFP Meal Pattern for Adults may be different.
Nutrient values were obtained from the USDA National Nutrient Database for Standard Reference, Release 23,
http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
15
3  Increasing Vitamins A and C
16
PLANNING HEALTHY MEALS
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Decreasing Fats and Cholesterol  4
4 — DECREASING FAT, SATURATED FAT, TRANS FAT
AND CHOLESTEROL IN CACFP MEALS
The Dietary Guidelines recommends the following limits for fats and cholesterol:
•
•
•
•
total fat should be no more than 30 to 35 percent of calories, with most fats coming from
sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts and vegetable
oils;
saturated fat should be less than 10 percent of calories;
cholesterol should be less than 300 milligrams per day; and
trans fats should be as low as possible.
The CSDE strongly recommends that all foods served in the CACFP meet the CSDE’s recommended
nutrition standards for fat, saturated fat and trans fat (see State Nutrition Recommendations in section 1).
Menu planners must choose foods carefully to ensure that CACFP meals and snacks are not too high
in fat, saturated fat, trans fat and cholesterol.
SOURCES OF FAT
Fat comes from both animal and vegetable sources. Animal sources provide about 57 percent of the
total fat in the American diet. The main animal sources of fat include red meats, poultry and fish, milk
and milk products, and eggs.
Fat from vegetable sources accounts for about 43 percent of the fat available in the diet. Vegetable fat
is consumed mostly in the form of plant oils, such as soybean, corn, sunflower, canola, cottonseed,
palm and coconut.
Fat is also consumed in fried foods and other products such as butter, margarine, dairy products,
cheese, nuts, baked goods, salad oils, shortening, mayonnaise dressings, frostings, gravies and sauces
and commercially prepared foods. CACFP menu planners can easily identify the fat content of
convenience foods by reading the food label (see How to Read a Food Label in section 8).
SOURCES OF SATURATED FAT
Animal foods provide about 75 percent of the saturated fat consumed in the American diet and plant
sources provide about 25 percent. Some plant sources are very high in saturated fat, including coconut
oil, palm oil and palm kernel oil.
Saturated fat is solid at room temperature, such as butter, lard and visible fat on meat and poultry. The
more unsaturated a fat, the more liquid it is at room temperature. However, liquid oils vary in the
amount of saturated fat they contain. The Nutrition Facts panel on the food label provides
information on saturated fat content.
Commercial convenience items and snack foods can be high in fat, saturated fat and trans fat, so it is
important for menu planners to read labels and compare products. Switching to a different brand of
the same product can often help decrease fat content.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
17
4  Decreasing Fats and Cholesterol
PLANNING HEALTHY MEALS
SOURCES OF TRANS FAT
About 20 percent of trans fats in the American diet occur naturally in food from animal sources, such
as butter, milk products, cheese, beef and lamb. However, most trans fats are artificially made when
oils undergo a chemical process known as hydrogenation. For more information, see “trans fats” and
“hydrogenated oils” in the Glossary.
Processed foods and oils provide approximately 80
percent of the trans fats in the diet. Artificial trans fats
can be found in vegetable shortenings, some
margarines, crackers, candies, cookies, snack foods,
fried foods, baked goods and other processed foods
made with hydrogenated or partially hydrogenated
vegetable oils.
Food labels provide information regarding the trans
fat content of foods. The FDA labeling regulations
allow food labels to state “0 grams” trans fats if the
serving contains less than 0.5 gram of trans fats, even
if the food contains sources of artificial trans fats, such
as hydrogenated oils. The CSDE strongly encourages CACFP menu planners to read labels and select
food products and cooking oils that do not contain any hydrogenated or partially hydrogenated oils.
SOURCES OF CHOLESTEROL
Cholesterol is a fat-like substance, but it is not a fat and contains no calories. It is only found in foods
of animal origin, such as meat, chicken, fish and eggs. Organ meats (such as liver) and egg yolks are
particularly high in cholesterol. Cholesterol is not found in vegetable foods such as vegetable oils and
shortenings, fruits, vegetables, grains, nuts and seeds. For more information, see “cholesterol” in the
Glossary.
18
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Decreasing Fats and Cholesterol  4
IMPROVING MENUS
The following pages provide ideas to assist CACFP facilities in planning healthy meals to reduce fats
and cholesterol through menu planning, purchasing, meal preparation and modifying recipes.
Menu Planning to Decrease Fat
•
Review recipes and commercial products for
compliance with the CSDE’s nutrition
recommendations for fat, saturated fat and
trans fat (see State Nutrition Recommendations in
section 1).
•
Eliminate or limit the number of desserts
served or modify recipe ingredients to lower
fat content.1, 2
•
Eliminate or limit the service of high-fat
snack items, such as cookies, cake,
doughnuts, brownies and chips.1, 2 Desserttype items can be served only at snack and
only if they meet specific requirements. They
cannot be served more than twice a week
between all snacks (morning, afternoon and
evening) provided in the CACFP. For more
information, see Foods that Qualify as
Grains/Breads in Nutrition Policies and Guidance
for Adult Day Care Centers: Crediting Foods —
Grains/Breads.
•
Increase servings of legumes, fruits,
vegetables and whole grains.
•
Serve only low-fat (1%) or nonfat milk.1 The
CACFP Meal Pattern for Adults requires
low-fat (1%) or less be served in adult
centers.
•
Limit servings of luncheon meats, hot dogs
and sausage.1
•
Limit servings of battered or breaded foods
that are fried in fat during processing.1
•
•
Limit or control the amount of full-fat
cheese served.1 Serve low-fat natural cheese
instead.
Plan only enough meat or meat alternate to
meet the minimum CACFP serving size
requirement.1
•
Offer fresh fruit as an alternative to dessert
at each meal.
•
Offer mustard, ketchup and low-fat
mayonnaise as alternatives to high-fat
spreads.1, 3
•
Offer low-fat or fat-free salad dressings
instead of regular varieties.1, 3
•
Use broth-based soups rather than creambased or prepared bases.1, 2 Only vegetablebased soups with a sufficient quantity of
vegetables are creditable in the CACFP Meal
Pattern for Adults. For more information,
see Nutrition Policies and Guidance for Adult Day
Care Centers: Crediting Foods —
Vegetables/Fruits.
1 This
strategy also helps to lower saturated fat and/or trans fat and/or cholesterol.
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
3 These foods are not creditable as a food component in the CACFP meal patterns.
2 These
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
19
4  Decreasing Fats and Cholesterol
PLANNING HEALTHY MEALS
Purchasing to Decrease Fat
•
If ice cream is served, purchase low-fat
alternatives, e.g., ice milk, frozen yogurt,
sherbet and frozen juice pops.3
•
If cake is served, use angel food cakes or
sponge cakes that contain little fat. Regular
cake recipes are difficult to modify for
reduced fat.1, 2
Purchase ground chicken or turkey (without
skin) to mix with or substitute for lean
ground beef.1
•
Substitute lean ham for bacon or sausage.1, 2
Note: Bacon is not creditable as a meat/meat
alternate.
•
Purchase leaner meats, e.g., ground beef with
no more than 15 percent fat.1
•
•
Purchase reduced-fat processed meats, such
as frankfurters and deli meats.1
•
Purchase water packed tuna (1 percent fat)
instead of oil packed (21 percent fat).1
Limit use of convenience and prepared items
that are higher in fat.1, 2 Read food labels to
compare and evaluate nutrition information
for processed food items such as pizza and
hot dogs. A different brand of the product
may contain less fat.
•
When purchasing from vendors, write
specifications for the fat content of products,
e.g., specify the percentage of fat contained
in meat items and make sure products
received are the same as those specified.1
•
Use margarine instead of butter. Purchase
soft margarine, which is lower in saturated
fat than stick margarine. Choose margarine
that is highly polyunsaturated.1, 3
•
If commercial baking mixes are used (e.g.,
muffins, pancakes), purchase only those to
which fat must be added so the amount of
fat can be controlled.1, 2
•
Request that vendors provide nutrition
information for all products purchased.
Read labels to determine fat, saturated fat,
trans fat and cholesterol content of
purchased products (see How to Read a Food
Label in section 8). Compare brands, as a
comparable product may be lower in
saturated fat.
•
Purchase foods that meet the CSDE’s
nutrition recommendations for fat, saturated
fat and trans fat (see State Nutrition
Recommendations in section 1).
•
Review commercially prepared entree
products to determine if lower fat products
are acceptable and affordable.1, 2
•
•
•
•
•
Purchase lower fat breads (e.g., bagels, pita
bread, corn tortillas, English muffins) to
offer more frequently instead of higher fat
grain products such as muffins, croissants,
doughnuts, Danish pastries and sweet rolls.1,2
Choose whole-grain breads most often.
Avoid products with animal fat (lard) or
saturated vegetable oils, such as coconut oil,
palm oil, palm kernel oil and hydrogenated
shortening or stick-type margarine.1, 3
Purchase low-fat natural cheeses and
products made with these cheeses, e.g., pizza
with part-skim mozzarella cheese instead of
regular mozzarella.1
Purchase low-fat mayonnaise and salad
dressings and avoid commercial barbecue
sauces and canned sauces.1, 3
1 This
strategy also helps to lower saturated fat and/or trans fat and/or cholesterol.
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
3 These foods are not creditable as a food component in the CACFP meal patterns.
2 These
20
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Decreasing Fats and Cholesterol  4
Meal Preparation to Decrease Fat
•
Use only enough salad dressing to lightly coat •
salad.1, 3
Prepare items from scratch to control the
amount of fat.1, 2
•
Brown meats by broiling or cooking in
nonstick pans with little or no oil.1
•
•
Instead of basting with drippings, keep meat
moist with fruit juices or an acceptable oilbased marinade containing polyunsaturated
or monounsaturated oils.1, 3
Replace shortening with soft margarine
(liquid oil should be the first listed
ingredient) or vegetable oil, as
appropriate. Choose oils low in saturated
fat, such as canola, corn, olive, safflower,
sesame, soybean and sunflower.1, 3
•
Use nonstick cooking spray in place of oil or
shortening for braising and sauteing.1, 3
•
•
Roast meat, poultry and fish on a rack so fat
will drain off. Completely drain fat from
precooked ground meats; drain in colander
or use a meat baster to remove fat that has
cooked out of product.1
Use low-fat natural cheese and reduce
amount on sandwiches, e.g., ¼ ounce
instead of ½ ounce; increase the amount
of lean meat if needed to meet the
meat/meat alternate requirements.1
•
When not needed to meet the meat/meat
alternate requirement, reduce the amount
of cheese in recipes by one-quarter to
one-half.1 Boost cheese flavor with
enhancers, such as dry mustard and
lemon juice. Make casserole toppings by
reducing cheese and combining with dry
bread crumbs and herbs.1
•
Brush breads and rolls with egg white,
nonfat or low-fat milk instead of butter
before baking to improve browning.1
•
Avoid frying foods. Bake, broil, steam,
poach, braise or stir-fry.1
•
Baste or coat foods with broth, herbs and
seasonings instead of fats.1, 3
•
For sauces and dressings, use low-calorie
bases (vinegar, mustard, tomato juice, fatfree bouillon) instead of high-calorie ones
(creams, fats, oils, mayonnaise).1, 3
•
Oven-bake instead of frying, e.g., chicken
nuggets, french fries.1
•
Cut mayonnaise with low-fat yogurt (up
to half).1, 3
•
Reduce ground beef in chili by half and add
more beans.1
•
Substitute low-fat cheese, such as ricotta,
farmer, cottage or mozzarella, for part of the
cheese in recipes.1
•
To thicken gravies and sauces without adding
fat, mix cornstarch with a small amount of
cold water to make a slurry. Slowly stir this
mixture into the liquid to be thickened and
bring back to a boil. Cornstarch can be used
to replace a roux (a butter-flour mixture used
for thickening). Use an amount of cornstarch
equal to one-half the amount of flour
indicated.1, 3
•
Use lean ham or a small amount of ham
base (omit salt) for seasonings.1
•
Cook soups, stews, sauces, broths and
boiled meat ahead of time. Refrigerate and
remove congealed fat. Make gravies after fat
has hardened and is removed from liquid.1, 2
1 This
strategy also helps to lower saturated fat and/or trans fat and/or cholesterol.
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
3 These foods are not creditable as a food component in the CACFP meal patterns.
2 These
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
21
4  Decreasing Fats and Cholesterol
PLANNING HEALTHY MEALS
Meal Preparation to Decrease Fat, continued
•
Use leanest cuts of meat and trim away all
fat. Remove all fat and skin from poultry.1
•
Do not add butter, margarine or oil to
cooked vegetables.1, 3
•
When sauteing or stir-frying, use only a small
amount of vegetable oil.1, 3
•
Use nonstick skillets and baking pans
whenever possible.1
•
For baked goods or other foods, use
panliners and nonstick cooking spray instead
of greasing sheet pans.1, 3
•
Use nonstick cooking spray instead of oil
when pan-frying or sauteing foods that do
not need a large amount of oil.1, 3
•
Substitute low-fat yogurt, applesauce, or plum
or prune puree for oil, shortening, margarine
or butter in recipes.1, 2 Generally, the amount
of fat can be reduced by half and fruit
product can be substituted for an equal
amount of fat in muffin or quick bread
recipes.
•
Make pizza with lean ham or Canadian bacon
instead of sausage or pepperoni.1
•
Make low-fat substitutions, such as
Modifying Recipes to Decrease Fat
•
Substitute ground turkey (without skin) for
half of ground beef in recipes such as chili,
spaghetti, lasagna and meat loaf.1
•
Reduce fat in recipes by as much as half,
starting with one-quarter less fat and testing
the recipe.1
•
Substitute vegetable oil or margarine for
butter. Choose margarine brands that are
lowest in saturated and trans fats.1, 3
•
Eliminate fat from recipes when possible, e.g.,
instead of sauteing onions in oil for spaghetti
sauce, cook the onions in the sauce.
•
•
In recipes, substitute two egg whites for one
whole egg or use an egg substitute product.1, 2
Egg whites and egg substitute are not
creditable as a meat/meat alternate. If used as
an ingredient in a recipe, the product must be
evaluated for compliance with the CACFP
meal pattern requirements.

low-fat or fat-free yogurt or low-fat or
fat-free sour cream for sour cream.1, 3

cocoa powder for chocolate.1, 3

nonfat milk or nonfat dry milk for whole
milk.1, 3

part-skim mozzarella cheese for regular
mozzarella.1
Replace one-quarter of ground meat with
mashed beans, e.g., Great Northern beans in
tacos.1
1 This
strategy also helps to lower saturated fat and/or trans fat and/or cholesterol.
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
3 These foods are not creditable as a food component in the CACFP meal patterns.
2 These
22
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Decreasing Sodium  5
5 — DECREASING SODIUM IN CACFP MEALS
The Dietary Guidelines recommends consuming less than 1,500 milligrams of sodium per day for ages 51
and older. It also recommends choosing and preparing foods with little salt and consuming potassiumrich foods, such as fruits and vegetables.
On average, Americans consume between 2,900 to 4,300 milligrams of sodium per day. A high sodium
intake increases the risk of high blood pressure in individuals who are sodium sensitive. One-third of
adults have high blood pressure. High blood pressure increases the risk of coronary heart disease,
stroke, congestive heart failure and kidney disease.
The CSDE strongly recommends that all foods served in the CACFP meet the CSDE’s recommended
nutrition standards for sodium (see State Nutrition Recommendations in section 1). Menu planners must
choose foods carefully to ensure that CACFP meals and snacks are not too high in sodium.
SOURCES OF SODIUM
The majority of sodium in the American diet comes from salt added to foods by manufacturers. The
natural salt content of foods accounts for only about 12 percent of total sodium intake. Adding salt at
the table or in cooking accounts for another 11 percent. Table salt contains 40 percent sodium by
weight. A teaspoon of salt contains 2,325 milligrams of sodium.
Foods in every food group contain sodium, including nutrientdense foods such as milk, cheese and bread. The sodium
content varies even among very similar foods, due to the way
foods are processed and prepared. Foods that are especially
high in salt or sodium include:
•
•
•
•
•
•
•
•
•
foods prepared in brine, such as pickles, relish, olives
and sauerkraut1;
cured or smoked meat, such as bologna, corned or
chipped beef1;
cured, canned or smoked fish, such as anchovies,
salted and dried cod, herring, sardines, tuna fish;
snack items, such as potato chips2, pretzels, salted
popcorn2, nuts and crackers;
seasonings2, such as bouillon cubes, seasoned salts,
meat tenderizer, monosodium glutamate (MSG),
autolysed yeast, soy sauce, Worcestershire sauce,
teriyaki sauce, barbecue sauce, condiments, such as
ketchup, mustard, steak sauce and salad dressings;
fast foods;
cheeses, especially processed;
canned and instant soups1; and
canned vegetables.
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
2 These foods are not creditable as a food component in the CACFP meal patterns.
1 These
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
23
5  Decreasing Sodium
PLANNING HEALTHY MEALS
Other indicators that a food may be high in sodium include descriptions such as broth, cured, pickled
and smoked, or ingredients listing salt, soda or sodium, such as:
•
•
•
•
•
•
•
•
•
•
baking soda (sodium bicarbonate);
baking powder;
brine (salt and water);
disodium phosphate;
salt (sodium chloride);
sodium caseinate;
sodium citrate;
sodium nitrate;
sodium propionate; and
sodium sulfate.
Limiting these foods and ingredients can greatly reduce the amount of sodium in CACFP menus.
Commercially prepared convenience items and snack foods can contain high amounts of sodium.
CACFP menu planners should read labels and compare products for sodium content (see How to Read
a Food Label in section 8). Foods containing 20 percent or more of the Daily Value for sodium are high
in sodium, and should be limited in CACFP menus.
The chart below indicates the range of sodium content for selected foods.
RANGE OF SODIUM CONTENT FOR SELECTED FOODS
Food Group
Serving Size
Range (milligrams)
Breads, all types ............................................................................ 1 ounce ......................................95-210
Fluid milk, all types .......................................................................... 1 cup .........................................98-152
Frozen pizza, plain, cheese ...........................................................4 ounces ...................................450-1200
Frozen vegetables, all types ............................................................ ½ cup .........................................2-160
Salad dressing, regular fat, all types ......................................... 2 tablespoons ................................110-505
Salsa..........................................................................................2 tablespoons ................................150-240
Soup (tomato), reconstituted ..................................................... 8 fluid ounces ...............................700-1260
Tomato juice .............................................................................. 8 fluid ounces ...............................340-1040
Potato chips (regular flavor, salted) ............................................... 1 ounce .....................................120-180
Tortilla chips (regular flavor, salted) .............................................. 1 ounce .....................................105-160
Pretzels (regular flavor, salted) ...................................................... 1 ounce .....................................290-560
Sources:
Dietary Guidelines for Americans. U.S. Department of Agriculture and U.S. Department of Health and Human Services, 2005.
http://www.healthierus.gov/dietaryguidelines/
USDA National Nutrient Database for Standard Reference, Release 23.
http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00
24
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Decreasing Sodium  5
IMPROVING MENUS
The following pages provide ideas to assist CACFP facilities in planning healthy meals to reduce
sodium through menu planning, purchasing, meal preparation and modifying recipes.
Menu Planning to Decrease Sodium
•
Review recipes and commercial products for
compliance with the CSDE’s nutrition
recommendations for sodium (see State
Nutrition Recommendations in section 1).
•
Plan low-sodium foods to accompany highsodium foods in a menu, e.g., fresh fruits and
vegetables with a breaded chicken pattie.
•
Serve smaller portions of high-sodium foods.
•
Avoid or decrease frequency of meals that use
cured foods, such as bacon, ham, luncheon
meats, pickles, sausage, hot dogs, olives and
sauerkraut.1
•
Use fresh vegetables whenever possible.
•
Use natural cheeses (e.g., brick, cheddar,
Colby, Monterey Jack, mozzarella, muenster,
provolone, Swiss) instead of processed
cheeses (e.g., pasteurized process cheese
food, pasteurized process cheese spread,
pasteurized process cheese product)
whenever possible.
•
Plan more menu items that are made from
scratch to control the amount of added salt.
•
Plan to use unprocessed whole foods
frequently.
Purchasing to Decrease Sodium
•
Purchase foods that meet the CSDE’s
nutrition recommendations for sodium (see
State Nutrition Recommendations in section 1).
•
When purchasing from vendors, write
specifications for products containing little or
no added sodium and make sure products
received are the same as those specified.
•
Recognize ingredients that contain sodium,
e.g., baking powder, baking soda, sodium
nitrite, MSG, soy sauce (see Sources of Sodium
in this section).2
•
Read labels. Convenience and processed
foods are usually high in salt (see How to Read
a Food Label in section 8).
•
Purchase lower sodium varieties of foods,
such as tomato products and canned
vegetables.
•
Instead of traditional crackers, purchase
brands of unsalted or reduced-salt crackers.
•
Use fresh, frozen and canned (low-sodium)
vegetables and fruits.
•
Purchase seasoning powders (e.g., garlic and
onion) instead of salts.2
•
Purchase old-fashioned cooked cereals (e.g.,
rolled oats) instead of instant cooked cereals
high in salt.
•
Request that vendors provide nutrition
information for all products purchased. Read
labels to determine sodium content of
purchased products (see How to Read a Food
Label in section 8). Compare brands, as a
comparable product may be lower in sodium.
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
2 These foods are not creditable as a food component in the CACFP meal patterns.
1 These
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
25
5  Decreasing Sodium
PLANNING HEALTHY MEALS
Meal Preparation to Decrease Sodium
•
•
Rinse canned vegetables under cold running
water for two to three minutes before heating.
•
Do not add salt to boiling water when
cooking pasta, vegetables or cereals.
•
Keep table salt and high-sodium condiments
off the table.2
•
Do not add additional salt to recipes.
•
•
Make cakes, biscuits, pancakes and desserts
from scratch instead of using prepared
mixes.1
Use spices and herb blends creatively in place
of salt.2
•
Use seasoning powders (e.g., garlic and
onion) instead of salts.2
•
Avoid recipes that contain substantial
amounts of baking soda or baking powder.
When possible, use fresh or frozen vegetables
instead of canned vegetables in a recipe.
Modifying Recipes to Decrease Sodium
•
Review recipes and reduce or eliminate the
amount of high-sodium products or added
salt whenever possible.
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
2 These foods are not creditable as a food component in the CACFP meal patterns.
1 These
26
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Decreasing Sugars  6
6 — DECREASING SUGARS IN CACFP MEALS
The Dietary Guidelines recommends consumption of a diet
moderate in added sugars, e.g., processed foods. The
naturally occurring sugars in foods such as fruit, grains and
milk products are not a concern because these foods also
contain substantial amounts of nutrients and other healthenhancing substances.
Diets that are high in added sugars tend to be low in
vitamins, minerals and fiber. High-sugar foods can displace
more nutrient-dense choices, such as fruits, vegetables and
whole grains. High-sugar diets also cause tooth decay.
CACFP menus should focus on providing foods that are
naturally nutrient rich and low in added sugars. Foods
containing artificial sweeteners, nonnutritive sweeteners and
sugar alcohols should not be used as a replacement for highsugar foods. People need to learn to enjoy the natural favors
of healthy foods that have not been artificially enhanced
with a sweet taste. Some research suggests that nonnutritive
sweeteners can increase cravings for sweet foods and lead to
increased calorie consumption.
The ingredients statement indicates whether a product
contains artificial or nonnutritive sweeteners or sugar
alcohols (see Sugars and Sweeteners at right). The CSDE
strongly recommends that foods and beverages with these
ingredients are not served in the CACFP.
SOURCES OF SUGARS
Sugars are found naturally in foods such as fruits and
vegetables (fructose), milk and milk products (lactose) and
legumes and cereals (maltose). Sugars are also added to
processed foods, most commonly as white table sugar
(sucrose) and corn sweeteners. Processed foods are the
major source of added sugars in the American diet. Foods
high in added sugars include regular soda and sweetened
drinks, cakes, pastries, cookies and bars, granola bars, presweetened cereals, toaster pastries, sweet rolls, doughnuts
and pie filling.
The amount of added sugars in a food cannot be
determined from the food label because it lists total sugars,
both naturally occurring and added. However, the list of
ingredients on the product label gives an idea of how much
added sugars the food contains (see Names for Added Sugars).
The suffix “-ose” means sugar. A food is likely to be high in
added sugars if one of these names appears first or second
in the ingredient statement, or if several names are listed.
SUGARS AND SWEETENERS
Added Sugars
• Brown sugar
• Corn sweetener
• Dextrose
• Fructose
• Fruit juice concentrate
• Glucose
• High-fructose corn syrup
• Honey
• Lactose
• Maltose
• Sorghum syrup
• Sucrose
• Syrup
Common Artificial Sweeteners
• Acesulfame Potassium (Acesulfame-K,
Sunett, Sweet & Safe, Sweet One)
• Aspartame (Nutrasweet, Equal)
• Neotame
• Saccharin (Sweet and Low, Sweet Twin,
Sweet ‘N Low Brown, Necta Sweet)
• Sucralose (Splenda)
• Tagatose
Sugar Alcohols
• Erythritol
• Isomalt
• Lactitol
• Maltitol
• Mannitol
• Sorbitol
• Xylitol
• Hydrogenated starch hydrolysates (e.g.,
hydrogenated glucose syrups, maltitol
syrups and sorbitol syrups)
“Natural” Nonnutritive Sweeteners*
• Stevia (Rebiana, Truvia, PureVia,
SweetLeaf)
* The term “natural” does not have any
consistent meaning when used to
describe foods or beverages. It has not
been defined by the FDA.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
27
6  Decreasing Sugars
PLANNING HEALTHY MEALS
IMPROVING MENUS
The following pages provide ideas to assist CACFP facilities in planning healthy meals to reduce
sugars through menu planning, purchasing, meal preparation and modifying recipes.
Menu Planning to Decrease Sugars
•
Review recipes and commercial products for
compliance with the CSDE’s nutrition
recommendations for sugars (see State
Nutrition Recommendations in section 1).
•
Increase the frequency of whole-grain breads
and pasta, and fresh vegetables and fruits in
place of processed foods high in sugars.
•
Serve unsweetened cooked fruit such as baked
apples with raisins. Add spices like cinnamon,
nutmeg, cloves and allspice to enhance the
flavor of the fruit.
•
If dessert items are served, choose those that
contain few added sugars and are made with
nutritious ingredients like whole-wheat flour,
oatmeal, finely chopped nuts, peanut butter,
raisins and fruit or vegetables, e.g., pumpkin,
zucchini, cranberries or carrots.1
•
Replace foods containing very high levels of
sugars with those containing moderate levels
of sugar.1
•
Eliminate or limit service of foods that are
major sources of added sugars, such as
cakes with frosting, cobblers, highly
sweetened cereals and cookies.1 Desserttype items can be served only at snack and
only if they meet specific requirements.
They cannot be served more than twice a
week between all snacks (morning,
afternoon and evening) provided in the
CACFP. For more information, see Foods
that Qualify as Grains/Breads in Nutrition
Policies and Guidance for Adult Day Care
Centers: Crediting Foods — Grains/Breads.
Purchasing to Decrease Sugars
•
Purchase foods that meet the CSDE’s nutrition
recommendations for sodium (see State
Nutrition Recommendations in section 1).
•
Purchase whole-grain breakfast cereals
containing no more than 35 percent of calories
from sugars and at least 2.5 grams of fiber per
serving.
•
Compare the ingredients statements of different
brands of a specific product before purchasing.
The amount of added sugars can vary greatly
between different brands of the same food.
•
When purchasing from vendors, revise
purchased food specifications to specify food
items without added sugars and sweeteners
(artificial, nonnutritive and sugar alcohols) and
make sure products received are the ones
specified.
•
Purchase canned fruit packed in natural
juices or water instead of syrup.
•
Purchase vanilla or lemon yogurt as an
alternative to higher-sugar fruit flavors or
mix half plain yogurt and half fruited
yogurt.
•
Avoid snack or convenience foods with
sugars as the first three ingredients.1
•
Request that vendors provide nutrition
information for all products purchased.
Read labels to determine sugar content of
purchased products (see How to Read a Food
Label in section 8). Compare brands, as a
comparable product may be lower in
sugars.
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
2 These foods are not creditable as a food component in the CACFP meal patterns.
1 These
28
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Decreasing Sugars  6
Meal Preparation to Decrease Sugars
•
Do not add sugar to recipes when it is not
listed as an ingredient.
Modifying Recipes to Decrease Sugars
•
Use cinnamon and vanilla to increase the
sweet flavor of a food, while reducing the
sugar content.2
•
Sprinkle cakes with powdered sugar or fruit
instead of frosting or icing.1
•
Replace canned pie fillings with unsweetened,
spiced cooked fruit when making cobblers or
pies.1
•
In baked goods, sugar can usually be reduced
by one-third to one-half without altering the
flavor. Adding spices, raisins, or other dried
fruits, vanilla, lemon zest and other similar
ingredients can make up for missing sugar.1
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
2 These foods are not creditable as a food component in the CACFP meal patterns.
1 These
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
29
6  Decreasing Sugars
30
PLANNING HEALTHY MEALS
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Increasing Fiber  7
7 — INCREASING FIBER IN CACFP MEALS
The Dietary Guidelines encourages increased consumption of complex carbohydrate foods, such as
whole grains, vegetables, and nuts and seeds. Complex carbohydrate foods are rich in fiber and other
nutrients and provide a variety of health benefits, such as decreasing the risk of cardiovascular disease.
The CSDE strongly recommends that all foods served in the CACFP meet the CSDE’s recommended
nutrition standards to choose whole grains and good sources of fiber (at least 2.5 grams) most often
(see State Nutrition Recommendations in section 1). Menu planners must choose foods carefully to ensure
that CACFP meals and snacks contain sufficient fiber.
FIBER REQUIREMENTS
The Recommended Dietary Allowance (RDA) for fiber for adults is 14 grams per 1,000 calories
consumed. For adults ages 51 and older, the RDA for fiber is 30 grams per day for males and 21 grams
per day for females. Most adults do not get enough fiber. The average intake in the United States is 15
grams per day.
Encouraging people to consume and enjoy high-fiber foods is an important strategy for healthy eating
habits. To increase fiber in CACFP meals and snacks, menu planners should focus on increasing the
variety of complex carbohydrate foods. Menus can be adjusted to increase the frequency and amount
of high-fiber foods, such as:
•
•
•
•
•
increasing the frequency of whole-grains and cereals, e.g., whole-wheat pasta,
whole-grain breads, oatmeal, bulgur and brown rice;
providing whole (unprocessed or minimally processed) fruits and vegetables most
often;
increasing the frequency of legumes (dry beans and peas);
providing additional servings of vegetables and fruits, e.g., serving three kinds of
fruits or vegetables instead of two; and
increasing the serving size of vegetables and fruits.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
31
7  Increasing Fiber
PLANNING HEALTHY MEALS
SOURCES OF FIBER
The following food groups are complex carbohydrates and
provide good sources of fiber.
•
Grains and Breads: Breads, cereals and other grainbased products made with whole grains and bran, such as
bulgur, whole-wheat flour, rolled oats, rolled wheat, oat
bran, brown rice, rice bran, wheat bran and barley. For
more information, see Identifying Whole Grains in Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting
Foods — Grains/Breads.
•
Legumes and Nuts: Dry beans and peas, including
black beans, kidney beans, chickpeas, lentils, pinto beans,
Great Northern beans, navy beans and nuts, including
almonds, cashews, hazelnuts, peanuts, pecans and
walnuts.
•
Fruits: Apples, bananas, blueberries, grapefruit, oranges,
nectarines with skin, peaches and pears with skin, prunes,
raisins and strawberries.
•
Vegetables: Beets, broccoli, Brussels sprouts, cabbage,
carrots, cauliflower, corn, green beans, green peas,
parsnips, potatoes with skin and turnips.
Food labels indicate the amount of fiber in foods as “dietary
fiber” in grams (g). This includes both soluble and insoluble fiber
(see Dietary Fiber at right).
DIETARY FIBER
Insoluble fibers aid in digestion
by adding bulk and softness to
stools to promote regularity and
prevent constipation. Insoluble
fibers decrease the amount of
“transit time” for food waste in the
intestine. Insoluble fibers include
whole-wheat products, wheat and
corn bran, popcorn*, many
vegetables (e.g., cauliflower,
beans and potatoes) and the skins
of fruits and root vegetables.
Soluble fibers (e.g., gums,
mucilages and pectin) bind to fatty
substances in the body to promote
their excretion as waste. They
help lower blood cholesterol levels
and also help regulate the body’s
use of sugars. Soluble fibers
include dry beans and peas, oats,
oatmeal, barley, psyllium seed
husk and many fruits and
vegetables, such as apples,
carrots, citrus fruits, strawberries,
prunes, dry beans and other
legumes.
The food label can state that a product is “a good source” of fiber
* Popcorn is not creditable as a
if it contributes 10 percent of the Daily Value (2.5 grams of fiber
grain/bread component in the
per serving). The package can claim “high in,” “rich in” or
CACFP.
“excellent source of” fiber if the product provides 20 percent of
the Daily Value (5 grams of fiber per serving). For more information on reading food labels, see How to
Read a Food Label in section 8.
Some processed convenience foods, such as breakfast cereals and snack bars, contain fiber but can also
contain added fat, sugars and sodium. Adding fiber or whole grains does not make an undesirable
product a healthy choice. Choose whole-grain foods with the lowest amount of saturated fat, trans fat,
sugars and sodium. By reading food labels, menu planners can compare the nutrient content of these
foods and make the best choices (see How to Read a Food Label in section 8).
It is always best to get fiber from minimally processed whole foods, such as fruits, vegetables and
grains, rather than processed convenience foods that are supplemented with fiber. Whole foods
contain a large variety of naturally occurring nutrients and other health-enhancing compounds that
cannot be duplicated in processed foods.
The chart on the following two pages, Fiber Content of Foods, indicates the fiber content of some foods
from most to least. It also provides the food’s contribution to the daily fiber requirement of ages 50
and older, based on the RDAs. This allows CACFP menu planners to identify the best sources of fiber.
For more information on the RDAs, see Dietary Reference Intakes in section 1.
32
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Increasing Fiber  7
FIBER CONTENT OF FOODS1
Food
Serving
Size2
Total Dietary
Fiber Grams (g)
per Serving
Contribution of Serving to Adults’
RDA for Fiber
Males (38 g)
Females (25 g)
8.3
8.1
7.8
6.9
6.7
28%
27%
26%
23%
22%
40%
39%
37%
33%
32%
5.3
18%
25%
5.5
4.4
3.1
3.1
18%
15%
10%
10%
26%
21%
15%
15%
Legumes
Black beans, canned
Split peas, cooked
Lentils, cooked
Kidney beans, canned
Navy beans, canned
½ cup
½ cup
½ cup
½ cup
½ cup
Chickpeas (garbanzo beans), canned
½ cup
Fruit
Pear, fresh, with skin
Apple, with skin
Banana
Orange
1 medium
1 medium
1 medium
1 medium
Figs, dried
Peaches, raw
Grapefruit, pink and red
Pears, canned
Prunes, dried, pitted
Blueberries, raw
3 each
1 medium
½ medium
½ cup
3 each
½ cup
2.5
2.2
2.0
2.0
2.0
1.8
8%
7%
7%
7%
7%
6%
12%
10%
10%
10%
10%
9%
Strawberries, raw, sliced
Peaches, canned
Raisins
Cantaloupe, cubed
½ cup
½ cup
¼ cup
½ cup
1.7
1.3
1.3
0.7
6%
4%
4%
2%
8%
6%
6%
3%
Peas, green, canned
½ cup
3.5
12%
17%
1 medium
½ cup
½ cup
½ cup
½ cup
½ cup
2.3
2.3
2.2
2.0
1.7
1.4
8%
8%
7%
7%
6%
5%
11%
11%
10%
10%
8%
7%
½ cup
½ cup
½ cup
1 each
1.1
1.0
0.4
0.3
4%
3%
1%
1%
5%
5%
2%
1%
Potatoes, baked, flesh only
Turnips, cooked, mashed
Spinach, cooked
Beans, snap, green, cooked
Carrots, raw, strips or slices
Cauliflower, cooked, 1-inch pieces
Broccoli, raw, chopped or diced
Brussels sprouts, cooked
Lettuce, iceberg, shredded
Celery, raw, 5-inch stalk
Vegetables
1 The
use of brand name products does not constitute approval or endorsement by the CSDE or the USDA. Product names are used
solely for clarification regarding nutrient content.
2 These serving sizes are used to illustrate the comparative nutrient content of foods. The actual serving sizes required in the CACFP
Meal Pattern for Adults may be different.
Nutrient values were obtained from the USDA National Nutrient Database for Standard Reference, Release 23,
http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
33
7  Increasing Fiber
PLANNING HEALTHY MEALS
FIBER CONTENT OF FOODS1, continued
Food
Serving
Size2
Total Dietary
Fiber Grams (g)
per Serving
Contribution of Serving to Adults’
RDA for Fiber
Males (38 g)
Females (25 g)
Grains
Kellogg’s All-Bran Bran Buds
1 /3
cup
13.0
43%
62%
1 cup
7.0
23%
33%
1 cup
1 ounce
6.0
20%
29%
4.3
14%
20%
Bulgur, cooked
½ cup
4.1
14%
20%
Spaghetti, whole wheat, cooked
½ cup
3.1
10%
15%
Barley, pearled, cooked
½ cup
3.0
10%
14%
General Mills Cheerios Cereal
1 cup
3.0
10%
14%
2 ounces
2.6
9%
12%
Oatmeal, instant, cooked
½ cup
2.0
7%
10%
Bread, whole wheat
1 slice
1.9
6%
9%
Rice, brown, cooked
½ cup
1.8
6%
9%
Spaghetti, enriched, cooked
½ cup
1.3
4%
6%
1.5 ounces
1.0
3%
5%
1 slice
0.6
2%
3%
2 squares
0.4
1%
2%
½ cup
0.3
1%
1%
1 ounce
3.3
11%
16%
1 ounce
3.1
10%
15%
1 ounce
2.9
10%
14%
1 ounce
2.7
9%
13%
1 ounce
1.9
6%
9%
Walnuts, English
1 ounce
1.9
6%
9%
Pumpkin seeds, dry roasted, unsalted
1 ounce
1.1
4%
5%
Cashews, dry roasted, unsalted
1 ounce
0.9
3%
4%
Peanuts, dry roasted, unsalted
1 ounce
0.1
0%
0%
Kellogg’s Raisin Bran
Post Shredded Wheat, Original
Wheat germ, toasted, plain
(2 tablespoons)
Oat bran muffin
Bagel, cinnamon raisin
Bread, white
Graham crackers, plain or honey
Rice, white, cooked
Nuts and Seeds
Almonds, dry roasted, unsalted
Sunflower seed kernels, dry roasted,
unsalted
Pistachio nuts, dry roasted, unsalted
Hazelnuts or filberts, dry roasted,
unsalted
Peanut butter, smooth, unsalted
(2 tablespoons)
1 The
use of brand name products does not constitute approval or endorsement by the CSDE or the USDA. Product names are used
solely for clarification regarding nutrient content.
2 These serving sizes are used to illustrate the comparative nutrient content of foods. The actual serving sizes required in the CACFP
Meal Pattern for Adults may be different.
Nutrient values were obtained from the USDA National Nutrient Database for Standard Reference, Release 23,
http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00.
34
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Increasing Fiber  7
IMPROVING MENUS
The following pages provide ideas to assist CACFP facilities in planning healthy meals to increase
fiber through menu planning, purchasing, meal preparation and modifying recipes.
Menu Planning to Increase Fiber
•
Include at least one serving of whole grains in
every meal. For more information, see
Identifying Whole Grains in Nutrition Policies and
Guidance for Adult Day Care Centers: Crediting
Foods — Grains/Breads.
•
Plan menus with whole-grain breads, rolls
and muffins instead of enriched bread
products, for example:

whole-wheat tortillas instead of white
flour tortillas.

whole-wheat bagels or whole-wheat
English muffins instead of white toast.

whole-grain or buckwheat pancakes
instead of pancakes made from enriched
flour.
•
Serve whole (unprocessed or minimally
processed) fruits and vegetables more often.
•
Serve a variety of raw vegetables regularly.
•
Serve fresh fruits instead of canned fruits.
•
Add new high-fiber foods and recipes to
menus, including such foods as legumes (e.g.,
chickpeas, lentils, pinto beans) and whole
grains (e.g., barley, bulgur, brown rice).
•
Serve a legume-based dish instead of a meat,
poultry or cheese dish at least once a week.
•
Serve more salads and offer a variety of
vegetable and fruit ingredients.
•
Serve whole-grain pasta-vegetable salads
made with low-fat dressings.
•
Serve fresh fruit or vegetables instead of fruit
or vegetable juice. Juice contains no fiber and
is not nutritionally equivalent to whole fruits
and vegetables.
•
Serve baked potatoes as an alternative to
mashed potatoes.
•
Serve whole-grain cereals instead of refined,
highly sugared cereals. The CSDE’s
recommended nutrition standards specify that
breakfast cereals should contain at least 2.5
grams of fiber per serving (see Crediting
Breakfast Cereals in Nutrition Policies and
Guidance for Adult Day Care Centers: Crediting
Foods — Grains/Breads.
•
Serve applesauce or other fruit sauces as an
alternative to maple syrup on pancakes and
waffles.1
•
Serve dried fruit such as raisins or a trail mix
containing dried fruits and whole-grain
cereals.1
•
Add vegetable-based soups to the menu.1 (If
purchased, read labels for sodium content.)
Only vegetable-based soups with a sufficient
quantity of vegetables are creditable in the
CACFP Meal Pattern for Adults. For more
information, see Nutrition Policies and Guidance
for Adult Day Care Centers: Crediting Foods —
Vegetables/Fruits.
•
Serve whole-grain hot cereals at breakfast,
such as oatmeal or buckwheat.
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
2 These foods are not creditable as a food component in the CACFP meal patterns.
1 These
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
35
7  Increasing Fiber
PLANNING HEALTHY MEALS
Purchasing to Increase Fiber
•
Specify and purchase whole-grain bread
products.
•
Purchase whole-grain cereals that list whole
wheat or oats as the first ingredient.
•
Compare product information and purchase
breakfast cereals containing at least 2.5 grams
of fiber per manufacturer’s serving. At least 5
grams of fiber per serving is ideal.
•
Purchase a variety of fresh fruits and
vegetables regularly.
•
Purchase and serve cruciferous vegetables
frequently, such as broccoli, cauliflower,
cabbage and Brussels sprouts.
•
Purchase and serve legumes and whole-grain
products frequently.
•
Request that vendors provide nutrition
information for all products purchased. Read
labels to determine fiber content of
purchased products (see How to Read a Food
Label in section 8). Compare brands, as a
comparable product may be higher in fiber.
•
Serve fruits and vegetables with their skins.
Meal Preparation to Increase Fiber
•
Add whole-grain pasta and brown rice to
soups, stews and casseroles.
•
Sprinkle oat bran or wheat germ over salad,
soups, breakfast cereals and yogurt.
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
2 These foods are not creditable as a food component in the CACFP meal patterns.
1 These
36
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Increasing Fiber  7
Modifying Recipes to Increase Fiber
•
Make French toast from whole-grain bread
instead of white bread.
•
Add rolled oats to entree recipes, such as
meatloaf, tacos and meat sauce.
•
Substitute whole-grain brown rice and bulgur
when recipes call for white rice.
•
•
Add chopped dried fruits (e.g., apricots,
raisins, dates, figs, prunes) finely chopped
nuts, oatmeal and pureed vegetables and
fruits (e.g., canned pumpkin, applesauce) to
baked goods.1
Add beans (e.g., kidney, pinto) to burritos,
chili and other Mexican dishes in addition to
meat.
•
Add pureed beans to taco mix and meat
sauce. They will thicken the mixture and take
on the flavor of the dish, while adding fiber.
•
Substitute whole-wheat flour for some of the
white flour in recipes calling for only white
flour.1 Generally, one-third to one-half of the
white flour can be replaced with whole-wheat
flour.
•
Add lentils or bulgur to hamburger dishes.
•
Add legumes such as kidney beans, lentils,
black beans and garbanzo beans (chickpeas)
to soups, stews or salads.
•
Add beans (whole, mashed or pureed) to
canned or homemade soups, e.g., kidney
beans added to minestrone soup.1
•
Add or increase the amount of grains and
vegetables (e.g., brown rice, pasta, potatoes,
corn and peas) in stews, soups and
casseroles.1
•
Substitute oatmeal, oat bran or rye flour to
replace some of the white flour in breads,
muffins and quick breads.1
•
Add bran (wheat bran or miller’s bran) to
entree recipes, such as meat sauce, tacos,
thick soups and coating mixtures.1
•
Add bran or wheat germ to bread crumbs and
use as a topping for casseroles or breading for
chicken.1
foods may or may not be creditable in the CACFP meal patterns. For specific crediting information, see Nutrition
Policies and Guidance for Adult Day Care Centers: Crediting Foods.
2 These foods are not creditable as a food component in the CACFP meal patterns.
1 These
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
37
7  Increasing Fiber
38
PLANNING HEALTHY MEALS
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Food Labels  8
8 — FOOD LABELS
USING FOOD LABELS IN THE CACFP
Food labels can help CACFP menu planners choose foods and
plan menus to meet the recommendations of the Dietary Guidelines
and the CSDE’s recommended nutrition standards (see State
Nutrition Recommendations in section 1). The Nutrition Facts panel
and ingredients statement appear on almost all packaged foods.
This information can be used to compare the nutritional value of
similar foods, for example, choosing products with less fat,
sodium and added sugars.
The product’s Nutrition Facts label
and ingredients statement do not
provide sufficient information to
document compliance with the
CACFP meal pattern components.
Information on determining
whether a food is creditable as a
CACFP meal pattern component is
contained in Nutrition Policies and
Guidance for Adult Day Care
Centers: Crediting Foods.
Food labels can also be used to budget and balance the intake of
fat, saturated fat, trans fat, cholesterol and sodium, and identify
good sources of fiber, vitamins and minerals. For example, if a
menu features a food that is high in fat, sugars or sodium, food labels can help menus planners choose
other foods that are low in these same nutrients to balance the overall menu.
FOOD LABEL INFORMATION
Ingredients Statement
Ingredients on product labels are listed by weight, from most to least. The closer an ingredient is to
the beginning of the list, the more of it the food contains.
The ingredients statement provides important information if a participant has special dietary
considerations. Knowing how to read a food label helps avoid problems caused by ingredients in food.
If a participant has food allergies or intolerances, or avoids foods for other reasons, the CACFP facility
must carefully check the ingredients on all processed food products. For more information on food
allergies, see Special Diets under Resources in section 9, and Nutrition Policies and Guidance for Adult Day Care
Centers: Accommodating Special Diets.
Nutrient Content Claims
Many food labels include nutrient content
claims, such as “low fat,” “lean” or “high in
fiber.” FDA regulations define these
descriptions, and they mean the same thing for
all foods, regardless of manufacturer. They refer
to a standard single serving size set by the FDA.
While the Nutrition Facts panel is required by
law, nutrition descriptions are optional. Food
manufacturers decide whether to include these
terms.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
39
8  Food Labels
PLANNING HEALTHY MEALS
Definitions for commonly used nutrient content claims are summarized in Label Language in this
section. Additional information on nutrient content claims can be found in the FDA’s Guidance for
Industry, A Food Labeling Guide — Appendix A: Definitions of Nutrient Content Claims and Appendix B:
Additional Requirements for Nutrient Content Claims (see References).
Health Claims
The FDA allows manufacturers to make certain claims linking the effect of a nutrient or food to a
disease or health-related condition. Only claims supported by scientific evidence are allowed. These
claims can only be used under certain conditions, such as when the food is an adequate source of the
appropriate nutrients. A reference to the claim usually appears on the front label, but the claim itself
may appear elsewhere on the label. For more information on allowable health claims, see the following
FDA resources:
•
Guidance for Industry, A Food Labeling Guide — Appendix C: Health Claims, Food and Drug
Administration, Revised April 2008:
http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/
GuidanceDocuments/FoodLabelingNutrition/FoodLabelingGuide/ucm064919.htm
•
Staking a Claim to Good Health, FDA Consumer, U.S. Food and Drug Administration, Center
for Food Safety and Applied Nutrition: http://vm.cfsan.fda.gov/~dms/fdhclm.html
Serving Sizes
Serving sizes on food labels are listed in household measures (e.g.,
cups, ounces) and metric measures (e.g., grams). The FDA
determines serving sizes based on commonly used portions. This
allows for consistency in comparing the nutritional value of similar
products from different manufacturers.
COMMON ABBREVIATIONS
AND EQUIVALENTS
FOR FOOD LABELS
1,000 milligrams (mg) = 1 gram (g)
28.35 grams (g) = 1 ounce (oz)
16 ounces (oz) = 1 pound (lb)
2 tablespoons (Tbsp) = 1 ounce (oz)
The nutrient values listed on the food label (e.g., sodium, fat,
saturated fat, trans fat, calories) are based on the stated serving
size. The portion size actually eaten may be more or less than the
serving size on the label, so these values must be adjusted accordingly. For example, a Nutrition Facts
label indicates that one serving (1 cup) of vegetable juice provides 885 milligrams of sodium. A ½ cup
portion would contain half this amount (443 milligrams).
It is important to note that the serving sizes on the food label usually differ from those used in the
CACFP Meal Pattern for Adults. For example, the label may indicate a serving size of ¼ cup, but ½
cup may be the amount required for the CACFP. CACFP facilities must always provide at least the
minimum amount required by the CACFP meal patterns. For more information on the CACFP meal
pattern requirements, see Nutrition Policies and Guidance for Adult Day Care Centers: Meal Pattern
Requirements.
40
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Food Labels  8
Nutrients Listed
The Nutrition Facts panel includes only a few of the many nutrients found in foods — those most
important to the health of today’s consumers. Unless their amounts are insignificant, labeling
regulations require that the following nutrients are listed:
•
•
•
•
fat
saturated fat
trans fat
cholesterol
•
•
•
•
total carbohydrate
dietary fiber
sugars
protein
•
•
vitamins A and C
calcium and iron.
If a nutrition description is used, e.g., “fortified with vitamin D,” then that nutrient must be listed on
the Nutrition Facts panel. Nutrients added to a food, such as fortified breakfast cereal, are also listed.
Manufacturers may also choose to list additional nutrients.
Daily Reference Values
Daily reference values or “daily values” are included for total fat, saturated fat, cholesterol, sodium,
total carbohydrate and fiber. The daily values provide recommendations for daily intake of nutrients
based on daily caloric intakes of 2,000 and 2,500 calories. Some of these values are maximums, as with
fat (65 grams or less) and others are minimums, as with carbohydrate (300 grams or more).
The percent Daily Values show how well the nutrients in a food fit into an overall daily diet with 2,000
calories. The sample food label on the next page shows that one serving provides 5 percent of the daily
value for total fat and 3 percent of the daily value for saturated fat (based on an intake of 2,000
calories). Daily values for each nutrient are less when fewer calories are eaten. Likewise, when caloric
intakes are greater, daily values are higher.
The Nutrition Facts panel can be used to see if a food is a good
As a guide, foods with 5 percent
source of a nutrient or to compare similar foods, for example, to
Daily Value or less contribute a
find which brand of frozen pizza is lower in saturated fat. The “%
small amount of that nutrient while
Daily Value” indicates whether a food is high or low in nutrients.
those with 20 percent or more
To limit a nutrient (such as fat, saturated fat, cholesterol or
contribute a large amount.
sodium), choose foods with a lower percent Daily Value. To
consume more of a nutrient (such as calcium, other vitamins and minerals, fiber), choose foods with a
higher percent Daily Value.
The food label does not list a Daily Value for trans fat, sugars or protein. The FDA has not set a
reference value for trans fats because national health recommendations have not set a reference value.
The Dietary Guidelines recommends that trans fat consumption should be kept as low as possible. A
reference value is not included for sugars because national health recommendations have not
established an amount for daily sugars consumption. Protein intake is not a public health concern for
adults and children older than 4, so it does not have a reference value.
Label Rounding
The FDA regulations include specific requirements for rounding the numbers on the food label. As a
result, the numbers on the food label may not add up exactly or the percentage may be slightly different
if it is calculated manually. For example, the product in the sample label on the next page contains 3.5
grams of fat, which equals 31.5 calories from fat. (There are 9 calories per gram of fat.) However, the
food label lists 35 calories from fat because of the FDA rounding rules. For more information, see the
FDA’s Appendix H: Rounding the Values According to FDA Rounding Rules (see References).
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
41
8  Food Labels
PLANNING HEALTHY MEALS
HOW TO READ A FOOD LABEL
Serving Size and
Number of Servings
• The Nutrition Facts label is
based on one serving but
many packages contain
more. If you are eating
more than one serving, the
calories and nutrients must
be multiplied by the number
of servings. For example,
24 crackers equal 1½
serving and contain 50
percent more calories and
nutrients.
Sodium
• Limit sodium to
reduce the risk of
high blood pressure.
• Less than 5 percent is
low sodium and 20 percent
or more is high sodium.
Fiber
• Most people do not
get enough fiber.
Foods with 10-19
percent Daily Value
are good sources and
foods with 20 percent
or more are high
sources.
• Choose whole-grain
foods as often as
possible by reading
the ingredients list.
Sugars
• There is no percent Daily
Value for sugars.
• Look for foods low in added
sugars. The Nutrition Facts
label lists total sugars
(naturally occurring and
added), so read the
ingredients to determine if
sugars are added (see
Sugars and Sweeteners in
section 6). The closer
sugar is to the beginning of
the ingredients list, the
more of it the food
contains.
42
Calories
Nutrition Facts
• The label lists the number of
Serving Size
16 crackers (29g)
Servings Per Container
About 14
Amount Per Serving
Calories 130
Calories from Fat 35
% Daily Value*
5%
3%
Total Fat 3.5g
Saturated Fat 0.5g
Trans Fat 0g
0%
11%
7%
Dietary Fiber 2g
Sugars 4g
Protein 2 g
4%
Vitamin A
Vitamin C
Calcium
0%
0%
2%
Iron
6%
* Percent Daily Values are based on a 2,000 calorie diet.
Your daily values may be higher or lower depending
on your calorie needs:
Calories:
Less than
Less than
Less than
Less than
2,000
2,500
25g
30g
65g
20g
300mg
2,400mg
300g
80g
25g
300mg
2,400mg
375g
•
how a serving of the food fits
into an overall daily diet of
2,000 calories. People may
need more or less calories,
depending on age, gender
and activity level.
Fats
• Look for foods that are lowest
in saturated fat, trans fat and
cholesterol.
• Most fats should be
polyunsaturated or
monounsaturated.
• There is no percent Daily
Value for trans fat, but
consume as little as possible.
• Labels can state “0 grams”
trans fats if the serving
contains less than 0.5 gram of
trans fats, even if the food
contains sources of artificial
trans fats. Read labels and
select products that do not
contain hydrogenated or
partially hydrogenated oils
(see the Glossary).
Nutrients
• Look for foods with higher
Calories per gram:
Fat 9
Percent Daily Value
• Percent Daily Value shows
Polyunsaturated Fat 2g
Monounsaturated Fat 0.5g
Cholesterol 0 mg
Sodium 230 mg
Potassium 55mg
Total Carbohydrate 21g
Total Fat
Sat Fat
Cholesterol
Sodium
Total
Carbohydrate
Dietary Fiber
calories in a single serving
and how many calories come
from fat.
• Low is 40 calories or less per
serving. High is 400 calories
or more per serving.
• Compare the calories per
serving to the nutrients to see
the “nutrient density” of the
food.
Carbohydrate 4
•
Protein 4
Ingredients: Whole Grain Wheat Flour, Unbleached
Enriched Flour (Wheat Flour, Niacin, Reduced Iron, Thiamine
Mononitrate {Vitamin B1}, Riboflavin {Vitamin B2}, Folic Acid),
Whole Grain Wheat Flour, Soybean Oil, Sugar, Defatted
Wheat Germ, Cornstarch, Malt Syrup (From Barley and
Corn), High Fructose Corn Syrup, Salt, Leavening (Calcium
Phosphate and/or Baking Soda), Monoglycerides, Vegetable
Color (Annatto Extract, Turmeric Oleoresin), Soy Lecithin.
percent daily values for these
nutrients.
Ingredients
• Ingredients on product labels
are listed by weight, from
most to least. The closer an
ingredient is to the beginning
of the list, the more of it the
food contains.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
PLANNING HEALTHY MEALS
Food Labels  8
LABEL LANGUAGE
extra lean: A serving of meat, poultry, seafood and game meats contains less than 5 grams of fat,
2 grams of saturated fat and 95 milligrams of cholesterol.
free: A serving contains none or a very small amount: less than 5 calories; less than 5 milligrams
sodium; less than 0.5 gram of total fat; less than 0.5 gram of saturated fat; less than 0.5 gram of
trans fat; less than 2 milligrams of cholesterol; less than 0.5 gram of sugar. Other terms: no, zero,
without, trivial source of, negligible source of, dietarily insignificant source of, non (nonfat only).
fresh: 1) A food is raw, has never been frozen or heated and contains no preservatives; or 2) the
term accurately describes the products, for example, “fresh milk” or “freshly baked bread.”
fresh frozen: The food has been quickly frozen while still fresh. Blanching is allowed before
freezing to prevent nutrient breakdown.
good source: A serving contains 10-19 percent of the Daily Value (compared with a standard
serving size of the traditional food) for a particular nutrient, for example “good source of fiber.”
Other terms: contains, provides.
healthy: A food is low in fat (3 grams or less) and saturated fat (1 gram or less and 15 percent or
less of calories) and a serving contains no more than 480 milligrams of sodium, 60 milligrams of
cholesterol and at least 10 percent of the Daily Value for vitamin A, vitamin C, calcium, iron,
protein and fiber.
high: A serving contains 20 percent or more of the Daily Value (compared with a standard
serving size of the traditional food) for a particular nutrient, for example, “high in vitamin C,”
“high fiber,” “high calcium.” Other terms: excellent source of, rich in.
lean: A serving of meat, poultry, seafood and game meats contains less than 10 grams of fat, 4.5
grams or less of saturated fat and less than 95 milligrams of cholesterol.
less: The food contains 25 percent less of a nutrient or 25 percent fewer calories than a reference
food.
light: A food with one-third fewer calories or 50 percent of the fat in a traditional food. A lowcalorie, low-fat food with 50 percent less sodium can also be called “light.” Other term: lite.
low: A serving contains no more than 40 calories; 140 milligrams of sodium; 3 grams of fat.
Other terms: few (calories), contains a small amount of, low source of, low in, little, a little.
more: A serving contains 10 percent or more of the Daily Value (compared with a standard
serving size of the traditional food) for a particular nutrient, for example “more fiber,” or “more
iron.” Does not apply to meat or poultry products. Other terms: enriched, fortified, added, plus,
more.
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PLANNING HEALTHY MEALS
LABEL LANGUAGE, continued
natural: For the purposes of food labeling, “natural” means that the food does not contain
added colors, artificial flavors or synthetic substances. However, it does not necessarily mean
that a product is healthier or more nutritious. While the FDA allows manufacturers to use this
term if a product meets these requirements, the FDA has not developed a definition for use of
the term natural or its derivatives.
organic: A regulatory term for food that meets specific standards set by the USDA. Organic
food differs from conventionally produced food in the way it is grown or produced. However,
the USDA makes no claims that organically produced food is safer or more nutritious than
conventionally produced food. For more information, see the Glossary.
percent (%) fat free: A product must be low fat or fat free and the percentage must accurately
reflect the amount of fat in 100 grams of a food. For example, 2.5 grams of fat in 50 grams of
food results in a “95% fat-free” claim.
reduced: A serving contains 25 percent less of a nutrient (e.g., fat, saturated fat, cholesterol,
sodium) or 25 percent fewer calories than a comparable food. “Reduced” cannot be used if the
reference food already meets the requirement for a “low” claim. Other terms: reduced in, ___%
reduced, fewer, lower, lower in, less.
Source: Guidance for Industry, A Food Labeling Guide. Food and Drug Administration, Revised April 2008.
http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/
GuidanceDocuments/FoodLabelingNutrition/FoodLabelingGuide/default.htm
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Resources  9
9 — RESOURCES
RESOURCES
Child and Adult Care Food Program (CACFP)
Click on the CSDE’s Nutrition-Related Resources, then Resources for Child Nutrition Programs then Child
and Adult Care Food Program.
Dietary Guidelines
Click on the CSDE’s Nutrition-Related Resources, then General Nutrition and Health then Dietary
Guidelines.
Food Labels
Click on the CSDE’s Nutrition-Related Resources, then General Nutrition and Health then Food Labels.
Fruits and Vegetables
Click on the CSDE’s Nutrition-Related Resources, then General Nutrition and Health then Fruits and
Vegetables.
Menu Planning and Recipes
Click on the CSDE’s Nutrition-Related Resources, then Menus, Recipes and Nutrient Information then
Menu Planning and Recipes.
Special Diets
Click on the CSDE’s Nutrition-Related Resources, then Special Diets.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
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Resources  9
WEB SITES
CACFP Meal Patterns (U.S. Department of Agriculture):
http://www.fns.usda.gov/cnd/care/ProgramBasics/Meals/Meal_Patterns.htm
CACFP Operational Memos (Connecticut State Department of Education):
http://www.sde.ct.gov/sde/cwp/view.asp?a=2626&q=321576
CACFP Regulations (U.S. Department of Agriculture):
http://www.fns.usda.gov/cnd/Care/Regs-Policy/Regulations.htm
Child and Adult Care Food Program (U.S. Department of Agriculture):
http://www.fns.usda.gov/cnd/care/
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
(Connecticut State Department of Education):
http://www.sde.ct.gov/sde/cwp/view.asp?a=2626&q=322694
USDA Policy Memoranda for the CACFP (U.S. Department of Agriculture):
http://www.fns.usda.gov/cnd/Care/Regs-Policy/PolicyMemoranda.htm
Additional resources on nutrition and the CACFP can be found in the CSDE’s Nutrition-Related
Resources at http://www.sde.ct.gov/sde/lib/sde/PDF/DEPS/Nutrition/nutrition_resources.pdf. The CSDE
updates this list regularly.
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Resources  9
REFERENCES
Code of Federal Regulations (CFR) for the Child and Adult Care Food Program (7CFR 226). U.S. Department
of Agriculture. http://www.fns.usda.gov/cnd/Care/Regs-Policy/policymemo/CFR226-2008.pdf
Dietary Guidelines for Americans. U.S. Department of Agriculture and U.S. Department of Health and
Human Services, 2010. http://health.gov/dietaryguidelines/
Dietary Reference Intakes, Elements. Institute of Medicine, 2001. http://www.iom.edu/Global/News%20
Announcements/~/media/48FAAA2FD9E74D95BBDA2236E7387B49.ashx
Dietary Reference Intakes, Macronutrients. Institute of Medicine, 2002. http://www.iom.edu/Global/
News%20Announcements/~/media/C5CD2DD7840544979A549EC47E56A02B.ashx
Dietary Reference Intakes, Vitamins. Institute of Medicine, 2000. http://www.iom.edu/Global/News%20
Announcements/~/media/474B28C39EA34C43A60A6D42CCE07427.ashx
Guidance for Industry, A Food Labeling Guide — Appendix A: Definitions of Nutrient Content Claims. U.S.
Food and Drug Administration, Revised April 2008.
http://www.fda.gov/Food/LabelingNutrition/LabelClaims/ucm064911.htm
Guidance for Industry, A Food Labeling Guide — Appendix B: Additional Requirements for Nutrient Content
Claims. Food and Drug Administration, Revised April 2008.
http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/F
oodLabelingNutrition/FoodLabelingGuide/ucm064916.htm
Guidance for Industry, A Food Labeling Guide — Appendix H: Rounding the Values According to FDA Rounding
Rules. U.S. Food and Drug Administration, Revised April 2008.
http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/F
oodLabelingNutrition/FoodLabelingGuide/ucm064932.htm
Nutrition Facts Label Brochure. Food and Drug Administration, August 2006. http://www.fda.gov/
downloads/Food/LabelingNutrition/ConsumerInformation/ucm120909.pdf
Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth. Institute of Medicine of the
National Academies, The National Academies Press, 2007.
http://www.iom.edu/CMS/3788/30181/42502.aspx
Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids.
Institute of Medicine, 2002. http://books.nap.edu/openbook.php?isbn=0309085373
Statistical Fact Sheet — Disease/Risk Factors 2008 Update. American Heart Association, 2008.
http://www.americanheart.org/downloadable/heart/1199892787721FS14HBP08.pdf
Why Should I Limit Sodium? American Heart Association, 2007. http://www.americanheart.org/
downloadable/heart/119618381045822%20WhyShldILmtSodium%209_07.pdf
Your Guide to Lowering Your Blood Pressure with DASH. U.S. Department of Health and Human Services,
National Institutes of Health, National Heart, Lung and Blood Institute, 1998, Revised April 2006.
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf
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References
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Glossary
GLOSSARY
added sugars: Sugars and syrups added to foods in processing or preparation, as opposed to the
naturally occurring sugars found in foods like fruits, vegetables, grains and dairy products. Names for
added sugars include brown sugar, corn sweetener, corn syrup, dextrose, fructose, fruit juice
concentrates, glucose, high-fructose corn syrup, honey, invert sugar, lactose, malt syrup, maltose,
molasses, raw sugar, sucrose, sugar and syrup.
adult day care center: Any public or private nonprofit organization or any for-profit center that 1) is
licensed or approved by federal, state or local authorities to provide nonresidential adult day care
services to functionally impaired adults or persons ages 60 and older in a group setting outside their
homes or a group living arrangement on a less than 24-hour basis; and 2) provides for such care and
services directly or under arrangements made by the agency or organization whereby the agency or
organization maintains professional management responsibility for all such services. Such centers shall
provide a structured, comprehensive program that provides a variety of health, social and related
support services to enrolled adult participants through an individual plan of care.
adult day care facility: A licensed or approved adult day care center under the auspices of a
sponsoring organization.
adult participant: A person enrolled in an adult day care center who is functionally impaired or ages
60 and older. For more information, see “functionally impaired adult” in this section.
artificial sweeteners: Ingredients with little or no calories used as sugar substitutes to sweeten foods
and beverages. Artificial sweeteners are hundreds of times sweeter than sugar. Common artificial
sweeteners include acesulfame potassium (Acesulfame-K, Sunett, Sweet & Safe, Sweet One), aspartame
(Nutrasweet, Equal), neotame, saccharin (Sweet and Low, Sweet Twin, Sweet ‘N Low Brown, Necta
Sweet), sucralose (Splenda) and tagatose. These nonnutritive sweeteners are calorie-free, except for
aspartame, which is very low in calories. The CSDE’s recommended nutrition standards do not allow
foods or beverages with these ingredients. For more information, see “nonnutritive sweeteners” in this
section.
bran: The protective coating around the whole-grain kernel that is rich in nutrients, fiber and other
health promoting substances called phytochemicals. Bran is not a whole grain. However, for the
purposes of determining its contribution to the CACFP grains/breads component, the USDA credits
bran the same as whole-grain or enriched flour or meal.
carbohydrates: A category of nutrients that includes sugars (simple carbohydrates) and starch and
fiber (complex carbohydrates). Foods in the basic food groups that provide carbohydrates — fruits,
vegetables, breads, cereals, grains, milk and dairy products — are important sources of many nutrients.
However, foods containing large amounts of added sugars provide calories but few, if any, nutrients.
Carbohydrates are easily converted by the body to energy (calories). The Dietary Guidelines for Americans
recommends consuming 45 to 65 percent of total daily calories from carbohydrates, especially complex
carbohydrates. For more information, see “added sugars,” “simple carbohydrates” and “complex
carbohydrates” in this section.
Child and Adult Care Food Program (CACFP): The USDA’s federally assisted meal program
providing nutritious meals and snacks to children in child care centers, family day care homes and
emergency shelters and snacks and suppers to children participating in eligible at-risk afterschool care
programs. The program also provides meals and snacks to adults who receive care in nonresidential
adult day care centers. For more information, see http://www.fns.usda.gov/cnd/care/.
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Glossary
Child and Adult Care Food Program (CACFP) facilities: Child care centers, family day care
homes, emergency shelters, at-risk afterschool care centers and adult day care centers that participate in
the USDA Child and Adult Care Food Program.
Child and Adult Care Food Program (CACFP) Meal Pattern for Adults: The required food
components and minimum serving sizes that facilities participating in the CACFP must provide to
receive federal reimbursement for meals and snacks served to adults. For more information, see the
CACFP Meal Pattern for Adults in Nutrition Policies and Guidance for Adult Day Care Centers: Meal Pattern
Requirements at http://www.sde.ct.gov/sde/cwp/view.asp?a=2626&q=322694.
Child and Adult Care Food Program (CACFP) sponsor: A public or nonprofit private
organization that is entirely responsible for the administration of the CACFP in one or more day care
homes, child care centers, emergency shelters or at-risk afterschool care centers. For more
information, see Section 226.2 Definitions in Code of Federal Regulations (CFR) for the Child and Adult
Care Food Program (7CFR 226) at http://www.fns.usda.gov/cnd/Care/RegsPolicy/policymemo/CFR226-2008.pdf.
Child Nutrition (CN) label: A statement that clearly identifies the contribution of a food product
toward the meal pattern requirements, based on the USDA’s evaluation of the product’s formulation.
Products eligible for CN labeling include main dish entrees that contribute to the meat/meat alternates
component of the meal pattern requirements, bread items that contribute to the grains/breads
component and juice and juice drink products that contain at least 50 percent full-strength juice by
volume. (Note: Only 100 percent juice is creditable in Connecticut Child Nutrition Programs.) The CN
label does not provide information or assurances regarding the nutrition content of the food. For more
information, see Child Nutrition (CN) Labeling Program in Nutrition Policies and Guidance for Adult Day Care
Centers: Crediting Foods —Introduction at http://www.sde.ct.gov/sde/cwp/view.asp?a=2626&q=322694.
Child Nutrition Programs: The USDA’s federally funded programs that provide nutritious meals
and snacks to children, including the National School Lunch Program (NSLP), School Breakfast
Program (SBP), Special Milk Program (SMP), Summer Food Service Program (SFSP), Child and Adult
Care Food Program (CACFP) and Fresh Fruit and Vegetable Program (FFVP). The CACFP also
provides nutritious meals and snacks to the frail elderly in adult day care centers.
cholesterol: A fat-like substance that performs important functions in the body such as making cell
membranes and some hormones. There are two different types of cholesterol. Blood (serum) cholesterol
circulates in the body in lipoproteins, such as low-density lipoprotein (LDL) and high-density
lipoprotein (HDL). LDL is known as “bad” cholesterol because high levels can clog arteries, causing
atherosclerosis. A high level of serum cholesterol is a major risk factor for coronary heart disease,
which leads to heart attack. HDL is known as “good” cholesterol because high levels seem to protect
against heart attack. Dietary cholesterol does not contain any calories. It comes from foods of animal
origin, including meat, fish, poultry, eggs, and dairy products. Plant foods (including vegetable oils) do
not contain cholesterol. There is no dietary requirement for cholesterol because the body can make all
it needs.
complex carbohydrates (starch and fiber): Complex carbohydrates include starch and fiber, which
are made from three or more simple sugars linked together. Starch is the storage form of energy in
plants and provides calories. Fiber is the structural framework of plants and does not contain any
calories. Food sources of complex carbohydrates include legumes, starchy vegetables (e.g., potatoes,
corn, dry beans and green peas), whole-grain breads and cereals, and nuts and seeds. For more
information, see “dietary fiber” in this section.
creditable food: A food or beverage that can be counted toward meeting the meal pattern
requirements for a reimbursable meal or snack in the USDA Child Nutrition Programs.
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Glossary
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Daily Value: A number on the Nutrition Facts panel of food labels that provides recommendations
for daily intake of nutrients based on daily caloric intakes of 2,000 and 2,500 calories. The Nutrition
Facts panel also includes percent Daily Value, which shows how a serving of the food fits into an
overall daily diet of 2,000 calories.
Dietary Guidelines for Americans: A federal document that provides science-based advice for
Americans ages 2 and older to promote health and to reduce risk for chronic diseases through diet and
physical activity. The Dietary Guidelines is published jointly every five years by the U.S. Department of
Health and Human Services and the U.S. Department of Agriculture and forms the basis of federal
food, nutrition education and information programs. For more information, see http://health.gov/
dietaryguidelines/.
dietary fiber: Nondigestible carbohydrates and lignin (a noncarbohydrate substance bound to fiber)
that are naturally occurring in plants, e.g., gums, cellulose, fiber in oats and wheat bran. Fiber improves
gastrointestinal health and reduces risk of some diseases, such as heart disease. There are two types of
dietary fiber, insoluble and soluble. Insoluble fibers aid in digestion by adding bulk and softness to stools
to promote regularity and prevent constipation. Insoluble fibers decrease the amount of “transit time”
for food waste in the intestine. Insoluble fibers include whole-wheat products, wheat and corn bran,
popcorn*, many vegetables (e.g., cauliflower, beans and potatoes) and the skins of fruits and root
vegetables. Soluble fibers (e.g., gums, mucilages and pectin) bind to fatty substances in the body to
promote their excretion as waste. They help lower blood cholesterol levels and also help regulate the
body’s use of sugars. Soluble fibers are found in dry beans and peas, oats, oatmeal, barley, psyllium
seed husk and many fruits and vegetables, such as apples, carrots, citrus fruits, strawberries, prunes, dry
beans and other legumes.*Note: Popcorn is not creditable as a grain/bread component in the CACFP.
Dietary Reference Intakes (DRIs): A set of nutrient-based reference values that expand upon and
replace the former Recommended Dietary Allowances (RDAs) in the United States and the
Recommended Nutrient Intakes (RNIs) in Canada. The DRIs include four reference values: Estimated
Average Requirements (EARs), RDAs, Adequate Intakes (AIs) and Tolerable Upper Intake Levels
(ULs). For more information, see Dietary Reference Intakes in section 1.
enriched grains: Refined grains (such as wheat, rice and corn) and grain products (such as cereal,
pasta and bread) that have vitamins and minerals added to replace the nutrients lost in processing.
These nutrients are added within limits specified by the FDA, and include thiamin (B1), riboflavin (B2),
niacin (B3), folic acid and iron. Regulations for the USDA Child Nutrition Programs require that all
bread and grain products must be enriched if they are not whole grain.
enrichment: Adding back nutrients (usually vitamins or minerals) originally present in a food that
were lost during processing. Enrichment nutrients are added back in approximately the same levels as
were originally present in the food. Regulations for the USDA Child Nutrition Programs require that
all bread and grain products must be enriched if they are not whole grain.
flour: Finely ground and sifted wheat or other grains, such as rye, corn, rice or buckwheat.
fiber: A general term for the indigestible carbohydrates (e.g., pectin, cellulose, and other substances)
that make up the framework of plants. Dietary fiber is the total amount of these materials that are not
digested by humans. For more information, see “dietary fiber” in this section.
food components: The four food groups that comprise the reimbursable CACFP meal, including
meat/meat alternates, vegetables/fruits, grains/breads and milk. For more information on the
individual food components, see Nutrition Policies and Guidance for Adult Day Care Centers: Crediting Foods
at http://www.sde.ct.gov/sde/cwp/view.asp?a=2626&q=322694.
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Glossary
food item: In the CACFP Meal Pattern for Adults, a food item is one of the four required foods for
breakfast; one of the six required foods for lunch; one of the five required foods for supper; or one of
the two required foods for snack.
fortification: Adding nutrients (usually vitamins or minerals) that were not originally present in a food
or beverage or adding nutrients at levels that are higher than originally present. Fortification is used
both for naturally nutrient-rich products based on scientifically documented health needs (e.g.,
fortifying milk with vitamin D to increase the body’s absorption of calcium), and to enhance the
perceived nutritional value of products with little or no natural nutritional value (e.g., fortifying
“energy” bars made from processed flour with multiple vitamins and minerals). Fortification nutrients
are added to products in varying amounts, from small percentages up to amounts greater than
recommended intakes.
fructose: The naturally occurring simple sugar found in fruits and honey. Fructose is also called
levulose or fruit sugar. For more information, see “simple carbohydrates (sugars) in this section.
functionally impaired adult: Chronically impaired disabled persons 18 years of age or older,
including victims of Alzheimer’s disease and related disorders with neurological and organic brain
dysfunction, who are physically or mentally impaired to the extent that their capacity for independence
and their ability to carry out activities of daily living is markedly limited. Activities of daily living
include, but are not limited to, adaptive activities such as cleaning, shopping, cooking, taking public
transportation, maintaining a residence, caring appropriately for one’s grooming or hygiene, using
telephones and directories, or using a post office. Marked limitations refer to the severity of
impairment, and not the number of limited activities, and occur when the degree of limitation is such
as to seriously interfere with the ability to function independently.
germ: The sprouting section of the whole-grain kernel. It contains B vitamins, vitamin E, trace
minerals, healthy fats, antioxidants and phytochemicals. Germ is not a whole grain. However, for the
purposes of determining its contribution to the CACFP grains/breads component, the USDA credits
germ the same as whole-grain or enriched flour or meal.
hydrogenated oils: Oils that have undergone hydrogenation, a chemical process that adds hydrogen
and changes the structure of unsaturated fatty acids to increase shelf life and flavor stability.
Hydrogenation turns oils that are liquid at room temperature into solids, e.g., shortening and
margarine. Oils can be either completely or partially hydrogenated. Partial hydrogenation results in the
formation of trans fats, a type of fat that increases the risk for cardiovascular disease. Fully
hydrogenated oil does not contain trans fat, e.g., fully hydrogenated palm oil. However, if the label lists
“hydrogenated” vegetable oil, it could mean the oil contains some trans fat. When foods contain
hydrogenated oils, they will be listed in the ingredients, e.g., hydrogenated cottonseed and soybean oil.
For more information, see “trans fats” in this section.
lactose: The naturally occurring sugar found in milk. Lactose contains glucose and galactose. For more
information, see “simple carbohydrates (sugars) in this section.
meat alternates: Meat alternates include alternate protein products, cheese, eggs, cooked dry beans or
peas, nuts and seeds and their butters (except for acorn, chestnut and coconut) and yogurt.
menu item: Any planned main dish, vegetable, fruit, bread, grain or milk that is part of the
reimbursable meal. Menu items consist of food items.
monosaturated fats: A type of unsaturated fat that is found in nuts, seeds, avocados and liquid
vegetable oils, such as canola oil, olive oil, high oleic safflower and sunflower oils. Monosaturated fats
may help lower blood cholesterol when used as part of an overall diet that is moderate in fat.
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MyPlate: Released in June 2011, MyPlate replaces MyPyramid as the USDA’s food guidance system to
translate the Dietary Guidelines into a healthy eating plan. MyPlate emphasizes consuming more fruits,
vegetables, whole grains and low-fat dairy. For more information, see
http://www.choosemyplate.gov/.
MyPyramid: From 1992 to 2011, MyPyramid was the USDA’s food guidance system to translate the
Dietary Guidelines into a healthy eating plan. It was replaced with MyPlate in 2011. For more
information, see “MyPlate” in this section.
natural: For the purposes of food labeling, “natural” means that the food does not contain added
colors, artificial flavors or synthetic substances. However, it does not necessarily mean that a product is
healthier or more nutritious. While the FDA allows manufacturers to use this term if a product meets
these requirements, the FDA has not developed a definition for use of the term natural or its
derivatives. For more information, see http://www.fda.gov/AboutFDA/Transparency/
Basics/ucm214868.htm.
noncreditable food: A food or beverage that does not count toward any meal pattern component
(meat/meat alternates, vegetables/fruits, grains/breads and milk) in the USDA Child Nutrition
Programs. For more information, see Noncreditable or “Other” Foods in Nutrition Policies and Guidance for
Adult Day Care Centers: Crediting Foods —Introduction at http://www.sde.ct.gov/sde/cwp/
view.asp?a=2626&q=322694.
nonnutritive sweeteners: Ingredients with no calories used as sugar substitutes to sweeten foods and
beverages. Nonnutritive sweeteners are hundreds of times sweeter than sugar. Nonnutritive sweeteners
include artificial sweeteners such as acesulfame potassium, neotame, saccharin and sucralose and
natural sweeteners such as stevia (e.g., Rebiana, Truvia, PureVia and SweetLeaf). The CSDE’s
recommended nutrition standards do not allow foods or beverages with these ingredients. For more
information, see “artificial sweeteners” in this section.
nutrient-dense foods or nutrient-rich foods: Foods that provide substantial amounts of naturally
occurring vitamins, minerals and other nutrients with relatively few calories. Nutrient-rich foods
include lean sources of protein and complex carbohydrates that are low in total fat and saturated fats.
Examples include fruits, vegetables, whole grains, low-fat or nonfat dairy products, lean meat, skinless
poultry, fish, eggs and legumes. Foods and beverages that are not nutrient dense supply calories (from
fat, added sugars and processed carbohydrates) but relatively small amounts of nutrients (and
sometimes none at all), unless fortified. For more information, see “fortification” in this section and
http://nutrientrichfoods.org/.
organic: A USDA labeling term that indicates the food or other agricultural product has been
produced through approved methods that integrate cultural, biological, and mechanical practices that
foster cycling of resources, promote ecological balance and conserve biodiversity. Synthetic fertilizers,
sewage sludge, irradiation and genetic engineering cannot be used. The USDA’s National Organic
Program provides for certification that agricultural ingredients have been produced under conditions
that meet the definition. They also include labeling standards based on the percentage of organic
ingredients in food. Organically produced foods are not necessarily safer or more nutritious than
conventionally produced foods. The FDA does not define the term “organic.” For more information,
see the USDA’s National Organic Program at http://www.ams.usda.gov/AMSv1.0/nop.
partially hydrogenated oils: Oils that have been through partial hydrogenation to change their
consistency from a liquid to a semi-solid, e.g., margarine. This process results in the formation of trans
fats, a type of fat that increases the risk for cardiovascular disease. When products contain partially
hydrogenated oils, they will be listed in the ingredients, e.g., partially hydrogenated cottonseed and
soybean oil. For more information, see “hydrogenated oils” and “trans fats” in this section.
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Glossary
polyunsaturated fats: A type of unsaturated fat that is found in fatty cold-water fish (e.g., salmon,
mackerel and herring), nuts, seeds and liquid vegetable oils, such as safflower, sesame, soy, corn and
sunflower. Polyunsaturated fats may help lower blood cholesterol when used as part of an overall diet
that is moderate in fat.
Recommended Dietary Allowance (RDA): The average daily dietary intake level that is sufficient to
meet the nutrient requirement of most healthy individuals in a particular life stage and gender group.
The RDA is one of four reference values that comprise the Dietary Reference Intakes (DRIs). For
more information, see Dietary Reference Intakes in section 1.
reimbursable meal: A meal or snack that meets the requirements of the U.S. Department of
Agriculture’s Child and Adult Care Food Program.
saturated fats: A type of fat that can raise blood cholesterol, which is a risk factor for cardiovascular
disease. Major sources of saturated fats include animal products (e.g., cheese, beef, milk, snack foods,
butter and lard) and tropical vegetable oils (palm, palm kernel and coconut).
serving size or portion: The weight, measure or number of pieces or slices. The minimum serving
size specified in the CACFP meal pattern must be provided for meals and snacks to be reimbursable.
simple carbohydrates (sugars): Carbohydrates consisting of one (e.g., fructose and galactose) or two
(e.g., lactose, maltose, sucrose) sugars. Sugars can be naturally present in foods (such as the fructose in
fruit or the lactose in milk) or added to foods (such as sucrose or table sugar). Foods that naturally
contain simple carbohydrates — such as fruits, milk and milk products and some vegetables — also
contain vitamins and minerals. Foods that contain large amounts of added sugars — such as cookies,
candy, pastries, sweetened baked goods, regular soft drinks and other sweetened drinks — provide
calories with few, if any, nutrients. For more information, see “added sugars” in this section.
sucrose: Another name for table sugar. Sucrose contains glucose and fructose. For more information,
see “simple carbohydrates (sugars) in this section.
sugar alcohols (polyols): A type of carbohydrate used as sugar substitutes to sweeten foods and
beverages. Sugar alcohols are incompletely absorbed and metabolized by the body and contribute
fewer calories than most sugars. They also perform other functions such as adding bulk and texture to
foods. Common sugar alcohols include sorbitol, mannitol, xylitol, maltitol, maltitol syrup, lactitol,
erythritol, isomalt and hydrogenated starch hydrolysates (HSH). Products with sugar alcohols are often
labeled “sugar free.” Large amounts of sugar alcohols may cause bloating, gas or diarrhea. The
Connecticut Child Care Nutrition Standards do not allow foods or beverages with these ingredients.
The CSDE strongly recommends that foods with these ingredients are not served in the CACFP. For
more information, see “nonnutritive sweeteners” in this section.
sugars: See “added sugars” and “simple carbohydrates” in this section.
supplements: Reimbursable snacks served in the CACFP.
trans fats: Trans fats include naturally occurring and artificial sources. Trans fats occur naturally in low
amounts in some foods of animal origin, e.g., dairy products, beef and lamb. Most trans fats are
artificially made as the result of “hydrogenation,” a process where vegetable oils are made into a more
solid (saturated) fat. Trans fats are used in food products to increase shelf life and enhance texture.
The majority of trans fats in the American diet (80 percent) come from processed foods made with
partially hydrogenated oils, such as cakes, cookies, crackers, snack chips, fried foods and margarine.
Trans fats are worse than saturated fats in increasing blood cholesterol levels. They raise “bad” lowdensity lipoproteins (LDL) blood cholesterol and decrease “good” high-density lipoproteins (HDL)
blood cholesterol, which are significant risk factors for cardiovascular disease. For more information,
see “hydrogenated oils” and “partially hydrogenated oils” in this section.
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Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
Glossary
PLANNING HEALTHY MEALS
whole foods: Foods that are unprocessed or minimally processed and do not contain added
ingredients, such as fat, sugars or sodium.
whole fruits and vegetables: Whole fruits and vegetables include fresh, frozen, canned and dried
fruits and vegetables that are unprocessed or minimally processed and do not contain added
ingredients, such as fat, sugars or sodium.
whole grains: Grains that consist of the entire kernel, including the starchy endosperm, the fiber-rich
bran and the germ. All grains start out as whole grains, but many are processed to remove the bran and
germ, which also removes many of the nutrients. Whole grains are nutrient rich, containing vitamins,
minerals, fiber, antioxidants and health-enhancing phytonutrients, such as lignans and flavonoids.
Examples include whole wheat, whole oats/oatmeal, whole grain cornmeal, brown rice, whole rye,
whole-grain barley, wild rice, buckwheat, triticale, bulgur (cracked wheat), millet, quinoa and sorghum.
For more information, see Identifying Whole Grains in Nutrition Policies and Guidance for Adult Day Care
Centers: Crediting Foods — Grains/Breads at http://www.sde.ct.gov/sde/cwp/view.asp?a=2626&q
=322694 and http://www.wholegrainscouncil.org.
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011
55
PLANNING HEALTHY MEALS
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Glossary
Nutrition Policies and Guidance for Adult Day Care Centers in the Child and Adult Care Food Program
Connecticut State Department of Education • September 2011