Sugar Cuts in Day Care Meals: A Public Health Victory

, science and policy analyst, Center for Science and Democracy | May 2, 2016, 2:29 pm EST
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The Child and Adult Food Care Program (CACFP) is one of the nutrition safety net programs run by the U.S. Department of Agriculture (USDA) Food and Nutrition Service and state agencies, and serves over 4 million eligible children every day. The program reimburses day care centers for nutritious meals and snacks (largely following the Dietary Guidelines) for children from low-income households. However, the guidelines hadn’t been revised to reflect changes in nutrition science since 1968, lagging behind the national school lunch and breakfast programs which made sweeping positive changes back in 2010.

CACFP serves infants, children and adults at day care homes, child care centers, at-risk afterschool care centers, adult day care centers, and emergency shelters. Graphic: USDA.

CACFP serves infants, children, and adults at day care homes, child care centers, at-risk afterschool care centers, adult day care centers, and emergency shelters across the United States. Photo: USDA.

That changed last week when the USDA released its much-awaited final rule on the CACFP guidelines, which were designed to follow the recommendations of the Institute of Medicine (IOM) and the 2015 Dietary Guidelines. Here at CSD, we have been tracking this proposed rule to see if the USDA would take strong action on reducing the allowed amounts of added sugar.

Lo and behold, the USDA made some significant sugar-related changes, including:

  • Cuts to added sugar ceilings for yogurt and cereal for children. The ceiling for yogurt sugar content was reduced by nearly half—from 40 to 23 grams per 6 ounces—and for breakfast cereals, sugar totals were spelled out to match Special Supplemental Nutrition Program for Women, Infant and Children (WIC) standards (6 grams of sugar per 1 ounce of cereal).
  • Prohibiting grain-based desserts from being counted as part of the grain component of a meal pattern.
  • Prohibiting juice in the infant meal pattern (0-11 months), and requiring that for children (ages one and up), juice is used to meet the daily fruit requirement at only one meal (including snacks) daily. USDA’s change is in line with recommendations from the American Heart Association and the Institute of Medicine.
The USDA acknowledges that 100% fruit juice can be a part of a healthful diet, but asserts that its consumption should be limited due to its lack of fiber and contribution to extra calories. One serving of this 100% apple juice contains as much sugar per ounce as Coca-Cola. Graphic: sugarstacks.com

The USDA acknowledges that 100 percent fruit juice can be a part of a healthful diet, but asserts that consumption should be limited due to its lack of fiber and contribution to extra calories. One serving of this 100 percent apple juice contains as much sugar per ounce as Coca-Cola. Photo: sugarstacks.com

These policy revisions came despite strong opposition from the Juice Products Association and Grocery Manufacturers Association on nearly all of the juice-related provisions of the CACFP proposed rule update. Not surprisingly, these same trade organizations have been opposed to FDA’s added sugar labeling on the nutrition facts panel and to changes to the WIC food packages.

The rule requires changes to be implemented by October 2017, so there’s still time for Congress to muck it up in the appropriations process. This is not an unusual phenomenon. Already, a House report for the agriculture appropriations bill contains language attempting to throw a wrench in the FDA’s process for requiring an added sugars line on its nutrition facts panel (see page 71). We will keep an eye on this and any new riders throughout the appropriations process, as my colleague Yogin details here.

Why USDA’s rule matters

While not a parent myself, I hear from friends, family and coworkers that getting young kids to eat anything at all is a victory, let alone getting them to eat healthy foods. Children are especially at risk for developing preferences for sugary foods, beginning as early as in utero. Early and repeated exposure to sweet foods will shape a child’s interest in these foods. Luckily, the converse is also true. Early and repeated exposure to fruits and vegetables and different textured foods will help children accept those foods as they grow.  During this critical period of infancy and early childhood, limiting sugar intake and increasing whole fruit and vegetable consumption is important for parents and caregivers to ensure the healthy diets of children.

Parents trust child care centers to provide quality care, which includes filling and nutritious meals and hopefully not too much junk food. After all, science tells us that diets high in sugary foods are associated with higher body weights and increased risk of tooth decay, type 2 diabetes, cardiovascular disease, high triglycerides and hypertension. A new study looking at CDC data shows that obesity prevalence has not significantly decreased among children, and in fact severe obesity has actually increased. Our public health policies must be strengthened in order to have a lasting impact on improving children’s diets and reducing childhood obesity in the United States.

Ultimately, USDA’s strong CACFP revisions and what will hopefully be FDA’s required added sugar label represent a general shift toward food policy that is informed by science rather than industry pressure, focused on protecting public health not private pockets. We hope to see this trend continue.

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