Policy Memo 133

DOH-CACFP: Number 133 (05/09), Supersedes Number 61 (07/01)

TO: CACFP Center Sponsors of Adult Day Care Centers

FROM: Lynne Oudekerk, Acting State Director, Child and Adult Care Food Program

SUBJECT: Healthy Adult Meal Pattern

I. Purpose and Scope

Obesity is an epidemic in this country and in New York State. More than two thirds of New York's adults are overweight or obese. The impact of overweight and obesity include social isolation, depression and an increased likelihood of developing debilitating chronic diseases that are life-limiting and life-shortening, such as diabetes mellitus and cardiovascular disease.

Your program can promote healthier eating by serving healthy foods and by teaching disabled adults and seniors in care how to make healthy food choices.

CACFP has revised and renamed its Adult Meal Pattern to reflect the important role that CACFP-participating adult day care programs play in serving healthy foods. Effective October 1, 2009, CACFP's Healthy Adult Meal Pattern (CACFP-101) will replace the current Adult Meal Pattern. Beginning on that date, all meals must meet the Healthy Adult Meal Pattern in order to be eligible for meal reimbursement.

II. Background Information

The Healthy Adult Meal Pattern improves meals served in day care by ensuring that adults in adult day care centers are offered a variety of nutritious meals and snacks.

  1. More than two thirds of New York State adults are overweight and obese.
  2. Obese adults are more likely to suffer from life-limiting and life-shortening chronic medical conditions.
  3. Caregivers determine what foods are available and accessible to adults in care, and can encourage healthy eating behaviors.

III. Required Adult Meal Pattern Changes

  1. Milk
    • Adults must be served only fat-free or low-fat (1%) milk.
    • As long as fat-free or low-fat (1%) milk is served at one meal or snack per day, one cup of fat-free or low-fat yogurt may be served in place of fluid milk at other meals.
    • The menu must specify the type of milk served.
  2. Vegetables/Fruits
    • No more than one serving of juice may be served per day.
  3. Grains/Breads
    • Sweet-grain products and sweet cereals may not be served at lunch or supper.
    • No more than two servings of sweet-grain products and/or sweet cereals may be served per week.
    • Sweet-grain products are specified in the Grains/Breads section of the Crediting Foods in CACFP under groups D, E, F and G. They include doughnuts, pastries, Pop-Tarts®, toaster pastries, granola bars, breakfast bars, muffins, cookies, cakes and brownies.
    • Sweet cereals are those that contain more than 6 grams of sugar per adult serving.
  4. Meat/Meat Alternates
    • Yogurt must be fat-free or low-fat and prepared without artificial sweeteners.
  5. Other
    • Water must be served with snack if neither of the two required components is a beverage. Water is not counted as a snack component.
    • The menu must specify when water is served at snack.

IV. Recommended Adult Meal Pattern Changes

The following are recommendations for improvement that would further enhance the quality of meals served. They are not required and are not incorporated into the Healthy Adult Meal Pattern.

  1. Milk
    • Unflavored fat-free or low-fat (1%) milk is recommended for adults.
  2. Vegetables/Fruits
    • Vegetables and fruits should be fresh, frozen, or canned and prepared with no added sugar, salt or fat.
    • At least one of the two servings of vegetable/fruit required at lunch and supper should be a vegetable.
    • One or more servings of vegetable/fruit per day should be high in vitamin C.
    • Three or more servings of vegetable/fruit per week should be high in vitamin A.
    • Three or more servings of vegetable/fruit per week should be fresh.
  3. Grains/Breads
    • All of the breads and cereals served should be whole grain. To be considered whole grain, the first ingredient listed on the nutrition label should be whole grain, not enriched.
  4. Meat/Meat Alternates
    • Meat and meat alternates (chicken, turkey, beef, pork, lamb, fish and/or vegetable proteins) should be lean or low-fat.
    • Meat and meat alternates should be prepared without adding extra fat.
    • No more than one serving of processed or high-fat meat should be served per week. This includes hot dogs, chicken nuggets, fish sticks, fried chicken, Vienna sausages, corn dogs and/or cold cuts.
    • No more than one serving of cheese should be served per week, unless the cheese is low-fat.

V. Summary of Changes

CACFP has created the Healthy Adult Meal Pattern to reflect menu improvements associated with a decreased risk of overweight, obesity, and chronic disease. Starting on October 1, 2009, CACFP programs must follow this new meal pattern in order to receive CACFP reimbursement for meals and snacks served.

Enclosure: Healthy Adult Meal Pattern (CACFP-101)