Search results: CACFP

Last week, the USDA issued new rules for the nutrient content of school meals and also child care programs.

These apply to sugar and sodium (nutrients), whole grains (ingredient or food),  and milk (food).

The New York Times report on this cut right to the chase

The Agriculture Department announced on Wednesday that it had finalized the regulation it had first proposed in February 2023, having weakened several provisions after feedback from food companies, school nutrition professionals and over 136,000 public comments.

The Update to the standards describes the changes and compares them to USDA’s original proposals.

• Sugars: For the first time (I’m not kidding), the USDA set limits on sugars, starting with breakfast cereals (6 grams per ounce), yogurt (12 grams per 6-ounce serving), and milk (10 grams per 8-ounce serving).  This allows chocolate and other flavored milks if companies get the sugar down to 10 grams.
• Sodium: beginning July 2027, sodium will be reduced by 15% for lunch and 10% for breakfast from current limits (USDA proposed 3 consecutive reductions of 10% over the next five years.
• Whole grains: no change from current standard (USDA proposed that 80% of grains be whole).
• Milk: Allows flavored fat-free and low-fat.

Comment: The sugar rule is an improvement, even though products still are sweetened.  The weakening of the sodium proposal is troubling.  We badly need to reduce sodium in processed and restaurant foods and need federal leadership for doing so.  USDA caved to political pressure here.  The USDA has a long history of captivity by Big Ag.  Now it looks captured by Big Food.

The food industry complaint is that its products won’t meet these standards.  The school food complaint is that the standards are too hard to meet, the kids won’t eat the food, and it will be wasted.

I have a lot of sympathy for school foodservice.  It’s the only thing going on in schools that has to be self-supporting, and school food programs are hugely underfunded.  And lots of schools don’t have kitchens to must rely on food products rather than real food.

But from what I’ve observed, two kinds of skills are needed for successful school meal programs: the ability (1) to prepare and serve edible healthy food, and (2) to get the kids to eat it.  I’ve seen every permutation.

1. Good food, kids eat it
2. Good food, kids won’t eat it
3. So-so food, kids eat it
4. So-so food, kids won’t eat it

Whenever I hear “the kids won’t eat it,” I wonder where the adults are. From what I’ve seen, if adults care that kids are fed, the kids will eat the food—not all, necessarily, but most.

School food is not just about the food.  It’s about the interactions of school food personnel, teachers, and the principal with the kids.  If the adults think it important and necessary to feed kids healthy food, the program has a good chance of success.  The new USDA standards are a step in the right direction but still have a way to go.

Wouldn’t it be nice if we had food standards rather than nutrition standards?  How about mandating numbers of servings of real foods instead of worrying about grams of sugar and milligrams of sodium.

A thought,

Additional Resources

• Comparison Chart: 2023 Proposed Standards vs. 2024 Final Standards
• Implementation Timeline – School Meals
• Implementation Timeline – CACFP & SFSP
• Media Toolkit
  • Infographic: Final Rule for School Meal Standards
  • Infographic: Implementation Timeline
  • Infographic: How We Got Here
  • Video: Rule Overview
  • Video: Added Sugars
• Federal Register notice 

This one is about activities of the National Pork Board, a USDA-sponsored checkoff program recipient (see comment at end).  It comes from a reader, Lily Doher, reproduced with her permission.

I receive emails from the National CACFP [Child and Adult Care Food Program] Sponsors Association and occasionally click to see what free trainings they’re offering providers. I was encouraged by a training that described how providers play a pivotal role in developing childrens’ food habits and preferences and how providers can create positive food environments that support healthy eating. I clicked on the link and was surprised to see the training was sponsored and presented by the National Pork Board, and even more surprised to see the egregious industry influence throughout the training. Hosted by a registered dietitian nonetheless.

• “Empowering children to explore new foods, like lean pork, is key to addressing nutritional challenges faced by children.”
• “…pork has a huge role to play in discussions around food choice, exposure, language, and acceptance in children.”
• “Dr. Hicks-Roof then shed light on the crucial role of pork in shaping children’s food preferences and dietary habits…”
• “She also shared the science behind hunger and satiety, emphasizing the pivotal role of protein intake and importance of lean pork in informing conditional satiety.”
• ” Additionally, she shed light on pork’s affordability, nutrition and cultural significance as pork is a widely consumed meat globally.”
• “Dr. Hicks-Roof clarified that pork is the ultimate carrier food for busting through food neophobia in children, unlocking a new world of varied food exposures, and supporting opportunities to use positive, inclusive language during conversations about food with children.”

While this training is being highlighted by National CACFP, this type of industry influence is ultimately what led me to leave the Academy of Nutrition and Dietetics, and I am disheartened to once again see a fellow registered dietitian be the puppet for Big Food. Our children, and the providers that care for them, deserve better.

Comment: CACFP is the USDA’s Child and Adult Care Food Program.  It provides reimbursements to providers of meals at child care centers, day care homes, and adult day care centers.  I wrote about it most recently in a previous “weekend reading” post.  Of course the National Pork Board, which runs the USDA-sponsored checkoff program, wants to encourage dietitians to promote pork.  It must welcome the opportunity to provide free continuing education credits.  Dietitians are required to complete 75 such credits every five years.  As I’ve written previously, they can easily do that with free industry-sponsored coursses.

Do those courses influence what dietitians tell clients?  Perhaps the Pork Board can answer that question (I wonder if it ever did before-and-after surveys).  I’m guessing it must view the expense as worthwhile.

I was guest editor for a supplement to the American Journal of Public Health: Policies and Strategies to Increase Equitable Access to Family Nutrition.

It is open access so you can access it here.

I wrote the lead editorial: Equitable Access to the USDA’s Food Assistance Programs: Policies Needed to Reduce Barriers and Increase Accessibility.  113(S3), pp. S167–S170.  

This special supplement to AJPH deals with a critically important topic: enabling and increasing access to federal nutrition assistance programs among low-income Americans who are eligible for these programs but unaware, unable, or unwilling to participate in them. To help identify the barriers to nonparticipation and to recommend policies to reduce them, the Robert Wood Johnson Foundation funded research projects aimed at these goals, especially as they pertain to families with young children.  PDF/EPUB

Editor’s choice

Jerry Mande, a co-founder of Nourish Science wrote me to urge support for a national action plan to reduce obesity—and the chronic diseases for which it raises risks. (Note: he also has an op-ed in The Hill on NIH research and leadership needs).

Here is what we should do. It’s time for a new federal nutrition goal. For decades it’s been some variation of “access to healthier options and nutrition information.” Jim Jones [the new head of food and nutrition at FDA] used that last week in his vision for the new human foods program. It’s in USDA FNS’s mission too. The WaPo reporting on life expectancy, fatty liver disease, & Lunchables in school meals reveals that goal has failed and needs to be replaced.

The goal should be updated to: ensuring that every child reaches age 18 at a healthy weight and in good metabolic health. Cory Booker proposed making it the U.S. goal in his attached letter to Susan Rice on the WHC [White House Conference]. It’s part of the Nourish Science vision.

It’s doable.  USDA has the necessary power, reach, and resources. Over half of infants are on WIC, 1/3 of children in CACFP [Child and Adult Care Feeding Program], virtually all in school meals, and almost ½ of SNAP recipients are under 18. If we leveraged those programs to achieve the new goal and with FDA’s & CDC’s help, we could make substantial progress. For example, USDA was able to raise school meal HEI [Healthy Eating Index] scores from failing U.S. average of 58 to an acceptable 82 in just three years.

We have a successful blueprint in FDA regulation of tobacco. When we began our FDA investigation in 1993 1/3 of adults and ¼ of kids smoked cigarettes. Today we have a $700M FDA tobacco center and 11% of adults and only 2% of high school students smoke cigarettes.

We should set the new goal in the upcoming Farm Bill. We should change USDA’s name to the U.S. Department of Food and Agriculture and state the new goal.

The only needed ingredient to make this happen is an effective federal nutrition champion. That’s how tobacco happened.

I’m optimistic. We can do this.

I like the vision.  I’m glad he’s optimistic.  Plenty of work to do to get this on the agenda.

Some background

• The CDC on how nearly 70% of American adults are overweight or have obesity.
• My report on the White House Conference, a year ago
• Politico (Helena Bottemiller Evich, now at Food Fix)  on how diet- and obesity-related diseases are a huge public health problem, especially for COVID-19, but no government program exists to prevent them.
• Politico (Catherine Boudreau and Helena Bottemiller Evich) on how federal research on prevention of diet- and obesity-related diseases hardly exists.

The USDA’s Food and Nutrition Service sent out one of the saddest emailed notices I have ever received, announcing the end of relief measures enacted during the COVID-19 emergency.

The FNS says it is working closely with participants, States, retailers, other federal agencies, and the White House to help with the transition.

This will not be easy.  The COVID-induced increases in benefits did much to reduce family and child poverty as well as food insecurity.

What follows is slightly edited, mainly to reduce repetitive statements.

End of the National COVID-19 Public Health Emergency – Impact on FNS Programs. 

The national public health emergency (PHE) put in place at the start of the COVID-19 pandemic is expected to expire on May 11, 2023. The end of the public health emergency…will trigger changes that impact low-income individuals and families.

• SNAP Emergency Allotments: The Consolidated Appropriations Act, 2023, required that pandemic-related SNAP Emergency Allotments (EA) be terminated after the issuance of February 2023 benefits.  See: The Supplemental Nutrition Assistance Program (SNAP).
• SNAP ABAWD Time Limit: Beginning July 1, 2023, able-bodied adults without dependents (ABAWDs) participating in SNAP will once again be required to meet the ABAWD work requirements or could risk losing benefits as soon as October 2023.
• Temporary Student Exemptions:  Beginning July 1, 2023, the temporary student exemptions – which allowed college students who wouldn’t typically be eligible for SNAP to receive benefits during the public health emergency – will begin to be phased out, impacting students as they are due for recertification.
• SNAP Administrative Adjustments and Waivers:  FNS is working very closely with States to help them successfully transition back to normal operations, including offering four certification-related waivers specifically designed to support the transition to post-pandemic program operations.
• Child Nutrition Programs: FNS offered States and child nutrition program operators extensive flexibilities during COVID to ensure they could continue to serve kids the nutrition they needed. Two of the flexibilities currently offered – CACFP benefits for young adults in shelters and offsite monitoring – are tied to the PHE and, therefore, will be coming to an end. See: Child Nutrition Programs
• Pandemic EBT: Since March 2020, Pandemic EBT, also known as P-EBT, has been helping eligible families cover food costs for kids who typically received free and reduced-priced school meals or were eligible through their child care facilities. These benefits will continue through the end of summer 2023 for school children, but will end when the PHE ends on May 11, 2023, for children in child care. The new nationwide Summer EBT program recently passed into law will be available starting in summer 2024, and will help families in need continue to put food on the table during the summer when children aren’t receiving meals in schools. See: Pandemic Electronic Benefits Transfer (P-EBT)  
• WIC: After the end of the public health emergency, most of the flexibilities FNS provided to WIC participants during the pandemic will continue to be available under a separate authority Congress provided FNS in the American Rescue Plan Act. With this authority, WIC state agencies can continue to offer – and build and improve upon – remote services after the PHE ends. Infant formula waivers, which are not tied to the PHE, will be phased out on a different timeline through the end of June 2023.  See:  Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

Additional information is available on the FNS website, here.

Comment: I consider this a national tragedy, and a huge mistake.  If COVID-19 proved anything, it was that these measures were highly effective in reducing child poverty in the United States.  Now what.  We go back to higher levels?  As I said, a national tragedy.

Congress will have much to answer for when the results of this shameful decision become to be apparent.

The USDA is trying to improve nutrition standards for school meals.  I wish it the best of luck.

It is proposing over the next several years to:

• Limit added sugars in certain high-sugar products and, later, across the weekly menu;
• Allow flavored milk in certain circumstances and with reasonable limits on added sugars;
• Incrementally reduce weekly sodium limits over many school years; and
• Emphasize products that are primarily whole grain, with the option for occasional non-whole grain products.

This does not make it sound as if USDA is in much of a hurry.  Or that it is doing anything particularly radical.

Take the sugar proposals, for example.  Currently, the re are no limits on sugars in school meals, which means that any limits ought to be an improvement.  The USDA proposal sugar limits in two phases:

1. Product-based limits: Beginning in school year (SY) 2025-26, the rule proposes limits on products that are the leading sources of added sugars in school meals:
   1. Grain-based desserts (cereal bars, doughnuts, sweet rolls, toaster pastries, coffee cakes, and fruit turnovers) would be limited to no more than 2 ounce equivalents per week in school breakfast, consistent with the current limit for school lunch.
   2. Breakfast cereals would be limited to no more than 6 grams of added sugars per dry ounce. This would apply to CACFP [Child and Adult Care Food Program] as well, replacing the current total sugars limit.
   3. Yogurts would be limited to no more than 12 grams of added sugars per 6 ounces.
   4. Flavored milks would be limited to no more than 10 grams of added sugars per 8 fluid ounces for milk served with school lunch or breakfast. For flavored milk sold outside of the meal (as a competitive beverage for middle and high school students), the limit would be 15 grams of added sugars per 12 fluid ounces.
2. Overall weekly limit: Beginning in SY 2027-28, this rule proposes limiting added sugars to an average of less than 10% of calories per meal, for both school breakfasts and lunches. This weekly limit would be in addition to the product-based limits described above.

Sugary products will still be allowed.  And schools have 4-5 years to comply (by that time, today’s elementary school children will be in high school).

Why the pussy-footing?  The USDA must be expecting ferocious pushback, and for good reason.  Anything, no matter how small, that threatens sales of foods commonly sold in schools will incite fights to the death.

• The dairy industry is gearing up to complain about restrictions on chocolate milk, which accounts for substantial revenues.
• The industry-funded School Nutrition Association, which represents school food serrvice personnel, strongly opposes the proposals, deeming them “unachievable.”

This, of course, was  precisely the reaction to Obama Administration immprovements to school meals, most of which were implemented with little difficulty.  Even so, Congress yielded to lobbying pressure and caved in on rules about potatoes, ketchup (a vegetable!), and whole grains.

I will never understand why everyone isn’t behind healthier foods for kids, but I’m not trying to get them to eat junk food.

As for why school meals matter so much to kids’ health, see Healthy Eating Research: Rapid Health Impact Assessment on Changes to School Nutrition Standards to Align with 2020-2025 Dietary Guidelines for Americans.

• Download the full report here.
• Download the executive summary here.
• Read the Press Release.

As for the gory details of the USDA’s proposals, see:

• Details of the proposed standards
• Comparison Chart: Current Standards vs. Proposed Standards
• Infographic: Proposed Rule for School Meal Standards
• Infographic: Proposed Timeline for Implementation
• Infographic: The Road Ahead – Building Back Better with School Meals
• Media Toolkit

Care to say something about this? FNS encourages all interested parties to comment on the proposed school meal standards rule during the 60-day comment period that begins February 7, 2023.

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Last week, the USDA sent out a press release announcing the last four Final Rules for school meals under the Healthy, Hunger-Free Kids Act (HHFKA) of 2010:

• Smart Snacks: this makes “modest improvements” to standards implemented in the 2014 – 2015 school year in accordance with the interim final rule.
• Local School Wellness Policy: requires schools to meet the Smart Snacks standards.
• Community Eligibility Provision (CEP): allows schools with high poverty rates to provide free breakfast and lunch to all students.
• Administrative Review: updates the administrative review processes used by state agencies to monitor federally-funded school meal programs.

The press release summarizes USDA’s view of what’s most beneficial in these policies:

• Improving the nutritional quality of all school food.
• Increasing farm to school programs to more than 42,000 participating schools;
• Coordinating school meal certification with SNAP.
• Implementing national professional standards for school nutrition employees.
• Expanding At Risk After School Meals Program to all states;
• Revising the Child and Adult Care Food Program nutrition standards.
• Implementing mentor-based training for school nutrition professionals through the Team Up for School Nutrition Success initiative.

You probably won’t want to read all the fine print.  Fortunately, others have done just that.

Bettina Siegel at The Lunch Tray

• Wellness policies will be required to prohibit on-campus marketing of foods and drinks that fail to meet the Smart Snacks nutritional standards.
• Whether companies can market “copycat” snacks in schools (Smart Snacks-compliant versions of junk food available in supermarkets) is left up to local districts.
• Also left to local districts are policies about incentive programs, such as Box Tops for Education or fast food coupons passed out to kids for reading books.
• School wellness policies will be required to set nutritional standards for foods and drinks offered to kids at classroom parties or by teachers as treats, but districts can determine the actual policies.
• Schools will be allowed to sell hard-boiled eggs, low-sodium canned vegetables, and peanut butter and celery.

Her bottom line:

With the finalization of these four rules, the historic work of the Obama administration in improving children’s school food environment is now complete. But, of course, we’re already one year overdue for the next CNR [Child Nutrition Reauthorization], a process which could easily roll back or weaken these reforms – many of which have already been overtly threatened by House Republicans.

CSPI’s Take on What’s New

• Local wellness policies must address marketing of foods and drinks that do not meet the Smart Snacks standards.
• Local wellness policies must involve the public and school community and produce an annual progress report.
• Local wellness policies must designate a school official for compliance and undergo administrative review every 3 years.
• School districts must update goals for nutrition promotion, nutrition education, physical activity, and school wellness activities based on evidence-based strategies.

CSPI says the new rules mean local wellness policies can and should:

• Shift unhealthy school fundraisers to profitable healthy food or non-food fundraisers
• Ensure that school celebrations support healthy eating and physical activity
• Use non-food rewards
• Provide ample opportunities for physical activity, quality physical education, and recess

My comments

Nutritionism: Many of the complaints about USDA’s nutrition standards derive from their focus on single nutrients—fat, salt, sugar—rather than on foods. Boiled eggs weren’t allowed because of their fat and cholesterol content, but copy-cat snack foods were.  If the standards applied to minimally processed whole foods, they would make more sense. USDA now has to take comments on whether to eliminate the standard for total fat from Smart Snacks because of the egg issue and the confusing nature of current research on saturated fat (also a problem resulting from studying one nutrient at a time).

Politics:  Regardless of how trivial some of these rules may appear, USDA’s school food standards must be considered an extraordinary achievement.  Against all odds—unrelenting opposition from companies that supply junk food to schools, Congress, and, weirdly, the School Nutrition Association—the new rules will improve the nutritional quality of school meals and snacks, at least most of the time.  School districts with officials who care deeply about improving the food served to kids now have a mandate to do so.  Those who don’t will have a harder time doing a bad job.  Applause to USDA for bringing the rules to closure.  May they survive the next round of lobbying.