CCEI530B: Nutrition II: Nutrition and Food Service in the Childcare Setting Course Handout Welcome to CCEI530B Nutrition II Nutrition and Food Service in the Childcare Setting Good nutrition is important for people of all ages, but it is especially important for children. Children need good nutrition for proper growth and development. This course is designed to provide information to assist food service staff, caregivers and members of program leadership develop positive, healthy nutritional programs for young children. Objectives By taking notes on the handout and successfully answering assessment questions, participants will meet the following objectives as a result of taking this course: Identify the risks children face if they receive poor nutrition Identify the main food groups according to USDA food guidelines Identify essential nutrients in various foods Identify major components of the CACFP Define important factors for serving safe, educational meals to children Identify effective educational activities related to nutrition Recognize the relationship between physical activity and overall health in young children References: Child and Adult Care Food Program. (2017). Meal Pattern Requirements and other program info, http://www.fns.usda.gov/cnd/care/programbasics/basics.htm National Resource Center for Health and Safety in Child Care and Early Education. (2011). Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs, 3rd edition. American Academy of Pediatrics, Elk Grove Village, IL. Herr, J. (2016). Working with Young Children 8 th Edition. The Goodheart-Wilcox Company, Inc. Sciarrino, C. and Siegfried, J. (2009). Reaching & Relating. HighRead Learning Martin, Jody (Ed.). (2011). Preschool Health and Safety Matters. Gryphon House. CDC. (2013). State Indicator Report on Fruits and Vegetables. Retrieved from https://www.cdc.gov/nutrition/downloads/state-indicator-report-fruits-vegetables-2013.pdf USDA. (2016). Choose MyPlate and other program information. Retrieved from http://www.choosemyplate.gov/ USDA.(2015). Dietary Guidelines for Americans 2015-2020, 8 th Edition. Retrieved from https://health.gov/dietaryguidelines/2015/resources/2015-2020_dietary_guidelines.pdf UDSA. (2017). Nutrition and Wellness Tips for Young Children and related Resources. Retrieved from https://www.fns.usda.gov/tn/nutrition-wellness-tips-young-children 1 of 22
Course Notes: Nutrition in Early Childhood Important Fact Unfortunately, current research has documented a number of problems with the nutritional health of children. As a result of poor nutrition and decreased levels of exercise, the occurrence of childhood obesity has: Poor nutrition has dangerous side effects: According to the State Indicator Report on Fruits and Vegetables, a study conducted by the CDC: About of American adults report eating fruits less than once per day. About of American adults report eating vegetables less than once per day. About of American adolescents report eating fruits less than once per day. About of American adolescents report eating vegetables less than once per day. Teachers should have basic knowledge of nutrition, food safety, and early childhood development so they can: 2 of 22
USDA Nutrition Guidelines Important Fact are substances the body needs in order to function. Being well-nourished requires just the right amount of nutrients and calories. Several key nutrients help your body get the most it can from the food you eat and allow your body to produce energy to live. Over 40 nutrients in foods are classified into six groups that have specific functions in your body. The six categories include: The United States Department of Agriculture (USDA) has created: More information about the 2015-2020 Dietary Guidelines for Americans can be located at: https://www.cnpp.usda.gov/2015-2020-dietary-guidelines-americans Important Fact The USDA categorizes food into different, which provide varying amounts of essential nutrients. 3 of 22
MyPlate contains the following food groups: Draw MyPlate: MyPlate is used to: Grains Nutrients and Varieties Essential nutrients found in grains include: Recommended Servings Young children do not have the same dietary needs as older children and adults. The number of servings and serving sizes vary by after the age of 8. 4 of 22
Here are the recommended daily servings of grains for: 2-3 years old: ounce equivalents 4-8 years old: ounce equivalents 9-13 year olds: ounce equivalents 14-18 year olds: ounce equivalents Adults: ounce equivalents For more information, visit: https://www.choosemyplate.gov/grains Important Fact The USDA recommends that at least: Vegetables Nutrients and Varieties Vegetables provide the following nutrients: Vegetables are divided into five subgroups based on their nutritional content. They are: Recommended Servings 5 of 22
Here are the recommended daily servings of vegetables for: 2-3 years old: cup 4-8 years old: cups 9-13 year olds: cups 14-18 years old: cups Adults: cups For more information, visit: https://www.choosemyplate.gov/vegetables Fruits Nutrients and Varieties Some of the nutrients fruits provide include: Recommended Servings Note about juice: Here are the recommended daily servings of fruits for: 2-3 years old: cup 4-8 years old: cups 9-13 years old: cups 14-18 years old: cups Adults: cups For more information, visit: https://www.choosemyplate.gov/fruit 6 of 22
Dairy Nutrients and Varieties Some of the nutrients dairy provides include: Recommended Servings Here are the recommended daily servings of dairy for: 2-3 year olds: cups 4-8 year olds: cups 9-13 year olds: cups 14-18 years old: cups Adults: cups For more information, visit: https://www.choosemyplate.gov/dairy Protein Nutrients and Varieties Some of the nutrients foods in the protein group provide include: 7 of 22
Recommended Servings Here are the recommended daily serving for proteins: 2-3 year olds: ounce equivalents 4-8 year olds: ounce equivalents 9-13 year olds: ounce equivalents 14-18 year olds: ounce equivalents Adults: ounce equivalents For more information, visit: https://www.choosemyplate.gov/protein-foods Oils Nutrients and Varieties Recommended Servings Here are the recommended daily servings of oils for: 2-3 year olds: teaspoons 4-8 year olds: teaspoons 9-13 year olds: teaspoons 14-18 year olds: teaspoons Adults: teaspoons For more information, visit: https://www.choosemyplate.gov/oils 8 of 22
The USDA s Child and Adult Care Food Program (CACFP) Important Fact Established in 1968, the Child and Adult Care Food Program (CACFP): Components of a CACFP Approved Meal Creditable Foods Meal Patterns and Serving Sizes The five components are: A meal is only considered creditable if it: 9 of 22
The components for meals and snacks are: Breakfast must contain: Lunch and dinner meals must contain: Snacks must contain: Special Considerations Menus Special Diets and Food Allergies Children may require a special diet due to: Important Fact Parents who require special diets to be prepared for their child should provide when the child enrolls in the program. Important Fact Food service staff and all teachers need to: Foods Sent from Home 10 of 22
Special Occasions Nutrition and Wellness Initiatives Food Safety Important Fact Food should be: Foods that may be choking hazards for young children include: The potential for choking can be reduced by: Important Fact Hand washing is: 11 of 22
Try This! Use the following ideas to teach children about hand-washing. Books and videos emphasizing the importance of hand-washing are available. Posters provide an easy way to teach hand washing. Your state s health department may provide posters free of charge, or they can be purchased at low cost or even printed free of charge from many websites. Practice proper hand-washing techniques. Teaching children to sing Twinkle Twinkle Little Star while they wash will help them remember to wash for 20 seconds. Help children establish a habit of washing their hands before every meal and snack, as well as after using the restroom. Creating Positive Meal Environments Family Style Dining Caregivers must supervise : Additional Mealtime Recommendations 1. 2. 3. 4. 12 of 22
Help children establish a healthy relationship with food by following these recommendations: Food is a not something that is received based on behavior. Feeding Infants and Toddlers Use the following precautions when feeding infants: Nutrition Education Activities Encouraging Children to Try New Foods 13 of 22
Try This Incorporate Children s Books about Nutrition The USDA Food and Nutrition Service has published a book called The Two Bite Club. This resource includes a story for children and a activities that caregivers can do with children in their ca re after reading the story. The resource is available online as a downloadable resource or for purchase. For more information, visit: https://www.fns.usda.gov/tn/two-bite-club-english-and-spanish Other children s books to consider: Here are some things to consider when educating children about nutrition: Be a Role Model Encouraging Active Play In addition to free play on the playground, caregivers have an opportunity to promote active play by: Children who are more active: 14 of 22
Infant Meal Pattern Breakfast Birth through 5 months 6 through 11 months 4-6 fluid ounces breastmilk 1 or formula 2 6-8 fluid ounces breastmilk 1 or formula 2 ; and 0-4 tablespoons infant cereal 2,3 meat, fish, poultry, whole egg, cooked dry beans, or cooked dry peas; or 0-2 ounces of cheese; or 0-4 ounces (volume) of cottage cheese; or 0-4 ounces or ½cup of yogurt 4 ; or a combination of the above 5 ; and 0-2 tablespoons vegetable or fruit or a combination of both 5,6 1 Breastmilk or formula, or portions of both, must be served; however, it is recommended that breastmilk be served in place of formula from birth through 11 months. For some breastfed infants who regularly consume less than the minimum amount of breastmilk per feeding, a serving of less than the minimum amount of breastmilk may be offered, with additional breastmilk offered at a later time if the infant will consume more. 2 Infant formula and dry infant cereal must be iron-fortified. 3 Beginning October 1, 2019, ounce equivalents are used to determine the quantity of creditable grains. 4 Yogurt must contain no more than 23 grams of total sugars per 6 ounces. 5 A serving of this component is required when the infant is developmentally ready to accept it. 6 Fruit and vegetable juices must not be served. 15 of 22 11/29/2016
Infant Meal Pattern Lunch and Supper Birth through 5 months 6 through 11 months 4-6 fluid ounces breastmilk 1 or formula 2 6-8 fluid ounces breastmilk 1 or formula 2 ; and 0-4 tablespoons infant cereal 2,3 meat, fish, poultry, whole egg, cooked dry beans, or cooked dry peas; or 0-2 ounces of cheese; or 0-4 ounces (volume) of cottage cheese; or 0-4 ounces or ½cup of yogurt 4 ; or a combination of the above 5 ; and 0-2 tablespoons vegetable or fruit or a combination of both 5,6 1 Breastmilk or formula, or portions of both, must be served; however, it is recommended that breastmilk be served in place of formula from birth through 11 months. For some breastfed infants who regularly consume less than the minimum amount of breastmilk per feeding, a serving of less than the minimum amount of breastmilk may be offered, with additional breastmilk offered at a later time if the infant will consume more. 2 Infant formula and dry infant cereal must be iron-fortified. 3 Beginning October 1, 2019, ounce equivalents are used to determine the quantity of creditable grains. 4 Yogurt must contain no more than 23 grams of total sugars per 6 ounces. 5 A serving of this component is required when the infant is developmentally ready to accept it. 6 Fruit and vegetable juices must not be served. 16 of 22 11/29/2016
Infant Meal Pattern Snack Birth through 5 months 6 through 11 months 4-6 fluid ounces breastmilk 1 or formula 2 2-4 fluid ounces breastmilk 1 or formula 2 ; and 0-½ slice bread 3,4 ; or 0-2 crackers 3,4 ; or 0-4 tablespoons infant cereal 2,3,4 or ready-to-eat breakfast cereal 3,4,5,6 ; and 0-2 tablespoons vegetable or fruit, or a combination of both 6,7 1 Breastmilk or formula, or portions of both, must be served; however, it is recommended that breastmilk be served in place of formula from birth through 11 months. For some breastfed infants who regularly consume less than the minimum amount of breastmilk per feeding, a serving of less than the minimum amount of breastmilk may be offered, with additional breastmilk offered at a later time if the infant will consume more. 2 Infant formula and dry infant cereal must be iron-fortified. 3 Beginning October 1, 2019, ounce equivalents are used to determine the quantity of creditable grains. 4 A serving of grains must be whole grain-rich, enriched meal, or enriched flour. 5 Breakfast cereals must contain no more than 6 grams of sugar per dry ounce (no more than 21.2 grams sucrose and other sugars per 100 grams of dry cereal). 6 A serving of this component is required when the infant is developmentally ready to accept it. 7 Fruit and vegetable juices must not be served. 17 of 22 11/29/2016
CHILD MEAL PATTERN Breakfast (Select all three components for a reimbursable meal) Food Components and Food Items 1 Ages 1-2 Ages 3-5 Ages 6-12 Ages 13-18 2 (at-risk afterschool programs and emergency shelters) Fluid Milk 3 4 fluid ounces 6 fluid ounces 8 fluid ounces 8 fluid ounces Vegetables, fruits, or portions of both 4 ¼ cup ½ cup ½ cup ½ cup Grains (oz eq) 5,6,7 Whole grain-rich or enriched bread ½ slice ½ slice 1 slice 1 slice Whole grain-rich or enriched bread product, such as biscuit, ½ serving ½ serving 1 serving 1 serving roll or muffin Whole grain-rich, enriched or fortified cooked breakfast ¼ cup ¼ cup ½ cup ½ cup cereal 8, cereal grain, and/or pasta Whole grain-rich, enriched or fortified ready-to-eat breakfast cereal (dry, cold) 8,9 Flakes or rounds ½ cup ½ cup 1 cup 1 cup Puffed cereal ¾ cup ¾ cup 1 ¼ cup 1 ¼ cup Granola ⅛ cup ⅛ cup ¼ cup ¼ cup 1 Must serve all three components for a reimbursable meal. Offer versus serve is an option for at-risk afterschool participants. 2 Larger portion sizes than specified may need to be served to children 13 through 18 years old to meet their nutritional needs. 3 Must be unflavored whole milk for children age one. Must be unflavored low-fat (1 percent) or unflavored fat-free (skim) milk for children two through five years old. Must be unflavored low-fat (1 percent), unflavored fat-free (skim), or flavored fat-free (skim) milk for children six years old and older. 4 Pasteurized full-strength juice may only be used to meet the vegetable or fruit requirement at one meal, including snack, per day. 5 At least one serving per day, across all eating occasions, must be whole grain-rich. Grain-based desserts do not count towards meeting the grains requirement. 6 Meat and meat alternates may be used to meet the entire grains requirement a maximum of three times a week. One ounce of meat and meat alternates is equal to one ounce equivalent of grains. 7 Beginning October 1, 2019, ounce equivalents are used to determine the quantity of creditable grains. 8 Breakfast cereals must contain no more than 6 grams of sugar per dry ounce (no more than 21.2 grams sucrose and other sugars per 100 grams of dry cereal). 9 Beginning October 1, 2019, the minimum serving size specified in this section for ready-to-eat breakfast cereals must be served. Until October 1, 2019, the minimum serving size for any type of ready-to-eat breakfast cereals is ¼ cup for children ages 1-2; 1/3 cup for children ages 3-5; and ¾ cup for children ages 6-12. 1 18 of 22
CHILD MEAL PATTERN Lunch and Supper (Select all five components for a reimbursable meal) Food Components and Food Items 1 Ages 1-2 Ages 3-5 Ages 6-12 Ages 13-18 2 (at-risk afterschool programs and emergency shelters) Fluid Milk 3 4 fluid ounces 6 fluid ounces 8 fluid ounces 8 fluid ounces Meat/meat alternates Lean meat, poultry, or fish 1 ounce 1 ½ ounce 2 ounces 2 ounces Tofu, soy product, or alternate protein products 4 1 ounce 1 ½ ounce 2 ounces 2 ounces Cheese 1 ounce 1 ½ ounce 2 ounces 2 ounces Large egg ½ ¾ 1 1 Cooked dry beans or peas ¼ cup ⅜ cup ½ cup ½ cup Peanut butter or soy nut butter or other nut or seed 2 tbsp 3 tbsp 4 tbsp 4 tbsp butters Yogurt, plain or flavored unsweetened or sweetened 5 The following may be used to meet no more than 50% of the requirement: Peanuts, soy nuts, tree nuts, or seeds, as listed in program guidance, or an equivalent quantity of any combination of the above meat/meat alternates (1 ounces of nuts/seeds = 1 ounce of cooked lean meat, poultry, or fish) 4 ounces or ½ cup ½ ounce = 50% 2 6 ounces or ¾ cup ¾ ounce = 50% 8 ounces or 1 cup 8 ounces or 1 cup 1 ounce = 50% 1 ounce = 50% Vegetables 6 ⅛ cup ¼ cup ½ cup ½ cup Fruits 6,7 ⅛ cup ¼ cup ¼ cup ¼ cup Grains (oz eq) 8,9 Whole grain-rich or enriched bread Whole grain-rich or enriched bread product, such as biscuit, roll or muffin Whole grain-rich, enriched or fortified cooked breakfast cereal 10, cereal grain, and/or pasta ½ slice ½ slice 1 slice 1 slice ½ serving ½ serving 1 serving 1 serving ¼ cup ¼ cup ½ cup ½ cup 1 Must serve all five components for a reimbursable meal. Offer versus serve is an option for at-risk afterschool participants. 19 of 22
2 Larger portion sizes than specified may need to be served to children 13 through 18 years old to meet their nutritional needs. 3 Must be unflavored whole milk for children age one. Must be unflavored low-fat (1 percent) or unflavored fat-free (skim) milk for children two through five years old. Must be unflavored low-fat (1 percent), unflavored fat-free (skim), or flavored fat-free (skim) milk for children six years old and older. 4 Alternate protein products must meet the requirements in Appendix A to Part 226. 5 Yogurt must contain no more than 23 grams of total sugars per 6 ounces. 6 Pasteurized full-strength juice may only be used to meet the vegetable or fruit requirement at one meal, including snack, per day. 7 A vegetable may be used to meet the entire fruit requirement. When two vegetables are served at lunch or supper, two different kinds of vegetables must be served. 8 At least one serving per day, across all eating occasions, must be whole grain-rich. Grain-based desserts do not count towards the grains requirement. 9 Beginning October 1, 2019, ounce equivalents are used to determine the quantity of the creditable grain. 10 Breakfast cereals must contain no more than 6 grams of sugar per dry ounce (no more than 21.2 grams sucrose and other sugars per 100 grams of dry cereal). 3 20 of 22
CHILD MEAL PATTERN Snack (Select two of the five components for a reimbursable snack) Food Components and Food Items 1 Ages 1-2 Ages 3-5 Ages 6-12 Ages 13-18 2 (at-risk afterschool programs and emergency shelters) Fluid Milk 3 4 fluid ounces 4 fluid ounces 8 fluid ounces 8 fluid ounces Meat/meat alternates Lean meat, poultry, or fish ½ ounce ½ ounce 1 ounce 1 ounce Tofu, soy product, or alternate protein products 4 ½ ounce ½ ounce 1 ounce 1 ounce Cheese ½ ounce ½ ounce 1 ounce 1 ounce Large egg ½ ½ ½ ½ Cooked dry beans or peas ⅛ cup ⅛ cup ¼ cup ¼ cup Peanut butter or soy nut butter or other nut or seed 1 tbsp 1 tbsp 2 tbsp 2 tbsp butters Yogurt, plain or flavored unsweetened or sweetened 5 2 ounces or ¼ cup 2 ounces or ¼ cup 4 ounces or ½ cup 4 ounces or ½ cup Peanuts, soy nuts, tree nuts, or seeds ½ ounce ½ ounce 1 ounce 1 ounce Vegetables 6 ½ cup ½ cup ¾ cup ¾ cup Fruits 6 ½ cup ½ cup ¾ cup ¾ cup Grains (oz eq) 7,8 Whole grain-rich or enriched bread ½ slice ½ slice 1 slice 1 slice Whole grain-rich or enriched bread product, such as ½ serving ½ serving 1 serving 1 serving biscuit, roll or muffin Whole grain-rich, enriched or fortified cooked breakfast ¼ cup ¼ cup ½ cup ½ cup cereal 9, cereal grain, and/or pasta Whole grain-rich, enriched or fortified ready-to-eat breakfast cereal (dry, cold) 9,10 Flakes or rounds ½ cup ½ cup 1 cup 1 cup Puffed cereal ¾ cup ¾ cup 1 ¼ cup 1 ¼ cup Granola ⅛ cup ⅛ cup ¼ cup ¼ cup 1 Select two of the five components for a reimbursable snack. Only one of the two components may be a beverage. 2 Larger portion sizes than specified may need to be served to children 13 through 18 years old to meet their nutritional needs. 3 Must be unflavored whole milk for children age one. Must be unflavored low-fat (1 percent) or unflavored fat-free (skim) milk for children two through five years old. Must be unflavored low-fat (1 percent), unflavored fat-free (skim), or flavored fat-free (skim) milk for children six years old and older. 4 Alternate protein products must meet the requirements in Appendix A to Part 226. 4 21 of 22
5 Yogurt must contain no more than 23 grams of total sugars per 6 ounces. 6 Pasteurized full-strength juice may only be used to meet the vegetable or fruit requirement at one meal, including snack, per day. 7 At least one serving per day, across all eating occasions, must be whole grain-rich. Grain-based desserts do not count towards meeting the grains requirement. 8 Beginning October 1, 2019, ounce equivalents are used to determine the quantity of creditable grains. 9 Breakfast cereals must contain no more than 6 grams of sugar per dry ounce (no more than 21.2 grams sucrose and other sugars per 100 grams of dry cereal). 10 Beginning October 1, 2019, the minimum serving sizes specified in this section for ready-to-eat breakfast cereals must be served. Until October 1, 2019, the minimum serving size for any type of ready-to-eat breakfast cereals is ¼ cup for children ages 1-2; 1/3 cup for children ages 3-5; and ¾ cup for children ages 6-12. 5 22 of 22