Part I: Summary of New Regulations on Nutrition for Group Child Care Services

Transcription

1 NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE Part I: Summary of New Regulations on Nutrition for Group Child Care Services Effective Date: January 1, 2007 Effective January 1, 2007, Article 47 of the New York City Health Code includes new provisions regarding nutrition services provided to children in child care services permitted by the New York City Department of Health and Mental Hygiene (DOHMH). These are: Beverages with added sweeteners, whether artificial or natural, shall not be provided. Juice shall only be provided to children over 8 months of age, and only 100% juice shall be permitted. Children shall receive no more than 6 ounces of 100% juice per day. Juice shall not be provided in bottles. When milk is provided, children ages two and older shall only be served milk with 1% or less milk-fat unless milk with a higher fat content is medically required for an individual child, as documented by the child s medical provider. When milk is provided, children ages 12 months to under age 2 should be served whole milk. Water shall be made available and shall be easily accessible to children throughout the day, including at meals. Requires the distribution of nutritional guidelines to parents for provision of meals brought into the day care service from other sources.

2 NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE Part II: NUTRITION GUIDELINES FOR GROUP CHILD CARE SERVICES Effective Date: January 1, 2007 The guidelines below are being provided as recommendations to assist in your menu development. Strict compliance with these guidelines is not a requirement of Article 47, although it is expected that programs will follow many of their recommendations. General Guidance for Nutrition Services Obesity and diabetes are key public health problems that are getting worse, and getting worse rapidly, in New York City and the rest of the country. These guidelines are meant to ensure that nutrition services provided in child care settings: 1) contribute to optimizing the health of young children by assuring good nutrition while preventing obesity; and 2) supplement and complement nutrition in the home and community. The Guidelines apply to meals, snacks and beverages provided by child care programs and to items parents send with children. Model guidelines for child care services to provide to parents are available from DOHMH. Child care services should assure that all children receive appropriate nutrition, whether provided by the center or by parents, and that no child goes without appropriate food. Food and beverages supplied to children should be wholesome, of good quality, ageappropriate in portion size and variety, and served at regular hours and appropriate intervals. Items served should meet nutrition and portion size standards (see Appendix 2). Nutritional needs and requirements are met by serving a variety of healthful foods, including whole grains, vegetables, fruits, lean meat and meat alternates (eggs, nuts, seeds, beans and peas), and milk and milk products (yogurt and cheese, which should be low-fat for children ages two and older). USDA s My Pyramid provides a basis for determining the kinds and amounts of the food groups to be eaten each day (see Appendix 1 for approximate daily calorie intake patterns for children). One third of the nutritional needs of children in part-day programs, and one-half to two-thirds of the nutritional needs of children in full-day programs should be met. Guidelines for meal and snack patterns from the Child and Adult Care Food Program (CACFP) provide a variety of options (see Appendix 2). The size and number of servings should reflect individual children s needs. Specific portion sizes for meal and snack components vary by age group. Appendix 2 outlines portion size recommendations for ages 1 to 2 and ages 3 to 5, based on CACFP. Child care services should provide children with an environment that models and promotes healthy eating Television should not be viewed during mealtimes.

3 Nutrition services should provide a variety of food that broadens the child s food experience while reinforcing cultural and ethnic preferences. Opportunities should be provided for children to be involved in activities related to food service, such as simple food preparation, setting the table, serving food to others or self, and cleaning up. These activities should be closely supervised to assure safe food handling. Food should not be used as punishment or reward, and children should be encouraged, but not forced, to eat. Children ages 12 to 24 months should be served whole milk. Beverages: These are required measures, see Part I Summary of New Regulations Meal and Snack Guidelines At lunch and dinner, two or more non-fried vegetable and/or fruit choices should be provided. Fresh fruits and vegetables are preferable to canned and frozen, and should be used whenever possible. When providing canned fruits, avoid fruits in syrup or those that have added sugar. Food items should have less than 30% of calories from fat and less than 10% of calories from saturated fat, with the exception of nuts, seeds, cheese, eggs and avocados. Snacks served in child care services should make a positive contribution to children's nutritional intake and health. Snacks should be planned to supplement nutritional needs not met in meals, with an emphasis on serving fruits and vegetables as the primary snacks and milk or water as the primary beverage. Services should consider having fresh fruit or vegetable bowls for children to snack on when hungry and to promote healthy habits. Food items should be low in added sugar 1 unless they provide significant nutritional value. Significant is defined as an individual serving that meets either of the following criteria: 5 grams of protein or 3 grams of dietary fiber. Examples of items that contribute significant nutritional value include whole grain cereals with at least 3 grams of dietary fiber per serving, or lowfat yogurt with at least 5 grams of protein per serving. 2 Breakfast cereals should contain no more than 10 grams of sugar per serving. Items should contain no artificial trans fat (listed as partially hydrogenated vegetable oil or vegetable shortening on ingredients labels). The nutrition facts panel should show < 0.5 grams of trans fat per serving. Replace margarine, lard, and shortening with trans fat-free spreads and liquid oils such as corn, canola or olive. Children s total daily sodium intake should be less than 1,700 mg. A good guideline for meals and snacks served during child care services is for children to consume no more than 425 mg at breakfast (25% daily sodium), 170 mg from snacks (15% daily sodium), 600 mg at lunch (30% daily sodium), and 600 mg (30% daily sodium) at dinner Added sugars include: sugars and syrups added to foods and beverages in processing or preparation, not naturally occurring sugars in fruits or milk. See Appendix A-3:

4 Special Occasions Special occasions like birthdays, holidays, and ceremonies occur often in child care settings. Offer sweets/desserts in moderation and in child-size portions such as mini-muffins or small cakes. Try healthy alternatives such as low-fat ice cream, frozen yogurt, fruit juice popsicles, low-fat pudding and jello. Healthy items, such as vegetables and low-fat dip, fruit slices, and low-fat cheese and wholegrain crackers, should be provided along with any sweets/desserts. Instead of sugar-sweetened soft drinks, try mixing 100% fruit juice with seltzer or water. Physical activity such as games and dancing should be promoted during special occasions. Infant Feeding Exclusive breastfeeding is recommended for infants up to age 6 months of age. Child care services caring for young infants should make every effort to assist parents in assuring continuity of breastfeeding. If breast milk is unavailable, infant formula may be used. Infant formula and dry infant cereals should be iron-fortified. 2 USDA guidelines establish a dietary allowance, rather than a recommended intake, for added sugar. This allows for some sweetened foods or beverages, without excess caloric intake and weight gain. See: Discretionary Calorie Allowance in the USDA Food Guide: 3 Based on recommendations from the Institute of Medicine s calculation of Adequate Intake for sodium for children 1 to 8 old and the USDA s School Meals Initiative for Healthy Children.

5 APPENDIX 1 DAILY CALORIE LEVELS FOR CHILDREN Young children need between 1,000 and 1,600 calories per day. The exact number of daily calories depends on the child s sex, age, and physical activity level, as shown in the table below. Eating or drinking more calories than the body uses causes weight gain which can lead to obesity, diabetes, and heart disease. MALES FEMALES Activity level Activity level AGE Sedentary* Moderate* Active* AGE Sedentary* Moderate* Active* * Sedentary means less than 30 minutes a day of moderate physical activity. Moderate means 30 to 60 minutes a day of moderate physical activity. Active means 60 or more minutes a day of moderate physical activity. Table adapted from MyPyramid Food Intake Pattern Calorie Levels, USDA, April For more information, visit

6 APPENDIX 2 MEAL AND SNACK PATTERNS FOR CHILDREN ONE TO FIVE YEARS OF AGE Child and Adult Care Food Program (CACFP) meal and snack patterns provide a variety of options to guide nutrition services at child care programs. The 4 CACFP components are: Fruit and Vegetables Grains and Breads Milk Meat and Meat Alternatives (protein). Breakfast: consists of three components: fruit or vegetable; grains or bread; and milk. Morning or Afternoon Snack: consists of two of the four components. If you select milk as one of the components, do not serve fruit juice as the other component. Lunch or Dinner: consists of four components each: fruit and/or vegetable (two or more non-fried fruit and/or vegetable choices); grains or bread; milk; and meat or meat alternative. The tables below are adapted from CACFP policy and are meant to provide guidance on portion sizes for meal and snack components. These DOHMH guidelines are NOT intended to replace CACFP reimbursement guidelines, however they are compatible with them. If your program utilizes CACFP for reimbursement of meals and snacks, follow CACFP regulations and these DOHMH guidelines. If a program does not utilize CACFP for reimbursement, the CACFP guidelines are not mandatory but provide useful guidance on portion size and meal patterns. Suggested Portion Sizes SOURCES Breakfast 1 to 2 3 to 5 DOHMH Guidance Fruit or Vegetable Grains and Breads (bread, bread alternate or cereal) Fruit or Juice or Vegetable ¼ ½ Bread, enriched or whole grain Cereal: Cold dry or Hot cooked Cooked pasta or noodle products ½ slice ¼ ½ slice ⅓ Milk Fluid milk ½ ¾ Fresh fruits or vegetables are preferable to frozen and canned. See Part I for limits on juice consumption Look for cereals that are low in added sugar ( 10g added sugar per serving). Whole grain options, such as high fiber cereals and bread, are recommended. Look for the word whole in the ingredients label on the package. Try for options that have 2 or more grams of dietary fiber per serving. Lowfat (1%) milk must be served to children ages 2 and up.

7 Snack Fruit or Vegetable 1 to 2 3 to 5 DOHMH Guidance Fruit or Juice or Vegetable ½ ½ See Fruit/Vegetable section above. Grains and Breads (bread, bread alternate or cereal) Bread, enriched or whole grain Cereal: Cold dry or Hot cooked Cooked pasta or noodle products ½ slice ¼ ½ slice ⅓ See Grains/Breads section above. Milk Fluid milk ½ ½ See Milk section above. Meat and Meat Alternatives Meat, poultry, or fish (cooked, lean meat without bone) Egg (large) Cooked dry beans, peas or tofu Cheese Yogurt, plain or sweetened ½ oz. ½ ⅛ ½ oz. 2 oz. ½ oz. ½ ⅛ ½ oz. 2 oz. Select chicken, turkey, fish and other lean meats. Bake, grill or steam meat and fish instead of frying. Lowfat dairy products are appropriate for children ages 2 and up. Lunch or Dinner Vegetable and/or Fruit Serve two or more vegetables and/or fruits 1 to 2 3 to 5 DOHMH Guidance ¼ ½ See Fruit/Vegetable section above. Bread or Bread Alternate Bread, enriched or whole grain Cooked pasta or noodle products Rice ½ slice ¼ ½ slice ¼ Whole grain options (such as whole grain bread, whole wheat pasta and brown rice) are high in fiber and are recommended. Try for options that have 2 or more grams of dietary fiber per serving. Milk Fluid milk ½ ¾ See Milk section above. Meat and Meat Alternatives Meat, poultry, or fish (cooked, lean meat without bone) Egg (large) Cooked dry beans, peas or tofu Cheese Yogurt, plain or sweetened 1 oz. ½ ¼ 1 oz. 4 oz. 1½ oz. ¾ ⅜ 1½ oz. 6 oz. See Meat/Meat Alternative section above.

8 Sources U.S. Department of Health and Human Services. Administration for Children and Families. Head Start Performance Standards: Child Nutrition. Code of Federal Regulations, Title 45, Volume 4, Section Revised as of October 1, United States Department of Agriculture. Food and Nutrition Service. CACFP Regulations. Code of Federal Regulations, Title 7, Part 226. URL: United States Department of Agriculture. My Pyramid Food Intake Pattern Calorie Levels. April URL: