4.2.0.4: Categories of Foods

The early care and education program should ensure the following food groups are being served to children in care. When incorporated into a child’s diet, these food groups make up foundational components of a healthy eating pattern.
 

Making Healthy Food Choicesa
Food Groups/Ingredients	USDAb	CFOC Guidelines for Young Children
Fruits	Whole Fruits Includes fresh, frozen, canned (packed in water or 100% fruit juice), and dried varieties that include good sources of potassium (e.g., bananas, dried plums) Fruit Juice 100% juice (i.e., without added sugars)	Eat a variety of whole fruits. Whole fruit, mashed or pureed, for infants. Do not serve juice to infants younger than 12 months. No more than 4 oz of juice per day for 1- to 3-year-olds. No more than 4–6 oz of juice per day for 4- to 6-year-olds. No more than 8 oz of juice per day for 7- to 12-year-olds.
Vegetables	Includes fresh, frozen, canned, and dried varieties Vegetable Subgroups Dark green Red and orange Beans and peas (legumes) Starchy vegetables Other vegetables	Include a variety of vegetables from the vegetable subgroups. Select low-sodium options when serving canned vegetables.
Grains	Whole Grains Contain the entire grain kernel (e.g., whole wheat flour, bulgur, oatmeal, brown rice) Refined Grains Enriched grains that have been milled, processed, and stripped of vital nutrients	Limit the amount of refined grains. Make half the grains served whole grains or whole-grain products.
Protein Foods (Meat and Meat Alternatives)	Includes food from animal and plant sources (e.g., seafood, lean meat, poultry, eggs, yogurt, cheese, soy products, nuts and seeds, cooked [mature] beans and peas)	Fish, poultry, lean meat, eggs. Unsalted nuts and seeds (if developmentally and age appropriate). Legumes (beans and peas) may also be considered a protein source. Limit processed meats and poultry. Avoid fried fish and poultry.
Dairy	Fat-free or low-fat (1%) milk or soy milk	Human milk and/or iron-fortified infant formula for infants 0–12 months of age. Unflavored whole milk for children 1–2 years of age. 2% (reduced-fat) milk for those children at risk for obesity or hypocholesteremia. Unflavored low-fat (1%) or fat-free milk for children 2 years and older. Nondairy milk substitutes that are nutritionally equivalent to milk. Yogurt must not contain more than 23 g of sugar per ounce.
Abbreviations: CFOC, Caring for Our Children: National Health and Safety Performance Standards; USDA, US Department of Agriculture. a All foods are assumed to be in nutrient-dense forms, lean or low-fat, and prepared without added fats, sugars, or salt. Solid fats and added sugars may be included up to the daily maximum limit identified in the 2015–2020 Dietary Guidelines for Americans. b The USDA recommends finding a balance between food and physical activity.

OTHER RECOMMENDATIONS

• Trans-fatty acids (trans fat) should be avoided.
• Avoid concentrated sweets (eg, candy, cake, cookies) and sugar-sweetened beverages (eg, sodas, sports and energy drinks, fruit nectars, flavored milk).¹ Offer foods and beverages that have little or no added sugars. Early care and education programs should establish water as the preferred safe and accessible beverage.²
• Limit salty foods such as chips and pretzels. When buying foods, choose no salt added, low-sodium, or reduced sodium versions, and prepare foods without adding salt. Use herbs or no-salt spice mixes instead of salt, soy sauce, ketchup, barbeque sauce, pickles, olives, salad dressings, butter, stick margarine, gravy, or cream sauce with seasonal vegetables and other dishes.
• Avoid caffeine.

ADDITIONAL RESOURCES

• American Academy of Pediatrics. American Academy of Pediatrics recommends no fruit juice for children under 1 year. https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-Pediatrics-Recommends-No-Fruit-Juice-For-Children-Under-1-Year.aspx. Published May 22, 2017. Accessed August 21, 2019
• Holt K, Wooldridge N, Story M, Sofka D. Bright Futures: Nutrition. 3rd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2011
• US Department of Agriculture. ChooseMyPlate.gov. Children. http://www.choosemyplate.gov/children. Updated August 26, 2015. Accessed August 21, 2019
• US Department of Health and Human Services. Physical Activity Guidelines for Americans. 2nd ed. Washington, DC: US Department of Health and Human Services; 2018. https://health.gov/paguidelines/second-edition. Accessed August 21, 2019

RATIONALE

The 2015–2020 Dietary Guidelines for Americans and The Surgeon General’s Call to Action to Support Breastfeeding support patterns of healthy eating to promote a healthy weight and lifestyle that, in turn, prevent the onset of overweight and obesity in children.^3,4 Incorporating each of the food groups by providing children with appropriate meals and snacks helps set the stage for a lifetime of healthy eating behaviors. Research reinforces the following suggestions as being a practical approach to selecting foods high in essential nutrients and moderate in calories/energy:

• Meals and snacks planned based on the food groups in the Making Healthy Food Choices Table promote normal growth and development of children as well as reduce children’s risk of overweight, obesity, and related chronic diseases later in life. Age-specific guidance for meals and snacks is outlined in the US Department of Agriculture Child and Adult Care Food Program (CACFP) guidelines.⁵
• Early care and education settings provide the opportunity for children to learn about the food they eat, to develop and strengthen their fine and gross motor skills, and to engage in social interaction at mealtimes.
• “Energy” or sports beverages are typically high in added sugars and, therefore, not recommended for consumption. They contain many nonnutritive stimulants, such as caffeine, that have a history of harmful effects on a child’s developing heart, brain, and nervous system.⁶ 

COMMENTS

Early care and education settings should encourage mothers to breastfeed their infants. Scientific evidence documents and supports the nutritional and health contributions of human milk.⁴ For more information on portion sizes and types of food, see the CACFP guidelines.⁵

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

4.2.0.5 Meal and Snack Patterns
4.2.0.7 100% Fruit Juice
4.2.0.8 Feeding Plans and Dietary Modifications
4.3.1.2 Responsive Feeding of Infants by a Consistent Caregiver/Teacher
4.3.1.3 Preparing, Feeding, and Storing Human Milk
4.3.1.5 Preparing, Feeding, and Storing Infant Formula
4.3.1.7 Feeding Cow’s Milk
4.3.2.1 Meal and Snack Patterns for Toddlers and Preschoolers
4.3.3.1 Meal and Snack Patterns for School-Age Children
4.7.0.1 Nutrition Learning Experiences for Children
4.7.0.2 Nutrition Education for Parents/Guardians
Appendix Q: MyPlate: Make It Yours
Appendix R: Choose MyPlate: 10 Tips to a Great Plate

REFERENCES

1. Muth ND, Dietz WH, Magge SN, Johnson RK; American Academy of Pediatrics Section on Obesity and Committee on Nutrition; American Heart Association. Public policies to reduce sugary drink consumption in children and adolescents. Pediatrics. 2019;143(4):e20190282

2. Centers for Disease Control and Prevention. Increasing Access to Drinking Water and Other Healthier Beverages in Early Care and Education Settings. Atlanta, GA: US Department of Health and Human Services; 2014. https://www.cdc.gov/obesity/downloads/early-childhood-drinking-water-toolkit-final-508reduced.pdf. Accessed August 21, 2019

3. US Department of Health and Human Services, US Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th ed. https://health.gov/dietaryguidelines/2015/resources/2015-2020_Dietary_Guidelines.pdf. Published December 2015. Accessed August 21, 2019

4. Office of the Surgeon General, Centers for Disease Control and Prevention, Office on Women’s Health. The Surgeon General’s Call to Action to Support Breastfeeding. https://www.hhs.gov/surgeongeneral/reports-and-publications/breastfeeding/index.html. Reviewed May 14, 2019. Accessed August 21, 2019

5. US Department of Agriculture Food and Nutrition Service. Child and Adult Care Food Program. Ensuring children and adults have access to nutritious meals and snacks. https://www.fns.usda.gov/cacfp/child-and-adult-care-food-program. Accessed August 21, 2019

6. Centers for Disease Control and Prevention. CDC Healthy Schools. The buzz on energy drinks. https://www.cdc.gov/healthyschools/nutrition/energy.htm. Reviewed March 22, 2016. Accessed August 21, 2019

NOTES

Content in the STANDARD was modified on 2/2012, 11/16/2017 and 02/27/2020.