Nutrition Programs For Children And Adults

One of the recently proposed regulations intended for this iam would amend the meal plan requirements for the Child and Adult Care Food Program. The meal plan requirements align with the 2010 Dietary Guidelines, that are required by Healthy, Hunger-Free Kids Act of 2010 (HHFKA). The proposed rule, “Healthy, Hunger-Free Kids Act of 2010”, was initially published by the United States Department of Agriculture on December 13, 2010, with a follow up announcement containing a summary of public comments on the rule on April 13, 2011. This rule would essentially help facilitate the state and federal funding allocated for the food program lunches under this act. Furthermore, this is how the final rule of the “Child and Adult Care Food Program” led to revisions and amendments in order to make improvements.

The new proposed rule has made a large impact on the availability and access of food lunch programs for school districts. The CACFP differs in many states, but the goal of the revised regulation is to ensure children and adults have access to healthy, balanced meals throughout the day. In addition, the meal patterns will consist of meals that obtain a greater variety of grains, fruits, vegetables, and less added sugars and solid fats. Why is healthy eating important, particularly in schools? There is a current public health risk at hand, which is childhood obesity and hunger status. Studies have shown that, “approximately one child in every three children in America is considered to be overweight or obese”. Therefore, it’s vital to take school lunches into account due to half of the children’s calorie intake each day.

Schools should be using their platform to push for healthy eating habits. This paper will address the background of the proposed regulation, the needs for the regulation, alternatives and stakeholders, the cost, and the associated impact and effectiveness of the proposed rule. The proposed regulation was created as a response to the USDA and FNS initiative to strengthen the CACFP meal patterns in accordance to the Dietary Guidelines for Americans. The United States Department of Agriculture (USDA) and The Food and Nutrition Service (FNS) administers the Child and Adult Care Food Program. The main objective of the Child and Adult Care Food Program (CACFP) is to provide reimbursement for child care centers and after-school programs to ensure healthy food is available to students.

The United States Department of Agriculture proposes the regulation since enforcement of CACFP is in the domain of the USDA’s Food and Nutrition Services, an agency under the U.S. Department of Agriculture.  Several months after these proposed orders, the USDA published the new revisions to the meal patterns on April 25, 2016. In addition, the Institute of Child Nutrition (ICN) developed the training materials for the CACFP meal patterns. The proposed rule has several technical components. The CACFP was designed to specifically to provide aid to child and adult care and public school institutions so that nutritious foods are provided to the population.

The development of health and wellness is imperative to maintain the provision for young children and older adults. For the child and adult meal patterns, the age group for children 13 through 18 was a new addition to insure the initiative is reaching older teenage adults. The proposed rule of the child and adult meal patterns are required to have the following segments. Some requirements mentioned are the fruits and vegetables component, breakfast cereals outlined by Women, Infant & Children Program (WIC), a meat as a required grain for breakfast, fat-free only flavored milk, exclusion of grain-based desserts and much more. Most importantly, the consumption of daily water throughout the day should be given to kids and young adults upon request.

There has been a call to action to have the policy mandated by Congress. The need that is being addressed through this regulation is ensuring that proper review and revisions are made in accordance to the CACFP meal patterns. Mandated by the 2010 Healthy, Hunger-Free Kids Act, the revisions to the CACFP standards went into effect in October 2017. The proposed rule comes in direct response to an order. The main problem this regulation is attempting to address is the obesity epidemic in the United States. Childhood obesity is at its’ most high prevalence rate of 18.5%, affecting 13.7 million children and adolescents. The consequences of childhood obesity imposes a range of health risks, from high blood pressure to joint problems to fatty liver disease(Centers for Disease Control and Prevention).

It is quite a complex phenomenon based on the demographics reported in the United States. These obesity rates have increased tremendously, even with other health risks and costs spreading. It has been reported that childhood obesity was associated with numerous factors. The biological factors consist of genetics and metabolism, psychological factors such as self-efficacy and mood, and environmental factors such as socioeconomic status and high risks in nutritional intake (Centers for Disease Control and Prevention). The question of this matter is why should food be regulated by the government instead of the free market system. Formal regulation of this act would ensure that possible market-failure will not occur.

The need for this issue is greater due to the high demand of families and children having access to food. The access to food specifically needs to be within nutritional standards to make sure children are receiving approximate food intakes. Through regulation, facilities such as day care centers would be able to serve as a source for low-income families to have as an option. These families already experience day-to-day troubles due to their socioeconomic backgrounds and living conditions in poor neighborhoods. This regulation is a form of an exchange where both parties would benefit: day care centers would get reimbursed through the government assistance and low-income families will have access to healthy food.

The potential market failure implications indeed are relevant enough to make this problem amenable to be addressed through regulation. If free market were to regulation access to quality of food, there would be no orderly construction of how low-income families will receive food. In addition, it is important to consider the factors that contribute to these difficulties. In poor neighborhoods, there is a greater possibility for there to be food desserts, less transportation, and time restraints. Access to obtain healthier food may be outside the rural, inner city so that would place time-consuming restraints on families that may or may not have ability to. Provision of healthy food through government regulated facilities like day care centers will ensure that children will receive the proper food on a contingent basis.

There has been some discussion about how to improve the meal patterns, and regulation has largely come out of a perception that proper meal patterns are a public health issue. There have been attempts from other sources to get low and middle class families better access to healthy food. Around the time when the Food and Nutrition Act of 2008 was passed by Congress, the Food Stamp Program was renamed as the Supplemental Nutrition Assistance Program (SNAP). SNAP has instilled requirements for the program so that eligibility is based on household assistance and claimed as the “largest federal nutrition program in America, encompassing three-quarters of all federal spending on nutritional assistance(Hollenbach, M.)”.

This program has had its’ own benefits and costs in terms of effectiveness. It thrives in many benefits such as low administrative costs, increase in participation from low-income households, and majority of funds going to beneficiaries. On the other hand, it has not been quite effective such like HHFKA of the Child and Adult Food Program due to its’ high in food insecurity. Individuals still would receive additional government food assistance, but a racial equity gap is visible due to food insecurity. On the contrary, SNAP cannot fully take responsibility for the food insecurity because this exists due to social and economic factors that affect the accessibility of healthy food resources for individuals.

Another program that serves as an alternative for healthy food assistance mainly for children would be the Special Supplemental Nutrition Program for Women, Infants, and Children(WIC). The target audience for this initiative is specifically for women, infants, and children who are living within low-income and poverty conditions and cannot afford access to healthier foods. The eligibility for WIC is a bit more specific, only for pregnant or postpartum women and children up to age 5. This is because it is highly encouraged for healthy eating habits to occur at an early stage for new mothers and children to maintain nutritional standards. The limitations within the WIC program are the specific types of foods chosen to help these individuals reach the optimal nutritional standard.

The foods consists of certain whole-grain bread, milk, fruits, vegetables, baby food and much more. WIC contributes to the positive outcome of healthier births, nutritious diets, and improved health care for women and children (Center on Budget and Policy Priorities). Both of these alternative programs have taken a tremendous leap in improving the populations’ intake significantly. Both aim to meet the goals set forth by the Dietary Guidelines for Americans, which is similar to HHFKA. No free market alternatives could necessarily contribute to helping the issue because regulation through the government is what brings forth the funding to support the programs. The services and benefits would not be significant enough if a free market initiative attempted to regulate the control of food assistance.

The day care centers and federal agencies serve as the two, prominent sources for the regulation. Representatives from providers, state government agencies, policy advocacy and community organizations serve as the federal agencies that mainly voiced their opinions about the revisions of the Hunger-Free, Kids Act. The nutritional deficiencies in foods offered at daycare facilities is the main concern for those in support of the act because they are looking towards improved nutritious balance meals. In additional, health professionals and physicians are in full support for the consistency of child nutrition programs across the board. Pediatricians and health care providers cosign with USDA and FNS working to align the federal child nutrition program standards with the meal and lunch patterns provided at schools.

For the most part, the majority of the comments for the final rule of this order are solemnly from individuals that coherently work for the federal government. Representatives from these backgrounds would have a greater understanding and appreciation for federal regulation over food assistance for children in day care facilities. The business of healthcare and additionally other agencies would potentially be affected by the regulation. For example, a food vendor that probably specializes in serving breakfast cereals commented on having consistency of cereal sugar restrictions across the NSLP, CACFP, and SBP programs. This would ensure that purchase and interchangeability would be consistent and easy among the vendors who is supplying the food cereals(Federal Register).

The proposed rule includes a “qualitative analysis of unquantified costs”, which gives an estimate of the costs in the rule. Since the regulation requires minimal change, the rule is expected to be cost neutral. The meaning of this could be a possible negligible cost to the government due to state and federal legislation. It is stated in the proposed rule that there are no additional meal reimbursement provided for the proposed changes. The presence of cost neutral initiatives are needed so there will be no discouragement in participation in the CACFP. The economical costs of the issue, childhood obesity is important to evaluate in regards to the CACFP. It has been reported that direct medical costs annually, that are around $14.1 billion is due to childhood obesity itself.

The impact of childhood obesity on healthcare will continue to increase if there not preventive measures taken. An everlasting burden could permanently be left on the healthcare system if the prevalence rate of diseases such as diabetes and hypertension increases. Obesity can start at a young age and continue to grown into the population having a majority of obese adults. Early prevention of childhood obesity is highly recommended so that the financial, physical and societal costs do not turn into burdens for the health care system(Hammond, R.A.).

The proposed regulation would be the step into the right direction, in order to fulfill its large, intended purpose. Studies have shown and reported that between the years of 2012 and 2016, there has been a significant, positive change due to the new Final Rule of the HHFKA. Despite the apparent gap between breakfast and lunch meal participation, there has been a combined average of 45 million children receiving meals through this government assistance program(Hayes, D.). The following figure below gives a further breakdown of the amount of meals served annually in the public schools. The strict standards from the USDA’s Nutrition Standards for School Meals has enforced and pushed these public entities to keep progression in healthy eating. This includes offering twice as much vegetables, fresh fruits, low-sodium canned vegetables, and less sodium in the content of meals.

The original Health, Hunger-Free Kids Act of 2010 may be acting as a barrier for health providers and day care facilities to submit relevant information to the USDA and FNS, important tools in regulating the governmental assistance and spending for healthy eating habits for children. Thus, the final rule to enhance the the Meal Pattern Revisions related to the Health, Hunger-Free Kids Act could help increase reporting to the USDA and FNS, leading to a positive impact in our society preventing childhood obesity. The Adult and Child Care Food Program under USDA is only effective if there is an adequate amount of resources and federal assistance to support funding.

Truthfully, I believe this final rule will remain a step in the right path if it continues to show progression. I think the Child and Adult Food Program is a valuable system, which has a variety of programs under it that support and serve for the greater cause of the act. Health providers, physicians, and day care facilities should be more of an asset and voice for this program because they would be able to report relevant information. In the long run, this could potentially eliminate the child obesity epidemic in our nation. I believe a larger movement in correlation to this final rule can further address this issue. Since the federal government is in complete control of the food regulation, it should be their main duty to have stakeholders involved as much as possible in this initiative. For example, the day care facilities should be giving more in-depth, monthly reports of what they need in assistance to better serve children