CACFP Early Intervention for Obesity Prevention Among U.S. Children
February 17, 2026
According to the U.S. Centers for Disease Control and Prevention (CDC), one in five children and adolescents in the United States has obesity, resulting in an estimated $1.3 billion in annual medical costs. Â CDC data also shows that rates of obesity increase as family income decreases, meaning that low-income families are more likely to be or become obese.[i] The most recent data shows that 19.1 million children live in low-income households[ii] and 14.1 million children live in food-insecure households.[iii]
The Child and Adult Care Food Program (CACFP) is one of the earliest points of intervention for obesity prevention, alongside the Supplemental Nutrition Program for Women, Infants, and Children (WIC). The CACFP is a federal child nutrition program administered by the United States Department of Agriculture (USDA) that reimburses child and adult care providers for serving nutritious meals to those in their care. The program primarily serves infants and children from birth to 5 years old in child care centers and family child care homes. The program also serves children up to age 18 in at-risk afterschool care settings and emergency shelters. Child care programs participating in the CACFP are more likely to be located in low-income communities and more frequently serve children from food insecure households, who have a higher risk of obesity.[iv]
To help decrease obesity rates among children, the CDC created High-Impact Obesity Prevention Standards (HIOPS) to encourage healthy eating habits early in life among young children. CDC also cites CACFP as a method for HIOPS implementation, as CACFP meal pattern regulations align with almost all HIOPS for nutrition (see Table 1). In addition, the CDC’s Spectrum of Opportunities Framework, which helps guide states in embedding obesity prevention policies and activities in their early care and education systems, lists the CACFP as one of the nine focus areas for obesity prevention.[v]
The Second Study of Nutrition and Activity in Child Care Settings, released by USDA, found that 3-to-5-year-old children have better overall diets on the days they attended care than days they did not attend. On days in care, children consume more vegetables, fruit, whole grains, and dairy and consume less saturated fats and added sugars. Although there are no physical activity requirements for CACFP operators, children, on average, have four physical activity sessions per day while attending a CACFP-participating child care.[vi]
Table 1. Comparison of Nutrition Quality HIOPS and CACFP Meal Pattern Regulatory Requirements[vii] [viii] [ix]
*CACFP meal types include Breakfast, Lunch/Supper, and Snack which each have their own requirements for which food components – Fruits, Vegetables, Grains, Meat/meat alternates, Grains – must be served, as well as the minimum serving size for each component.
CACFP meal patterns are guided by the Dietary Guidelines for Americans and therefore ensure that meals served through the CACFP are high-quality and nutritious. The CACFP also ensures that children have healthy diets that ensure proper development and that children learn healthy eating habits early in life, helping to mitigate the risk of obesity. Studies have found that CACFP lowers the odds of food insecurity and obesity.[x] The CACFP is not only vital for ensuring that children receive meals while in care and do not go hungry, but it also ensures that the meals they receive meet their nutrient needs and help reduce their risk of childhood obesity.
References
[i] Childhood Obesity Facts (2024). U.S. Centers for Disease Control and Prevention.
[ii] Kids Count Data Center (2024). The Annie E. Casey Foundation (2024).
[iii] Rabbitt, M.P., Reed-Jones, M., Hales, L.J., Suttles, S., & Burke, M.P. (2025). Household food security in the United States in 2024 (Report No. ERR-358). U.S. Department of Agriculture, Economic Research Service.
[iv] Schochet, O., Franckle, R., Boyle, M., Navarro, S., & Childcare and Meal Provision Data Analysis Team (2024). Childcare and Meal Provision: Data Analysis Report. U.S. Department of Agriculture, Food and Nutrition Service.
[v] Centers for Disease Control and Prevention. Early Care and Education State Indicator Report 2023 (2023). US Dept of Health and Human Services.
[vi]Forrestal, Sarah, Maria Boyle, Rachel Bleiweiss-Sande, Rebecca Franckle, Mindy Hu, Jennifer Kali, Theresa Neelan, and Katherine Niland (2025). Second Study of Nutrition and Activity in Child Care Settings: Summary of Findings. Report submitted to the Food and Nutrition Service, U.S. Department of Agriculture. Chicago, IL: Mathematica, July 2025.
[vii] HIOPS for Nutrition (2024). U.S. Centers for Disease Control and Prevention
[viii] Code of Federal Regulations, Title 7, Subtitle B, Chapter II, Subchapter A, Part 226 – Child and Adult Care Food Program.
[ix] CACFP Best Practices (2024). U.S. Department of Agriculture, Food and Nutrition Service.
[x] Ettinger de Cuba, S. et al. (2023). Child care feeding programs associated with food security and health for young children from families with low incomes. Journal of the Academy of Nutrition and Dietetics, 123(10), pp. 1429–1439. doi:10.1016/j. jand.2023.06.003.