Achieving a State of Healthy Weight Report
November 11, 2026
The latest 2025 Annual Report: Achieving a State of Healthy Weight (ASHW) underscores the critical role that child care licensing regulations play in promoting healthy eating, physical activity, and obesity prevention in early care and education settings. Developed by the University of Colorado College of Nursing in partnership with the CDC, the report evaluates how all 50 states and Washington, D.C., align their licensing requirements with 47 evidence-based High-Impact Obesity Prevention Standards (HIOPS).
For CACFP advocates and operators, the report offers encouraging evidence that CACFP meal pattern requirements continue to drive improvements in state nutrition and infant feeding standards.
Why It Matters
CACFP remains one of the strongest policy tools available for improving nutrition in child care settings. The ASHW report found that 33 states explicitly require providers to follow CACFP meal patterns in licensing regulations for at least one child care type, regardless of whether programs participate in CACFP. Additionally, 65% of states align infant feeding or nutrition standards with USDA CACFP meal patterns for at least one care type.
When CACFP standards are incorporated into licensing regulations, more children benefit from evidence-based nutrition practices.
CACFP's Lasting Influence on State Nutrition Standards
Since 2010, the largest gains in state obesity prevention standards have occurred in infant feeding and nutrition policies. Four of the five standards showing the greatest improvement nationwide are directly connected to CACFP requirements. These include:
- Serving no juice to children under 12 months of age.
- Offering 100% juice only during meals.
- Serving whole fruits to infants beginning around six months of age.
- Limiting sugary foods and sweetened beverages.
The report specifically notes that nutrition and infant feeding standards have experienced the strongest growth over the past 16 years, highlighting CACFP's substantial influence on state policy.
New Hampshire Negatively Impacted by Removal of CACFP Licensing Requirement
While many states made positive changes in 2025, the report highlights an important cautionary example. New Hampshire removed licensing language that aligned child care programs with USDA CACFP meal patterns. As a result, the state experienced declines across seven infant feeding standards and sixteen nutrition standards.
The report points to this change as evidence that maintaining explicit CACFP references in licensing regulations matters. When CACFP-aligned language disappears, support for evidence-based nutrition practices can erode quickly.
States Continue Expanding Healthy Mealtime Practices
Several states strengthened regulations that support responsive feeding and healthy mealtime environments in 2025. Arizona, Oregon, and Utah expanded protections against using food as punishment or reward, aligning with practices that CACFP organizations have promoted for years. Oregon also strengthened infant feeding policies by clarifying that infant bottles should contain only human milk or formula unless medically indicated.
These changes reflect growing recognition that healthy eating is about more than the foods served. Mealtime interactions and feeding practices also influence children's long-term health and relationship with food.
Areas Where States Still Need Improvement
Despite progress, significant opportunities remain. The report found that the least-supported obesity prevention standards nationwide continue to be:
- Limiting oils and fried foods.
- Limiting salty foods.
- Providing staff training related to healthy physical activity.
The obesity prevention standards with the strongest support nationwide include:
- Making water readily available.
- Serving age-appropriate portion sizes.
- Providing children with space for play
Lessons for CACFP Advocates and Policymakers
The report concludes with a clear recommendation: states should explicitly align child care licensing regulations with current USDA CACFP meal patterns, even for providers that do not participate in CACFP. Researchers emphasize that maintaining strong CACFP-aligned language helps preserve progress in infant feeding and nutrition standards over time.
The findings provide additional evidence that CACFP's science-based meal patterns continue to shape healthier child care environments nationwide. As states revisit licensing regulations, CACFP advocates have an opportunity to encourage policymakers to adopt, strengthen, and protect these standards so that more children can benefit from healthy eating practices from the earliest years of life.