We aimed to examine the current policy guidance for ICDS SNP and operationalization of these at the state-level. To do so, we compared India’s SNP guidance for THR with global guidelines for infant and young child feeding (IYCF). Additionally, the current state of the take-home ration supplied for infants and young children across India was reviewed and summarized. Findings on state- and district-specific coverage of services is described elsewhere.

A notable approach to addressing maternal undernutrition during pregnancy in India in recent years has been the integration of hot-cooked meals (HCM) for pregnant and lactating women together with the provision of other health/nutrition services. Called the One Full Meal (OFM) program, these efforts aim to improve maternal nutrition and health across India by bundling center-based HCM with other nutrition services and behavior change communication implemented through the Integrated Child Development Services (ICDS) scheme. The program is offered at anganwadi centers (AWCs) and has been implemented in eight states in India, including Andhra Pradesh, Chhattisgarh, Gujarat, Karnataka, Maharashtra, Telangana, Madhya Pradesh, and Uttar Pradesh. Although the OFM program has been implemented since 2013, there is limited consolidated insight on its effectiveness or on broader lessons for implementation. The objectives of this evidence review of the OFM program are, therefore, to (1) compare the different state OFM program models on their objectives, implementation elements, cost norms and monitoring mechanisms; (2) develop program impact pathways on the potential ways in which the program could influence intended outcomes; and (3) examine the availability of evidence underpinning the program’s intended pathways to impact.

The Child and Adult Care Food Program (CACFP) is a federally-funded program designed to provide healthy meals and snacks to children and adults while receiving day care at participating family day care homes, traditional child care centers, afterschool facilities, adult care facilities, and emergency shelters. CACFP has the broadest scope of any of the U.S. Department of Agriculture (USDA) food program, serving more than 3 million children and 114,000 adults across the nation. To receive reimbursement for the foods served, participating programs must abide by requirements set by the USDA. Child and Adult Care Food Program assesses the nutritional needs of the CACFP population based on Dietary Guidelines for Americans and the Dietary Reference Intakes (DRIs) and makes recommendations for revisions to the CACFP meal requirements. The book outlines meal requirements that include food specifications that could be used for specific meals and across a full day, covering all age groups from infants to older adults and meal patterns designed for use in a variety of settings, including in-home care and in large centers. By implementing these meal requirements, consumption of fruits, vegetables, and whole-grain rich foods will increase while consumption of solid fats, added sugars, and sodium will decrease. Not only will this address the high prevalence of childhood obesity, it will also help to achieve consistency with the standards and regulations of other USDA nutrition assistance programs, particularly the Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the National School Lunch and School Breakfast programs. Child and Adult Care Food Program makes practical recommendations that would bring CACFP meals and snacks into alignment with current dietary guidance. The book will serve as a vital resource for federal and state public health officials, care providers working in child and adult day care facilities, WIC agencies, officials working with the National School Lunch and School Breakfast programs, and other organizations serving at-risk populations.

More than 16 million children in the United States live in food-insecure households where they are unable to obtain enough food to meet their needs. At the same time, a growing number of children are overweight or obese. Because of these challenges, improving child nutrition has emerged as one of the nation's most urgent public health needs. The Child and Adult Care Food Program (CACFP), a U.S. Department of Agriculture (USDA) food program, served about 3.3 million children in 2011, as well as more than 124,000 adults who require daily supervision or assistance. Since many children rely on CACFP for the majority of their daily food, the quality of foods provided has the potential to greatly improve the health of the children's diets. The USDA asked the IOM to review and recommend improvements, as necessary, to the CACFP meal requirements in order to keep them aligned with other federally funded food assistance programs and with the Dietary Guidelines for Americans. The 2011 IOM report, Child and Adult Care Food Program Aligning Dietary Guidance for All, reviewed the program in detail and provided recommendations for improvement. In February 2012, at the request of the USDA, the IOM conducted an additional workshop to examine research methods and approaches that could be used to design and conduct a nationally representative study assessing children's dietary intake and participation rates in child care facilities, including CACFP-sponsored child care centers and homes. Research Methods to Assess Dietary Intake and Program Participation in Child Day Care: Application to the Child and Adult Care Food Program Workshop Summary is the report that summarizes the workshop.