Comparison of Eat Smart Standard with Institute of Medicine Recommendations
INTERMEDIATE
(More Healthful than Minimum)
ADVANCED
(More Healthful than Intermediate)
BREAKFAST:
BREAKFAST:
B.1.I. 
At least 50% of cereals offered contain no more
than 35% of calories from sugar (less than 9
grams of sugar per 100 calories) per serving. *
B.1.A. 
At least 50% of cereals offered contain no more than
35% of calories from sugar (less than 9 grams of
sugar per 100 calories) per serving* .
INSTITUTE OF MEDICINE
RECOMMENDATIONS
Ready to eat and hot cereals must contain less than or
equal to 21.2 g. of sucrose or other sugars per 100 g. dry
cereal (less than or equal to 6 g. sugar per one ounce of
dry cereal, as specified in the WIC food package).
B.2.A. 
At least 50% of cereals offered contain at least 1
gram of fiber per serving.
B.3.I. 
Sweet breakfast items, such as breakfast
pastries, donuts, poptarts, toaster pastries,
sweet rolls, muffins, cereal bars and other sweet
breads are served no more than one time per
week or not at all
B.3.A. 
Sweet breakfast items, such as breakfast pastries,
donuts, poptarts, toaster pastries, sweet rolls,
muffins, cereal bars and other sweet breads are
served no more than two times per month or not at
all.
Baked or fried grain products that are high in solid fats and
added sugars are limited to one serving per week across all
eating occasions. These include pancakes and waffles with
syrup, muffins and quick breads, sweet rolls, croissants,
toaster pastries, donuts, flour tortillas, granola/cereal bars,
cookies, brownies, cakes and pies.
B.4.I. 
A whole grain food is served at least one
breakfast per week.
B.4.A. 
A whole grain food is served at least three breakfasts
per week.
At least half of grains/breads must be whole grain rich.
Encourages use of 100% whole grain foods.
B.5.I. 
Fresh, canned (packed in juice), dried or frozen
fruits or vegetables (excluding juice) are served
at least three breakfasts per week.
B.5.A. 
 Fresh, canned (packed in juice), dried or frozen
fruits or vegetables (excluding juice) are served
for breakfast every day.
 Fresh fruits or vegetables are served at least one
breakfast per week.
Fruit or non-starchy vegetable served every day. Starchy
vegetables include corn, green peas, lima beans, and
potatoes. No specific requirement for “fresh.”
B.6.I. 
Menus include low sugar or “lite” syrups and
jellies with no artificial sweeteners.
B.6.A. 
Fresh fruit, applesauce and other fruit toppings
(unsweetened) are used to sweeten breakfast foods
in place of syrups and added sugars.
Syrups, jams and jellies are considered added sugars and
limited to one time per week across all eating occasions.
B.7.I. 
Only Low fat (1% or ½%) or skim (nonfat) milk is
served, flavored or unflavored.
B.7.A. 
Only low fat (1% or ½%) or skim (nonfat) milk is
served, flavored or unflavored.
Skim or low-fat (no higher than 1%). Flavored milks only
for children in after-school programs.
Adds requirement for meat/meat alternate at breakfast at
least three days per week. On days meat/meat alternate is
not served, serve an additional serving of bread/grains.
*See Definitions at the end of the document for calculation.
Jan 10 2013
Missouri Department of Health and Senior Services
Page 1 of 4
Comparison of Eat Smart Standard with Institute of Medicine Recommendations
INTERMEDIATE
(More Healthful than Minimum)
ADVANCED
(More Healthful than Intermediate)
LUNCH/SUPPER:
LUNCH/SUPPER:
INSTITUTE OF MEDICINE
RECOMMENDATIONS
L.1.I. 
Processed breaded meats such as fish sticks,
chicken nuggets, chicken patties, pork patties,
etc. are served no more than two times per
week, unless items served contain no more than
12 grams of total fat per 1½ oz meat/meat
alternate serving (or no more than 16 grams of
total fat per 2 oz serving).
L.1.A. 
Processed breaded meats such as fish sticks, chicken
nuggets, chicken patties, pork patties, etc. are served
no more than one time per week unless items served
contain no more than 12 grams of total fat per 1½ oz
meat/meat alternate serving (or no more than 16
grams of total fat per 2 oz serving).
L.2.I. 
Hot dogs, corndogs, bologna, pepperoni, Polish
sausage, Spam, Treet, liverwurst, smoked
sausage, salami, summer sausage, and other
luncheon meats+ are served no more than once
every two weeks.
L.2.A. 
Hot dogs, corndogs, bologna, pepperoni, Polish
sausage, Spam, Treet, liverwurst, smoked sausage,
salami, summer sausage and other luncheon meats+
are served no more than once per month.
See above
L.3.I. 
A whole grain food is served at least one lunch
per week.
L.3.A. 
A whole grain food is served at least three lunches
per week.
Half of grains/breads are whole grain rich.
L.4.I. 
Fresh (raw) fruits or vegetables are served one or
more times per week.
L.4.A. 
Fresh (raw) fruits or vegetables are served three or
more times per week.
No specific mention of “fresh” fruits/vegetables. One
fruit and two vegetables required at lunch/supper – dark
green vegetables at least twice per week, orange
vegetables at least twice per week, legumes at least once
per week, and starchy vegetables no more than twice per
week.
L.5.I. 
Juice is not served as one of the required
fruit/vegetable servings at lunch or supper.
L.5.A. 
Juice is not served as one of the required
fruit/vegetable servings at lunch or supper.
Fruit, rather than juice, is to be served at most meals.
100% fruit juice allowed only once per day.
L.6.A. 
Only reduced fat and/or fat free salad dressings are
served.
Moderate amounts of healthy fats provided in salad
dressings, vegetable oil, soft margarine, mayonnaise, etc.
are to be included daily.
L.7.A. 
Only low fat (1% or ½ %) or skim (nonfat) milk is
served, flavored or unflavored.
Skim or low-fat (no higher than 1%). Flavored milks only
for children in after-school programs.
L.7.I. 
Only low fat (1% or ½ %) or skim (nonfat) milk is
served, flavored or unflavored.
Limit highly processed meat, poultry, fish (including
highly salted and breaded fried products) to one time per
week across all eating occasions.
+
Luncheon meats include hot dogs, Frankfurters, bologna, pepperoni, Polish sausage, salami, Summer sausage, liverwurst and other pressed type meats. This does
not include deli meats, which include lean ham, turkey, roast beef and chicken breast meats that are sliced for sandwiches and salads and are at least 95% fat free.
Jan 10 2013
Missouri Department of Health and Senior Services
Page 2 of 4
Comparison of Eat Smart Standard with Institute of Medicine Recommendations
INTERMEDIATE
(More Healthful than Minimum)
OVERALL MEAL PATTERN
ADVANCED
(More Healthful than Intermediate)
OVERALL MEAL PATTERN
P.1.I. 
Dark green or orange fruits or vegetables are
served at least two times per week.
P.1.A. 
Dark green or orange fruits or vegetables are served
at least three times per week.
P.2.I. 
The menu is at least a 3 week cycle. Different
vegetables, fruits, and entrees are used so there
is little repetition in the cycle.
P.2.A. 
 The menu is at least a 3 week cycle Different
vegetables, fruits, and entrees are used so there is
little repetition in the cycle.
 Foods served at a meal include a variety of
textures, shapes, temperatures, sizes and colors.
 Menus reflect the ethnicity and culture of all
children in the center.
P.3.I. 
100% fruit juice is served no more than once per
day or not at all.
P.3.A. 
100% fruit juice is served no more than three times
per week, or not at all.
P.4.I. 
No foods containing artificial sweeteners are
served.
P.4.A. 
No foods containing artificial sweeteners are served.
SNACKS:
INSTITUTE OF MEDICINE
RECOMMENDATIONS
Lunch: Dark green vegetables are served two times per
week, and orange vegetables are served two times per
week.
Fruit, rather than juice, is to be served at most meals.
100% fruit juice allowed only once per day.
SNACKS:
S.1.I. 
Sweet snacks, such as sweet pastry items,
cookies, cakes, pie, quick breads, cereal bars,
etc., are served no more than one time per week
or not at all.
S.1.A. 
Sweet snacks, such as sweet pastry items, cookies,
cakes, pie, quick breads, cereal bars, etc., are served
no more than one time every two weeks, or not at
all.
Baked or fried grain products that are high in solid fats
and added sugars are limited to one serving per week
across all eating occasions. These include pancakes and
waffles with syrup, muffins and quick breads, sweet rolls,
croissants, toaster pastries, donuts, flour tortillas,
granola/cereal bars, cookies, brownies, cakes and pies.
S.2.I. 
One or more snacks per week contain a
meat/meat alternate.
S.2.A. 
Two or more snacks per week contain a meat/meat
alternate.
Lean meat or meat alternate required two snacks per
week.
S.3.I. 
At least one fresh, frozen, canned or dried fruit
or vegetable (excluding juice) is served two times
a week or more often.
S.3.A. 
At least one fresh, frozen, canned or dried fruit or
vegetable (excluding juice) is served 3 times a week
or more often.
Two fruit servings required each week plus one orange
vegetable and one non-starchy vegetable per week.
Two servings of grain/breads required each week. At least
half of all grains provided must be whole grain rich.
Jan 10 2013
Missouri Department of Health and Senior Services
Page 3 of 4
Comparison of Eat Smart Standard with Institute of Medicine Recommendations
S.4.I. 
If milk is served, low fat (1% or ½%) or skim milk
is provided, flavored or unflavored.
Jan 10 2013
S.4.A. 
If milk is served, low fat (1% or ½%) or skim milk is
provided, flavored or unflavored.
Missouri Department of Health and Senior Services
Skim or low-fat (no higher than 1%). Flavored milks only
for children in after-school programs.
Page 4 of 4