1

IssueBRIEF

Purpose

The purpose of this issue

brief is to describe the types 

of foods that participants 

consumed as part of 

congregate and homedelivered meals and examine 

differences between 

participants and 

nonparticipants in foods 

consumed over 24 hours.

January 2019

MATHEMATICA-MPR.COM

By Elizabeth Gearan and Katherine Niland, Mathematica Policy Research

Older Americans Act Title III-C Nutrition 

Services Program: 

Examining the Types of Foods Older 

Adults Consumed from Program Meals 

and Over 24 Hours

BACKGROUND

For older adults, adequate nutrition is essential for maintaining cognitive and physical 

functions, preventing and managing chronic diseases, and sustaining health and a good quality 

of life (Reppas et al. n.d.). The Administration on Aging (AoA), within the Administration 

for Community Living of the U.S. Department of Health and Human Services, administers 

the Older Americans Act (OAA) Title III-C Nutrition Services Program (NSP). The 

purposes of the NSP are to (1) reduce hunger and food insecurity; (2) promote socialization 

of older individuals; and (3) promote the health and well-being of older individuals by helping 

them access services that encourage proper nutrition, prevent disease, and promote health.

The program provides meals, nutrition education, nutrition risk screening, and nutrition 

counseling to older adults. Meals and services are provided in congregate meal sites located 

in a variety of settings, including community senior centers, senior cafes, schools, churches, 

farmers markets, and other community settings. In addition, the NSP provides homedelivered meals and services to homebound older adults. Congregate and home-delivered 

meals must adhere to the current Dietary Guidelines for Americans and provide a minimum of 

one-third of the Dietary Reference Intakes (Administration for Community Living 2017). 

Previous research has shown that the meals provided through the NSP make substantial 

contributions to older adults’ diets (Mabli et al. 2017). On average, older adults who 

participated in the NSP obtained about 40 percent of their daily intakes of calories from 

program meals, as well as 35 to 47 percent of daily intakes of nutrients from program 

meals. In addition, the program had positive effects on the overall quality of participants’ 

diets, particularly among congregate meal participants. Despite these positive findings, 

participants’ diets (like the diets of most Americans) were not fully consistent with the

Dietary Guidelines for Americans recommendations for a healthy diet (Mabli et al. 2017). 

The Healthy Eating Index-2010 was used to measure the overall quality of participants’ 

diets by assessing conformance to key recommendations of the 2010 Dietary Guidelines 

for Americans (U.S. Department of Agriculture [USDA] and U.S. Department of Health 

and Human Services 2010). Participants’ diets were very consistent with the Dietary 

Guidelines for Americans recommendations for fruits, vegetables, and dairy, but at the 

same time, they exceeded recommended limits for sodium and empty calories (that 

provide little or no nutritional benefit). 

PRINCETON, NJ - ANN ARBOR, MI - CAMBRIDGE, MA - CHICAGO, IL - OAKLAND, CA - SEATTLE, WA 

TUCSON, AZ - WASHINGTON, DC - WOODLAWN, MD
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Box 1. Food groups 

examined in the analysis

Milk and dairy:

Milk, cheese, and yogurt

Fruits: 

Fresh, canned, frozen, or 

dried fruit, or 100% fruit 

juice

Vegetables:

Raw or cooked vegetables

Protein foods: 

Meat, poultry, seafood, 

and eggs

Mixed dishes:

Meat, vegetable, and/or 

grain mixtures, including 

pasta, sandwiches, entree 

salads, and soups

Grains: 

Pasta, rice, breads, rolls, 

tortillas, and cereals

Snacks and sweets: 

Bakery products, crackers, 

chips, pretzels, crackers, 

candy, and ice cream

Beverages other than 

milk and 100% juice:

Coffee and tea, sweetened 

or diet soft drinks, water, 

sports drinks, and 

alcoholic beverages 

Added fats, oils, 

condiments, and sauces: 

Butter, mayonnaise, salad 

dressings, ketchup, 

mustard, gravy, and 

tomato-based sauces

This issue brief expands on the prior 

analysis that assessed the quality of 

participants’ diets by examining the types 

of foods that participants included their 

diets. Specifically, it describes the types of 

foods that participants consumed as part of 

congregate and home-delivered meals and 

examines differences between participants 

and nonparticipants in foods consumed 

over 24 hours. The findings we present 

here can be helpful for targeting nutrition 

education efforts with participants and for 

the program staff who plan congregate and 

home-delivered meals. 

METHODS

The data used in the analysis were collected as 

part of the Title III-C NSP Evaluation, which 

Mathematica Policy Research conducted under 

contract to the AoA. The evaluation consisted of a 

process evaluation of program administration and 

service delivery (Mabli et al. 2015), a program cost 

analysis (Ziegler et al. 2015), and an evaluation 

of the effect of the program on participants’ 

outcomes, including food security, socialization, 

and diet quality (Mabli et al. 2017). To estimate 

the effect of receiving a congregate meal or 

home-delivered meal on these outcomes, the study 

team compared outcomes for participants and a 

matched comparison group of program-eligible 

nonparticipants. The purpose of the matched 

comparison group of eligible nonparticipants was 

to represent what would happen to participants in 

the absence of the program. In constructing the 

matched comparison groups for congregate meal 

participants and home-delivered meal participants, 

the study team used statistical methods to control 

for differences in the characteristics of participants 

and their respective group of nonparticipants 

that could affect both outcomes and program 

participation decisions.

Trained interviewers conducted 24-hour 

dietary recalls with both participants and 

nonparticipants. Interviewers used the Automated 

Self-Administered 24-hour hour dietary recall 

system (National Cancer Institute 2014) to collect 

detailed information about all foods and beverages 

consumed during a midnight-to-midnight recall 

period, including where each item was obtained 

(for example, from a store, restaurant, congregate 

meal site, or home-delivered meal). 

To examine the types of foods older adults 

consumed, the study team classified foods 

reported in the dietary recalls into a set of major 

and minor food groups. The food groups were 

based on those USDA developed for analyzing 

dietary recall data collected in What We Eat in 

America, the dietary interview component of the 

National Health and Nutrition Examination 

Survey (USDA, Agricultural Research Service 

2016). Each food was assigned to one of nine 

major food groups—Box 1 lists the name of 

each major food group and examples of foods 

included in each group. Foods in each major food 

group were then assigned to subgroups based on 

specific characteristics of the food. For example, 

subgroups for the milk and dairy group include 

fluid milk, cheese, and yogurt, with additional 

subgroups for fluid milk based on fat content 

(nonfat, low-fat, reduced-fat, or whole). Foods 

that included more than one component (for 

example, sandwiches, entree salads, mixed dishes 

with pasta or rice) counted as a single food choice.

The study team conducted two analyses to 

examine older adults’ food consumption. 

1. Foods that congregate and home-delivered 

meal participants consumed as part of a 

program meal. This analysis counted all 

foods consumed from a program meal, 

regardless of when the foods were consumed. 

For example, if a congregate meal participant 

consumed most of the meal as lunch and 

then consumed a piece of fruit from the 

meal later in the day, all of these foods were 

counted in this analysis. The analysis sample 

included 468 congregate meal participants 

and 433 home-delivered meal participants. 

2. All foods consumed over 24 hours among 

program participants and the comparison 

groups of nonparticipants. This analysis 

counted all foods consumed over 24 hours, 

including foods that participants consumed 

as part of a program meal. The study team 

tested differences between each group 

of participants and nonparticipants for 

statistical significance at the 0.05 level. All 

estimates are presented as the percentage of 

older adults who consumed a food from the 

major food group or subgroup in any amount. 

The analysis sample included 468 congregate 

meal participants and 619 nonparticipants, 

and 433 home-delivered meal participants 

and 514 nonparticipants. 
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FINDINGS

Findings for each analysis are presented 

separately for congregate meal participants 

and nonparticipants and home-delivered meal 

participants and nonparticipants. 

CONGREGATE MEAL PROGRAM

Types of foods consumed from congregate 

meals

Figure 1 shows the percentage of congregate 

meal participants who consumed at least one 

food from each major food group as part of a 

program meal. Key findings for each major food 

group are summarized below. 

Milk and dairy. Just under half (46 percent) of 

congregate meal participants consumed milk 

and dairy as part of a program meal. Fluid milk 

was the most commonly consumed food in this 

group (45 percent). Congregate meal participants 

consumed reduced-fat (2%) milk most often as 

part of a program meal (26 percent), followed 

by low-fat (1%) milk (14 percent).

Fruit and 100% juice. More than half (53 

percent) of congregate meal participants 

consumed fruit or 100% juice as part of a 

program meal. Congregate meal participants 

consumed canned fruit and fresh fruit as 

part of a program meal more frequently than 

100% fruit juice (27 and 25 percent versus 6 

percent) (Figure 2). Fruit cocktail, pineapple, 

pears, peaches, and nectarines were the most 

commonly consumed canned fruits. Pineapples, 

pears, fruit salads, and apples were the most 

commonly consumed fresh fruits.

Vegetables. Three-quarters of congregate meal 

participants consumed a vegetable as part of a 

program meal. Congregate meal participants 

consumed cooked vegetables more frequently 

than raw vegetables (56 versus 30 percent) 

(Figure 2). Congregate meal participants 

consumed a variety of cooked vegetables from 

program meals and most frequently reported 

mashed potatoes and white potato mixtures; 

other vegetables and combinations (such as 

cauliflower, Brussel sprouts, cabbage, and squash; 

and combinations such as peas and carrots); dark 

FIGURE 1:

Types of foods congregate meal participants consumed as part of program meals

FIGURE 2:

Types of fruits and vegetables congregate meal participants consumed as part of program meals

Source: Administration on Aging Title III-C Nutrition Services Program 24-hour dietary recall (Day 1), 2015–2016, weighted data.

Note: Estimates are based on an unweighted sample size of 468 congregate meal participants.
4

green vegetables (such as spinach and broccoli); 

starchy vegetables (including green peas, lima 

beans, and corn). Lettuce and lettuce salads were 

the most commonly consumed raw vegetables, 

followed by mixed vegetable dishes (such as 

coleslaw and carrot salads). 

Mixed dishes and protein foods. Nearly 

three-quarters (70 percent) of congregate meal 

participants consumed mixed dishes as part of a 

program meal. Mixed dishes with meat or poultry, 

including entree salads and other mixtures of 

meat and vegetables (such as meatloaf, chicken 

or turkey with noodles and vegetables, beef stew, 

or Salisbury steak) were the most commonly 

consumed mixed dishes (28 percent), followed by 

sandwiches (21 percent), soups (13 percent), and 

grain-based mixed dishes including lasagna and 

spaghetti with tomato sauce (11 percent). More 

than one-third (36 percent) of congregate meal 

participants also consumed separate protein foods, 

including poultry, red meats, cured meats, and 

seafood, as part of a program meal.

Grains. Forty-one percent of congregate meal 

participants consumed a separate grain item as part 

of a program meal. Breads, rolls, and tortillas were 

the most commonly consumed grain items among 

congregate meal participants (28 percent). Other 

grain items were consumed less frequently (4 to 5 

percent) as part of a program meal and included 

rice and biscuits, muffins, and quick breads.

Snacks and sweets. Nearly half (47 percent) of 

congregate meal participants consumed snacks 

and sweets as part of a program meal. The 

most commonly consumed snacks and sweets 

obtained from program meals were cookies, 

brownies, cakes, and pies (16 to 17 percent). 

Beverages other than milk and 100% juice.

Two-thirds of congregate meal participants 

consumed a beverage other than milk or 100% 

juice as part of a program meal. Coffee and tea 

(45 percent) and plain water (31 percent) were 

most frequently reported. 

Added fats, oils, condiments, and sauces. 

About two-thirds (67 percent) of congregate 

meal participants consumed added fats, oils, 

condiments, and sauces as part of a program 

meal. Nearly half (46 percent) of congregate 

meal participants consumed added fats and oils 

such as salad dressing, vegetable oil, margarine, 

butter, mayonnaise and cream. 

Differences between congregate meal 

participants and nonparticipants in the type 

of foods consumed over 24 hours 

Figure 3 presents the percentages of congregate 

meal participants and nonparticipants who 

consumed at least one food from each major 

food group over 24 hours. Key findings on 

differences between congregate meal participants 

and nonparticipants are summarized below. 

FIGURE 3:

Differences in the types of foods congregate meal participants and nonparticipants

consumed over 24 hours

Source: Administration on Aging Title III-C Nutrition Services Program 24-hour dietary recall (Day 1), 2015–2016, weighted data.

Note: Estimates are based on an unweighted sample size of 468 congregate meal participants and 619 nonparticipants.

* Difference between participants and nonparticipants is significantly different from zero at the .05 level, two-tailed test.
5

Milk and dairy. Congregate meal participants 

were significantly more likely than nonparticipants 

to consume milk and dairy over 24 hours (77 

versus 62 percent). This difference was driven 

by more common consumption of fluid milk 

among congregate meal participants (71 versus 49 

percent). Congregate meal participants were more 

likely than nonparticipants to consume reducedfat or low-fat milk and were less likely to consume 

whole milk (Figure 4). 

Fruit and 100% juice. Congregate meal 

participants were significantly more likely than 

nonparticipants to consume fruit and 100% 

juice over 24 hours (87 versus 57 percent). This 

pattern of findings was observed for canned 

fruit, fresh fruit, and 100% fruit juice.

Vegetables. Over 24 hours, congregate meal 

participants were significantly more likely than 

nonparticipants to consume vegetables (88 versus 

57 percent). Congregate meal participants were 

more likely than nonparticipants to consume 

both cooked and raw vegetables over 24 hours (71 

versus 46 percent for cooked vegetables, and 40 

versus 22 percent for raw vegetable). 

Mixed dishes and protein foods. Congregate meal 

participants were more likely than nonparticipants 

to consume mixed dishes over 24 hours (87 versus 

79 percent). The difference in the percentages of 

congregate meal participants and nonparticipants 

who consumed protein foods (which include 

discrete servings of eggs, poultry, and meat) was not 

significant (70 versus 69 percent). 

Grains. Roughly 80 percent of congregate meal 

participants and nonparticipants consumed at 

least one separate grain item over 24 hours (83 

and 79 percent, respectively). The difference in 

the percentages of congregate meal participants 

and nonparticipants who consumed grains was 

not statistically significant.

Snacks and sweets. Over 24 hours, comparable 

proportions of congregate meal participants and 

nonparticipants consumed at least one snack or 

sweet (80 and 74 percent, respectively). Congregate 

meal participants were significantly more likely 

than nonparticipants to consume cookies and 

brownies (35 versus 20 percent) and cakes and pies 

(29 versus 12 percent) over 24 hours. 

Beverages other than milk and 100% juice. 

Nearly all congregate meal participants and 

nonparticipants consumed beverages other than 

milk and 100% juice over 24 hours. Congregate 

meal participants were significantly less likely 

than nonparticipants to consume such beverages, 

though the magnitude of the difference was small 

(98 versus 100 percent). This difference was driven 

largely by the significantly smaller percentages of 

participants who consumed sweetened beverages 

(including soft drinks and fruit drinks) (19 versus 

29 percent), diet beverages (5 percent versus 11 

percent), and alcoholic beverages (4 versus 9 

percent), relative to nonparticipants.

Added fats, oils, condiments, and sauces. 

More than three-quarters of congregate meal 

participants and nonparticipants consumed added 

FIGURE 4:

Differences in the types of milk congregate meal participants and nonparticipants

consumed over 24 hours

Source: Administration on Aging Title III-C Nutrition Services Program 24-hour dietary recall (Day 1), 2015–2016, weighted data.

Note: Estimates are based on an unweighted sample size of 468 congregate meal participants and 619 nonparticipants.

* Difference between participants and nonparticipants is significantly different from zero at the .05 level, two-tailed test.
6

fats, oils, condiments, and sauces over 24 hours 

(84 and 79 percent, respectively). The difference 

in the percentages of congregate meal participants 

and nonparticipants who consumed foods from 

this group was not statistically significant. 

HOME-DELIVERED MEAL PROGRAM

Types of foods consumed from homedelivered meals

Figure 5 shows the percentage of homedelivered participants who consumed at least one 

food from each major food group as part of a 

program meal. Key findings for each major food 

group are summarized below. 

Milk and dairy. Just under half (42 percent) of 

home-delivered meal participants consumed 

milk and dairy as part of a program meal. Fluid 

milk was the most commonly consumed food in 

this group (39 percent). Reduced-fat milk was 

reported most often (18 percent), followed by 

low-fat milk (17 percent).

Fruit and 100% juice. About half (51 percent) of 

home-delivered meal participants consumed fruit 

or 100% juice as part of a program meal. Canned 

fruit was consumed most frequently (27 percent), 

followed by fresh fruit (20 percent) (Figure 6). 

Fruit cocktail, pineapple, pears, peaches, and 

nectarines were the most commonly consumed 

canned fruits. Citrus fruit, apples, fruit salads, 

pineapples, and pears were the most commonly 

consumed fresh fruits. Eight percent of homedelivered meal participants consumed 100% fruit 

juice as part of a program meal.

Vegetables. Most home delivered meal participants 

(81 percent) consumed a vegetable as part of a 

program meal. Home-delivered meal participants 

consumed cooked vegetables more frequently than 

raw vegetables (73 versus 16 percent) (Figure 6). 

The most commonly reported cooked vegetables 

included other vegetables and combinations (such 

as cauliflower, Brussel sprouts, cabbage, and squash; 

and combinations such as peas and carrots); mashed 

potatoes and white potato mixtures; string beans; 

FIGURE 5:

Types of foods home-delivered meal participants consumed as part of program meals

FIGURE 6:

Types of fruits and vegetables home-delivered meal participants consumed as part of 

program meals

Source: Administration on Aging Title III-C Nutrition Services Program 24-hour dietary recall (Day 1), 2015–2016, weighted data.

Note: Estimates are based on an unweighted sample size of 433 home-delivered meal participants.
7

and dark green vegetables (such as spinach and 

broccoli). Mixed vegetable dishes (such as coleslaw 

and carrot salads) and lettuce and lettuce salads 

were the most commonly consumed raw vegetables 

among home-delivered meal participants. 

Mixed dishes and protein foods. About half (51 

percent) of home-delivered meal participants 

consumed mixed dishes as part of a program meal. 

Mixed dishes with meat or poultry, including entree 

salads and other mixtures of meat and vegetables 

(such as meatloaf, chicken or turkey with noodles 

and vegetables, chili with meat, or Salisbury steak) 

were the most commonly consumed mixed dishes 

(16 percent), followed by grain-based mixed dishes 

including spaghetti and tomato sauce and lasagna 

(14 percent), sandwiches (12 percent) and soups 

(8 percent). Nearly half (49 percent) of homedelivered meal participants also consumed separate 

protein foods, including poultry, red meats, cured 

meats, and seafood, as part of a program meal.

Grains. Just under 40 percent of home-delivered 

meal participants consumed a separate grain 

item as part of a program meal. Breads, rolls, 

and tortillas were the most commonly consumed 

grain items (23 percent). Other grain items were 

consumed by home-delivered meal participants 

less frequently as part of program meals and 

included rice (10 percent) and biscuits, muffins, 

and quick breads (6 percent).

Snacks and sweets. More than one-quarter (28 

percent) of home-delivered meal participants 

consumed snacks and sweets as part of a 

program meal. The most commonly consumed 

foods in this group were cakes and pies (9 

percent), cookies and brownies (8 percent), and 

pudding (7 percent). 

Beverages other than milk and 100% juice. Only 

7 percent of home-delivered meal participants 

consumed beverages other than milk and 100% 

juice as part of a program meal. This indicates 

that home-delivered meals do not typically 

include these beverages. 

Added fats, oils, condiments, and sauces. 

One-third of home-delivered meal participants 

consumed added fats, oils, condiments, and 

sauces as part of a program meal. About onequarter (24 percent) of home-delivered meal 

participants consumed added fats and oils such 

as salad dressing, vegetable oil, margarine, butter, 

mayonnaise and cream. 

Differences between home-delivered meal 

participants and nonparticipants in the type 

of foods consumed over 24 hours 

Figure 7 presents the percentages of homedelivered meal participants and nonparticipants 

who consumed at least one food from each 

major food group over 24 hours. Key findings 

FIGURE 7:

Differences in the types of foods home-delivered meal participants and nonparticipants 

consumed over 24 hours

Source: Administration on Aging Title III-C Nutrition Services Program 24-hour dietary recall (Day 1), 2015–2016, weighted data.

Note: Estimates are based on an unweighted sample size of 433 home-delivered meal participants and 514 nonparticipants. 

* Difference between participants and nonparticipants is significantly different from zero at the .05 level, two-tailed test.
8

on differences between home-delivered meal 

participants and nonparticipants are 

summarized below. 

Milk and dairy. Home-delivered meal 

participants were significantly more likely 

than nonparticipants to consume milk and 

dairy over 24 hours (79 versus 63 percent). 

Consumption of fluid milk was more common 

among home-delivered meal participants than 

nonparticipants (68 versus 51 percent). Homedelivered meal participants were more likely 

than nonparticipants to consume reduced-fat 

or low-fat milk and were less likely to consume 

whole milk (Figure 8). 

Fruit and 100% juice. Home-delivered meal 

participants were significantly more likely than 

nonparticipants to consume fruit and 100% juice 

over 24 hours (78 versus 65 percent). This pattern 

of findings was observed for canned fruit and 

100% juice, but the difference between homedelivered meal participants and nonparticipants 

was not statistically significant for fresh fruit. 

Vegetables. Over 24 hours, home-delivered 

meal participants were significantly more likely 

than nonparticipants to consume vegetables 

(91 versus 62 percent). This difference was 

driven largely by the significantly higher 

percentage of home-delivered meal participants 

who consumed cooked vegetables relative to 

nonparticipants (81 percent versus 50 percent). 

Mixed dishes and protein foods. Roughly threequarters of home-delivered meal participants 

and nonparticipants consumed mixed dishes 

over 24 hours (78 percent for both groups) and 

comparable proportions also consumed protein 

foods (which include discrete servings of eggs, 

poultry, and meat) (75 and 70 percent). The 

differences in the percentages of participants and 

nonparticipants who consumed mixed dishes or 

protein foods were not statistically significant. 

Grains. More than three-quarters of homedelivered meal participants and nonparticipants 

consumed at least one separate grain item 

over 24 hours. Home-delivered meal 

participants were significantly more likely than 

nonparticipants to consume separate grain items 

(85 versus 79 percent). 

Snacks and sweets. Over 24 hours, comparable 

proportions of home-delivered meal participants 

and nonparticipants consumed at least one snack 

or sweet (75 and 72 percent, respectively). Homedelivered meal participants were significantly less 

likely than nonparticipants to consume ice cream 

and frozen dairy desserts (8 versus 15 percent). 

Beverages other than milk and 100% juice. 

Nearly all home-delivered meal participants 

and nonparticipants consumed beverages other 

than milk and 100% juice over 24 hours (98 and 

99 percent, respectively). The difference in the 

percentages of home-delivered meal participants 

FIGURE 8:

Differences in the types of milk home-delivered meal participants and nonparticipants

consumed over 24 hours

Source: Administration on Aging Title III-C Nutrition Services Program 24-hour dietary recall (Day 1), 2015–2016, weighted data.

Note: Estimates are based on an unweighted sample size of 433 home-delivered meal participants and 514 nonparticipants. 

* Difference between participants and nonparticipants is significantly different from zero at the .05 level, two-tailed test
9

and nonparticipants who consumed foods from 

this group was not statistically significant.

Added fats, oils, condiments, and sauces. More 

than three-quarters of home-delivered meal 

participants and nonparticipants consumed 

added fats, oils, condiments, and sauces over 

24 hours (79 and 83 percent, respectively). 

The difference in the percentages of homedelivered meal participants and nonparticipants 

who consumed foods from this group was not 

statistically significant. 

DISCUSSION

Congregate and home-delivered meal 

participants consumed a variety of foods 

from program meals, and there were several 

significant differences in foods consumed 

over 24 hours by program participants and 

nonparticipants. Congregate and homedelivered meals were an important source of 

fruits and vegetables in participants’ diets. 

Over 24 hours, both congregate and homedelivered meal participants were more likely 

than nonparticipants to consume fruits 

and vegetables, as well as milk and dairy. In 

addition, the findings indicate that more than 

half of participants who consumed any fruits, 

vegetables, or milk and dairy over 24 hours 

obtained these items as part of a program meal. 

Daily consumption of these foods is consistent 

with the Dietary Guidelines for Americans. 

Although the differences between participants 

and nonparticipants in the proportions who 

consumed snacks and sweets or added fats, oils, 

condiments, and sauces were not statistically 

significant, large proportions of older adults 

consumed these foods over 24 hours. The 

findings indicate that most congregate meal 

participants who consumed any added fats, oils, 

condiments, or sauces over 24 hours obtained 

them from program meals, whereas most 

home-delivered meal participants obtained these 

foods outside of program meals. The Dietary 

Guidelines for Americans recommend limiting 

consumption of these types of foods because 

they can contribute to excessive intakes of 

calories, saturated fat, sodium, and added sugars. 

This analysis did not examine the amounts of 

foods consumed, yet it does provide important 

insight into the types of foods participants 

consumed from congregate and home-delivered 

meals and differences between participants 

and nonparticipants in the types of foods 

they consumed over 24 hours. Findings 

from these analyses can help programs tailor 

nutrition education efforts with participants 

to improve their daily food choices and better 

align their diets with the Dietary Guidelines 

for Americans. Programs can also use this 

information to modify the types of foods 

offered in congregate and home-delivered 

meals to ensure they are consistent with the 

Dietary Guidelines for Americans. For example, 

reduced-fat (2%) milk was the most common 

type of milk that congregate and home-delivered 

meal participants consumed as part of a program 

meal and over 24 hours. The Dietary Guidelines 

for Americans recommend consuming nonfat or 

low-fat (1%) dairy to limit intakes of saturated 

fat, so educating participants and programs 

on milk choices would be useful. Encouraging 

congregate meal sites to limit snacks and 

sweets and added fats, oils, condiments, and 

sauces could also help improve the quality of 

participants’ diets. 

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Washington, DC: ACL, 2017. Available at https://

www.acl.gov/programs/health-wellness/nutritionservices. Accessed July 9, 2018. 

Mabli, James, Elizabeth Gearan, Rhoda Cohen, 

Katherine Niland, Nicholas Redel, Erin Panzarella, 

and Barbara Carlson. “Evaluation of the Effect 

of the Older Americans Act Title III-C Nutrition 

Services Program on Participants’ Food Security, 

Socialization, and Diet Quality.” Washington, DC: 

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Administration for Community Living, April 1, 

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files/programs/2017-07/AoA_outcomesevaluation_

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Mabli, James, Nicholas Redel, Rhoda Cohen, 

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30, 2015. Available at https://www.acl.gov/sites/

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System.” 2014. Available at http://epi.grants.cancer.

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Reppas, S., L. Rosenzweig, and H. Silver. “Older 

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and Aging, Florida International University, n.d. 

Available at http://nutrition.fiu.edu/OANP_Toolkit/

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Categories 2013-2014.” 2016. Available at www.ars.

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U.S. Department of Health and Human Services 

(DHHS), Administration on Aging. “Dietary 

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Providers Guide.” Washington, DC: DHHS, 2005. 

Available at https://health.gov/dietaryguidelines/

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Accessed July 9, 2018.

Ziegler, Jessica, Nicholas Redel, Linda Rosenberg, 

and Barbara Carlson. “Older Americans Act 

Nutrition Programs Evaluation: Meal Cost 

Analysis.” Washington, DC: U.S. Department 

of Health and Human Services, Administration 

for Community Living, September 25, 2015. 

Available at https://www.acl.gov/sites/default/files/

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