H9_Food Model Booklet

H9. Food Model Booklet

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OMB Number: 0584-XXXX
Expiration Date: XX/XX/20XX

Food Model Booklet (English)
Note to reviewers: Respondents use the Food Model Booklet during the Parent Interview for In-Care
Day and Parent Interview for ASA24 Only (Appendices H3/H4 and H11/H12, respectively). The
estimated burden reported in the burden disclosure statement on this document is not in addition to the
burden of the Parent Interviews. As noted in cell C111 underneath the burden table (Appendix N), no
separate burden is associated with the Food Model Booklet.

The Food and Nutrition Service (FNS) is collecting this information to understand the nutritional quality of CACFP meals
and snacks, the cost to produce them, and dietary intakes and activity levels of CACFP participants. This is a voluntary
collection and FNS will use the information to examine CACFP operations. The collection does request personally
identifiable information under the Privacy Act of 1974. Responses will be kept private to the extent provided by law and FNS
regulations. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0584-xxxx. The time required to complete this information collection is estimated to
average 0.5 hours (30 minutes) per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this
burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 1320 Braddock Place, 5th
Floor, Alexandria, VA 22314. ATTN: PRA (0584-xxxx). Do not return the completed form to this address.

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Description:
The food model booklet was developed by the Agricultural Research Service of the United States
Department of Agriculture for use in the National Health and Nutrition Examination Survey. 1 It
is used during the dietary phone follow up interview.
The booklet includes a list of frequently forgotten foods, eating occasions, and pictures of plates,
mugs, glasses, bowls, mounds, wedges, grids, circles, a shape chart, and chicken chart to
estimate portion sizes of foods consumed.

1

Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition
Examination Survey. 2002+ Measuring Guides; Model Name: Food Model Booklet.
https://www.cdc.gov/nchs/nhanes/measuring_guides_dri/2002/fmb.htm#:~:text=%20%20%20%20Product%20Infor
mation%20%20,%20Food%20Model%20Booklet%20%20%20USDA%20

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