The 18-Month Impact of Special Supplemental Nutrition Program for Women, Infants, and Children Food Package Revisions on Diets of Recipient Families

Abstract

Background Beginning in 2009, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) revised its food packages and provided more whole grains, fruits, and vegetables, and fewer foods with high saturated fat content. However, knowledge of the impact of this policy shift on the diets of WIC participants remains limited. Purpose To examine the longer-term impact of the 2009 WIC food package change on nutrient and food group intake and overall diet quality among African American and Hispanic WIC child participants and their mothers/caregivers. Methods In this natural experiment, 24-hour dietary recalls were collected in the summer of 2009, immediately before WIC food package revisions occurred in Chicago, Illinois, and at 18 months following the food package change (winter/spring 2011). Generalized estimating equation models were used to compare dietary intake at these two time points. Data were analyzed in July 2013. Results Eighteen months following the WIC food package revisions, significant decreases in total fat (p=0.002) and saturated fat (p=0.0004) and increases in dietary fiber (p=0.03), and overall diet quality (p=0.02) were observed among Hispanic children only. No significant changes in nutrient intake or diet quality were observed for any other group. The prevalence of reduced-fat milk intake significantly increased for African American and Hispanic children, whereas the prevalence of whole milk intake significantly decreased for all groups. Conclusions Positive dietary changes were observed at 18-months post-policy implementation, with the effects most pronounced among Hispanic children.

Revised WIC Food Package and Children’s Diet Quality

“…23 The WIC package change also included a shift toward offering lower fat milk, and previous studies demonstrated a favorable effect on children's saturated fat intake that may be attributable to this change. 10,[12][13][14]23 Dairy intake was high at baseline, and did not go down with the mandated shift in the kind of milk offered. Of note, Fatty Acids scores increased more for WIC participants than for nonparticipants, presumably due to substitutions away from high-fat milk.…”

“…Using rigorous methods of dietary assessment and a nationally representative sample from NHANES, our study results are consistent with earlier findings from regional studies. 4,10,[12][13][14] It has been shown that WIC participation is associated with better nutrient intake among preschool-aged children compared with their peers who are also from low-income households. [20][21][22] In this analysis, children in WIC households between 2003 and 2008 had a diet quality score that was higher than that of their peers by >2 points.…”

“…13 Eighteen months after the policy change, statistically significant improvements in diet (decreased total and saturated fat, increased dietary fiber, and overall dietary quality) was seen but only among Hispanic children. 14 However, there have been no nationally representative studies examining the impact of this policy on the diets of low-income children. The National Health and Nutrition Examination Survey (NHANES) continuously collects household information and detailed 24-hour diet recalls on children and adults in the United States.…”

Predictors of Obesity in a Cohort of Children Enrolled in WIC as Infants and Retained to 3 Years of Age

“…The New York State (NYS) WIC Program has been actively and progressively promoting these and other healthy living activities since 1997 [8,9], and the NYS WIC program was the first in the nation to implement the required USDA food package changes in January 2009. Shortly after implementation of the revised WIC food package, modest changes in food consumption and purchasing patterns among WIC participants in NYS [10], and elsewhere around the country [11][12][13][14][15][16] were observed in cross-sectional studies. The current longitudinal study examines breastfeeding and other food consumption patterns in relation to the prevalence of obesity at 3 years of age in a cohort of children enrolled in the NYS WIC Program as infants in 2008-2009.…”

Sugar-Sweetened Beverages and Children's Health

“…Families participating in federal nutrition programs nationwide were more likely to have unhealthy grocery store purchases than were families who did not participate; the article estimates that the Supplemental Nutrition Assistance Program (SNAP) paid at least $1.7 billion to $2.1 billion annually for SSBs purchased in grocery stores (3). Public health policy has been looking into how to change these programs to give more emphasis to healthier options (4,79), and this remains a promising area for intervention.…”