The Impact of the 2009 Special Supplemental Nutrition Program for Women, Infants, and Children Food Package Revisions on Participants: A Systematic Review

Abstract

For the first time since 1980, the US Department of Agriculture Food and Nutrition Service Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package policies were revised in 2009 to meet the Institute of Medicine's nutrition recommendations. These changes included increases in fruits, vegetables, whole grains, and low-fat dairy to improve nutrition and health of WIC participants. Our systematic review of the literature assessed the influence that the 2009 WIC food package revisions have had on dietary intake, healthy food and beverage availability, and breastfeeding participation. The systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Four electronic databases were searched between April 1 and 30, 2014, for peer-reviewed research. Two reviewers screened the articles, extracted the data, and established inter-rater reliability by discussing and resolving discrepancies. Twenty articles were included that met our inclusion criteria. Nine of the studies analyzed changes in dietary intake, eight examined changes in healthy food and beverage availability, and three evaluated breastfeeding participation exclusively. The review demonstrated an improved dietary intake and an increase in the availability of healthier foods and beverages in authorized WIC stores. The revised food package was also associated with improved dietary intake of WIC participants. Mixed results were demonstrated in regard to improved breastfeeding outcomes. Further research is needed to assess the influence of WIC 2009 food package revisions on breastfeeding outcomes and to make conclusions about broad nutrition-related implications.

Revised WIC Food Package and Children’s Diet Quality

“…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.…”

“…[4][5][6][7][8][9] There has also been evidence regarding positive changes in dietary intake according to regionally based data. 4 Telephone surveys with WIC participants in California 10 and administrative records from millions of WIC visits in the state of New York 11 showed increases in reported consumption of whole-grain foods and decreases in consumption of whole milk, with increased consumption of fruits and vegetables. This shift from whole milk to lower fat milk, with a concomitant decrease in consumption of saturated fats, was also reported in low-income, preschool-aged children in New Mexico.…”

Longitudinal Associations Between Observed and Perceived Neighborhood Food Availability and Body Mass Index in a Multiethnic Urban Sample

“…The success of strategies to improve the neighborhood food environment is likely to be enhanced by policymakers, local residents, advocates, and when possible, the business community working in partnership (Karpyn et al, 2012; Ulmer, Rathert, & Rose, 2012). Evaluation data examining changes in diet and body weight among community members where these initiatives are unfolding will provide critical information to help assess their implications for health and well being of community residents (Chiasson et al, 2013; Schultz et al 2015; Whaley, Ritchie, Spector, & Gomez, 2012). …”

Likelihood of Breastfeeding Within the USDA’s Food and Nutrition Service Special Supplemental Nutrition Program for Women, Infants, and Children Population

“…A recent review highlighted specific barriers to breastfeeding within the WIC population: lack of social and provider support, return to work and worksite barriers, lactation issues, WIC program and policy issues, and social or cultural hindrances (Hedberg, 2013). Another review studied the effect of the recent 2009 WIC food package revisions on participants’ dietary intake, access to healthy food and beverages, and breastfeeding (Schultz, Byker Shanks, & Houghtaling, 2015). …”