National Academies Press: OpenBook

Dietary Risk Assessment in the WIC Program (2002)

Chapter: Front Matter

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

DIETARY RISK ASSESSMENT IN THE WIC PROGRAM

Committee on Dietary Risk Assessment in the WIC Program

Food and Nutrition Board

INSTITUTE OF MEDICINE

NATIONAL ACADEMY PRESS
Washington, DC

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

NATIONAL ACADEMY PRESS
2101 Constitution Avenue, N.W. Washington, DC 20418

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

Support for this project was provided by the Food and Nutrition Service, U.S. Department of Agriculture. The views presented in this report are those of the Institute of Medicine Committee on Dietary Risk Assessment in the WIC Program and are not necessarily those of the funding agency.

International Standard Book Number: 0-309-08284-6

Library of Congress Control Number: 2002100331

Additional copies of this report are available for sale from the
National Academy Press,
2101 Constitution Avenue, N.W., Box 285, Washington, D.C. 20055. Call (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area), or visit the NAP’s home page at www.nap.edu. The full text of this report is available at www.nap.edu.

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2002 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America.

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

Knowing is not enough; we must apply.

Willing is not enough; we must do.

—Goethe

INSTITUTE OF MEDICINE

Shaping the Future for Health

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

THE NATIONAL ACADEMIES

National Academy of Sciences

National Academy of Engineering

Institute of Medicine

National Research Council

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A. Wulf are chairman and vice chairman, respectively, of Research the National Council.

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

COMMITTEE ON DIETARY RISK ASSESSMENT IN THE WIC PROGRAM

VIRGINIA A. STALLINGS (chair),

Division of Gastroenterology and Nutrition, The Children’s Hospital of Philadelphia, Pennsylvania

TOM BARANOWSKI,

Department of Pediatrics, Baylor College of Medicine, Houston, Texas

RONETTE R. BRIEFEL,

Mathematica Policy Research, Washington, D.C.

YVONNE BRONNER,

Public Health Program, Morgan State University, Baltimore, Maryland

LAURA E. CAULFIELD,

Department of International Health, Johns Hopkins University, Baltimore, Maryland

EZRA C. DAVIDSON, JR.,

Department of Obstetrics and Gynecology, Charles R. Drew University of Medicine and Science, Los Angeles, California

THERESA O. SCHOLL,

Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey, Stratford, New Jersey

CAROL W. SUITOR, Nutrition Consultant,

Northfield, Vermont

ROBERT C. WHITAKER,

Division of General and Community Pediatrics, Children’s Hospital Medical Center, Cincinnati, Ohio

Staff

Romy Gunter-Nathan, Study Director

Kimberly Stitzel, Research Associate

Jaime Lanier, Project Assistant (until May 2001)

Peter Keo, Project Assistant (after May 2001)

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

FOOD AND NUTRITION BOARD

CUTBERTO GARZA (chair),

Division of Nutritional Science, Cornell University, Ithaca, New York

ALFRED H. MERRILL, JR. (vice chair),

School of Biology, Georgia Institute of Technology, Atlanta

ROBERT M. RUSSELL (vice chair),

Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts

VIRGINIA A. STALLINGS (vice chair),

Division of Gastroenterology and Nutrition, The Children’s Hospital of Philadelphia, Pennsylvania

LARRY R. BEUCHAT,

Center for Food Safety and Quality Enhancement, University of Georgia, Griffin

BENJAMIN CABALLERO,

Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

ROBERT J. COUSINS,

Center for Nutritional Sciences, University of Florida, Gainesville

SHIRIKI KUMANYIKA,

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia

LYNN PARKER,

Child Nutrition Programs and Nutrition Policy, Food Research and Action Center, Washington, D.C.

ROSS L. PRENTICE,

Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington

A. CATHARINE ROSS,

Department of Nutrition, The Pennsylvania State University, University Park

BARBARA O. SCHNEEMAN,

Department of Nutrition, University of California, Davis

ROBERT E. SMITH,

R.E. Smith Consulting, Inc., Newport, Vermont

STEVE L. TAYLOR,

Food Processing Center, University of Nebraska, Lincoln

BARRY L. ZOUMAS,

Department of Agricultural Economics and Rural Sociology, The Pennsylvania State University, University Park

Staff

ALLISON A. YATES, Director

LINDA D. MEYERS, Deputy Director

GAIL E. SPEARS, Administrative Assistant

GARY WALKER, Financial Associate

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

Acknowledgments

Sincere appreciation is extended to the many individuals and groups who were instrumental in the development of this report. First and foremost, many thanks are due to the committee members who volunteered countless hours to the research, deliberations, and preparation of the report. Their dedication to this project and to a stringent timeline was commendable, and the basis of our success.

Many individuals volunteered significant time and effort to address and educate our committee members during the workshop and public meeting. Workshop speakers included Jean Anliker, PhD, RD, University of Maryland; Ann Barone, LDN, Rhode Island Department of Health; Gladys Block, PhD, University of California at Berkeley; Graham Colditz, MD, DrPH, Harvard University; Cutberto Garza, MD, PhD, Cornell University; Bob Greenstein, Center on Budget and Policy Priorities, Washington, D.C.; Jill Leppert, LD, RD, North Dakota State Department of Health; Kristin Marcoe, MBA, RD, U.S. Department of Agriculture; Lynn Parker, MS, RD, Food Research and Action Center, Washington, D.C.; Carol Rankin, MS, RD, LD, Mississippi Department of Health; Anna Maria Siega-Riz, PhD, University of North Carolina; Amy Subar, PhD, MPH, RD, National Cancer Institute; Valerie Tarasuk, PhD, University of Toronto; and Amanda Watkins, MD, RD, Arizona Department of Health Services. In addition, two organizations provided oral testimony to the committee during its public meeting: the National Association of WIC Directors and the Food and Nutrition Service, U.S. Department of Agriculture. Sincere thanks and appreciation are also extended to Barbara Ainsworth, PhD, University of South

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

Carolina, for her valuable assistance as a consultant in the field of physical activity assessment.

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

Maxine Hayes, Washington State Department of Health

Jules Hirsch, Rockefeller University

Elvira Jarka, Health Resources and Services Administration

Louise C. Masse, National Cancer Institute

Esther Myers, American Dietetic Association

Valerie Tarasuk, University of Toronto

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Gail Harrison, University of California, Los Angeles. Appointed by the National Research Council and Institute of Medicine, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

It is apparent that many organizations and individuals from a variety of clinical and scientific backgrounds provided timely and essential support for this project. Yet we would have never succeeded without the efforts, skills, and grace that was provided in large measure by Romy Gunter-Nathan, MPH, RD, our study director for this project; Kimberly Stitzel, MS, RD, research associate; Geraldine Kennedo, project assistant; Jaime Lanier, project assistant; Peter Keo, project assistant; and Allison A. Yates, PhD, RD, director, Food and Nutrition Board, Institute of Medicine.

Last, as chair, I express my sincere appreciation to each member of this committee for their extraordinary commitment to the project and the wonderful

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

opportunity to work with them on this important task for the nutrition and policy community and for the women and children of the WIC population whose care we were asked to consider.

Virginia A. Stallings, MD

Chair, Committee on Dietary

Risk Assessment in the WIC Program

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
This page in the original is blank.
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

5

 

FOOD-BASED ASSESSMENT OF DIETARY INTAKE

 

57

   

A Focus on Usual Intake,

 

58

   

Overview of Research-Quality Dietary Methods for Estimating Food or Nutrient Intake,

 

60

   

Methods to Compare Food Intakes with the Dietary Guidelines,

 

79

   

Conclusions Regarding Food-Based Dietary Assessment Methods for Eligibility Determination,

 

83

6

 

ASSESSMENT OF PHYSICAL ACTIVITY

 

85

   

Challenges in Assessing Physical Activity,

 

85

   

Methods to Assess Physical Activity,

 

88

   

Conclusions Regarding the Role of Physical Activity Assessment for Eligibility Determination,

 

90

   

Recommendations for Future Research,

 

92

7

 

BEHAVIORAL INDICATORS OF DIET AND PHYSICAL ACTIVITY

 

93

   

The Concept of Behavioral Indicators,

 

94

   

Behavioral Indicators of Diet,

 

96

   

Behavioral Indicators of Physical Activity,

 

112

   

Conclusions Regarding the Use of Behavioral Indicators for Eligibility Determination,

 

114

8

 

EVIDENCE OF DIETARY RISK AMONG LOW-INCOME WOMEN AND CHILDREN

 

115

   

Nutritional Vulnerability of Groups Served by WIC,

 

115

   

Results from Relevant Dietary Intake Studies,

 

120

   

Associations of Food Intake with Income,

 

124

   

Summary of Evidence Suggesting Dietary Risk,

 

126

9

 

FINDINGS AND RECOMMENDATIONS

 

129

   

Findings,

 

129

   

Recommendation,

 

133

   

Concluding Remark,

 

135

10

 

REFERENCES

 

137

 

 

APPENDIXES

 

 

A

 

Allowed Nutrition Risk Criteria,

 

159

B

 

Workshop Agenda and Presentations,

 

163

C

 

Biographical Sketches,

 

165

Page xiii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×

DIETARY RISK ASSESSMENT IN THE WIC PROGRAM

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
This page in the original is blank.
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R1
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R2
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R3
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R4
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R5
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R6
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R7
Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R8
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R9
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R10
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R11
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R12
Page xiii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R13
Suggested Citation:"Front Matter." Institute of Medicine. 2002. Dietary Risk Assessment in the WIC Program. Washington, DC: The National Academies Press. doi: 10.17226/10342.
×
Page R14
Next: Executive Summary »
Dietary Risk Assessment in the WIC Program Get This Book
×
Buy Paperback | $46.00 Buy Ebook | $36.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

Dietary Risk Assessment in the WIC Program reviews methods used to determine dietary risk based on failure to meet Dietary Guidelines for applicants to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Applicants to the WIC program must be at nutritional risk to be eligible for program benefits. Although “dietary risk” is only one of five nutrition risk categories, it is the category most commonly reported among WIC applicants.

This book documents that nearly all low-income women in the childbearing years and children 2 years and over are at risk because their diets fail to meet the recommended numbers of servings of the food guide pyramid. The committee recommends that all women and children (ages 2-4 years) who meet the eligibility requirements based on income, categorical and residency status also be presumed to meet the requirement of nutrition risk. By presuming that all who meet the categorical and income eligibility requirements are at dietary risk, WIC retains its potential for preventing and correcting nutrition-related problems while avoiding serious misclassification errors that could lead to denial of services for eligible individuals.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!