assess the dietary intake of all WIC participants. The practice consumes considerable time resources on the part of both WIC personnel and their clients.

In any venue, the assessment of dietary risk poses a challenge. Indeed, in an earlier report, the Institute of Medicine stated, “Research is urgently needed to develop practical and valid assessment tools for the identification of inadequate diets” (IOM, 1996). Moreover, a joint working group of the National Association of WIC Directors and of the Food and Nutrition Service of the U.S. Department of Agriculture did not find a sufficient scientific basis for developing standardized criteria for two major types of dietary risk: failure to meet Dietary Guidelines and inadequate diet. These are the two types of dietary risk that WIC personnel use extensively as the sole basis for determining that postpartum women and children are at nutritional risk.

Failure to meet Dietary Guidelines refers to the 10 guidelines in the Dietary Guidelines for Americans (USDA/HHS, 2000; see Box ES-1). These guidelines emphasize overall dietary and lifestyle patterns that can help to achieve favorable long-term health outcomes. Based on current knowledge about how dietary and physical activity patterns may reduce the risk of major chronic diseases and how a healthful diet may promote health, the 10 guidelines are designed to serve as the basis for federal policy and are used to guide nutrition information, education, and interventions for federal, state, and local agencies.

BOX ES-1 Dietary Guidelines for Americans


  • Aim for a healthy weight.

  • Be physically active each day.


  • Let the Pyramid guide your food choices.

  • Choose a variety of grains daily, especially whole grains.

  • Choose a variety of fruits and vegetables daily.

  • Keep foods safe to eat.


  • Choose a diet that is low in saturated fat and cholesterol and moderate in total fat.

  • Choose beverages and foods to moderate your intake of sugars.

  • Choose and prepare foods with less salt.

  • If you drink alcoholic beverages, do so in moderation.


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