children in 18 states and Washington, DC (most were WIC recipients) found that one in ten was overweight in 1995, a relative increase of 20 percent from 1983 (Mei et al., 1998). Two studies examining potential associations between the WIC food package and overweight status in children found that WIC foods did not contribute to overweight (CDC, 1996) and that the weight status of children in the WIC program was comparable to that of other low-income children (Burstein et al., 2000). The Institute of Medicine is currently conducting a study to review the nutritional needs of the populations served by the WIC Program, assess their supplemental nutritional needs, and propose recommendations for the contents of the WIC food packages.

Given that a great deal is known about good nutrition and the dietary composition of balanced diets, it would be advantageous to the health of children participating in federal nutrition assistance programs if nutrient-rich foods were made available and if there was access to ethnically and culturally appropriate foods. The committee is particularly interested in urging USDA to expand pilot programs that focus on increasing the availability of fresh fruits and vegetables and other nutritious foods or provide incentives for the purchase of these items. Ideas for such programs have included double or specifically designated fruit and vegetable vouchers; coupons or other discount promotions; and the ability to use electronic benefit transfer cards at farmers’ markets or community-supported agricultural markets (GAO, 2002). Additionally, a systematic study should examine potential strategies for improving the community food environment to ensure that FSP recipients have access to supermarkets, farmers’ markets, and other venues that provide fresh, high-quality, and affordable produce and other healthful foods (see Chapter 6).

In addition to their current objectives to improve food access and dietary quality, the federal nutrition assistance programs (e.g., WIC, FSP) should include obesity prevention as an explicit goal for the populations served. Congress should request independent assessments of these programs to ensure that each provides adequate access to healthful dietary choices (including fruits, vegetables, and whole grains) for the populations served. USDA should also continue to explore pilot programs within the nutrition assistance programs that encourage diet and physical activity behaviors that promote energy balance at a healthy weight in children and youth.


As the traditional paradigm of “farm to table” shifts to one of “table to farm,” driven by consumer demand and an awareness of the connections between diet and health, decision makers in the United States should take a new look at the impact of agricultural and food policies (NRC, 2004). The

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