B
NUTRIENT PROFILES OF CURRENT AND REVISED FOOD PACKAGES

INTRODUCTION

For the analyses presented in this report, the committee conducted detailed analyses of the nutrient content of the current and revised WIC food packages. Many of the details are presented in here in Appendix B. Additional details are presented in Appendix ECost Calculations. Specifically, details of the assumptions used in both the nutrient and cost analyses of the food packages are presented in Tables E-1 and E-2.

The following is a list of the tables presented here in Appendix B.

Table B-1

 

Specifications for Foods in the Revised Food Packages,

 

218

Table B-2

 

Nutrient Analysis of Current and Revised Food Packages Using NDS-R

 

 

A

 

Elements,

 

226

B

 

Fat-Soluble Vitamins,

 

228

C

 

Water-Soluble Vitamins,

 

230

D

 

Macronutrients, Fiber, Phytate, and Cholesterol,

 

232

E

 

Fats,

 

234

Table B-3

 

Nutrient Analysis of Current and Revised Food Packages Using USDA Nutrient Database for Standard Reference (SR-17)

 

 

A

 

Elements,

 

236

B

 

Fat-Soluble Vitamins,

 

238

C

 

Water-Soluble Vitamins,

 

240



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement



Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.

OCR for page 216
WIC Food Packages: Time for a Change B NUTRIENT PROFILES OF CURRENT AND REVISED FOOD PACKAGES INTRODUCTION For the analyses presented in this report, the committee conducted detailed analyses of the nutrient content of the current and revised WIC food packages. Many of the details are presented in here in Appendix B. Additional details are presented in Appendix E—Cost Calculations. Specifically, details of the assumptions used in both the nutrient and cost analyses of the food packages are presented in Tables E-1 and E-2. The following is a list of the tables presented here in Appendix B. Table B-1   Specifications for Foods in the Revised Food Packages,   218 Table B-2   Nutrient Analysis of Current and Revised Food Packages Using NDS-R     A   Elements,   226 B   Fat-Soluble Vitamins,   228 C   Water-Soluble Vitamins,   230 D   Macronutrients, Fiber, Phytate, and Cholesterol,   232 E   Fats,   234 Table B-3   Nutrient Analysis of Current and Revised Food Packages Using USDA Nutrient Database for Standard Reference (SR-17)     A   Elements,   236 B   Fat-Soluble Vitamins,   238 C   Water-Soluble Vitamins,   240

OCR for page 216
WIC Food Packages: Time for a Change D   Macronutrients, Fiber, Phytate, and Cholesterol,   242 E   Fats,   244 Table B-4   Comparison of Food Items Used in Nutrient Analyses from Two Databases,   246 Table B-5   Comparison of Current and Revised Food Packages with Regard to Nutrients Offered     A   Nutrients of Concern with Regard to Inadequate Intake,   252 B   Nutrients of Concern with Regard to Excessive Intake,   256 C   Nutrients and Ingredients to Limit in the Diet,   260 Table B-6   Substitutions for Various Volumes of Formula Concentrate—Easy Reference Guide,   262

OCR for page 216
WIC Food Packages: Time for a Change TABLE B-1 Specifications for Foods in the Revised Food Packages Category / Food Package Number and Participant Description Allowable Foods and Minimum Requirements Infant Foods Infant formula I-FF, II-FF Infants, fully formulafed, 0–11.9 mo I-BF/FF-B, II-BF/FF Infants, partially breastfed, 4–11.9 mo No change from current specifications. All allowed infant formulas must meet the definitions and requirements for an infant formula as regulated by FDA: Federal Food, Drug, and Cosmetic Act, definitions [21 USC § 321(z)]; requirements [21 CFR § 106 and §107]; and any updates of these regulations. The iron fortification level must be 10 mg per liter of formula (as prepared for consumption as directed on the container). Liquid concentrate, powdered, or ready-to-feed forms of formula are allowed.a Infant formula, powdered I-BF/FF-A Infants, partially breastfed, 1–3.9 mo Only powdered formula is allowed (except when powdered formula is contraindicated).b Infant formula, powdered I-BF Infants, fully breast-fed Allowed only during the first month after birth under special conditions. Only powdered formula is allowed (except when powdered formula is contraindicated).b Baby food fruits and vegetables II Infants, 6–11.9 mo Commercial baby food fruits and vegetables without added sugars, starches, or salt (i.e., sodium). Texture may range from strained through diced. Fresh banana may replace up to 16 oz of baby food fruit (e.g., 4 4-oz jars per month) at a rate of 1 lb of bananas per 8 oz of baby food fruit. Infant cereal II Infants, 6–11.9 mo No change from current specifications. Infant cereal, instant (must conform to USDA commercial item description A-A-20022B and any updates of these regulations) Must contain a minimum of 45 mg of iron per 100 g of dry cereal. Infant cereals containing infant formula, milk, fruit, or other noncereal ingredients are not allowed. Baby food meat II-BF Infants, fully breast-fed, 6–11.9 mo Single major ingredient, commercial baby food meat without added sugars, starches, vegetables, or salt (i.e., sodium). Broth (unsalted; that is,

OCR for page 216
WIC Food Packages: Time for a Change Category / Food Package Number and Participant Description Allowable Foods and Minimum Requirements     without added sodium) may be an ingredient. Texture may range from pureed through diced. Fruits and Vegetables Juice IV, V, VI, VII Children and women No change from current specifications. Must be pasteurized 100% unsweetened fruit juice (must conform to FDA standard of identity [21 CFR § 146] and any updates of these regulations) or vegetable juice (must conform to FDA standard of identity [21 CFR § 156] and any updates of these regulations) and contain at least 30 mg of vitamin C per 100 mL of juice. Juices that are fortified with other nutrients may be allowed at the state agency’s option. Juice may be fresh, from concentrate, frozen, canned, or shelf-stable. Vegetable juice may be regular or lower in sodium.c Fresh fruits and vegetables IV, V, VI, VII Children and women Any variety of fresh whole or cut fruit without added sugars. Any fresh whole or cut vegetable except white potatoes (orange yams and sweet potatoes are allowed); without added sugars, fats, or oils. Processed fruits and vegetablesd IV, V, VI, VII Children and women Any variety of cannede fruits (must conform to FDA standard of identity [21 CFR § 145] and any updates of these regulations); juice pack or water pack without added sugars. Any variety of frozen fruits without added sugars. Any variety of cannede or frozen vegetables (must conform to FDA standard of identity [21 CFR § 155] and any updates of these regulations) except white potatoes (orange yams and sweet potatoes are allowed); without added sugars, fats, or oils. May be regular or lower in sodium.c Excludes soups, condiments such as catsup, pickles, and olives.   V, VI, VII Women Any type of dried fruits without added sugars, fats, oils, or salt (i.e., sodium).

OCR for page 216
WIC Food Packages: Time for a Change Category / Food Package Number and Participant Description Allowable Foods and Minimum Requirements Milk and Alternatives Milk IV-A Children, 1–1.9 y Similar in types and forms under current specification, except that only whole milk (not less that 3.25% milk fat) is allowed. Cow’s milk (must conform to FDA standard of identity [21 CFR § 131.110]; USDA commercial item description A-A-20338; and any updates of these regulations) or goat’s milk, pasteurized fluid whole milk, finished milk contains at least 400 IU (ca. 10 mcg) of vitamin D per quart of milk or reconstituted milk. May be fluid, shelf-stable, evaporated (21 CFR § 131.130; A-A-20072B), or dried (i.e., powdered) (21 CFR § 131.147). Lactose-reduced milk (must conform to FDA standard of identity [21 CFR § 184.1387 or § 184.1388] and any updates of these regulations) (i.e., must contain at least 70% less lactose than regular milk) is allowed. Buttermilk (must conform to FDA standard of identity for cultured milk [21 CFR § 131.112—cultured buttermilk, kefir cultured milk, acidophilus cultured milk] and any updates of these regulations) may be allowed at the state agency’s option.   IV-B, V, VI, VII Children (≥ 2 y) and women (adolescent and adult) Similar in types and forms under current specification, except that no more than 2% milk fat allowed. Cow’s milk (must conform to FDA standard of identity [21 CFR § 131.110]; USDA commercial item description A-A-20338; and any updates of these regulations) or goat’s milk, pasteurized fluid fat-reduced milk (i.e., reduced-fat milk [2% or less milk fat]; lowfat milk [1% or less milk fat]; or nonfat milk [skim milk]), finished milk contains at least 400 IU (ca. 10 mcg) of vitamin D and 2,000 IU (ca. 600 mcg) vitamin A per quart of milk or reconstituted milk. May be fluid, shelf-stable, evaporated [21 CFR § 131.130; A-A-20072B], or

OCR for page 216
WIC Food Packages: Time for a Change Category / Food Package Number and Participant Description Allowable Foods and Minimum Requirements     powdered (i.e., dry whole milk) [21 CFR § 131.127]. Milk includes lactose-reduced milk and buttermilk as above except no more than 2% milk fat. Cheese IV, V, VI, VII Children and women No change from current specifications. Domestic cheese (must conform to FDA standard of identity [21 CFR § 133] and any updates of these regulations); brick, cheddar, colby, jack, monterey, mozzarella, muenster, pasteurized processed American, provolone, Swiss, or blends of any of these cheeses are allowed. Allowed cheeses may be regular or reduced in content of fat, cholesterol, or sodium—that is, labeled low, free, reduced, less, or light in any of these nutrients.c Yogurt, fat-reduced IV, V, VI, VII Children and women Yogurt (must conform to FDA standard of identity [21 CFR § 131.200] and any updates of these regulations; reduced-fat [FDA, 1998; that is, no more than 2% milk fat], low-fat [21 CFR § 131.203; FDA, 1998; that is, no more than 1% milk fat], or nonfat [21 CFR § 131.206; that is, less than 0.5% milk fat]); plain or flavored with ≤ 17 g of total sugars per 100 g yogurt. May contain low-calorie sweetener (i.e., sugar substitutes) approved by the FDA. Yogurts that are fortified with vitamin D, vitamin A, and other nutrients may be allowed at the state agency’s option.f Soy beverage V, VI, VII Women Soy beverage (sometimes referred to as “soy milk”) must be fortified to contain nutrients in amounts similar to cow’s milk. Specifications are to include at least 300 mg calcium and 120 IU (ca. 3 mcg) vitamin D per 8 fl oz. Soy beverages typically contain no cholesterol and are low in saturated fat.

OCR for page 216
WIC Food Packages: Time for a Change Category / Food Package Number and Participant Description Allowable Foods and Minimum Requirements Tofu Women Calcium-set tofu (prepared with only calcium salts [e.g., calcium sulfate]). May not contain added fats, oils, or sodium. Grains Cereal IV, V, VI, VII Children and women Ready-to-eat cereals and hot cereals (must conform to FDA standard of identity—21 CFR § 170.3[n][4]); USDA commercial item description A-A-20000B (for ready-to-eat cereals); and any updates of these regulations]: contain a minimum of 28 mg iron per 100 g dry cereal; contain 21.2 g sucrose and other sugars per 100 g dry cereal ( 6 g per dry oz); and meet labeling requirements for making a health claim as a “whole-grain food with moderate fat content” (see CFSAN, 1999, 2003b): –contain a minimum of 51% whole grains—a minimum of 51% of the grain in the product must be whole grains—using dietary fiber as the indicator; –meet the regulatory definitions for “low saturated fat” (≤ 1 g saturated fat per RACC) and “low cholesterol” (≤ 20 mg cholesterol per RACC); –bear quantitative trans fat labeling; and –contain ≤ 6.5 g total fat per RACC and ≤ 0.5 g trans fat per RACC. Instant-, quick- and regular-cooking forms are allowed. Whole grain bread IV, V, VII Children and women except nonbreastfeeding Whole wheat bread (must conform to FDA standard of identity [21 CFR § 136.180] and any updates of these postpartum women regulations) or Bread must meet labeling requirements for making a health claim as a “whole-grain food with moderate fat content” (see CFSAN, 1999, 2003b): contain a minimum of 51% whole grains—a minimum of 51% of the grain in the product must be whole grains—using dietary fiber as a marker;

OCR for page 216
WIC Food Packages: Time for a Change Category / Food Package Number and Participant Description Allowable Foods and Minimum Requirements       meet the regulatory definitions for “low saturated fat” (≤ 1 g saturated fat per RACC) and “low cholesterol” (≤ 20 mg cholesterol per RACC); bear quantitative trans fat labeling; and contain ≤ 6.5 g total fat per RACC and ≤ 0.5 g trans fat per RACC. Other whole grains IV, V, VII Children and women except non-breastfeeding postpartum women Brown rice, bulgur, oatmeal, whole-grain barley without added sugars, fats, oils, or salt (i.e., sodium). May be instant-, quick-, or regular-cooking. Soft corn or whole wheat tortillas without added fats or oils may be allowed at the state agency’s option. Meat and Alternatives Eggs IV, V, VI, VII Children and women Fresh shell domestic hens’ eggs (no standard of identity has been established [21 CFR § 160.100]) or dried eggs (must confirm to FDA standard of identity [21 CFR § 160.105] and any updates of these regulations) made from whole eggs (liquid or shell eggs) that have been pasteurized and dried. No change from current specifications. Hard boiled eggs, where readily available in small quantities, may be provided for participants with limited cooking facilities. Fish VII Woman, fully breastfeeding Canned only: light tuna (no white tuna or albacore) (must conform to FDA standard of identity [21 CFR § 161.190]; USDA commercial item description A-A-20155C; and any updates of these regulations); salmon (bones, if any, must be soft and friable) (must conform to FDA standard of identity [21 CFR § 161.170]; USDA commercial item description A-A-20158D; and any updates of these regulations); and other varieties of fish that do not pose a mercury hazard (≤ 1.0 ppm, the standard set for tuna [USDA commercial item description A-A-20155C] as amended by

OCR for page 216
WIC Food Packages: Time for a Change Category / Food Package Number and Participant Description Allowable Foods and Minimum Requirements     additional standards such as EPA’s stricter Tissue Residue Criterion of ≤ 0.3 ppm for freshwater and estuarine fish [EPA, 2001]) as identified by advisories from the FDA and EPA. May be packed in water or oil. May be regular or lower in sodium content.c Dry beans (legumes) IV, V, VI, VII Children and women Any type of mature dry beans, peas, or lentils in dry-packaged (i.e., dried) or cannede forms.g Examples include but are not limited to black beans (“turtle beans”), blackeye peas (cowpeas of the blackeye variety, “cow beans”), garbanzo beans (chickpeas), great northern beans, kidney beans, lima beans (“butter beans”), pinto beans, soybeans, split peas, and lentils. All categories exclude soups. May not contain added sugars, fats, or oils. Canned legumes may be regular or lower in sodium content.c Baked beans may be provided for participants with limited cooking facilities. Peanut butter IV, V, VI, VII Children and women No change from current specifications. Peanut butter (must conform to FDA standard of identity [21 CFR §164.150]; USDA commercial item description A-A-20328; and any updates of these regulations); creamy or chunky, regular or reduced fat, salted or unsaltedc forms are allowed. Additional Foods for Food Package III Exempt infant formula III Infants, children, and women with special dietary needs Must meet the requirements for an exempt infant formula as regulated by FDA: Federal Food, Drug, and Cosmetic Act, definitions (21 USC § 350[a][h]; 21 CFR § 107.3); requirements (21 CFR § 106 and § 107); and any updates of these regulations. Medical foods III Infants, children, and women with special dietary needs Certain enteral products that are specifically formulated to provide nutritional support for individuals with a diagnosed medical condition, allowable when the use of conventional foods is precluded, restricted, or inadequate.

OCR for page 216
WIC Food Packages: Time for a Change aFollowing the current practice (see Table 1-1—Current WIC Food Packages), the revised maximum monthly allowances for infant formula are listed as fl oz of the liquid concentrate form (see Table 4-1—Revised WIC Food Packages). In converting a maximum monthly allowance for formula to powdered or ready-to-feed forms, the committee’s recommendations for rounding to whole cans may vary from current practice if only rounding up to whole cans was used. For details, see Table B-6—Substitution Rates for Various Volumes of Formula Concentrate. bAn example of when powdered formula is contraindicated is any situation in which water quality is compromised. cAny of the following lower sodium forms are allowable: (Adapted from FDA website [Kurtzweil, 1995].) • Sodium-free—less than 5 mg sodium per serving; • Very low sodium—35 mg sodium or less per serving or, if the serving is 30 g or less or 2 tablespoons or less, 35 mg sodium or less per 50 g of the food; • Low-sodium—140 mg sodium or less per serving or, if the serving is 30 g or less or 2 tablespoons or less, 140 mg sodium or less per 50 g of the food; • Light in sodium—at least 50 percent less sodium per serving than average reference amount for same food with no sodium reduction; • Lightly salted—at least 50 percent less sodium per serving than reference amount (If the food is not “low in sodium,” the statement “not a low-sodium food” must appear on the same panel as the Nutrition Facts panel.); and • Reduced or less sodium—at least 25 percent less sodium per serving than reference food. dProcessed fruits and vegetables can be substituted for fresh produce on the basis of equivalent numbers of servings. The committee’s calculations were based on information in USDA’s Food Buying Guide for Child Nutrition Programs (FNS, 1884a, 1984b). For women, 140 oz of canned fruit plus 140 oz of canned vegetables would be approximately equivalent to $10 fresh fruits and vegetables; for children, 110 oz of canned fruit plus 110 oz of canned vegetables would be approximately equivalent to $8 fresh fruits and vegetables. eFor the purposes of this specifications table, the term canned refers to processed food items in cans or other shelf-stable containers. fAs more brands of fortified yogurt appear in the market, state agencies may decide to increase the total amount of yogurt that can be substituted for milk. gCanned legumes could substitute for dried legumes at the rate or 64 oz of canned beans for 1 lb dried beans. The equivalence of 64 oz of canned beans for 1 lb dried beans was calculated using several methods. One method used the following conversion factors: 1 lb of dried beans = 6 cups of cooked beans (drained); and 1 15-oz can of beans (mature legumes) = 1 1/2 cups cooked beans (drained) (American Dry Bean Board, 2004). Thus, 1 lb of dried beans = 4 15-oz cans of beans (60 oz). Common can sizes for legumes currently on the market ranged from 15 to 16 oz; the equivalence was raised from 60 oz to 64 oz of canned beans for 1 lb dried beans to allow a participant to obtain 4 16-cans per month. NOTES: BF = fully breast-fed (i.e., the infant receives no formula through the WIC program); BF/FF = partially breast-fed (i.e., the infant is breast-fed but receives some formula through the WIC program); ca. = calculated amount; CFR = Code of Federal Regulations; DHHS = U.S. Department of Health and Human Services; EPA = U.S. Environmental Protection Agency; FDA = U.S. Food and Drug Administration; FF = fully formula-fed; IU = International Units; mL = milliliter; RACC = reference amounts customarily consumed per eating occasion, defined in 21 CFR § 101.12; USC = U.S. Code; USDA = U.S. Department of Agriculture. DATA SOURCES: CFR (U.S. Congress, 2004b); CFSAN (CFSAN, 1999, 2003b); USDA commercial item descriptions (USDA, 2005); FDA Standards of Identity (FDA, 2005); USC (U.S. Congress, 2005).

OCR for page 216
WIC Food Packages: Time for a Change TABLE B-2A Nutrient Analysis of Current and Revised Food Packages Using NDS-R,a Elements   Dietary Component   Calcium (mg/d) Iron (mg/d) Zinc (mg/d) Current Food Package I (0–3.9 mo) 417 9.5 4.9 Revised Food Package I-FF-A (0–3.9 mo) 417 9.5 4.9 Change from current package 0 0 0 Current Food Package II (4–5.9 mo) 555 19.6 6.4 Revised Food Package I-FF-B (4–5.9 mo) 457 10.4 5.4 Change from current package –98 –9.2 –1.0 Current Food Package II (6–11.9 mo) 555 19.6 6.4 Revised Food Package II-FF (6–11.9 mo) 475 17.6 5.4 Change from current package –80 –2.0 –1.0 Current Food Package II, breast-fedb 138 10.1 1.5 Revised Food Package II-BF (6–11.9 mo) 202 11.4 3.3 Change from current package +64 +1.3 +1.8 Current Food Package IV (1–4.9 y) 1,219 13.8 9.3 Revised Food Package IV-A (1–1.9 y) 1,084 15.4 10.5 Change from current package –135 +1.6 +1.2 Revised Food Package IV-B (2–4.9 y) 1,085 15.5 10.7 Change from current package –134 +1.7 +1.4 Current Food Package V 1,374 13.9 9.9 Revised Food Package V 1,341 16.9 11.8 Change from current package –33 +3.0 +1.9 Current Food Package VI 1,199 13.0 8.8 Revised Food Package VI 1,063 15.4 10.0 Change from current package –136 +2.4 +1.2 Current Food Package VII 1,494 15.3 11.1 Revised Food Package VII 1,538 17.7 12.9 Change from current package +44 +2.4 +1.8 NOTES: The sodium content of the revised food packages was increased when the processed option (i.e., canned fruits and vegetables as described in Tables B-4 and E-2) was substituted for fresh produce; using canned vegetables, the sodium content increased by 27% for Food Package IV, 32% for Food Package V, 48% for Food Package VI, and 24% for Food Package VII. See notes for Tables B-2A through B-2E following Table B-2E.

OCR for page 216
WIC Food Packages: Time for a Change Participant Category and Priority Nutrient Dietary Reference Intakes EAR AI* RDA Potassium, mg/d — 4,700* — Vitamin A, mcg RAE/d 485–500 — 700 Vitamin C, mg/d 56–60 — 65–75 Vitamin D, mcg/d — 5.0* — Vitamin B6, mg/d 1.0–1.1 — 1.2–1.3 Folate, mcg DFE/da 320–330 — 400 Lactating women, 14–44 y Food Package No. — — — Calcium, mg/d — 1,000*–1,300* — Iron, mg/d 6.5–7.0 — 9.0–10.0 Magnesium, mg/d 255–300 — 310–360 Vitamin E, mg AT/da — — 19.0 Vitamin E, mg ATE/da — — — Fiber, g/d — 29* — Potassium, mg/d — 5,100* — Vitamin A, mcg RAE/d 885–900 — 1,200–1,300 Vitamin C, mg/d 96–100 — 115–120 Vitamin D, mcg/d — 5.0* — Vitamin B6, mg/d 1.7 — 2.0 Folate, mcg DFE/da 450 — 500 See notes for Tables B-5A through B-5C following Table B-5C.

OCR for page 216
WIC Food Packages: Time for a Change Nutrients Offered Current Package Revised Package Change 1,393 1,463 + 609 734 + 84 81 – 7.5 5.6 – 1.2 1.6 + 439 506 + Current VII Revised VII   1,494 1,538 + 15.3 17.7 + 215 255 + 6.0 9.0 + 9.7 16.1 + 7.3 12.6 + 2,237 2,235 + 971 945 – 135 99 – 10.1 10.3 + 1.6 1.9 + 551 587 +

OCR for page 216
WIC Food Packages: Time for a Change TABLE B-5B Comparison of Current and Revised Food Packages with Regard to Nutrients Offered, Nutrients of Concern with Regard to Excessive Intake Participant Category and Priority Nutrient Dietary Reference Intakes UL Mean EER AMDR† Infants, 0–3.9 mo, fully formula-fed Food Package No. Zinc, mg/d 4.0 — — Preformed vitamin A, mcg/d 600 — — Food energy, kcal/d — 555c — Infants, 4–5.9 mo, fully formula-fed Food Package No. Zinc, mg/d 4.0 — — Preformed vitamin A, mcg/d 600 — — Food energy, kcal/d — 623c — Infants, 6–11.9 mo, fully formula-fed Food Package No. Zinc, mg/d 5.0 — — Preformed vitamin A, mcg/d 600 — — Food energy, kcal/d — 754c — Children, 1–1.9 y Food Package No. Zinc, mg/d 7.0 — — Preformed vitamin A, mcg/d 600 — — Food energy, kcal/d — 942c — Children, 2–4.9 y Food Package No. Zinc, mg/d 7.0 / 12.0b — — Sodium, mg/d 1,500 / 1,900b — — Preformed vitamin A, mcg/d 600 / 900b — — Food energy, kcal/d     1,282c Pregnant women and lactating women, 14–44 y Food Package No. Sodium, mg/d 2,300 — — Food energy, kcal/d — 2,465c — Total fat, g/d — — — Total fat, % of food energy — — 25–35†, <19y 20–35†, ≤ 19y Non-breastfeeding postpartum women, 14–44 y Food Package No. Sodium, mg/d 2,300 — — Food energy, kcal/d — 2,163c — Total fat, g/d — — — Total fat, % of food energy     25–35†, <19y 20–35†, 19y

OCR for page 216
WIC Food Packages: Time for a Change Nutrients Offered Current Package Revised Package Change Current I Revised I-FF-A   4.9 4.9 = 413 413 = 529 529 = Current II Revised I-FF-B   6.4 5.4 – 413 453 + 663 581 – Current II Revised II-FF   6.4 5.4 – 413 320 – 663 547 – Current IV Revised IV-A   9.3 10.5 + 596 345 – 797 753 – Current IV Revised IV-B   9.3 10.7 + 875 796 – 596 455 – 797 672 – Current V Revised V   940 848 – 858 823 – 31.3 23.4 – 30.4 25.1 – Current VI Revised VI   829 571 – 676 577 – 24.7 16.0 – 31.4 22.9 –

OCR for page 216
WIC Food Packages: Time for a Change Participant Category and Priority Nutrient Dietary Reference Intakes UL Mean EER AMDR† Lactating women, 14–44 y Food Package No. Sodium, mg/d 2,300 — — Food energy, kcal/d — 2,465c — Total fat, g/d — — — Total fat, % of food energy — — 25–35†, <19y 20–35†, ≥ 19y See notes for Tables B-5A through B-5C following Table B-5C.

OCR for page 216
WIC Food Packages: Time for a Change Nutrients Offered Current Package Revised Package Change Current VII Revised VII   1,198 1,133 – 1,061 981 – 41.4 32.0 – 33.8 28.7 –

OCR for page 216
WIC Food Packages: Time for a Change TABLE B-5C Comparison of Current and Revised Food Packages with Regard to Nutrients Offered, Nutrients and Ingredients to Limit in the Diete     Nutrients Offered Participant Category and Priority Nutrient Dietary Guidance Current Package Revised Package Change Infants, 6–11.9 mo, fully breast-fed Food Package No.   Current II Revised II-BF   Trans fatty acids, g/dd — <0.1 0.14 + Infants, 6–11.9 mo, fully formula-fed Food Package No.   Current II Revised II-FF   Trans fatty acids, g/dd — 0.02 0.02 – Children, 1–1.9 y Food Package No.   Current IV Revised IV-A   Trans fatty acids, g/dd — 0.59 0.69 + Children, 2–4.9 ye Food Package No.   Current IV Revised IV-B   Saturated fat, g/d — 13.8 6.3 – Saturated fat, % of food energy <10 15.6 8.4 – Cholesterol, mg/d <300 279 113 – Trans fatty acids, g/dd — 0.59 0.42 – Pregnant women and lactating women, 14–44 ye Food Package No.   Current V Revised V   Saturated fat, g/d — 15.1 7.9 – Saturated fat, % of food energy <10 15.8 8.7 – Cholesterol, mg/d <300 288 118 – Trans fatty acids, g/d — 0.66 0.45 – Non-breastfeeding postpartum women, 14–44 ye Food Package No.   Current VI Revised VI   Saturated fat, g/d — 12.9 5.9 – Saturated fat, % of food energy <10 17.2 9.1 – Cholesterol, g/d <300 279 111 – Trans fatty acids, g/d — 0.53 0.28 – Lactating women, 14–44 ye Food Package No.   Current VII Revised VII   Saturated fat, g/d — 19.0 12.0 – Saturated fat, % of food energy <10 16.1 11.0 – Cholesterol, mg/d <300 307 227 – Trans fatty acids, g/d — 0.81 0.58 – NOTES FOR TABLES B-5A THROUGH B-5C: AI = Adequate Intake, used when necessary, indicated by an asterisk (*); AMDR = Acceptable Macronutrient Distribution Range, indicated by a dagger (†); AT = (alpha)-tocopherol; ATE = (alpha)-tocopherol equivalents; DFE = dietary folate equivalents; EAR = Estimated Average Requirement, used when available; EER = Estimated Energy Requirement; kcal = kilocalories; RAE = retinol activity equivalents; RDA = Recommended Dietary Allowance; UL = Tolerable Upper Intake Level.

OCR for page 216
WIC Food Packages: Time for a Change aFor discussion of important issues regarding differences between the Dietary Reference Intakes (DRIs) and dietary intake data in the units used for vitamin E and folate, please see the section Data Set—Nutrients Examined in Appendix A—Nutrient Intake of WIC Subgroups. bValues are for children ages 2–3.9 y and children age 4 y, respectively. cMean EER (kcal/d) (Table B-5B) was calculated based on CSFII data (FSRG, 2000) using the method described in the DRI report (IOM, 2002/2005). For additional detail, see Appendix C—Nutrient Intakes of WIC Subgroups. dTrans fatty acids have not specifically been identified as a hazard for infants and children, and thus are shown in Table 2-10 (Chapter 2—Nutrient and Food Priorities) as nutrients to limit only in the diets of adolescents and adults (IOM, 2002/2005). However, the current dietary guidance to limit trans fatty acids from processed foods in the diet is presumed to apply to all individuals regardless of age. The term trans fatty acids refers to unsaturated fatty acids that contain at least one double bond in the trans configuration. eAdded sugars were identified as an ingredient to limit in the diet for women and children over the age of 2 y; however, the committee did not include added sugars in the nutrient analyses because the databases used did not list added sugars as a separate component of foods. DATA SOURCES: EARs, AIs, and RDAs (Table B-5A) are from the DRI reports (IOM, 1997, 1998, 2000b, 2001, 2002/2005, 2005a). ULs and AMDRs (Table B-5B) are from the DRI reports (IOM, 2001, 2002/2005, 2005a). The dietary guidance in Table B-5C is from the American Heart Association (AHA, 2004) and the Dietary Guidelines for Americans 2005 (DHHS/USDA, 2005). Nutrients offered were calculated using data from the Nutrition Coordinating Center (NCC), University of Minnesota, Minneapolis, MN, using Nutrition Data System for Research software (NDS-R version 5.0/35, 2004) (Schakel et al., 1988, 1997; Schakel, 2001). The assumptions used for the calculations of nutrient content of the current and revised food packages are detailed in Appendix D—Cost Calculations.

OCR for page 216
WIC Food Packages: Time for a Change TABLE B-6 Substitutions for Various Volumes of Formula Concentrate—Easy Reference Guidea     Liquid Concentrate Formula-Fed infants I-FF-A: 0–3.9 mo Maximum monthly allowance 403 fl oz Available units (e.g., cans) 13-fl oz Number of units (total oz powder) 31 Amount as reconstituted 806 fl oz I-FF-B: 4–5.9 mo Maximum monthly allowance 442 fl oz Available units (e.g., cans) 13-fl oz Number of units (total oz powder) 34 Amount as reconstituted 884 fl oz II-FF: 6–11.9 mo Maximum monthly allowance 312 fl oz Available units (e.g., cans) 13-fl oz Number of units (total oz powder) 24 Amount as reconstituted 624 fl oz Partially Breast-Fed Infants I-BF/FF-A: 1–3.9 mo Maximum monthly allowance   Available units (e.g., cans) Not recommendedf Number of units (total oz powder) Amount as reconstituted I-BF/FF-B: 4–5.9 mo Maximum monthly allowance 221 fl oz Available units (e.g., cans) 13-fl oz Number of units (total oz powder) 17 Amount as reconstituted 442 fl oz II-BF/FF: 6–11.9 mo Maximum monthly allowance 156 fl oz Available units (e.g., cans) 13-fl oz Number of units (total oz powder) 12 Amount as reconstituted 312 fl oz aWhen determining the maximum number of cans of each type of formula, the committee recommends rounding to whole cans to approximate the target amount (the maximum monthly allowance shown in Table 4-1, Chapter 4—Revised Food Packages). In some cases this may be different from the rounding currently in use (e.g., rounding up to whole cans). The results of this method may differ from the rounding currently in use; some rounding methods (e.g., rounding up to whole cans) could result in providing excess formula in some cases.

OCR for page 216
WIC Food Packages: Time for a Change   Powdered Formulab Ready-to-Feed Similac with Ironc (~7 fl oz/oz) Enfamil with Irond (~7 fl oz/oz) Carnation Good Starte (~5 fl oz/oz) 800 fl oz 103–115 oz powder 32-fl oz 12.9-oz 14.3-oz 12-oz 25 8 (103.2 oz powder) 8 (114.4 oz powder) 9 (108 oz powder) 800 fl oz 768 fl oz 840 fl oz 783 fl oz 896 fl oz 114–120 oz powder 32-fl oz 12.9-oz 14.3-oz 12-oz 28 9 (116.1 oz powder) 8 (114.4 oz powder) 10 (120 oz powder) 896 fl oz 864 fl oz 840 fl oz 870 fl oz 640 fl oz 84–91 oz powder 32-fl oz 12.9-oz 14.3-oz 12-oz 20 7 (90.3 oz powder) 6 (85.8 oz powder) 7 (84 oz powder) 640 fl oz 672 fl oz 630 fl oz 609 fl oz   51–60 oz powder Not recommendedf 12.9-oz 14.3-oz 12-oz 4 (51.6 oz powder) 4 (57.2 oz powder) 5 (60 oz powder) 384 fl oz 420 fl oz 435 fl oz 448 fl oz 57–65 oz powder 32-fl oz 12.9-oz 14.3-oz 12-oz 14 5 (64.5 oz powder) 4 (57.2 oz powder) 5 (60 oz powder) 448 fl oz 480 fl oz 420 fl oz 435 fl oz 320 fl oz 38–48 oz powder 32-fl oz 12.9-oz 14.3-oz 12-oz 10 3 (38.7 oz powder) 3 (42.9 oz powder) 4 (48 oz powder) 320 fl oz 288 fl oz 315 fl oz 348 fl oz bThis table uses container sizes currently available for Similac with Iron (Ross), Enfamil with Iron (Mead Johnson), and Carnation Good Start Supreme (Nestlé) as examples of commonly prescribed formulas with reconstitution rates of ~7 fl oz of formula per oz powder (e.g., Similac with Iron, Enfamil with Iron) and ~5 fl oz of formula per oz powder (e.g., Carnation Good Start Supreme).

OCR for page 216
WIC Food Packages: Time for a Change cA 12.9-oz can of powdered formula reconstitutes to 94–96 fl oz of formula; for calculation purposes 96 fl oz was used as representative of Similac with Iron (Abbott Laboratories, 2004). The container sizes in this column are representative of other formulas currently being used in the WIC program: Similac Advance with Iron (Ross; reconstitutes to 96 fl oz); and Enfamil Lipil with Iron (Mead Johnson; reconstitutes to 94 fl oz). dA 14.3-oz can of powdered formula reconstitutes to 105 fl oz of formula (Mead Johnson, 2004). The container sizes in this column are representative of Enfamil with Iron (Mead Johnson). eA 12-oz can of powdered formula reconstitutes to 87 fl oz of formula (Nestlé, 2005). The container sizes in this column are representative of Carnation Good Start Supreme (Nestlé) and Carnation Good Start Essentials (Nestlé). fFormula concentrate and ready-to-feed formula are not recommended because the partially breast-fed infant ages 0–3.9 mo will not routinely consume the entire contents of a can with a 24 h period leading to issues of food safety and wastage. For this reason, powdered formula is recommended. For the few circumstances where powdered formula is inappropriate (e.g., the water supply is inappropriate for preparation of formula from powder), formula can be prescribed in other forms at the following monthly maximum allowances: 208 fl oz liquid concentrate (e.g., 16 13-fl oz cans; 416 fl oz formula as reconstituted); or 416 fl oz ready-to-feed formula (e.g., 13 32-fl oz cans). DATA SOURCES: Abbott Laboratories, 2004; Mead Johnson, 2004; Nestlé, 2005.