as size at birth that is appropriate for gestational age, and the mother. Thought needs to be given to methods for studying how WIC interventions can affect the woman’s risk of such outcomes as gestational diabetes and obesity, and especially how WIC could help reduce risks during the first pregnancy. Currently, the interconceptional period provides an opportunity to conduct research on how WIC can influence maternal health and behaviors. Another key message was that researchers should study long-term health outcomes.

Suggested methods for studying birth outcomes included collaboration with the National Children’s Study and setting priorities with the goal of gaining the greatest benefit from the research. One way to gain benefit would be to focus on women with prior adverse outcomes or on communities with marked disparities. In a study of relationships of pregnancy outcomes with vitamin D intakes, for example, one could select, as subjects, women at risk for vitamin D deficiency because of dark skin color or lack of exposure to sunlight. Harrison closed her summary by showing selected slides used by the presenters (also see Chapter 2) and reemphasizing the following types of studies:

  1. Observational studies on the effect of interconceptional nutrition on birth and long-term child health outcomes.

  2. Nutritional intervention studies that begin at interconception.

  3. Nutritional research that focuses on women’s health before, between, and beyond pregnancy.

  4. Studies designed to examine the effects of interventions to reduce preconceptional smoking and obesity, to achieve prenatal weight gain that falls within Institute of Medicine recommendations, and to support breastfeeding.

Overweight and Obesity

Patricia B. Crawford


Obesity has become the foremost health problem of children, said Crawford, and WIC is well positioned to address the problem. A number of risk factors for obesity have been identified, and they are applicable to the diverse population served by WIC. The speakers agreed that studies should focus on messages aimed at reducing those risk factors, and they agreed on study design. In particular, the speakers proposed a multi-stage approach that would involve many community partners as messengers. The first step would be to conduct formative research to develop the preventive messages and to consider the context in which they will be received. The process would include selecting the message that has the most promise for reducing



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