. "Assessing Dietary Risk Among WIC Program Applicants." Framework for Dietary Risk Assessment in the WIC Program: An Interim Report from the Food and Nutrition Board. Washington, DC: The National Academies Press, 2000.
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Framework for Dietary Risk Assessment in the WIC Program: InterimReport
TABLE 1 WIC Priority System
Pregnant and breastfeeding women and infants at nutrition risk asdemonstrated by anthropometric or hematologic measurements or byother documented nutrition-related medical condition.
Infants up to 6 months of age of mothers who participated in WICduring pregnancy or who would have been eligible to participate underPriority I documented medical condition. This priority may also beassigned to a breastfeeding mother of an infant who is classifiedas Priority II.
Children at nutrition risk, as demonstrated by anthropometric orhematological assessment or other documented medical condition. AtState option, this priority can also include high-risk postpartumwomen.
Pregnant and breastfeeding women and infants at nutrition risk asdemonstrated by inadequate dietary pattern. At State option, thispriority can also include homeless and migrant pregnant and breastfeedingwomen and infants and high-risk postpartum women.
Children at nutrition risk because of inadequate dietary pattern.At State option, this priority can also include homeless and migrantchildren and high-risk postpartum women.
Postpartum women, not breastfeeding, at nutrition risk either medicalor dietary criteria unless they are assigned to higher prioritiesat State discretion. At State option, this priority may also includehomeless and migrant postpartum women.
Previously certified participants likely to regress in nutritionalstatus without continuation of supplemental foods. At State option,this priority can also include homeless and migrant participants.
growing concern among women and children enrolled in WIC (Mei etal., 1998; USDA, 2000). This is consistent with recent CDC reportsthat obesity rates among children and adolescents have doubled overthe past 20 years (Troiano and Flegal, 1998)
Dietary risk includes two major types of risk through which individuals may becomeeligible for participation in the WIC program. Inadequate diet as a risk criterion includes reported food intakes that are identifiedto be potentially low in nutrients. Inappropriate dietary pattern includes descriptors of dietary intake or habits, developmentallyor age-inappropriate patterns of feeding, and the ingestion of specificinappropriate substances. Dietary inadequacy has been defined (IOM,1996) as food or nutrient intake insufficient to meet a specifiedpercentage of the Recommended Dietary Allowances (RDAs) (NRC, 1989)for one or more nutrients. Determination of inadequate diets usuallyinvolves estimating nutrient intakes using some method of dietaryrecall or food frequency, and then comparing the intake with a specifiedpercentage of the RDAs for the individual (often between 70 and 100percent of the RDA) (IOM, 1996). Examples of inappropriate dietarypatterns include inappropriate infant or child feeding practices,pica, high caffeine intakes, and reported food intakes that do notmeet one or more of the Dietary Guidelines for Americans (USDA/DHHS,2000). The latter may include consumption of less than the recommendednumber of servings from food groups of the Food Guide Pyramid, unsupplementedvegan diets, or other highly restrictive diets.
In 1998, approximately 49 percent of all WIC enrollees (47 percentof women, 13 percent of infants, and 68 percent of children overthe age of 1 year) were certified for participation on the basisof dietary risk, either alone or in conjunction with other nutritional risks