Review of WIC Food Packages Proposed Framework for Revisions: Interim Report (2016) / Chapter Skim
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5 Food Intake of WIC-Eligible Populations
5 Food Intake of WIC-Eligible Populations
Pages 159-194
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From page 159... ...
The information summarized in this chapter, in combination with the nutrient intake information presented in Chapter 4, support identification of nutrient and food group priorities for the WIC food packages. LITERATURE AND REPORT FINDINGS: FOOD INTAKE OF WIC PARTICIPANTS The committee reviewed the literature for information on food intakes of WIC participants, with a particular focus on complementary feeding practices.
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. Food Intake and the Revised Food Packages Except for studies on breastfeeding, data characterizing the effect of the 2009 WIC food package changes on children's food intake or health are sparse.
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(2015) conducted a pre-post study that surveyed African American WIC participant mothers and their eldest child at two WIC clinics in Atlanta, Georgia, specifically to examine the impact of the 2009 food package changes on milk intake.
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Geographical Differences in Food Intakes The committee identified one cross-sectional study on geographic differences in food intake. In a comparison of fruit and vegetable consumption between urban and rural African American Texas WIC participants, Ettienne-Gittens et al.
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A comparison of the designs of IFPS II and FITS 2008 is outlined in Table 5-1. It should be noted that the data from these two studies were collected before the October 1, 2009, deadline for states to implement revisions to the WIC food packages.
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794 WIC infants and Not identified in this Participants of enrolled children analysis in Sample households (mother 117 infants, 0–5.9 and/or infant) months participated in WIC 84 infants, 6–8.9 in the neonatal months period 76 infants 9–11.9 912 (30.1 percent)
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h Two days of dietary intake per sampled child was used to calculate usual nutrient intake distributions, Briefel et al., 2010. i While two 24-hour recalls are part of the NHANES procedures, Grimes et al.
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166 REVIEW OF WIC FOOD PACKAGES TABLE 5-2 Complementary Food Intake of Infants, Ages 0 to 2 Years of Age, from IFPS II and FITS 2008 IFPS IIa FITS 2008b Percent Percent Consuming Consuming in on a Given Day Age in the Previous Age in Food Group Months Week Months WIC Non-WIC Fruit (Excluding Juice) 3 2.8 0–5.9 8.6c 6.4c 6 71.3 6–11.9 69.1 75.6 9 97.0 12–23.9 62.3 83.6d 12 98.4 100% Juice 3 5.0 0–5.9 8.2c 3.8c 6 33.4 6–11.9 46.1 28.3e 9 62.8 12–23.9 61.9 52.4 12 76.9 Vegetables, total 3 1.4 0–5.9 11.2c 8.4 6 73.1 6–11.9 57.7 75.6e 9 97.2 12–23.9 73.5 69.5 12 98.7 Grains and Grain 3 18.3 0–5.9 26.7 22.7 Products, total 6 86.1 6–11.9 91.5c 90.3 9 96.3 12–23.9 99.5c 98.4c 12 97.0 Infant Cereal 3 18.2 0–5.9 26.7 21.9 6 83.7 6–11.9 61.8 66.9 9 83.4 12–23.9 6.9c 11.4 12 46.6 Meats and Meat 3 0.7 0–5.9 2.8c 0.0c Substitutesf 6 22.0 6–11.9 64.1 53.6 9 78.4 12–23.9 93.9c 94.1 12 96.6 Cow's Milk, total 3 0.3 0–5.9 0.0 0.0 6 1.2 6–11.9 13.3 9.4 9 5.3 12–23.9 86.5 81.0 12 81.2 Cow's Milk, Whole NR 6–11.9 10.0c 7.8 12–23.9 59.2 64.2
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. The FITS 2008 data showed that fruit consumption on a given day was less common in WIC participants 12–23.9 months old than in their nonparticipant counterparts (Deming et al., 2014)
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(2015) , as intake contributed to less than 1 percent of total energy intake.
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. In the 12–23.9 month group, 56.2 and 63 percent WIC participants were consuming grains in mixed dishes and non-infant cereals, respectively ( eming et al., 2014)
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. Point estimates of meat and meat substitute consumption among FITS 2008 WIC participants ages 0 to less than 6 months are imprecise due to sample size and because consumption of meats and meat substitutes was an uncommon event for this age group (Deming et al., 2014)
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The 2005–2012 NHANES analysis found that sweet bakery products contributed 1.8 percent of the total energy intake of 6–11.9-montholds (Grimes et al., 2015)
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. Women who introduced complementary foods early were more likely to be participating in the WIC program, according to Clayton et al.
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recommends that infants who consume at least half of their daily feedings from human milk receive a 1 mg/kg/day iron supplement starting at 4 months of age, with the supplement eventually being displaced by iron-rich complementary foods (Baker and Greer, 2010; AAP, 2014)
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Therefore, it was not possible to compare food intakes among WIC participants before the 2009 food package changes occured to those after the changes were implemented. Moreover, only the 2005–2008 NHANES data were considered appropriate for comparison of WIC participants to WIC
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No statistically significant differences between WIC participant and WIC-eligible nonparticipant subgroups were identified. For low-income women in the 2011–2012 NHANES dataset, the estimated percentage below recommendations data are not reliable because the population subgroup size was small and the variance was large.2 Therefore, mean usual intake data are presented so comparisons can be made 1 The 2009–2010 NHANES dataset spanned the period of time over which the 2009 food package changes were implemented.
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0 (8.57) Total Protein Foods 6 oz-eq/d 5.10 (0.23)
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did not include a red and orange vegetables subgroup. h For solid fats and added sugars, Recommended Intakes indicate an upper limit.
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There were small differences across these groups in food intake, but women in the 2011–2012 NHANES dataset consumed more total fruit, total vegetables (as well as dark green and red and orange) , whole grains, total protein foods (including meat, poultry, and eggs; nuts, seeds, and soy)
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. Reference values are the USDA food patterns from the Scientific Report of the 2015 Dietary Guidelines Advisory Committee (USDA/HHS, 2015)
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Food Group Intakes of Children 1 to Less Than 2 Years of Age As was the case for infants, the 2015 DGAC report does not include recommended food patterns for children 1 to less than 2 years of age. For this reason, mean usual food group and subgroup intakes for children of these ages are presented in Table 5-7 (intake distributions are presented in Appendix Q)
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. Reference values are the USDA food patterns from the Scientific Report of the 2015 Dietary Guidelines Advisory Committee (USDA/HHS, 2015)
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. Reference values are the USDA food patterns from the Scientific Report of the 2015 Dietary Guidelines Advisory Committee (USDA/HHS, 2015)
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2 (2.82) Total Protein Foods 3.13 oz-eq/d 57 (4.87)
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Intakes were particularly poor (80 percent or more below recommended intakes across all three subgroups of children) for total vegetables (and, within total vegetables, dark green vegetables and red and orange vegetables)
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, although still well below the maximum score of 100. WIC participating children and income-eligible nonparticipant children in the NHANES 2005–2008 surveys had virtually identical mean scores for the HEI-2010 overall (total score)
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. k Calories from solid fats, alcohol, and added sugars; threshold for counting alcohol is more than 13 grams/1,000 kcal.
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. k Calories from solid fats, alcohol, and added sugars; threshold for counting alcohol is more than 13 grams/1,000 kcal.
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analysis found that WIC-participating children had significantly higher scores than WIC-eligible nonparticipant children for all three of the dietary components that should be consumed in moderation: sodium, refined grains, and empty calories. In the committee's analysis, there were no significant differences between WIC children and income-eligible nonparticipant children for these components.4 One potential reason for the discrepant findings (both analyses are based on 2005–2008 NHANES data)
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and the Iowa State University method were used instead of SPADE, and for different sample years and respondent selection criteria, so mean intakes and the comparisons to recommended intakes differ between the Letter Report and the analyses presented here. Overall, comparisons to recommended food patterns presented in this report are similar to those in other studies.
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2014. Infant feeding practices study II and its year six follow-up, chapter 2: Neonatal survey.
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2013. The effect of revised WIC food packages on Native American children.
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food packages on dietary intake and home food availability in African-American and Hispanic families. Public Health Nutrition 17(1)
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: Revisions in the WIC food packages; final rule, 7 C.F.R.
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