Framework for Dietary Risk Assessment in the WIC Program Interim Report (2000) / Chapter Skim
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Assessing Dietary Risk Among WIC Program Applicants
Assessing Dietary Risk Among WIC Program Applicants
Pages 3-20
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From page 3... ...
In the event that a WIC agency has reached its magnum caseload given funding constraints, nutrition risk criteria provide the basis for a priority system in which program applicants can be placed on an eligibility waiting list. As openings become available, applicants from the waiting list may enter the program according to priority level.
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(IOM, 19961. Examples of inappropriate dietary patterns include inappropriate infant or child feeding practices, pica, high caffeine intakes, and reported food intakes that do not meet one or more of the Dietary Guidelines for Americans (USDA/DHHS, 2000~.
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From page 5... ...
The ~ 996 FNB committee recommended discontinuing the use of the criterion inadequate diets. Although it concluded that individuals in this category would benefit greatly from the supplemental food provided through participation in the WIC program, it also concluded that currently available assessment tools have inherent limitations that make them unacceptable for determining which income-eligible individuals consume inadequate diets.
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From page 6... ...
The committee's task is to evaluate the use of various dietary assessment tools and to make recommendations for the assessment of inadequate or inappropriate dietary patterns. These assessments should accurately identify dietary risk of individuals and thus eligibility for 6
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More specifically, during its deliberations, the committee is charged with the following tasks: I Propose a framework for assessing dietary risk among WIC program applicants, focusing on "Failure to Meet Dietary Guidelines" as a risk criterion.
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NAWD and FNS agree with TOM's recommendation for research to develop practical and valid assessment tools for identification of inadequate diets or inappropriate dietary patterns. Dietary adequacy will be considered a high priority for further research.
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From page 9... ...
For this reason, dietary intakes are generally assessed for most WIC applicants regardless of whether or not they have already met eligibility requirements based on nutrition risk criterion other than dietary risk. In 1998, 86 percent of state agencies had policies that required obtaining dietary intake information from all participants (USDA, 2000~.
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From page 10... ...
The validity of FFQs is usually determined by correlating estimates of nutrient intake with nutrient-intake estimates obtained from a set of diet recalls or prospectively collected diet records. The correlation coefficients for intake of specific nutrients between FFQ and diet records or recalls (after adjustment for within-person variability)
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From page 11... ...
Data coding, data entry, and data analysis are usually more expensive than those entailed with the food frequency method. Estimates of nutrient intake from a single 24-hour recall are poorly correlated with nutrient intake estimates obtained from a set of diet records, from weighed intakes, or from intakes recorded by independent observers (Bingham, 1991)
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From page 12... ...
Behavioral Approaches in Assessing Dietary Intake The above dietary assessment methods focus on determining what and/or how much of a food or nutrient a WTC client consumes. In comparison, a behavioral approach to diet assessment can be viewed as examining the context of eating—where, when, and how.
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From page 13... ...
For children ages 2 to 5 years and for pregnant, lactating, and noniactating postpartum women, the 1996 lOM report suggested using the indicator "failure to meet Dietary Guidelines" (IOM, 1996~. To be current, this would involve using the consensus document Dietary Guidelines for Americans (USDA/DHHS, 2000)
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In most dietary assessment research, the investigator intends to measure a person's usual intake. However, research has demonstrated that a person's food intake varies substantially from day to day (Nelson et al., 19891.
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To assess dietary intake and patterns effectively, dietary assessment tools need to be developed with each specific culture in mind. Thus, many WIC agencies are likely to require several or even many different dietary assessment tools to serve their population mix.
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who assess dietary intake in the WTC setting. CPAs are often paraprofessional staff who have received basic nutrition training.
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1996. WIC Nutrition Risk Criteria: A Scientific Assessment.
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1989. Between- and w~thin-subject variation in nutrient intake from infancy to old age: Estimating the number of days required to rank dietary intakes with desired precision.
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2000. Nutrition and Your Health: Dietary Guidelines for Americans, 2000, 5th Edition.
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