National Academies Press: OpenBook

WIC Food Packages: Time for a Change (2006)

Chapter: Index

« Previous: Appendix I Acronyms and Abbreviations
Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

INDEX

A

AAP. See American Academy of Pediatrics

Acceptable Macronutrient Distribution Ranges (AMDRs), 34, 52–53, 55n, 155, 260n, 267, 290n, 291–292, 297, 313n, 372n

ACNielsen Homescan, 127, 129, 323n, 341n, 343n, 349n, 351n, 354n

ADA. See American Dietetic Association

Added sugars, specifying none, 13

Adequate Intake (AI) values, 34, 49, 266

and mean reported usual intakes of calcium, potassium, and fiber, 50

Adequate nutrients within food energy needs, and consistency of the revised food packages with recommendations from the Dietary Guidel ines for Americans, 153

Administrators in WIC state and local agencies, 22

flexibility and variety from, 171–172

Adolescent and adult women

nutrient intake profiles, 300–301

Food Package V for pregnant and partially breastfeeding women, 300

Food Package VI for non-breastfeeding postpartum women, 300

Food Package VII for fully breastfeeding women, 300–301

overweight and obesity in, 32–33

Advanced Notice of Proposed Rulemaking, 124

AHA. See American Heart Association

AIs. See Adequate Intake values

Alpha-tocopherol (AT), 234n, 244n, 260n, 312n, 364n, 366n

Alpha-tocopherol equivalents (ATEs), 234n, 244n, 260n, 272, 312n, 364n

AMDRs. See Acceptable Macronutrient Distribution Ranges

American Academy of Pediatrics (AAP), 5, 8–9, 16, 62, 68, 70n, 79n, 82, 103, 115, 155, 161n, 171, 323n, 341n, 370n, 374n

Committee on Nutrition, 155

American Dietetic Association (ADA), 68, 155, 157, 161n

American Heart Association (AHA), 55n, 261n, 313n, 341n, 370n, 372n, 374n

Amounts provided by current and revised food packages

compared with amounts suggested for caloric level, 156–157

fruits and vegetables, 156–157

grains, 156–157

meat and alternatives, 156–157

milk and alternatives, 156–157

infant formula provided, 113–114

fully formula-fed infants, 113–114

partially breast-fed infants, 114

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Analysis samples, 271

breast-fed infants 6-11 months old, 271

non-breastfed WIC infants under 1 year old, 271

non-breastfeeding women 14-44 years old, up to 1 year postpartum, 271

pregnant and lactating women 14-44 years old, 271

WIC children 1-4 years old, 271

Asian Americans, 32

Assessment of nutrient adequacy using the DRIs, 267–270

characteristics of the usual nutrient intake distributions, 268

proportion at risk of excessive intake levels, 269–270

proportion of subgroup with inadequate usual intake, 268–269

AT. See Alpha-tocopherol

ATE. See Alpha-tocopherol equivalents

B

Baby foods, in Food Package II, 7

Background, 19–45

committee’s task, 21

criteria for the redesign of the WIC food packages, 36–45

reasons to consider changes in the WIC food packages, 27–36

Special Supplemental Nutrition Program for Women, Infants, and Children, 22–27

Barriers to overcome, 43

Basic foods

candidates for addition to the packages, 82

including foods from each group, allowing some variety and choice, 12

selected substitutions and net cost changes resulting from substitutions, estimated costs of, 140–141

Benefits, 301–302

changes in food packages possibly having multiplier effects, 302

increasing choice possibly increasing consumption of WIC foods, 301

methods for evaluation of, 292–297

Black women, non-Hispanic, 32

BLS. See U.S. Bureau of Labor Statistics

Body mass index (BMI), 32n, 33

Body weight management, and consistency of the revised food packages with recommendations from the Dietary Guidelines for Americans, 153

Breast-fed infants 6-12 months old.

See also Fully breast-fed infants;

Partially breast-fed infants

analysis sample, 271

direction of changes in the level of priority nutrients in the revised food packages for, 147

nutrients of concern with regard to inadequate intake by, 252–253

priority nutrients for, 60

usual intake distributions of selected micro-nutrients and electrolytes, 94, 276

Breastfeeding, 69, 83.

See also Fully breastfeeding women

consistency of the revised food packages for infants and children under 2 years old with established dietary recommendations, 158

possibilities for incentivizing, 383

recommendations for promoting and supporting, 16, 174–175

studies on changes to promote, 168–169

C

Calcium, 12, 23, 30–31, 34, 56, 120

adequate intakes and mean reported usual intakes of, 50

health risks from intake of, and lead exposure, 62

increases in dietary oxalates interfering with absorption of, 302

low intake for many women, 49

Calculated costs of representative amounts of foods in revised packages, 125n, 129, 134, 342–349, 342n, 348n

children and women, 344–349

infants, 342–343

Calories, reducing, 13

Carbohydrates, and consistency of the revised food packages with recommendations from the Dietary Guidelines for Americans, 154

Cash-value vouchers, 104–105, 165

definitions of, 100

representations of, 100, 359

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Categorical eligibility, required for the WIC program, 22

Caveats and other potential benefits and risks, 301–302

non-quantified benefits and risks, 301–302

CDC. See Centers for Disease Control and Prevention

Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration (CFSAN), 225n

Center for Nutrition Policy and Promotion, U.S. Department of Agriculture (CNPP), 272

Centers for Disease Control and Prevention, U.S. Department of Health and Human Services (CDC), 128

CFR. See Code of Federal Regulations

CFSAN. See Center for Food Safety and Applied Nutrition

Changes in nutrient recommendations and dietary guidance, 33–35

new dietary guidance, 34–35

new nutrient recommendations, 33–34

Changes in the food supply and dietary patterns, 29–31

changes in food consumption, 30–31

increased variety in the food supply, 29–30

Changes in the health risks of the WIC-eligible population, 31–33

overweight and obesity in adolescent and adult women, 32–33

overweight in children, 33

Changes in the WIC population, demographic, 27–29

Changes in WIC food packages

in age specifications and breastfeeding categories, in Food Packages I and II for infants, 5–6

in allowed foods, possibly leading to decreased consumption of WIC foods, 302

called for by stakeholders, 35–36

need for, 17

in potential intakes paralleling changes in nutrients provided in the packages, 149–151

children 1 year old, 150

children 2-4 years old, 150

formula-fed infants younger than one year old, 150

fully breastfeeding women, 151

non-breastfeeding postpartum women, 151

pregnant women and partially breastfeeding women, 151

to promote breastfeeding, studies on, 168–169

to promote healthier eating patterns and improved nutrient adequacy, studies on, 169–171

in the revised food packages

addressing developmental needs of infants and young children, 112–115

addressing obesity concerns, 115–117

discussion of major, 100–120

including fruits and vegetables in the WIC food packages, 101–106

including more whole-grain products, 106

promoting and supporting breastfeeding, 108–112

proposed specifications for foods in the revised food packages, 121–123

providing more flexibility for WIC state agencies and more variety and choice for WIC participants, 117–120

reducing saturated fat and limiting cholesterol for participants 2 years old and older, 107–108

in the types and timing of the availability of complementary foods, 114–115

Cheese, 108

Child Nutrition Act, 20, 356–357

Child Nutrition and WIC Reauthorization Act, 356–357

Children

1 year old

changes in potential intakes paralleling changes in nutrients provided in the packages, 150

nutrient intake profiles for, 299

1-2 years old

direction of changes in the level of priority nutrients in the revised food packages for, 147

nutrients and ingredients to limit in the diet of, 260

nutrients of concern with regard to excessive intake by, 256–257

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

1-4 years old, considering public comments about food packages for, 81

2-4 years old

changes in potential intakes paralleling changes in nutrients provided in the packages, 150

food group priorities for, 65

nutrient intake profiles for, 299–300

2-4 years old and women in the childbearing years, 64–68

children ages 2-4 years, 65

overall, 65, 68

summary, 65, 68

women in the childbearing years, 65

2-5 years old

direction of changes in the level of priority nutrients in the revised food packages for, 147

nutrients and ingredients to limit in the diet of, 260

nutrients of concern with regard to excessive intake by, 256–257

comparison of estimated costs of current and revised food packages for, 130–131

defined, 20n

estimated program costs for food per participant per month using current packages for, 132–133

estimated program costs for food per participant per month using revised packages for, 136–137

overweight in, 33

revised food package for, 98

revised Food Package III for, 99

WIC food packages for, 97–98

Children and women

bases of assumptions used in nutrient and cost analyses of food packages for, 149n, 226n, 236n, 324–341

calculated costs of representative amounts of foods in revised packages for, 344–349

combined fresh and processed option for, 104–105

fresh produce option for, 104

maximum monthly allowances for revised WIC food packages, 90–92

processed fruit and vegetable option for, 104

Cholesterol

nutrient analysis of current and revised food packages using NDS-R, 232–233, 302

nutrient analysis of current and revised food packages using SR-17, 242–243

reducing, 13

Chronology of statutes pertaining to the definition of WIC supplemental foods, 22, 95n, 267, 356–357, 373n

Child Nutrition Act, 356–357

Child Nutrition and WIC Reauthorization Act, 356–357

CNPP. See Center for Nutrition Policy and Promotion

Code of Federal Regulations, U.S. Congress (CFR), 225n

Combined fresh and processed option, for children and women, 104–105

Committee on Nutrition, American Academy of Pediatrics, 155

Committee to Review the WIC Food Packages, 21, 23, 120

addressing concerns of WIC program staff and venders, 13–14

as consistent with dietary guidelines, 12–13

criteria of, 11–14

having wide appeal to diverse populations, 13–14

supporting improved nutrient intakes, 11–12

task of, 2

Comparison of cost incentives for breastfeeding, 139–141

comparison of the market (pre-rebate) value of maximum allowances for current and revised food packages for mother/infant pairs, 142–143

Comparison of current and revised food packages, 3, 151, 207–215, 296n, 303–313

for children (Food Package IV), 212

maximum monthly allowances, in Food Package IV for children, 9

estimated costs, 130–131

for children, 130–131

for infants, 130–131

for women, 130–131

for fully breastfeeding women (Food Package VII), 215

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

for non-breastfeeding postpartum women (Food Package VI), 214

nutrients and ingredients to limit in the diet, 312–313

nutrients of concern with regard to excessive intake, 150–151, 308–311

nutrients of concern with regard to inadequate intake, 304–307

for older infants (Food Package II), 209–210

for participants with special dietary needs (Food Package III), 211

for pregnant and partially breastfeeding women (Food Package V), 213

with regard to nutrients offered, 255–261

nutrients and ingredients to limit in the diet, 260–261

nutrients of concern with regard to excessive intake, 256–259

nutrients of concern with regard to inadequate intake, 252–255

for young infants (Food Package I), 208

Comparison of current food packages with dietary guidance, 77

dietary guidance related to foods in current WIC food packages, 78–79

Comparison of food items used in nutrient analyses from two databases, 226n, 246–251

fruits and vegetables, 246–249

grains, 248–249

infant foods, 246–247

meat and alternatives, 248–251

milk and alternatives, 248–249

Competent Professional Authorities (CPAs), 26, 92–93, 104, 171–172, 175

defined, 16n, 93n, 167n

Complementary foods, 70n, 115

changes in the types and timing of the availability of, 114–115

studies on delay in offering, 169

Concerns about current food packages, 164

from vendors, 164

from WIC local agencies, 164

from WIC state agencies, 164

Consistency of the revised food packages

for infants and children under 2 years old with established dietary recommendations, 158–161

breastfeeding, 158

developing healthy eating patterns, 160–161

feeding other foods to infants and young children, 159–160

formula feeding, 158–159

promoting food safety, 161

with recommendations from the Dietary Guidelines for Americans, 153–154

adequate nutrients within food energy needs, 153

body weight management, 153

carbohydrates, 154

fats, 154

food groups encouraged, 153–154

food safety, 154

sodium and potassium, 154

Consumer Price Index, 139

Consumption of WIC foods

changes in allowed foods possibly leading to decreased, 302

increasing choice possibly increasing, 301

Container size, addressing, 13

Continuing Survey of Food Intakes by Individuals (CSFII), 49, 50n, 51n, 53n, 55n, 56–57, 67n, 76, 261n, 270–272, 283n, 288n, 290n, 313n

limitations in the data set from, 47n

Cost calculations, 314–354

assumptions on feeding method, 315–316

bases of assumptions used in nutrient and cost analyses of food packages, 125n, 129, 318–341

calculated costs of representative amounts of foods in revised packages, 125n, 129, 134, 342–349

estimated program costs for food per month, 350–354

possible shifts in participation rates, 316–317

Cost-neutrality, 135

proposed WIC food packages as, 14–15

Costs of substitutions, 135, 139

CPAs. See Competent Professional Authorities

Criteria and priorities for revisions, 2–3

criteria for a WIC food package, 3

Phases I and II on developing and using, 4, 21

Criteria for the redesign of the WIC food packages, 36–45

Criterion 1, addressing the dual problems of undernutrition and overnutrition, 37–38

Criterion 2, consistency with the Dietary Guidelines for Americans, 38

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Criterion 3, consistency with recommendations for infants and children younger than age 2 years, 38

Criterion 4, suitability and safety for persons with limited transportation options, storage, and cooking facilities, 38–39

Criterion 5, acceptability, availability, and incentive value, 39–43

Criterion 6, consideration ofadministrative impacts, 43–45

Criterion 1, reducing the prevalence of inadequate and excessive nutrient intakes, 145–151

addressing the dual problems of undernutrition and overnutrition, 37–38

changes in potential intakes paralleling changes in nutrients provided in the packages, 149–151

and evaluating possible food packages, 84

priority nutrients changing in the desired direction in the revised food packages, 146

revised packages, 146–149

Criterion 2, promoting an overall dietary pattern consistent with Dietary Guidelines for Americans, 38, 152–154

amounts provided by current and revised food packages compared with amounts suggested for caloric level, 156–157

consistency of the revised food packages with recommendations from the Dietary Guidelines for Americans, 153–154

and evaluating possible food packages, 84

Criterion 3, promoting an overall diet consistent with Dietary Recommendations for Infants and Children, including support for breastfeeding, 152, 155

consistency of the revised food packages for infants and children under 2 years old with established dietary recommendations, 158–161

consistency with recommendations for infants and children younger than age 2 years, 38

and evaluating possible food packages, 85

Criterion 4, suitability and safety for persons with limited transportation options, storage, and cooking facilities, 38–39, 155, 162

and evaluating possible food packages, 85

tailoring the revised food packages for persons with limited resources, 162

Criterion 5, providing readily acceptable, widely available, and culturally suitable foods and incentives for families to participate, 155–157, 162–163

acceptability, availability, and incentive value, 39–43

food acceptability, 40

food availability, 42–43

foods commonly consumed, 40

incentive value, 43

participant diversity, 41–42

and evaluating possible food packages, 85–86

tailoring revised food packages to be readily acceptable, 163

Criterion 6, considering impacts on vendors and WIC agencies, 43–45, 162, 164–165

concerns about current food packages, 164

and evaluating possible food packages, 86

vendors, 43–44

WIC agencies, 44–45

CSFII. See Continuing Survey of Food Intakes by Individuals

Cultural acceptability, 41

Cultural diversity, 117

Culture, defining, 41

Current and revised food packages for mother/infant pairs, comparison of the market (pre-rebate) value of maximum allowances for, 142–143

Current Food Package III, overview of, 98

Current WIC food packages

for children, overview of, 97–98

estimated program costs for food per month using, 133n, 138n, 350–351, 352n

for infants, overview of, 92–93

maximum monthly allowances, 24–25

for women, overview of, 95

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

D

Data limitations, 56–57

Data on cost evaluation, 126–128

general considerations, 126

infant formula rebate assumption, 128

numbers of participants, 128

prices, 127–128

Data set, 270–273

analysis sample, 271

nutrients examined, 272–273

Delays, in offering complementary foods, studies on, 169

Delta approach, for evaluating nutritional benefits and risks, 295–296

Demographic changes in the WIC population, 27–29

annual number of participants in the WIC Program, 27

ethnic composition of the WIC population, 29

the WIC population by participant category, 28

Description of the revised food packages, 87–100

Food Package III for children and women with special dietary needs, 98–100

WIC food packages for children, 97–98

WIC food packages for infants, 92–95

WIC food packages for women, 95–97

Devaney, Barbara L., 375

Developing healthy eating patterns, consistency of the revised food packages for infants and children under 2 years old with established dietary recommendations, 160–161

Developmental needs of infants and young children

addressing, 112–115

changed from previous food packages, 112–115

amounts of infant formula provided, 113–114

changes in the types and timing of availability of complementary foods, 114–115

DFEs. See Dietary Folate Equivalents

DHHS. See U.S. Department of Health and Human Services

Dietary changes, possibly leading to undesirable nutrient-nutrient interactions, 302

Dietary fiber. See Fiber

Dietary Folate Equivalents (DFEs), 234n, 244n, 260n, 272n, 312, 365n, 366n

Dietary guidance

for infants and young children, 12

under the age of two years, 69–70

breastfeeding, 69

developing healthy eating patterns, 70

feeding other foods to infants and young children, 69–70

formula feeding, 69

promoting food safety, 70

new, 34–35

proposed WIC food packages as consistent with, 12–13

related to foods in current WIC food packages, 78–79

Dietary Guidelines Advisory Committee, 3, 58, 66n, 85n, 297

Dietary Guidelines for Americans, 3, 9–17, 22, 34–35, 38, 55n, 58, 62–63, 65, 76–77, 84, 98, 101–103, 107, 118, 152–154, 165–166, 170, 175–176, 261n, 290n, 291–292, 297, 313n, 372n

addressing container size and food safety concerns, 13

including foods from each basic food group, allowing some variety and choice, 12

including only whole grain products in the breads and cereals, 13

including options that contain no added salt, 13

promoting the consumption of whole fruits and vegetables, 13

providing fruits and vegetables, 13

reducing saturated fat, cholesterol, total fat, and calories, 13

specifying no added sugars, 13

Dietary oxalates, increases in interfering with calcium absorption, 302

Dietary Reference Intakes (DRIs), 33–34, 46, 49, 53n, 58, 148n, 261, 266–267, 280n, 292, 312n, 370n, 373n

acceptable macronutrient distribution ranges, 267

adequate intake, 266

estimated average requirement, 266

recommended dietary allowance, 266

tolerable upper intake level, 266

used for assessing intakes of WIC-eligible subgroups, 360–374

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Differences in nutritional needs, in promoting and supporting breastfeeding, 110–111

Dioxin-like compounds (DLC), 62–63

Dioxins, health risks from, 62–63

Direction of changes in the level of priority nutrients in the revised food packages, 147–148

for breastfed infants 6-12 months old, 147

for children 1-2 years old, 147

for children 2-5 years old, 147

for fully breastfeeding women, 148

for non-breastfed infants younger than 1 year, 147

for non-breastfeeding postpartum women, 148

pregnant and partially breastfeeding women, 147

Diverse populations, 117

having wide appeal to, 13–14

DLC. See Dioxin-like compounds

Dose-response assessment, 293–294

Dried fruit, 115

DRIs. See Dietary Reference Intakes

Dry beans or peas, in Food Package IV for children, 11

E

EARs. See Estimated Average Requirements

Easy Reference Guide to substitutions for various volumes of formula concentrate, 88n, 93–94, 113n, 236n, 262–264

formula-fed infants, 262–263

partially breastfed infants, 262–263

EBTs. See Electronic benefit transfers

Economic Research Service, U.S. Department of Agriculture (ERS), 127, 131n, 133n, 138n, 141n, 143n, 323n, 341n, 343n, 349n

Economical packaging, 16

Education. See Nutrition education

EERs. See Estimated Energy Requirements

Eggs, 30, 108

in Food Package IV for children, 9

price data on, 127

Electronic benefit transfers (EBTs), 44, 100, 172

Elements

DRIs used for assessing intakes of, 360–363

nutrient analysis of current and revised food packages using NDS-R, 101n, 110, 226–227

nutrient analysis of current and revised food packages using SR-17, 101n, 236–237

Eligibility. See Participants in the WIC Program

EPA. See U.S. Environmental Protection Agency

ERS. See Economic Research Service

Estimated adequacy of micronutrient usual intakes, 47–48

estimated prevalence of inadequacy of micronutrients and protein, 48–49

using usual intakes for children and women, 49

using usual intakes for infants, 48

Estimated Average Requirements (EARs), 34, 47, 50n, 260n, 266, 268, 273, 282n, 312n, 370n

Estimated Energy Requirements (EERs), 51–52, 113, 260n, 261n, 267–269, 370n

reported usual food energy intakes and, 51

Estimated program costs for food, 129–131

comparison of estimated costs of current and revised food packages, 130–131

Estimated program costs for food per month, 15, 350–354

selected substitutions and net cost changes resulting from substitutions, 140–141

using current packages, 133n, 138n, 350–351, 352n

using revised packages, 352–354

Estimated program costs for food per month per participant

using current packages, 132–133

for children, 132–133

for infants, 132–133

for women, 132–133

using revised packages, 136–138

for children, 136–137

for infants, 136–137

for women, 136–137

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Estimates of requirements, 57–58

vitamin E, 58

Estimates of upper levels, 58–59

vitamin A, 58–59

zinc, 58–59

Ethnic composition of the WIC population, marked demographic changes in, 29

Evaluation of cost, 124–144

comparing cost incentives for breastfeeding, 139–141

methods, 126–131

overview, 125–126

projecting the effects of changes in infant formula and milk prices, 142–144

results and discussion, 131, 134–139

of the revised packages, 86

summary, 144

Evaluation of nutritional benefits and risks, 292–297

the delta approach, 295–296

nutrient intake, 294–295

the proportional approach, 296–297

Evaluation of possible food packages, 83–86

Criterion 1, addressing the dual problems of undernutrition and overnutrition, 84

Criterion 2, consistency with the Dietary Guidelines for Americans, 84

Criterion 3, consistency with recommendations for infants and children younger than age 2 years, 85

Criterion 4, suitability and safety for persons with limited transportation options, storage, and cooking facilities, 85

Criterion 5, acceptability, availability, and incentive value, 85–86

Criterion 6, consideration of administrative impacts, 86

Evaluation of potential benefits and risks of the revised food packages, 291–313

application of methods, 297–301

caveats and other potential benefits and risks, 301–302

comparison of current and revised food packages, 151, 296n, 303–313

methods for evaluating nutritional benefits and risks, 292–297

summary, 303

Excessive intake levels, 53–56

nutrients of concern with regard to, 150–151, 308–311

proportion at risk of, 269–270

providing less of nutrients with, 148–149

reported usual intakes above the Tolerable Upper Intake Level and dietary guidance, 54–55

Exposure assessment, 293

F

Factor for days per month, 113n

Farmers Market Nutrition Program, 172

Fat-reduced milk and milk products, 13

Fat-soluble vitamins

nutrient analysis of current and revised food packages using NDS-R, 150, 228–229

nutrient analysis of current and revised food packages using USDA Nutrient Database for Standard Reference (SR-17), 238–239

Fats

and consistency of the revised food packages with recommendations from the Dietary Guidelines for Americans, 154

DRIs used for assessing intakes of selected, 372–374

nutrient analysis of current and revised food packages using NDS-R, 234–235

nutrient analysis of current and revised food packages using SR-17, 244–245

FDA. See Food and Drug Administration

Feeding Infants and Toddlers Study (FITS), 68, 315

Feeding infants and young children

and nutrition education, 176

other foods, 69–70

consistency of the revised food packages for infants and children under 2 years old with established dietary recommendations, 159–160

Feeding method assumptions, 315–316

for infants in the WIC program, 315–316

for women in the WIC program, 316

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Fiber, 51, 56, 60, 64, 106

adequate intakes and mean reported usual intakes of, 50

AIs for children, 58

increases in interfering with mineral absorption, 302

nutrient analysis of current and revised food packages using NDS-R, 232–233, 302

nutrient analysis of current and revised food packages using SR-17, 242–243

First month after birth, revised Food Package I for, 93

FITS. See Feeding Infants and Toddlers Study

Flexibility and variety in revising the WIC food packages, 16, 171–172

administrators in WIC state and local agencies, 22, 171–172

Food and Nutrition Service, 171

need for, 74–76

recommendations for, 16, 171–172

Flexibility for WIC state agencies

changed from previous food packages, 117–120

fruits and vegetables, 117–119

milk products, 119–120

providing more, 117–120

FNB. See Food and Nutrition Board, Institute of Medicine

FNDDS. See Food and Nutrient Database for Dietary Studies

FNS. See Food and Nutrition Service

Folate, 48.

See also Dietary Folate Equivalents

and birth defects, 61

as folic acid, 273

Food acceptability, 40

Food and Drug Administration, U.S. Department of Health and Human Services (FDA), 63, 96, 123n, 225n

Standards of Identity, 225n

Food and Nutrient Database for Dietary Studies (FNDDS), 272

Food and Nutrition Board, Institute of Medicine, The National Academies (FNB), 21

Food and Nutrition Service, U.S. Department of Agriculture (FNS), 2, 16, 21, 23, 26, 42, 128, 131, 136n, 167, 171, 175, 177, 235n, 341n, 352n

flexibility and variety, 171

special recommendation on vitamin D supplementation, 171

Food availability, 42–43

Food consumption, changes in, 30–31

Food energy needs, adequate nutrients within, and consistency of the revised food packages with recommendations from the Dietary Guidelines for Americans, 153

Food groups

and consistency of the revised food packages with recommendations from the Dietary Guidelines for Americans, encouraging, 153–154

priorities for the WIC food packages, 63–71, 76

children ages 2-4 years and women in the childbearing years, 64–68

low-income children 2-4 years old, and women, 64

low-income children younger than 2 years old, 68–71

mean numbers of servings from five basic food groups consumed by selected age groups, 66–67

nutrient and food group priorities for revision of the WIC food packages, 72–73

in for proposed Food Package II for infants ages 6 months to 1 year, 7

Food Guide, USDA, 118

Food instruments

cash-value voucher, 100

definitions of, 100

standard WIC food instrument, 100

workable procedures for, 172–173

Food Package Advisory Panel, 23

Food package costs, estimating, 129

Food Package I for young infants, 5–7, 26, 93–94, 98, 149n, 168, 208, 298–299

for 1-3 month olds, 93–94

at 4 months old, 94

for the first month after birth, 93

fully formula-fed infants, 208

partially breastfed infants, 208

participant eligibility, 208

proposed, 6–7

fully formula-fed infants, 6

partially breast-fed infants, 6

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Food Package II for older infants, 5, 7–8, 16, 26, 94–95, 98–99, 103, 113, 115, 149n, 161n, 209–210, 235n, 298–299

at 6 months old, 94

baby foods, 7

formula, 7

fully breast-fed infants, 209

fully formula-fed infants, 209–210

juice, 8

maximum monthly allowances for proposed Food Package II for infants ages 6 months to 1 year, 7

partially breast-fed infants, 209

participant eligibility, 210

Food Package III for individuals with special dietary needs, 8, 26, 81, 88n, 98–100, 130, 134, 154n, 211

current Food Package III, 98

participant eligibility, 211

revised Food Package III, 98–100

Food Package IV for children, 8–9, 11, 99, 150, 212, 299

comparison of the current and proposed food package for children, maximum monthly allowances, 9

dry beans or peas, 11

eggs, 9

fruits and vegetables, 9

juice, 8

milk and milk alternatives, 9

participant eligibility, 212

whole grains, 11

Food Package V for pregnant and partially breastfeeding women, 5, 6n, 24n, 80, 111, 151, 213

and nutrient intake profiles for adolescent and adult women, 300

participant eligibility, 213

Food Package VI for non-breastfeeding postpartum women, 6n, 151, 214

and nutrient intake profiles for adolescent and adult women, 300

participant eligibility, 214

Food Package VII for fully breastfeeding women, 24n, 43, 90n, 111, 175, 215

and nutrient intake profiles for adolescent and adult women, 300–301

participant eligibility, 215

Food packages

as supplementary foods, 81

types of, 82

Food Packages I and II for infants, 5–8

change in age specifications and breastfeeding categories, 5–6

Food Packages V, VI, and VII for women, 11

proposed food packages for women, maximum monthly allowances, 10

Food safety, 39

addressing concerns, 13

and consistency of the revised food packages with recommendations from the Dietary Guidelines for Americans, 154

promoting, 70

Food Stamp program, 22

The food supply

and dietary patterns, changes in, 29–31

increased variety in, 29–30

Food Surveys Research Group (FSRG), 313n

Foods

for addition to the packages

basic foods, 82

food packages as supplementary foods, 81

fruits and vegetables, 82

identifying candidate, 81–83

milk and milk products, 83

supporting and promoting breastfeeding, 83

types of food packages, 82

whole grains, 83

commonly consumed, 40

in the current WIC packages to be deleted or reduced in the revised food packages, 82

foods in the current WIC packages to be deleted or reduced in the revised food packages, 82

identifying, 81

and nutrition education, 176

Formula. See Infant formula

Formula-fed infants.

See also Fully formula-fed infants

Easy Reference Guide to substitutions for various volumes of formula concentrate, 262–263

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

younger than 1 year old

changes in potential intakes paralleling changes in nutrients provided in the packages, 150

nutrient intake profiles for, 298–299

Formula feeding, 69

consistency of the revised food packages for infants and children under 2 years old with established dietary recommendations, 158–159

in Food Package II, 7

Fortification of food, 177

Four Food Groups, 34

Fragile Families and Child Well-Being Study, 109, 174

Fresh produce

an option for children and women, 104

workable procedures for, 173–174

Freshness of fruits and vegetables, ensuring, 13, 30

Fruits and vegetables, 12, 14.

See also Processed fruit and vegetable option

amounts provided by current and revised food packages compared with amounts suggested for caloric level, 156–157

candidates for addition to the packages, 82

comparison of food items used in nutrient analyses from two databases, 246–249

definitions of food instruments, 100

effects on program staff and vendors of adding, 105–106

ensuring freshness of, 13, 30

in Food Package IV for children, 9

including in the WIC food packages, 101–106

changed from previous food packages, 101–106

price data on, 127

promoting the consumption of whole, 13

proposed specifications for, 121

providing, 13, 173–174

providing more flexibility for WIC state agencies and more variety and choice for WIC participants, 117–119

rationale for adding, 100–103

specific recommendations, 103–105

specifications for foods in the revised food packages, 218–219

FSRG. See Food Surveys Research Group

Fully breast-fed infants, 209

6-12 months old, nutrients and ingredients to limit in the diet of, 260

Fully breastfeeding women

changes in potential intakes paralleling changes in nutrients provided in the packages, 151

direction of changes in the level of priority nutrients in the revised food packages for, 148

Fully formula-fed infants, 208–210

0-4 months old, nutrients of concern with regard to excessive intake by, 256–257

4-6 months old, nutrients of concern with regard to excessive intake by, 256–257

6-12 months old

nutrients and ingredients to limit in the diet of, 260

nutrients of concern with regard to excessive intake by, 256–257

amounts of infant formula provided to, 113–114

Food Package I for, 6

G

GAO. See U.S. General Accounting Office (now U.S. Government Accountability Office)

Grains. See also Whole-grain products

amounts provided by current and revised food packages compared with amounts suggested for caloric level, 156–157

comparison of food items used in nutrient analyses from two databases, 248–249

proposed specifications for, 122–123

specifications for foods in the revised food packages, 222–223

Gray, George M., 375–376

Groceries, price data on, 127–128

H

Handling food in the home, and nutrition education, 176

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Harrison, Gail G., 376

Hazard identification, 293

Health risks of the WIC-eligible population, changes in, 31–33

Healthier eating patterns

developing, 70

studies on changes to promote, 169–171

Healthy People 2010, 38, 61, 68, 79, 108

HHS Blueprint for Action on Breastfeeding, 108

High-quality protein, 23

I

Impacts of changes in the WIC food packages

on vendors, 384

on WIC agencies, 383–384

Implementation. See also Studies related to implementation and its effects

and its effects, studies on, 167–171

Improved nutrient intakes, supporting, 11–12

Inadequate usual intake

nutrients of concern with regard to, 304–307

proportion of subgroup with, 268–269

providing greater amounts of nutrients with, 146–148

Incentive value, 43

Incentivizing breastfeeding, possibilities for, 383

Income eligibility, required for the WIC program, 22

Infant Feeding Practices Study, 109

Infant foods

comparison of food items used in nutrient analyses from two databases, 246–247

proposed specifications for, 121

specifications for foods in the revised food packages, 218–219

Infant formula

amounts provided, 113–114

price data on, 127

rebate assumption, 128

Infants and children younger than 2 years old

dietary guidance for, 69–70

summary for, 71

Infants in the WIC program

0-3 months old, 315

1-3 months old, revised Food Package I for, 93–94

4-5 months old, 315

4 months old, revised Food Package I at, 94

6-12 months old, 315

6 months old, Food Package II at, 94

bases of assumptions used in nutrient and cost analyses of food packages for, 138n, 315n, 318–323

calculated costs of representative amounts of foods in revised packages for, 342–343

comparison of estimated costs of current and revised food packages for, 130–131

considering public comments about food packages, 80

defined, 20n

estimated program costs for food per participant per month using current packages for, 132–133

estimated program costs for food per participant per month using revised packages for, 136–137

feeding method assumptions for, 315–316

revised Food Package III for, 99

revised food packages for, 93–95

WIC food packages for, 92–95

Information Resources, Inc. (IRI), 127

Institute of Medicine, The National Academies (IOM), 2, 15, 21, 23, 82, 97n, 102, 107, 118, 120, 363n, 370n

Committee to Review the WIC Food Packages, 2, 11–14

Intakes of sodium, 53, 56

Intakes of WIC-eligible subgroups

DRIs used for assessing, 360–374

elements, 360–363

selected fats, 372–374

selected macronutrients, 368–370

vitamins, 364–366

International Zinc Nutrition Consultative Group (IZiNCG), 149n

IOM. See Institute of Medicine

Iowa State University (ISU) method, 268

IRI. See Information Resources, Inc.

Iron, 23, 30, 34, 47, 60, 115, 362n

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Iron-deficiency anemia, 61

ISU. See Iowa State University

IZiNCG. See International Zinc Nutrition Consultative Group

J

Jensen, Helen H., 376–377

Juice

in Food Package II, 8, 103

in Food Package IV for children, 8

K

Kaiser, Lucia L., 377

Kinsey, Jean D., 377–378

Korean Americans, 42

L

Lactating women 14-44 years old

nutrients and ingredients to limit in the diet of, 260

nutrients of concern with regard to excessive intake by, 258–259

nutrients of concern with regard to inadequate intake by, 254–255

Lactation, defined, 97

Listerosis, 39

Local WIC State Agency, 383

Low-fat, defined, 107n

Low-income children

2-4 years old, and women, 64

younger than 2 years old, 68–71

M

Macronutrients

and added sugars, reported usual intakes outside dietary guidance, 53

DRIs used for assessing intakes of selected, 368–370

nutrient analysis of current and revised food packages

using NDS-R, 232–233, 302

using SR-17, 242–243

Magnesium, 47, 56, 362n

requirements for adults, 58

March of Dimes Birth Defects Foundation, 61

Market baskets of food, 23

Market value of the packages for the mother/infant pair, in promoting and supporting breastfeeding, 109–110

Maximum monthly allowances

for children and women in the revised WIC food packages, 90–92

for infants in the revised WIC food packages, 88–89

for proposed Food Package II for infants ages 6 months to 1 year, 7

food groups, 7

specialty foods, 7

in revised WIC food packages for children and women, 90–92

Mean numbers of servings from five basic food groups consumed by selected age groups, 66–67

Meat and alternatives

amounts provided by current and revised food packages compared with amounts suggested for caloric level, 156–157

comparison of food items used in nutrient analyses from two databases, 248–251

proposed specifications for, 123

specifications for foods in the revised food packages, 223–224

Medicaid program, 22, 32

Methodological approaches, 383

Local WIC State Agency, 383

National WIC Association, 383

USDA, 383

Methods of cost evaluation, 126–131

data, 126–128

estimating food package costs, 129

estimating program costs for food, 129–131

Methylmercury, health risks from, 63

Mexican American women, 32

Micronutrients and protein, estimated prevalence of inadequacy of

using usual intakes for children and women, 49

using usual intakes for infants, 48

Milk and milk alternatives

amounts provided by current and revised food packages compared with amounts suggested for caloric level, 156–157

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

candidates for addition to the packages, 83

comparison of food items used in nutrient analyses from two databases, 248–249

fat content of, 96

fat-reduced, 107

in Food Package IV for children, 9

proposed specifications for, 122

providing more flexibility for WIC state agencies and more variety and choice for WIC participants, 119–120

specifications for foods in the revised food packages, 220–222

Mineral absorption, increases in dietary fiber interfering with, 302

Minimizing early supplementation, 111–112

basis for policy change, 111–112

in promoting and supporting breastfeeding, 111–112

proposed policy change related to initial

food package options for mother/infant pairs after delivery, 111

Multiplier effects, changes in food packages possibly having, 302

Murphy, Suzanne P., 378

N

National Advisory Council on Maternal, Infant, and Fetal Nutrition (NACMIFN), 23

National Association of WIC Directors (NAWD). See National WIC Association

National Health and Nutrition Examination Survey (NHANES), 32–33, 60–61

National Immunization Survey, 351n, 354n

National Maternal and Infant Health Survey, 174

National Research Council (NRC), 268–269

National WIC Association (formerly National Association of WIC Directors) (NWA), 35, 41, 80, 383

NAWD. See National Association of WIC Directors

NCC. See Nutrition Coordinating Center, University of Minnesota

NDL. See Nutrient Data Laboratory, U.S. Department of Agriculture

NDS-R. See Nutrient Data System for Research

nutrient analysis of current and revised food packages using, 226–235

NEs. See Niacin Equivalents

New dietary guidance, 34–35

New nutrient recommendations, 33–34

NHANES. See National Health and Nutrition Examination Survey

Niacin, 48, 272

Niacin equivalents (NEs), 365n

NOAELs (No Observed Adverse Effect Levels), 149n

Non-breastfed infants younger than 1 year old

direction of changes in the level of priority nutrients in the revised food packages for, 147

non-breastfed WIC infants 0-3 months old

usual intake distributions of selected macronutrients (cholesterol and fiber), 284

usual intake distributions of selected micronutrients and electrolytes, 274

non-breastfed WIC infants 4-5 months old

usual intake distributions of selected macronutrients (cholesterol and fiber), 284

usual intake distributions of selected micronutrients and electrolytes, 275

non-breastfed WIC infants 6-12 months old

usual intake distributions of selected macronutrients (cholesterol and fiber), 285

usual intake distributions of selected micronutrients and electrolytes, 94, 276

Non-breastfeeding postpartum women

14-44 years old

nutrients and ingredients to limit in the diet of, 260

nutrients of concern with regard to excessive intake by, 256–257

nutrients of concern with regard to inadequate intake by, 252–255

adolescent and adult

usual intake distributions of selected macronutrients (cholesterol and fiber), 49n, 288

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

usual intake distributions of selected micronutrients and electrolytes, 49n, 282–283

changes in potential intakes paralleling changes in nutrients provided in the packages, 151

direction of changes in the level of priority nutrients in the revised food packages for, 148

Non-breastfeeding women 14-44 years old, up to 1 year postpartum, analysis sample, 271

Non-Hispanic black women, 32–33

Non-Hispanic white women, 32

Non-quantified benefits and risks, 301–302

benefits, 301–302

risks, 302

NRC. See National Research Council

Nutrient adequacy, studies on changes to promote improved, 169–171

Nutrient analysis of current and revised food packages, 95n, 149n, 226–237, 228n, 230n, 232n, 234n, 341n

using NDS-R, 226–235

elements, 101n, 110, 226–227

fat-soluble vitamins, 150, 228–229

fats, 234–235

macronutrients, fiber, phytate, and cholesterol, 232–233, 302

water-soluble vitamins, 230–231

using SR-17, 95n, 145n, 236–245, 322n, 340n

elements, 101n, 236–237

fat-soluble vitamins, 238–239

fats, 244–245

macronutrients, fiber, phytate, and cholesterol, 242–243

water-soluble vitamins, 240–241

Nutrient and cost analyses of food packages assumptions, 125n, 129, 318–341

for children and women, 149n, 226n, 236n, 324–341

for infants, 138n, 315n, 318–323

Nutrient and food group priorities for revision of the WIC food packages, 72–73

Nutrient Data Laboratory, U.S. Department of Agriculture (NDL), 250n

Nutrient Data System for Research (NDSR), 83, 234n, 235n, 244n, 250n, 261n, 322n, 340n

Nutrient Database for Standard Reference, U.S. Department of Agriculture (SR17), 83, 234n, 244n, 245n, 250n, 322n

Nutrient intake

for evaluating nutritional benefits and risks, 294–295

profiles, 298–301

for adolescent and adult women, 300–301

for children 1 year old, 299

for children 2-4 years old, 299–300

for formula-fed infants younger than 1 year old, 298–299

of WIC subgroups, 265–290

data set, 270–273

Dietary Reference Intakes, 266–267

using the DRIs to assess nutrient adequacy, 267–270

usual intake distributions of selected macronutrients (cholesterol and fiber), 54n, 284–288

usual intake distributions of selected micronutrients and electrolytes, 54n, 274–283

usual intakes and percentages with reported usual intakes of macronutrients and added sugars outside dietary guidance, 289–290

Nutrient-nutrient interactions, dietary changes possibly leading to undesirable, 302

Nutrient priorities for the WIC food packages, 46–60

because of excessive intakes, 77

because of inadequate intakes, 76–77

calcium, potassium, and fiber usual intakes, 48–51

data limitations, 56–57

discussion of results, 56–59

estimated adequacy of micronutrient usual intakes, 47–48

estimates of requirements, 57–58

estimates of upper levels, 58–59

excessive intake levels, 53–56

priority nutrients, 59–60

usual food energy intakes, 51–52

usual intakes of macronutrients and added sugars, 52–53

Nutrient profiles of current and revised food packages, 146, 216–264

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

comparison of current and revised food packages with regard to nutrients offered, 255–261

comparison of food items used in nutrient analyses from two databases, 226n, 246–251

nutrient analysis of current and revised food packages, 95n, 149n, 226–237, 228n, 230n, 232n, 234n, 341n

specifications for foods in the revised food packages, 90n, 92n, 97, 101, 106, 123n, 177, 218–225, 323n

substitutions for various volumes of formula concentrate Easy Reference Guide, 88n, 93–94, 113n, 236n, 262–264

Nutrient recommendations

and dietary guidance, changes in, 33–35

new, 33–34

Nutrients. See also Target nutrients target, 22–23

Nutrients and ingredients to limit in the diet, 260–261

children 1-2 years old, 260

children 2-5 years old, 260

comparison of current and revised food packages, 312–313

comparison of current and revised food packages with regard to, 260–261

fully breast-fed infants 6-12 months old, 260

fully formula-fed infants 6-12 months old, 260

lactating women 14-44 years old, 260

non-breastfeeding postpartum women 14-44 years old, 260

pregnant and lactating women 14-44 years old, 260

Nutrients examined, 272–273

folate as folic acid, 273

folate in Dietary Folate Equivalents, 272

niacin, 272

vitamin E, 272

Nutrients of concern

providing greater amounts of, 146–148

with regard to excessive intake, 256–259

children 1-2 years old, 256–257

children 2-5 years old, 256–257

comparison of current and revised food packages, 150–151, 308–311

comparison of current and revised food packages with regard to, 256–259

fully formula-fed infants 0-4 months old, 256–257

fully formula-fed infants 4-6 months old, 256–257

fully formula-fed infants 6-12 months old, 256–257

lactating women 14-44 years old, 258–259

non-breastfeeding postpartum women 14-44 years old, 256–257

pregnant and lactating women 14-44 years old, 256–257

with regard to inadequate intake, 252–255

breast-fed infants 6-12 months old, 252–253

comparison of current and revised food packages, 252–255, 304–307

lactating women 14-44 years old, 254–255

non-breastfeeding postpartum women 14-44 years old, 252–255

pregnant and lactating women 14-44 years old, 252–253

WIC children 1-2 years old, 252–253

WIC children 2-5 years old, 252–253

Nutrition Coordinating Center, University of Minnesota (NCC), 234n, 245n, 250n, 261n, 322n, 340n

Nutrition Data System for Research software, 234n

Nutrition education, 16–17, 175–177

feeding infants and young children, 176

foods, 176

handling food in the home, 176

recommendations for, 16–17, 175–177

shopping, 176

Nutrition-related health priorities for the WIC food packages, 60–63

folate and birth defects, 61

iron-deficiency anemia, 61

other nutrition-related health risks, 62–63

overweight and obesity, 60

summary of nutrition-related health priorities, 63

summary of nutrition-related health risks, 64

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Nutrition-related health risks, 22, 62–63

calcium intake and lead exposure, 62

dioxins, 62–63

methylmercury, 63

vitamin D and bone health, 62

zinc and breast-fed infants 6 through 11 months, 62

NWA. See National WIC Association

O

Obesity concerns, 60

addressing, changed from previous food packages, 115–117

in adolescent and adult women, 32–33

Class 3, 33

Odoms-Young, Angela M., 378–379

Overweight, 60

in adolescent and adult women, 32–33

in children, 33

P

Packaging

economical, 16

re-sealable, 16

Partially breast-fed infants, 208, 209

amounts of infant formula provided to, 114

Easy Reference Guide to substitutions for various volumes of formula concentrate, 262–263

Food Package I for, 6

Participants in the WIC Program

diversity of, 41–42

eligibility of

for children (Food Package IV), 212

for fully breastfeeding women (Food Package VII), 215

for non-breastfeeding postpartum women (Food Package VI), 214

for older infants (Food Package II), 210

for participants with special dietary

needs (Food Package III), 211

for pregnant and partially breastfeeding women (Food Package V), 213

for young infants (Food Package I), 208

marked changes in annual number of, 27

marked demographic changes in the WIC population by category, 28

numbers of, 128

Participation rates, possible shifts in, 316–317

Pediatric Nutrition Surveillance System, 60

Pennsylvania State University, 23

Peterson, Karen E., 379

Phases I and II, on developing and using criteria, 4, 21

Physical Activity Level, 51n

Phytate

nutrient analysis of current and revised food packages using NDS-R, 232–233, 302

nutrient analysis of current and revised food packages using SR-17, 242–243

Policy change, basis for minimizing early supplementation, 111–112

Postpartum, defined, 20n

Potassium, 12, 51, 56, 60, 102

adequate intakes and mean reported usual intakes of, 50

and consistency of the revised food packages with recommendations from the Dietary Guidelines for Americans, 154

Pregnancy, defined, 97

Pregnant, lactating, and non-breastfeeding post partum women, priority nutrients for, 60

Pregnant or lactating adolescent and adult women

analysis sample, 271

nutrients and ingredients to limit in the diet of, 260

nutrients of concern with regard to excessive intake by, 256–257

nutrients of concern with regard to inadequate intake by, 252–253

usual intake distributions of selected macronutrients (cholesterol and fiber), 49n, 287

usual intake distributions of selected micronutrients and electrolytes, 49n, 280–281

Pregnant women and partially breastfeeding women, changes in potential intakes paralleling changes in nutrients provided in the packages, 151

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Preliminary Open Session, 172, 382

Prescription rate, defined, 126n

Price data, 127–128

for eggs, 127

for fruits and vegetables, 127

for infant formula, 127

for other groceries, 127–128

Priority food groups, 76–77

Priority nutrients, 59–60

breast-fed infants 6-11 months, 60

changing in the desired direction in the revised food packages, 146

nutrient priorities because of excessive intakes, 77

nutrient priorities because of inadequate intakes, 76–77

pregnant, lactating, and non-breastfeeding post partum women, 60

WIC children 1-4 years old, 60

WIC infants under 1 year old, non-breastfed, 59

Private-label brands, 30

Process used for revising the WIC food packages, 74–86

comparing current food packages with dietary guidance, 77

considering public comments, 77–81

evaluating possible food packages, 83–86

evaluating the cost of the revised packages, 86

identifying candidate foods for addition to the packages, 81–83

identifying foods that could be deleted or reduced in quantity, 81

need for flexibility, 74–76

Phase I, developing criteria, 4, 75

Phase II, using criteria, 4, 75

priority food groups and nutrients, 76–77

summary, 86

Processed fruit and vegetable option, for children and women, 104

Product availability, recommendations for, 177, 179

Program costs for food

estimating, 129–131

per participant per month

using current packages, estimated, 132–133

using revised packages, estimated, 136–138

Projections, of the effects of changes in infant formula and milk prices, 142–144

Promoting and supporting breastfeeding, 108–112

changed from previous food packages, 108–112

differences in nutritional needs, 110–111

market value of the packages for the mother/infant pair, 109–110

minimizing early supplementation, 111–112

recommended studies, 112

Proportional approach, for evaluating nutritional benefits and risks, 296–297

Proposed Criteria for Selecting the WIC Food Packages: A Preliminary report of the Committee to Review the WIC Food Packages, 21, 36

Proposed food packages for women, maximum monthly allowances, in Food Packages V, VI, and VII for women, 10

Proposed policy change related to initial food package options, for mother/infant pairs after delivery, minimizing early supplementation, 111

Proposed specifications for foods in the revised food packages, 121–123

changed from previous food packages, 121–123

fruits and vegetables, 121

grains, 122–123

infant foods, 121

meat and alternatives, 123

milk and alternatives, 122

Proposed WIC food packages, 3–11

as cost-neutral, 14–15

Food Package I, 6–7

Food Package II, 7–8

Food Package III for those with special dietary needs, 8

Food Package IV for children, 8–9, 11

Food Packages I and II for infants, 5–8

Food Packages V, VI, and VII for women, 11

in line with the committee’s criteria, 11–14

process for revising the WIC food package, 4

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Protein, 47

high-quality, 23

Public comments, 77–81

about food packages for children ages 1-4 years, 81

about food packages for those with special dietary needs, 81

about infants’ food packages, 80

about women’s food packages, 80

Pyramid Serving Data, 64

Q

Quantity-denominated vouchers, 165

R

RACC. See Reference amounts customarily consumed per eating occasion

RAEs. See Retinol Activity Equivalents

RDAs. See Recommended Dietary Allowances

Re-sealable packaging, 16

Reasons to consider changes in the WIC food packages, 27–36

changes called for by stakeholders, 35–36

changes in nutrient recommendations and dietary guidance, 33–35

changes in the food supply and dietary patterns, 29–31

changes in the health risks of the WIC-eligible population, 31–33

marked demographic changes in the WIC population, 27–29

Rebate assumption, for infant formula, 128

Recognized Medical Authority (RMA), 98n

Recommendations, 103–105

combined fresh and processed option for children and women, 104–105

fresh produce option for children and women, 104

processed fruit and vegetable option for children and women, 104

Recommendations for implementation and evaluation of the revised WIC food packages, 15–17, 166–179

breastfeeding promotion and support, 16, 174–175

flexibility and variety, 16, 171–172

nutrition education, 16–17, 175–177

product availability, 177, 179

studies prior to implementation of the revised packages, 16

summary, 179

workable procedures, 16, 172–174

Recommended Dietary Allowances (RDAs), 33–34, 58–59, 260n, 266, 299, 363n, 366n, 370n

Redemption rate, defined, 126n

Reduced-fat, defined, 107n

Reducing saturated fat and limiting cholesterol for participants 2 years old and older, changed from previous food packages, 107–108

Reference amounts customarily consumed per eating occasion (RACC), 225n

Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 38

Representations of WIC food instruments, 266, 358–359

cash-value, 100, 359

standard, 100, 358

Requirements for WIC program, 22

categorical eligibility, 22

income eligibility, 22

nutritional risk, 22

Retinol activity equivalent (RAE), 234n, 244n, 260n, 282n, 312n, 346n

Revised Food Package I, for 1-3 month olds, 93–94

Revised Food Package III, 98–100

for children, 99

for infants, 99

for women, 99–100

The revised food packages, 87–123, 146–149

description of, 87–100

discussion of major changes, 100–120

estimated program costs for food per month using, 352–354

Food Package III for children and women with special dietary needs, 98–100

for infants, 93–95

Food Package I, 93–94

Food Package II, 94–95

maximum monthly allowances, 88–92

for children and women, 90–92

for infants, 88–89

meeting the criteria specified, 145–165

Criterion 1, reducing the prevalence of inadequate and excessive nutrient intakes, 145–151

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Criterion 2, promoting an overall dietary pattern consistent with Dietary Guidelines for Americans, 152–154

Criterion 3, promoting an overall diet consistent with Dietary Recommendations for Infants and Children, including support for breastfeeding, 152, 155

Criterion 4, foods in package available in forms suitable for low-income persons with limited transportation, storage, and cooking facilities, 155, 162

Criterion 5, providing readily acceptable, widely available, and culturally suitable foods and incentives for families to participate, 155–157, 162–163

Criterion 6, considering impacts on vendors and WIC agencies, 162, 164–165

summary, 165

providing greater amounts of nutrients of concern, 146–148

providing greater amounts of nutrients with inadequate intake, 146–148

providing less of nutrients with excessive intake, 148–149

summary, 120

WIC food packages for children, 97–98

WIC food packages for infants, 92–95

WIC food packages for women, 95–97

for women, 96–97

Risks, 302

changes in allowed foods possibly leading to decreased consumption of WIC foods, 302

characterizing, 293–294

dietary changes possibly leading to undesirable nutrient-nutrient interactions, 302

methods for evaluation of, 292–297

RMA. See Recognized Medical Authority

S

Salt, including options that contain no added, 13, 17

Saturated fat, reducing, 13

Select Committee on Nutrition and Human Needs, U.S. Senate, 34

Shopping, and nutrition education, 176

Siega-Riz, Anna Maria, 379–380

SKU. See Stock-keeping unit

Socioeconomic status, 33

Sodium, 53, 56, 101n

and consistency of the revised food packages with recommendations from the Dietary Guidelines for Americans, 154

reducing, 16

Soy beverage, 119

Special dietary needs, 26

considering public comments about food packages for those with, 81

Food Package III for children and women with, 98–100

Special recommendation on vitamin D supplementation, from the FNS, 171

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), 1, 19, 22–27

requirements for WIC program, 22

supplemental foods and target nutrients, 22–23

WIC food packages, 23, 26–27

Specialty foods, in for proposed Food Package II for infants ages 6 months to 1 year, 7

Specifications for foods in the revised food packages, 90n, 92n, 97, 101, 106, 123n, 177, 218–225, 323n

additional foods for Food Package III, 224

fruits and vegetables, 218–219

grains, 222–223

infant foods, 218–219

meat and alternatives, 223–224

milk and alternatives, 220–222

SR-17. See Nutrient Database for Standard Reference

Stakeholders, changes called for by, 35–36

Stallings, Virginia A., 380

Standard Reference 17 (SR-17).

See Nutrient Database for Standard Reference

Standard WIC food instruments

definitions of, 100

representations of, 100, 358

Standards of Identity, 225n

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

State health departments, increasing frequency of inspection by, 44

State WIC associations, 35

Statutes pertaining to the definition of WIC supplemental foods, 22, 95n, 267, 356–357, 373n

Child Nutrition Act, 356–357

Child Nutrition and WIC Reauthorization Act, 356–357

Stock-keeping unit (SKU), 30

Store-brand products, 30

Studies recommended in promoting and supporting breastfeeding, 112

Studies related to implementation and its effects, 167–171

changes to promote breastfeeding, 168–169

changes to promote healthier eating patterns and improved nutrient adequacy, 169–171

delay in offering complementary foods, 169

prior to implementation of the revised packages, recommendations for, 16

Substitutions

costs of, 135, 139

for powdered formula, 113n

for various volumes of formula concentrate, ‘Easy Reference Guide,’ 88n, 93–94, 113n, 236n, 262–264

formula-fed infants, 262–263

partially breast-fed infants, 262–263

Sugars, specifying no added, 13

Suitor, Carol West, 380–381

Supplemental Children’s Survey, 270

Supplemental foods, 22–23, 356–357

Supporting breastfeeding. See Breastfeeding;

Promoting and supporting breastfeeding

Surgeon General’s Report on Health Promotion and Disease Prevention, 35

T

Tailoring the revised food packages

to be readily acceptable, 163

for persons with limited resources, 162

Target nutrients, 22–23

Temporary Assistance for Needy Families program, 22

Thiamin, 48

Tolerable Upper Intake Levels (ULs), 12, 34, 47, 55, 58–59, 72n, 149, 260n, 266, 269–270, 282n, 298–299, 312n, 362n, 363n, 366n, 374n

and dietary guidance, reported usual intakes above, 54–55

Total fat, reducing, 13

Trans fatty acids, 73n, 76, 235n, 245n, 261n, 373n

U

ULs. See Tolerable Upper Intake Levels (ULs)

Undesirable nutrient-nutrient interactions

dietary changes possibly leading to, 302

increases in dietary fiber interfering with mineral absorption, 302

increases in dietary oxalates interfering with calcium absorption, 302

University of Minnesota, 83

U.S. Bureau of Labor Statistics (BLS), 29, 127, 131n, 341n, 349n, 351n, 354n

Consumer Price Index, 139

U.S. Department of Agriculture (USDA), 2, 21, 23, 35, 64–65, 77, 118, 123n, 137n, 225n, 383

Nutrient Database for Standard Reference (SR-17), nutrient analysis of current and revised food packages using, 95n, 145n, 236–245, 322n, 340n

Standard Reference Database, 83

U.S. Department of Health and Human Services (DHHS), 35, 225n

U.S. Environmental Protection Agency (EPA), 63, 97, 123n, 225n

U.S. General Accounting Office (now U.S. Government Accountability Office) (GAO), 177

U.S. Senate, Select Committee on Nutrition and Human Needs, 34

USDA. See U.S. Department of Agriculture

Usual food energy intakes, 51–52

reported usual food energy intakes and estimated energy requirements, 51

Usual intake distributions

characteristics of nutrient, 268

of selected macronutrients and added sugars, 52–53

outside dietary guidance, 53, 289–290

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

of selected macronutrients (cholesterol and fiber), 54n, 284–288

non-breastfed WIC infants 0-3 months old, 284

non-breastfed WIC infants 4-5 months old, 284

non-breastfed WIC infants 6-12 months old, 285

non-breastfeeding postpartum adolescent and adult women, 49n, 288

pregnant or lactating adolescent and adult women, 49n, 287

WIC children 2-4 years old, 49n, 286

WIC children 12-24 months old, 49n, 285

of selected micronutrients and electrolytes, 54n, 274–283

breast-fed and non-breastfed WIC infants 6-11 months old, 94, 276

non-breastfed WIC infants 0-3 months old, 274

non-breastfed WIC infants 4-5 months old, 275

non-breastfeeding postpartum adolescent and adult women, 49n, 282–283

pregnant or lactating adolescent and adult women, 49n, 280–281

WIC children 1-2 years old, 49n, 277

WIC children 2-4 years old, 49n, 278–279

V

Variety and choice for WIC participants

changed from previous food packages, 117–120

fruits and vegetables, 117–119

milk products, 119–120

providing more, 117–120

Variety in the food supply

increased, 29–30

increasing, 29–30

Vegetables. See Fruits and vegetables

Vendors

concerns about current food packages from, 164

consideration of administrative impacts on, 43–44

impact of changes in the WIC food packages on, 384

Vitamins

DRIs used for assessing intakes of, 364–366

vitamin A, 12, 23, 31, 34, 47, 56, 102

estimates of upper levels, 58–59

vitamin C, 23, 31, 34, 47, 102

vitamin D, 12, 30, 119–120

and bone health, health risks from, 62

special recommendation for supplementation from the FNS, 171

supplementing, 16, 114n

vitamin E, 47, 56–57, 60, 272

estimates of requirements, 58

vitamin K, supplementing, 114n

Vouchers or other food instruments, workable procedures for, 172–173

W

Washington, DC, Public Forum, 384–385

Water-soluble vitamins

nutrient analysis of current and revised food packages using NDS-R, 230–231

nutrient analysis of current and revised food packages using USDA Nutrient Database for Standard Reference (SR-17), 240–241

White women, non-Hispanic, 32

WHO. See World Health Organization

Whole-grain products

in the breads and cereals, including only, 13–14

candidates for addition to the packages, 83

in Food Package IV for children, 11

including more, changed from previous food packages, 106

WIC. See Process used for revising the WIC food packages;

Special Supplemental Nutrition Program for Women, Infants, and Children

WIC agencies

consideration of administrative impacts on, 44–45

impact of changes in the WIC food packages on, 383–384

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

WIC children

1-2 years old

nutrients of concern with regard to inadequate intake by, 252–253

usual intake distributions of selected macronutrients (cholesterol and fiber), 49n, 285

usual intake distributions of selected micronutrients and electrolytes, 49n, 277

1-4 years old

analysis sample, 271

priority nutrients for, 60

2-4 years old

usual intake distributions of selected macronutrients (cholesterol and fiber), 49n, 286

usual intake distributions of selected micronutrients and electrolytes, 49n, 278–279

2-5 years old, nutrients of concern with regard to inadequate intake by, 252–253

WIC food instruments

definitions of, 100

representations of, 266, 358–359

The WIC food packages, 23, 26–27

for children, 97–98

overview of the current food package for children, 97–98

revised food package for children, 98

revised WIC food packages, maximum monthly allowances for children and women, 90–92

current, maximum monthly allowances, 24–25

food priorities for, 46–73

for infants, 92–95

overview of current food packages for infants, 92–93

revised food packages for infants, 93–95

revised WIC food packages, maximum monthly allowances for infants, 88–89

nutrient priorities for, 46–60, 72–73

reasons to consider changes in, 27–36

for women, 95–97

overview of current food packages for women, 95

revised food packages for women, 96–97

revised WIC food packages, maximum monthly allowances for children and women, 90–92

WIC infants under 1 year old, non-breastfed, priority nutrients for, 59

WIC local agencies, concerns about current food packages from, 164

WIC Participant and Program Characteristics, 128, 132n, 137n, 350n, 354n

The WIC population

ethnic composition of, marked demographic changes in, 29

by participant category, marked demographic changes in, 28

The WIC Program

marked changes in the annual number of participants, 27

staff and venders, addressing concerns of, 13–14

WIC state agencies, concerns about current food packages from, 164

Women

in the childbearing years, food group priorities for, 65

comparison of estimated costs of current and revised food packages for, 130–131

estimated program costs for food per participant per month

using current packages for, 132–133

using revised packages for, 136–137

revised Food Package III for, 99–100

revised food packages for, 96–97

WIC food packages for, 95–97

feeding method assumptions for, 316

women’s food packages, considering public comments about, 80

Workable procedures, 16, 172–174

fresh produce, 173–174

recommendations for, 16, 172–174

vouchers or other food instruments, 172–173

World Health Organization (WHO), 161n

Suggested Citation:"Index." Institute of Medicine. 2006. WIC Food Packages: Time for a Change. Washington, DC: The National Academies Press. doi: 10.17226/11280.
×

Y

Younger than 2 years old and low-income children, 68–71

dietary guidance for infants and children under the age of two years, 69–70

summary for infants and children younger than 2 years old, 71

Z

Zinc, 12, 47–48, 56, 60, 115, 362n

estimates of upper levels, 58–59

health risks from in breast-fed infants 6 through 12 months, 62

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The Special Supplemental Nutrition Program for Women, Infants, and Children (the WIC program) has promoted the health of low-income families for more than 30 years by providing nutrition education, supplemental food, and other valuable services. The program reaches millions of families every year, is one of the largest nutrition programs in the United States, and is an important investment in the nation’s health. The U.S. Department of Agriculture charged the Institute of Medicine with creating a committee to evaluate the WIC food packages (the list of specific foods WIC participants obtain each month). The goal of the study was to improve the quality of the diet of WIC participants while also promoting a healthy body weight that will reduce the risk of chronic diseases. The committee concluded that it is time for a change in the WIC food packages and the book provides details on the proposed new food packages, summarizes how the proposed packages differ from current packages, and discusses the rationale for the proposed packages.

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