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Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report (2016)

Chapter: Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation

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Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

TABLE C-1 Comparison of IOM 2006 Recommendations and USDA and State Implementation Specific to Meeting Dietary Guidance

2006 IOM Report USDA Action
Major Proposed Changes Specific Recommendation Federal Regulationa State Option

Include fruits and vegetables for all individuals 6 months and older

Provide a CVV for fruit and vegetable purchases, $8 for children and $10 for women; allow fresh and processed, and jarred infant fruits and vegetables. One pound of fresh bananas may replace 8 oz of baby food

Provide a CVV of $8 for children; $10 for women; fruits and vegetables may be fresh or processed with no added sugars or fats; vendors must stock at least two fruits and two vegetables

States may allow fresh and/ or processed; may restrict packagingb; may allow farmers’ markets to accept vouchers; substitution of a portion of jarred infant fruits and vegetables with a CVV ($4 for partially BF, $6 for fully BF) by individual assessment

Include more whole grain products

Allow only whole grain breakfast cerealsc

Allow whole grain bread with other possible whole grain substitutions

At least one-half of all breakfast cereal on each state agency’s authorized food list must have whole grain as the primary ingredient by weight and meet labeling requirements for making a health claim as a “whole grain food with moderate fat content”

States may select authorized cereals

Allow whole wheat bread, brown rice, bulgur, oats, whole-grain barley, soft corn or whole wheat tortillas, and whole wheat macaroni products

States may select authorized breads and substitutions

Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

Reduce amounts of saturated fat for participants ages 2 years and older (thereby reducing cholesterol and total fat provided)

Reduce quantities of milk

Permit whole milk for children 1 to 2 years of age

Reduce quantity of cheese

Reduce quantity of eggsd

Reduce amounts of milk

Permit whole milk between 1 and 2 years of age only; for others milk must be skim or 1% only

Reduce cheese and limit substitution rate

Reduce quantity of eggs

No option to increase milk amounts

States may issue reduced-fat milks to infants 1 year of age if weight is a concern

No option to increase substitution of cheese for milk

No option for eggs

Provide more flexibility for WIC state agencies and more variety and choice for WIC participants

In grain category, allow soft corn or whole wheat tortillas, brown rice, oatmeal, bulgur, and barley, as bread substitutes; allow soy beverage, tofu, and yogurt as milk substitutes; allow canned beans; allow tuna, sardines, mackerel, and salmon

Whole grain tortillas (corn or wheat), brown rice, oatmeal, bulgur, barley, and whole wheat pasta may be substituted for bread; tofu may be substituted for milk; yogurt may be substituted for 1 q milk; dried or canned beans; tuna, salmon, sardines, and jack mackerel permitted as fish options

States must provide bread, milk, dry or canned beans, and at least two fish options; additional substitutions at state option

Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
2006 IOM Report USDA Action
Major Proposed Changes Specific Recommendation Federal Regulationa State Option

Promote and support breastfeeding, especially full breastfeeding

Provide higher CVV value for breastfeeding mothers

Reduce formula to partially breastfed infants

Infant formula not provided in the first month to breastfeeding infants

Fully breastfeeding infants receive jarred baby food meats in addition to greater amounts of baby food fruits and vegetables

Additional quantities of milk, eggs, and cheese; also fish, whole grains, and cheese for breastfeeding mothers

Provide a $10 CVV for all women

No routine issuance of formula to partially breastfeeding infants

Infant formula may be provided to breastfed infants in the first month, but this should not be standardized

Individual needs should be assessed and the food quantities issued accordingly

Additional quantities of milk, eggs, and cheese; also fish, whole grains and cheese for breastfeeding mothers

No option to change the CVV amount

States may tailor amounts of formula up to the maximum allowance

No routine issuance in the first month to breastfeeding mothers, or may provide 1 can of powdered infant formula in the first month

Assess individual needs to tailor packages

States may offer various substitutions in the whole grains and fish categories

Address developmental needs of infants and young children

Slightly increase formula amounts for fully formula-fed infants 4 to 5 months of age (and exclusion of juice and cereal)

Fully formula-fed infants 4 to 5 months of age received a slightly increased amount of infant formula

No option

Reduce formula amounts for infants 6 to 11 months of age; infant foods provided only at 6 months of age or older

Reduced maximum amounts of formula; no infant foods provided from 0 to less than 6 months of age

No option

Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

Commercial baby food and fresh bananas for infants

From 9 months to less than 1 year, half of jarred foods may be substituted with fresh fruits and vegetablese; for infants 6 months to less than 1 year, fresh bananas may be substituted for a limited amount of jarred baby food fruit

State option to allow the infant fruit and vegetable substitutions

Address obesity concerns

Slightly decrease total food energy provided by the packages after 4 months of age (except for fully breastfeeding infants), including reduced milk, cheese, eggs, and juice

Limit added sugars in commercial baby food, processed fruits and vegetables, breakfast cereals, and whole grains

Milk, cheese, eggs, and juice quantities were reduced overall

No option

Limits placed on added sugars content of breakfast cereals and yogurt

States may further reduce added sugars limits

NOTES: BF = breastfeeding; CVV = cash value voucher; IOM = Institute of Medicine; USDA = U.S. Department of Agriculture.

a Federal regulation information is from the final rule issued March 4, 2014. See the documentation for the minimum requirements and specifications for foods, including sugar limits and Standards of Identity.

b States may not selectively choose the fruits and vegetables allowable, but may restrict packaging type and packaging sizes. Types may be restricted if vendor or participant confusion is anticipated.

c At least 51 percent of the grain in the product was required to be whole grain.

d The primary reason for reducing the quantity of eggs was to maintain cost neutrality; fat and cholesterol reduction was a secondary result.

e Partially breastfed infants may receive a $4 CVV plus 64 ounces of infant food fruits and vegetables; fully breastfed infants may receive an $8 CVV plus 128 ounces of infant food fruits and vegetables.

SOURCES: IOM, 2006; USDA/FNS, 2014.

Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

REFERENCES

IOM (Institute of Medicine). 2006. WIC food packages: Time for a change. Washington, DC: The National Academies Press.

USDA/FNS (U.S. Department of Agriculture/Food and Nutrition Service). 2014. Special Supplemental Nutrition Program for Women, Infants and Children (WIC): Revisions in the WIC food packages; final rule, 7 C.F.R. § 246.

Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 367
Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 368
Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 369
Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 370
Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 371
Suggested Citation:"Appendix C: Comparison of Institute of Medicine 2006 Recommendations and Regulatory Implementation." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 372
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The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began 40 years ago as a pilot program and has since grown to serve over 8 million pregnant women, and mothers of and their infants and young children. Today the program serves more than a quarter of the pregnant women and half of the infants in the United States, at an annual cost of about $6.2 billion. Through its contribution to the nutritional needs of pregnant, breastfeeding, and post-partum women; infants; and children under 5 years of age; this federally supported nutrition assistance program is integral to meeting national nutrition policy goals for a significant portion of the U.S. population.

To assure the continued success of the WIC, Congress mandated that the Food and Nutrition Service of the U.S. Department of Agriculture (USDA) reevaluate the program's food packages every 10 years. In 2014, the USDA asked the Institute of Medicine to undertake this reevaluation to ensure continued alignment with the goals of the Dietary Guidelines for Americans. This, the second report of this series, provides a summary of the work of phase I of the study, and serves as the analytical underpinning for phase II in which the committee will report its final conclusions and recommendations.

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