Index
A
Academy of Nutrition and Dietetics, 40, 126, 144, 146, 447
Acceptable macronutrient distribution range (AMDR), 218, 219, 471, 565, 570, 573
Added sugars (see also Calories for other uses; Total sugars)
AAP guidance, 129
adverse health consequences, 217
alignment with DGA, 13, 39, 87, 109, 111, 124–125, 149, 193, 215, 219, 386, 389, 845, 847, 849, 851, 853, 855, 858, 860, 861, 862, 863, 865
alignment with DRIs, 131, 133, 135, 173, 175, 178, 184, 225, 230, 235, 240
assessment of intakes, 573, 574, 578, 580, 754, 756
breakfast cereal limits, 123, 124, 225, 230, 234, 235, 240, 306, 348, 487, 720, 729, 754, 782, 784, 785
criteria for inclusion, 376, 379
current packages, 123–125, 218, 296, 300, 306, 714, 715, 716, 717, 720, 722–723, 724, 729, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
health effects linked to, 217, 218
and Healthy Eating Index, 196–197
impacts of changes, 344–345, 348–349, 364, 365, 376, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
infant intakes, 133, 175, 178, 207, 217, 219, 290, 714, 715, 858, 860
intake patterns, 81, 82, 84, 109, 120, 125, 135, 149, 164, 172, 173, 175, 178, 180, 184, 188, 189, 190, 191, 192, 193, 195, 196, 204, 207, 217, 218, 219, 223, 240, 344–345, 348, 644–665, 681–684, 687, 715, 716, 720, 731, 861, 862, 863, 865
in milks and milk substitutes, 7, 13, 123, 149, 225, 230, 240, 296, 303, 304, 305, 344–345, 346, 376, 379, 386, 716, 776, 778, 780, 900, 902
nutrition education on, 456
and palatability of nutrient-dense foods, 124, 295, 303, 379, 730
prioritization rationale and preliminary actions, 217, 218, 219, 223–224, 225, 230, 235, 240, 295, 303, 343, 363, 378, 682, 683, 684, 687, 900, 902
proposed changes, 295, 296, 297, 299, 303, 720
racial and ethnic differences in consumption, 164
regulatory analysis, 484
revised packages, 290, 295, 296, 297, 299, 300, 303, 304, 305, 306, 343, 344–345, 346, 363, 364, 365, 720, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
sensitivity analysis, 343, 344, 345, 346, 348, 349, 363, 364, 365, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
substitutions and, 346
“supplemental” concept and, 44
women participant’s intakes, 81, 125, 131, 172, 173, 188, 189, 190, 194, 195, 204, 207, 217, 218, 223, 225, 230, 235, 344–345, 348, 363, 644–653, 682–684, 715, 716, 720, 845, 847, 849, 851, 853, 855
in yogurt, 7, 13, 123, 218, 225, 227, 230, 235, 240, 303, 379, 386, 389, 781
Adequate Intake (AI; see also Alignment of food packages with DRIs; Dietary Reference Intakes)
for assessing nutrient intakes of WIC-eligible subgroups, 566–569
interpretation of food package profile, 127, 172
interpretation of intakes, 572, 574, 671
Administrative burden (see also Vendor effects of requirements)
educational messages and materials, 404, 909
infant formula, 402–403, 405–406, 440, 906–907, 910
information systems updates, 55, 274, 281–282, 403, 404, 405, 408, 411, 412, 413–414, 907, 910, 912, 916, 917, 918, 927
jarred infant foods, 404–405, 908–909
legumes and peanut butter, 274, 281, 412–413, 917
milks and milk substitutes, 52, 53, 277, 375, 376, 393, 407–408, 888, 912, 978
of recommended revisions, 6, 7, 222, 310, 730
of rotation of foods, 281–282, 411
of state and local agency retraining, 42, 310, 404, 407–408, 411–412, 907–909, 912, 916, 917, 918, 927
Agricultural Research Service, 507
Alignment of food packages with DGA (see also American Academy of Pediatrics; Dietary Giudelines for Americans)
added sugars, 13, 39, 87, 109, 111, 124–125, 131, 133, 135, 149, 215, 219, 386, 389, 845, 847, 849, 851, 853, 855, 858, 860, 861, 862, 863, 865
for allergy prevention, 142–144, 150
breads, 112, 113, 116, 118, 119, 375, 376, 825, 827, 829, 831, 837, 839, 841, 843
breakfast cereals, 112, 116, 118, 123, 124, 138, 245, 247, 248, 251, 253, 255, 309, 825, 827, 829, 831, 833, 835, 837, 841, 843, 881, 904
calories for other uses, 13, 84, 85, 87, 109, 124–126, 149, 192, 194, 386
for celiac disease, 143, 144–145, 150
children 1 to <2 years, 126, 132–135, 136
children 2 to <5 years, 118–119, 125, 134–135, 136–137
cultural considerations, 147–148, 150
current packages, 12, 109–126, 128–129, 137, 149, 263, 274, 275, 276, 277, 278, 287, 377, 820
CVV and, 221, 223–227, 229–232, 234–236, 239, 244, 247–252, 254, 255, 256, 258, 276, 283, 289, 350, 351, 352–353, 356–357, 358–359, 366, 368, 374, 382, 386, 387, 388, 391, 414, 484, 486, 820–839, 843, 867, 880, 887, 984
eggs, 84, 113, 114, 116, 118, 191, 247, 249, 253, 256, 377, 382, 825–844
for food-triggered immune-mediated sensitivities, 141–145, 150
forms and composition of foods, 137, 138–139, 149
infants and toddlers 0 to 24 months, 126, 132–135, 136
intake trends by food group, 84–85
juice, 112, 113, 114, 116, 118, 124, 126, 137, 138, 139, 149, 188, 254, 275, 276, 377, 379, 388, 455, 484, 487, 517, 820–844, 880, 887
Kosher or Halal diets, 143, 146–147, 150
for lactose intolerance, 143, 145, 150
legumes and peanut butter, 110, 112, 114, 116, 118, 149, 246–247, 249, 252, 253, 256–257, 281–282, 377, 382, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 890, 893, 894, 917
for medical conditions, 137, 140–145
milks and milk substitutes, 112, 114, 116, 118, 120, 129, 137, 138, 246, 247, 249, 250, 251, 253, 254, 256, 277–278, 389, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843
postpartum women, 114–115, 125, 130–131, 136
potential areas for modification, 148–150
pregnant women, 112–113, 127–135
regulatory impact analysis, 411, 412, 414, 436, 876–877, 879–881, 887, 888, 890, 892, 893, 884, 894, 902, 904, 916, 917, 918, 979
revised food packages, 6, 262, 263, 275, 276, 280, 281–282, 283, 286, 287–292, 294, 298, 299, 301, 302, 304, 305, 308, 309–310, 820
saturated fats, 120, 122, 109, 120, 122, 131, 133, 135, 215, 219, 240, 386, 573
sodium limits, 111, 116–117, 121
for vegan or vegetarian diets, 143, 145–146, 150
Alignment of food packages with DRIs (see also Dietary Reference Intakes)
added sugars, 131, 133, 135, 173, 175, 178, 184, 225, 230, 235, 240
breakfast cereals, 224, 226, 227, 230, 231, 232–233, 234, 235, 236–237, 238, 306
children 1 to <5 years, 134–135, 180, 183, 184, 240–241, 378, 566, 568, 686–687, 861–867
current food packages, 126–127, 130–137, 149, 179 n.13, 181, 207, 263, 373, 588
eggs, 224
fully breastfeeding women (VII), 112–113, 116–117, 127, 130–131, 136, 172, 173, 204, 229–233, 567, 569, 683, 845–848, 853–856, 867
identifying targets for supplementation, 6, 216, 219, 224–233
infant cereal, 728
infant formula, 727–729
intakes relative to, 173, 174, 175, 176, 177, 178, 179, 180, 181, 183, 184, 187, 204
infants, 132–133, 175, 176, 177, 178, 179, 180, 181, 186–187, 566, 568, 727–729, 814–815, 857–860
legumes and peanut butter, 224, 225, 226, 229–230, 231, 232, 234, 235, 236–237, 239, 810–811
milks and milk substitutes, 224, 225, 226, 227, 229, 230, 231, 232–233, 239, 240, 773, 776–781
non-WIC-participating women, 612–613
postpartum women, 130–131, 172, 173, 204, 234–238, 684–685, 849–852, 867
pregnant women, 127, 130–131, 172, 173, 204, 224–229, 567, 569, 682, 845–848, 867
priorities and preliminary actions for food packages, 12, 220, 224–241
revised versus current packages, 12, 357, 377, 378, 379, 845–867
saturated fats, 131, 133, 135, 173, 225, 230, 235, 682–684, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845, 847, 849, 851, 853, 855, 858, 860, 861, 862, 863, 865
substitutions and, 814–815
Allergies and sensitivities
lactose intolerance, 27, 28, 40, 145, 150, 267, 269, 270, 282, 476, 515, 700, 702, 704, 706, 887, 888, 892, 896, 897, 898–899, 901, 902
options unsuitable for, 143
peanuts, 7, 142, 267, 269, 282, 284, 517, 700, 703, 703, 706
American Academy of Pediatrics (AAP) guidance
added sugars, 124, 798, 800, 802
aligning infant food amounts with recommendations of, 32, 40, 83, 109, 126, 242, 244, 254, 287–292, 388, 876–877, 881
complementary foods for breastfed infants, 139, 146, 180, 188, 190, 217, 254, 288, 290–291, 388, 881, 885
cultural considerations, 137
energy density of human milk, 729
home preparation of foods, 290
infant cereal, 126, 138, 287–288, 884
infant formula, 128, 146, 264, 519, 728–729, 881, 919
jarred infant foods, 126, 190, 287, 288, 290–291, 881, 884, 885, 887
juices, 13, 118, 126, 129, 137, 149, 190, 254, 275, 841, 842, 843, 844
USDA reliance on, 447, 528–529
whole grains, 278
American College of Cardiology, 87
American Heart Association (AHA), 87, 110–111, 120
American Recovery and Reinvestment Act of 2009, 56, 167, 586 n.5
American Time Use Survey, 61–62
B
Baby-Friendly Hospital Initiative, 22 n.8, 74, 472
Behavioral economic approaches to improve intakes, 220, 221, 223, 226, 227, 229, 231, 232–233, 234, 236–237, 244, 249, 253–254, 256, 288, 323, 452, 457–458, 689–691
Behavioral Economics Research Center, 458
Bioavailability of nutrients, 23, 179 n.13, 188, 291, 492, 734
Breads (see also Whole grains)
added sugars limit, 123
alignment with DGA, 112, 113, 116, 118, 119, 375, 376, 825, 827, 829, 831, 837, 839, 841, 843
alignment with DRIs, 224, 235, 731, 754
children 2 to <5 years, 118, 119, 239, 278–279, 300, 410–411, 421, 422, 699, 721, 841, 843, 888–889, 915, 923, 943, 944, 946, 947
complementary foods, 556
cost considerations, 324, 326, 419, 421, 422, 423, 438, 742, 888, 922, 923, 925, 979, 983, 984
cultural preferences, 148, 903, 914–915
current food packages, 2, 26, 31, 52, 112, 113, 116, 118, 119, 121, 122, 123, 139, 279, 300, 410, 419, 423, 438, 699, 700, 701, 705, 721, 825, 827, 829, 831, 837, 839, 841, 843, 925, 943, 944, 957, 984
effect of proposed revision, 410–411, 888–889, 892, 914–915
federal implementation guidance to states, 446, 889, 892
fully breastfeeding women (VII), 116, 117, 230, 300, 410–411, 705, 721, 837, 839, 899, 914–915, 944, 948
gluten-free option, 143, 144, 308
healthy food availability score, 96
implementation of 2006 recommendations, 485
marketplace options, 83, 279, 307–308, 410, 514, 515
nutrient contributions/priorities, 224, 235, 731, 754
postpartum women, 234, 300, 721
pregnant and partially breastfeeding women, 112, 224, 300, 410–411, 701, 721, 825, 827, 829, 831, 892, 896, 914–915, 944, 947
product size considerations, 52, 278–279, 327, 375, 393, 410, 515, 542, 889, 914–915, 979, 983
redemption rates, 92, 446, 522, 831, 943, 944, 946, 947, 948, 954, 979
regulatory impact analysis, 419, 421, 422, 423, 438, 888–889, 922, 923, 925, 979, 983, 984
revised food packages, 7, 22, 224, 225, 235, 239, 267, 270, 278–279, 284, 300, 307–308, 309, 326–327, 376, 393, 411, 419, 421, 422, 423, 438, 446, 699, 700, 701, 705, 721, 825, 827, 829, 831, 837, 839, 841, 843, 923, 925, 946, 947, 948, 957, 958, 984
saturated fat limit, 122
sodium limit, 121, 225, 229–230, 235, 239, 731
substitutions, 22, 28, 31, 143, 267, 270, 279, 284, 324, 326–327, 410, 484, 485, 700, 702, 706, 733, 888–889, 892, 896, 899, 903
vendor burdens, 279, 383, 410, 542, 889, 914–915
whole grain specification, 7, 22, 139, 300, 307–308, 309, 376, 721, 888, 888–889, 892, 896, 899, 903, 914–915
Breakfast cereal
added sugar limits, 123, 124, 225, 230, 234, 235, 240, 306, 348, 487, 720, 729, 754, 782, 784, 785
alignment with DGA, 112, 116, 118, 123, 124, 138, 245, 247, 248, 251, 253, 255, 309, 825, 827, 829, 831, 833, 835, 837, 841, 843, 881, 904
alignment with DRIs, 224, 226, 227, 230, 231, 232–233, 234, 235, 236–237, 238, 306
children 1 to <2 years, 10, 26, 240, 268, 299, 306, 699, 720, 940, 943, 946
children 2 to <5 years, 10, 26, 118, 138, 240, 255, 268, 299, 306, 347, 348, 699, 720, 791, 841, 843, 940, 944, 947
costs, 347, 348–349, 350, 368, 419, 423, 438, 742, 922, 925, 984
criteria for inclusion, 375
cultural alternatives or preferences, 148
current food packages, 26, 112, 116, 118, 123, 124, 138, 299, 303, 305, 306, 307, 347, 348–349, 419, 423, 438, 699, 701, 703, 705, 720, 729–730, 731, 742, 753, 763, 782–785, 791, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 922, 925, 940, 943, 944, 957, 984
fully breastfeeding women (VII), 9, 26, 116, 229, 230, 231, 232–233, 248, 265, 299, 306, 347, 349, 705, 720, 791, 837, 839, 940, 944, 948
HEI score, 348–349
implementation of 2006 recommendations, 484, 487, 904
labeling, 484
marketplace options, 307–308, 904
mother–infant dyad, 265
nutrient levels/priorities, 138, 224, 226, 227, 230, 231, 232–233, 234, 235, 236–237, 238, 280, 306, 307, 309, 347, 348–349, 350, 368, 455, 730, 753–754, 904
partially (mostly) breastfeeding women (V-B), 9, 26, 112, 229, 230, 231, 232–233, 248, 265, 306, 701, 720, 829, 831, 940, 944, 947
postpartum women (VI), 9, 26, 116, 234, 235, 236–237, 238, 251, 253, 265, 299, 306, 703, 720, 833, 835, 940, 944, 947
pregnant women (V-A), 10, 26, 112, 224, 226, 227, 245, 247, 268, 299, 306, 347, 348–349, 701, 720, 791, 827, 940, 944, 947
price, 957
product list, 753
public comments, 516
redemption rates, 92, 307, 347, 348–350, 753, 782–785, 791, 825, 827, 829, 831, 833, 835, 837, 839, 841, 938, 940, 943, 944, 946, 947, 948
revised food packages, 9, 10, 265, 267, 268, 270, 280, 299, 303, 305–308, 309, 347, 419, 423, 438, 699, 701, 703, 705, 720, 742, 753–754, 791, 827, 831, 835, 839, 841, 843, 922, 925, 940, 946, 947, 948, 957, 984
sensitivity analysis, 339, 347–350, 368, 773, 782–784, 791
specifications, 7, 28, 123, 124, 138, 267, 299, 303, 305–307, 309, 347–350, 484, 487, 700, 720, 729–730, 903–904, 958
total sugars limit, 303, 309, 487, 729–730
whole grain, 7, 28, 138, 267, 299, 305–307, 309, 347–350, 484, 700, 720, 730, 903–904, 958
Breastfeeding
Baby-Friendly Hospital Initiative, 22 n.8, 74, 472
changes in food packages since last review and, 5, 53, 55, 57, 59, 70–77, 97, 525, 526, 527, 530
and complementary foods, 128, 146, 180, 188, 217, 254, 288, 290–291, 388, 873, 880
cost incentives compared, 315, 317, 331–334, 335
criterion for revision of foods and, 383, 388–390
current program, 1, 5, 17, 19–22, 74, 75–76
effects of, 21–22, 55, 75–78, 97
evaluation of, 74
formula limits to encourage breastfeeding choice, 5, 20, 74–77, 93, 285–286, 331–334, 452–453, 690, 881
guidance for infant nutrition, 128
Healthy Habits Begin at Birth campaign, 76
Healthy Habits for Life campaign, 76
Healthy People 2020 objectives, 1, 20, 40, 70
income relative to poverty level and, 15, 71, 72, 73
infant food package amounts and, 288, 884
infant formula introduction and, 5, 20, 74–77, 93, 285
infants’ and children’s diets and, 39–40, 383, 388–390
Loving Support© program, 74, 446, 476
multiple infants, 11
promotion and support strategies, 5, 11, 20, 21, 22 n.8, 44, 74, 77–78, 150, 157, 206 n.19, 285–286, 288, 331, 383, 388–390, 884
proportion of children by age, 70
race/ethnicity and, 71–72
recommendations, 11, 14, 285, 446–447
shift from fully formula-feeding to, 402, 415, 416, 417, 419, 420, 422, 425, 431, 434–436, 438, 439, 876, 905, 906, 919, 920, 922, 924, 926, 931–933, 936–937, 941, 973, 976–978, 980–981, 984, 985
statutory basis, 21
trends of WIC participants, 40, 55, 57, 59, 70–74, 97
worksite lactation support programs, 74
Breastfeeding women/dyads (see also Fully breastfeeding women; Partially breastfeeding; Package V-B; Package VII)
DGA, 110
EER distribution, 591
food group intakes, 188, 189–190, 648, 652
nutrient intakes, inadequacies, and excesses, 171, 172, 173, 174, 175, 217, 589, 594, 595, 608–609
Buckwheat, 13, 267, 270, 279, 284, 300, 308, 324, 326, 411, 472, 700, 702, 722, 731, 881, 888, 889, 892, 896, 899, 903, 915
C
Calcium, 86, 130, 132, 134, 170, 171, 176, 178, 182, 186, 217, 227, 228, 231, 234, 297, 344, 345, 346, 566, 585, 604–641, 682–684, 708, 709, 717, 731, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 845, 848, 849, 851, 853, 855, 857, 859, 861, 862, 863, 864
California Cancer Research Program, 544
Calories for other uses (COU)
added sugars, 124, 125, 126, 149, 188 n.15, 192–193, 295, 381, 472
alignment with DGA, 13, 84, 85, 87, 109, 124–126, 149, 192, 194, 386
current packages, 124–126, 295, 303, 381
defined, 87 n.13, 188 n.15, 295 n.19, 472
intake patterns, 84, 85, 188, 192, 194
revised packages, 376, 380, 381, 386
yogurt total sugars, 376
Carbohydrate (see also Calories for other uses), 80, 144, 159, 177, 218, 219, 570, 571, 573, 593–603, 708, 709, 717, 731, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
Cash value voucher (CVV)
and added sugars, 218
administrative burdens, 53, 93, 289, 374, 393, 404, 413, 908, 909, 918
and alignment of intakes with dietary guidance, 221, 223–227, 229–232, 234–236, 239, 244, 247–252, 254, 255, 256, 258, 276, 283, 289, 350, 351, 352–353, 356–357, 358–359, 366, 368, 374, 382, 386, 387, 388, 391, 414, 484, 486, 820–839, 843, 867, 880, 887, 984
allowance relative to DGA food pattern, 112–118, 149
barriers and incentives to use, 542, 543
for children, 10, 15, 26, 118, 239, 255, 256, 268, 269, 271, 273, 283, 340, 350, 351, 352–353, 356, 358–359, 374, 382, 388, 413, 418, 421, 454–456, 488, 699, 765, 773, 786–787, 792–793, 798–801, 820, 824, 841, 843, 867, 890–891
and costs, 289, 327, 331, 340, 350, 352–359, 366, 390, 404, 413–414, 418, 420, 421, 428–431, 438, 744, 763, 890–891, 909, 911, 918, 921–922, 923–924, 926, 962–972, 984–985
cultural considerations, 7, 13, 147–148, 150, 272, 284, 289, 374, 388, 392, 413–414
current versus revised allowances, 26, 350–353, 356–357, 413–414, 696, 697, 699, 701, 703, 705, 773–774, 786–803, 814–815, 820–824, 825, 827, 829, 831, 833, 837, 839, 841, 843, 867, 918, 921–922
and EBT-linked Universal Product Codes, 273, 289
and expenditures by participants, 65 nn.8 & 9
forms of fruits and vegetables, 7, 28, 53, 223, 224, 226, 235, 239, 266, 269, 272–273, 284, 289–290, 292, 295, 392, 393, 404, 715, 908
for fully breastfeeding women, 9, 26, 116, 229, 230, 231, 232, 244, 248, 249, 250, 264, 283, 288, 289, 293, 350, 351, 352–353, 356–357, 358–359, 413–414, 420, 421, 445, 705, 767, 774, 790–791, 796–797, 802–803, 823, 837, 839, 867, 898–899
funding above cost neutrality, 454–456
and HEI scores, 352–353, 356, 358–359, 374
implementation challenges, 52, 53, 484, 488
and incentives for breastfeeding, 383, 414, 486
incremental increases, 961
inflation adjustment, 28, 418 n.5, 420, 422, 426–427, 430, 439 n.8, 488, 921 n.8, 926, 956–961, 964–965, 966–969, 985
and jarred infant food substitution, 7, 8, 11, 13, 53, 139, 141 n.9, 147–148, 264, 265, 266, 267–268, 288, 289, 292, 293, 296, 327, 340, 363, 366, 374, 389, 392, 393, 404, 421, 525, 696, 697, 764, 775, 814–815, 881, 884, 885, 901, 908, 909, 941, 965, 970–971
juice substitution, 7, 12, 13, 149, 227, 232, 236, 265, 267, 269, 275–276, 284, 288, 327, 339, 340, 343, 356–357, 358–359, 368, 374, 392, 393, 406–407, 441, 701, 705, 765, 766, 767, 774, 798–803, 886–887, 891, 895, 897, 901, 911, 921, 941, 962, 965, 972–973
legume reduction and, 7, 223, 229, 235, 239, 274, 374
for mother–infant dyads, 8–9, 26, 264, 288, 422
multiple fetuses and, 294
paper vouchers, 445
for partially breastfeeding women, 9, 10, 26, 112, 224, 225, 226, 227, 245, 247, 264, 268, 271, 283, 288, 289, 293, 294, 340, 356, 358–359, 413–414, 421, 422, 701, 766, 774, 788–789, 794–795, 821, 825, 827, 829, 831, 867, 894, 895–897, 900
for postpartum (nonbreastfeeding) women, 9, 26, 114, 234, 235, 236, 251, 252, 254, 264, 283, 293, 414–415, 421, 422, 703, 774, 822, 833, 835, 898
for pregnant women, 9, 10, 26, 112, 224, 225, 226, 227, 245, 247, 264, 268, 271, 283, 288, 289, 293, 294, 340, 352–353, 356, 358–359, 413–414, 421, 422, 701, 766, 774, 788–789, 794–795, 821, 825, 827, 829, 831, 867, 894, 895–897, 900
promoting effective use, 457, 460
proportions of vegetables to fruits, 16, 351–356, 457, 460, 984
public comments on proposed revisions, 515, 517, 518, 519
recommended increase, 7, 15, 271–272, 283, 284, 292, 454–456
redemption rates, 16, 44, 92, 94, 113, 115, 117, 119, 272, 322, 350–351, 352–353, 356, 357, 382, 390, 404, 428, 429, 445, 522, 524, 525, 757, 758, 760, 763, 764, 765, 766, 773–774, 775, 786–803, 814–815, 820–824, 831, 835, 839, 841, 908, 941, 962–964
regional variation in purchasing power, 15, 95, 453–454
research designs on, 206 n.19, 522
research recommendation on, 15, 452–454
revising monthly allowance, 5, 6, 8–10, 12, 16, 220, 221, 262, 350–351, 515, 517
sensitivity analysis, 339, 340, 343, 350–359, 368, 773–774, 775, 786–803, 814–815
and shopping experience of participants, 94, 404, 542, 543
and shopping process, 29, 93, 444
for special dietary needs, 293
split tender, 29, 53, 94–95, 488
USDA studies on outcomes, 522, 524, 525
vendor burdens, 53, 94, 299, 373, 984
white potatoes, 2, 31, 85, 488
Celiac disease, 41, 141, 144–145, 150, 282, 308, 472
Center for Nutrition Policy and Promotion
Nutrition Evidence Library, 459
Centers for Disease Control and Prevention (CDC), 70, 73, 280, 526, 527
Changes in food packages since last review
adaptation to 2006 proposals, 51–55, 97
and availability and variety of foods, 52, 53, 54, 80–83, 88, 89, 90, 91, 93, 94, 95, 96, 98, 522–523, 524, 526, 527, 530, 545
barriers to participation and redemption, 90, 91, 93–94, 97
and breastfeeding trends and promotion, 53, 55, 57, 59, 70–77, 97, 525, 526, 527, 530
and costs, 51, 53, 54, 78–79, 95, 96, 97, 528, 529, 530
cultural considerations, 88, 89, 94, 524, 526–527, 530, 545
and dietary guidance changes, 51, 74–76, 83–88, 98, 484–487
and dietary pattern changes, 80, 81, 82, 84, 85, 87, 88, 523, 529
and expenditures for food, 51, 55, 64, 65, 66, 68, 70, 97
implementation of 2009 packages, 2, 52–55, 56, 97, 484–487
infant formula and formula feeding, 57, 59, 67, 70, 73, 74–76, 77, 78, 79, 83, 92, 93, 97, 527, 529, 530
outcomes studies of 2009 changes, 522–531
participant characteristics and, 55–78, 524
participant satisfaction today, 88–98, 524, 525, 526–527
and participation rates, 55, 56–58, 59, 71, 78, 79, 93–94, 97, 535–540
and shopping experience of participants, 93, 94–98
substitutions, 2, 53, 93, 96, 528–529
“supplemental” concept and, 45
vendor behavior and challenges, 2, 52, 53, 54, 55, 88, 90, 91, 93, 94, 95, 96, 97, 98, 545
Cheese
added sugars limit, 123
administrative burdens, 912
alignment with DGA, 116, 246, 247, 249, 250, 251, 253, 256, 780–781, 837–840
alignment with DRI, 224, 225, 227, 229, 230, 231, 234, 235, 239, 776–777, 780–781
allergies and intolerances and, 143, 145, 267, 269, 282, 517, 700, 702, 704, 706, 887, 892, 896, 897, 898–899, 901, 902
authoritative recommendations, 138
children 1 to <2 years, 26, 27, 138, 239, 240, 269, 276–277, 298, 408, 556, 700, 718–719, 741, 751, 887
children 2 to <5 years, 26, 27, 82, 239, 240, 256, 269, 276–277, 339, 408–409, 718–719, 741, 751–752, 776–777, 887
cost considerations, 323, 326, 346, 419, 420, 422, 423, 438, 741, 742, 777, 781, 914, 922, 923, 924, 925, 984
cultural and preference considerations, 392
current packages, 26, 343, 346, 408–409, 312, 438, 705, 741, 750, 751–753, 776–777, 780–781, 837–840, 912–913, 922, 925, 958
fully breastfeeding women, 26, 27, 28, 116, 145, 229, 230, 231, 249, 250, 267, 276–277, 298, 408–409, 420, 421, 422, 486, 488, 705, 706, 718–719, 741, 742, 753, 780–781, 837–840, 898–899, 914, 923, 924, 925, 940, 944, 958
HEI score, 777
implementation of 2006 recommendations, 485, 486, 487, 488
marketplace availability, 387
nutrient levels/priorities, 224, 229, 231, 234, 239, 556, 750, 751–753, 754, 776–777, 780–781
partially breastfeeding women, 26, 27, 28, 229, 230, 231, 249, 250, 267, 276–277, 298, 408–409, 700, 702, 718–719, 741, 742, 752, 896
postpartum women, 26, 27, 28, 234, 235, 251, 253, 267, 276–277, 298, 408–409, 517, 704, 718–719, 741, 742, 752, 897
pregnant women, 26, 27, 28, 224, 225, 227, 246, 247, 269, 276–277, 298, 408–409, 517, 702, 718–719, 741, 742, 752, 887, 892
redemption rates, 92, 323, 340, 517, 764, 938, 940, 944
revised packages, 276–277, 278, 303, 343, 346, 409, 421, 422, 423, 438, 705, 741, 750, 751–753, 776–777, 780–781, 837–840, 913–914, 922, 925, 958
saturated fat limits, 120, 122, 138, 225, 230, 235, 240, 340, 345, 346, 485, 523, 777, 779, 781
sensitivity testing, 339–340, 341, 776–777, 780–781
sodium limits, 111, 121, 225, 229, 234, 239
soy-based, 7, 267, 269, 276–277, 282, 284, 298, 309, 700, 702, 704, 706, 718–719, 887, 892, 896, 897, 898–899, 901, 902
specifications, 298, 309, 718–719, 887, 892, 896, 897, 901, 902
substitution amounts, 7, 27, 28, 30, 267, 268, 276–277, 282, 284, 408–409, 700, 702, 704, 706, 751–753, 887, 888, 892, 896, 897, 898
vegan diets, 7, 145, 146, 150, 269, 282, 298, 309, 700, 702, 704, 706, 887, 892, 896, 897, 898–899, 901, 902
Child and Adult Care Food Program (CACFP), 18, 56, 119, 120, 296, 299, 304, 305–306, 308, 516, 519, 576, 716, 720, 732, 842, 900, 901, 904
Child Nutrition and WIC Reauthorization Act, 83, 490
Children 1 to <2 years (see also Package IV-A)
adverse health impacts of nutrient inadequacies and excesses, 217
cow’s milk, 2
DRIs for, 134–135, 182, 183, 185, 186
EER distribution, 592
food group intakes, 82, 190, 192, 654–657
gap analysis, 239–241, 682, 686
identifying priorities for, 219
Nutrient-Based Diet Quality Index score, 197
nutrient intakes, inadequacies, and excesses, 180, 182–183, 184, 185, 186, 217, 590, 599–601, 626–633
Children 2 to <5 years (see also Package IV-B)
adverse health impacts of nutrient inadequacies and excesses, 217
DGA recommendations, 138–139, 193
DRIs for, 134–135, 182, 183, 185, 186
EER distribution, 592
food group intakes, 81, 82, 191–192, 193–194, 658–665
NHANES survey years, 167
Nutrient-Based Diet Quality Index score, 197
nutrient intakes, inadequacies, and excesses, 182, 183, 184, 185, 186, 217, 590, 601–603, 634–642
Choline, 12, 86, 87, 88, 127, 131, 133, 135, 146, 149, 158, 172, 174, 175, 176, 178, 180, 183, 184, 185, 204, 217, 224, 242, 350, 353, 355, 357, 358, 359, 377, 379, 460, 568, 572, 573, 604–642, 682, 708, 710, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845, 847, 850, 852, 854, 856, 858, 860, 861, 862, 864, 866
definition of supplemental food, 33–34
limitations to, 34
special requests from FNS, 32–33
statement of task, 32–33
Competent Professional Authority (CPA; WIC program), 393, 402, 472, 488, 888–889, 906, 948
Complementary foods and feeding (see also Infant cereal; Infant food meat; Infant food vegetables and fruits; Package II)
alignment with dietary guidance, 146, 180, 188, 217, 254, 288, 290–291, 388–389, 881
authoritative recommendations, 120, 128–129, 146, 175, 188, 217, 388–389
breads, 556
breastfeeding and, 128, 146, 180, 188, 217, 254, 288, 290–291, 388, 873, 880
defined, 472
eggs, 138
energy intakes by food group, 556
evaluation of, 551–556
intake trends, 164–165, 175 n.10, 188, 190, 191, 554–555
milks and milk substitutes, 165, 389, 554, 556
nutrient intakes/priorities, 146, 165, 180, 217, 218–219, 291, 556
public comments on, 518–519
study designs and characteristics of selected reports, 552–553
Consumer Price Index adjustments, 113, 115, 117, 119, 320, 327, 329, 426, 427, 428, 430–431, 528, 741, 742, 744, 745, 746, 826, 828, 830, 832, 834, 836, 838, 840, 842, 844, 954, 956–957, 958, 959, 960, 961, 964–965, 966–967, 968–969
Container/product size
breads, 52, 278–279, 327, 375, 393, 410, 515, 542, 889, 914–915, 979, 983
juice, 52, 53, 54, 275–276, 391, 393, 518, 911
legumes and peanut butter, 275, 733
milks and milk substitutes, 52, 53, 277, 375, 376, 393, 407–408, 888, 912, 978
Copper, 12, 130, 132, 134, 170, 171, 174, 176, 182, 183, 185, 186, 232, 236, 350, 351, 352, 353, 354, 355, 357, 358, 359, 363, 364, 365, 377, 566–567, 572, 573, 604–641, 683, 685, 708, 709, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 846, 848, 849, 851, 853, 855, 857, 859, 861, 862, 863, 864
Corn masa flour, 13, 158, 267, 270, 279, 280, 284, 300, 301, 308, 387, 411, 472, 700, 702, 706, 722, 723, 731, 754, 888, 889, 892, 896, 899, 903, 915
Cost profiles of food packages, current versus revised packages (see also Food cost estimates of proposed revisions; Regulatory impact analysis; Sensitivity analysis)
average package cost versus USDA national average, 325, 330
breads, 324, 326, 419, 421, 422, 423, 438, 742, 888, 922, 923, 925, 979, 983, 984
breakfast cereals, 347, 348–349, 350, 368, 419, 423, 438, 742, 922, 925, 984
breastfeeding cost incentives compared, 315, 317, 331–334, 335
composites of food categories, 321–322
cost neutrality constraint, 3, 6, 18, 44, 315–316, 317, 324, 330–331, 334, 763–767
CVV and, 289, 327, 331, 340, 350, 352–359, 366, 390, 404, 413–414, 418, 420, 421, 428–431, 438, 744, 763, 890–891, 909, 911, 918, 921–922, 923–924, 926, 962–972, 984–985
data and assumptions, 316, 317, 320, 321, 322–323, 325, 330, 331, 741–746
eggs, 323, 327, 419, 420, 423, 438, 741, 922, 925, 926, 940, 984
infant cereal, 403, 419, 421, 423, 438, 922, 923, 925, 984
infant food meat, 327, 405, 419, 423, 438, 746, 909, 922, 925, 984
infant food vegetables and fruits, 289, 404–405, 909, 962, 965, 970
infant formula, 16, 78, 79, 315, 317–318, 320, 321, 330, 331–334, 335, 399, 401, 403, 415, 416, 417, 419, 420, 422, 425, 431, 432–433, 434–435, 460, 746, 875, 882, 883, 906–907, 910, 919, 922, 925, 926, 949, 973, 974–981, 984
juice, 15, 327, 356–357, 358–359, 741
legumes and peanut butter, 320, 322, 363, 364–365, 413, 419, 421, 423, 438, 742–743, 763, 811, 813, 917, 922, 923, 925, 984
milks and milk substitutes, 323–324, 326, 344–345, 346, 419, 420, 422, 423, 438, 741, 742, 777, 779, 781, 914, 922, 923, 924, 925, 978, 984
participant distribution across food packages, 316, 317–320, 325, 334
per-participant costs of food packages, 79, 316, 324–325, 329, 330–331, 334–335
redemption data and, 11, 315–316, 320, 321–323, 324, 325–326, 328–329, 330, 331, 333, 338, 344–345, 347, 348–349, 350, 351, 352–355, 356, 358–362, 363, 364–365, 395, 397, 739, 741–744, 745, 746, 763–768, 869, 871, 909, 921, 938, 980
substitutions, 317, 323–324, 326–327, 330
WIC food costs, 320–324
Criteria for inclusion of foods
administrative burdens, 3, 13, 38, 42, 372, 374–376, 390, 391, 394, 519, 543, 887, 889, 901
balanced supplement to participants’ diets, 3, 12, 37, 38, 371–373, 374–377
consistency with DGA, 3, 12–13, 39, 379–383, 386–387
DRI alignment, 3, 12, 39, 373, 377–379
cultural eating patterns and food preferences, 3, 13, 40–42, 387, 390, 392
infants’ and children’s diets and breastfeeding support, 39–40, 383, 388–390
rationales for, 37–42
transportation, storage, and cooking facility considerations, 3, 13, 40, 383, 387, 391
Cultural considerations (see also Kosher or Halal diets; Vegetarian or vegan diets)
and alignment with DGA, 147–148, 150
breakfast cereals, 148
CVV and, 7, 13, 147–148, 150, 272, 284, 289, 374, 388, 392, 413–414
in current packages, 147–148, 150, 279–280
eggs, 392
legumes and peanut butter, 7, 148, 274
milks and milk substitutes, 13, 89, 150, 392, 526–527, 888, 912
satisfaction with food packages, 89
vendor burdens, 93–94
Current food packages (see also Changes in food packages; Cost profiles; Food cost estimates; Regulatory impact analysis; Sensitivity analysis; specific foods and packages)
added sugar limits, 123–125, 218, 296, 300, 306, 714, 715, 716, 717, 720, 722–723, 724, 729, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
administrative burdens, 289
alignment with dietary guidance, 12, 109–126, 128–129, 137, 149, 263, 274, 275, 276, 277, 278, 287, 377, 820
alignment with DRIs, 126–127, 130–137, 149, 179 n.13, 181, 207, 263, 373, 588
amounts of foods contributed to USDA food patterns, 5, 110, 112–119
breads, 2, 26, 31, 52, 112, 113, 116, 118, 119, 121, 122, 123, 139, 279, 300, 307–308, 410, 419, 423, 438, 699, 700, 701, 705, 721, 731, 742, 825, 827, 829, 831, 837, 839, 841, 843, 925, 943, 944, 957, 984
breakfast cereals, 26, 112, 116, 118, 123, 124, 138, 299, 303, 305, 306, 307, 347, 348–349, 419, 423, 438, 699, 701, 703, 705, 720, 729–730, 731, 742, 753, 763, 782–785, 791, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 922, 925, 940, 943, 944, 957, 984
breastfeeding promotion, 1, 5, 17, 19–22, 74, 75–76
calories for other uses, 124–126, 295, 303, 381
categorical eligibility by package, 23, 400
children 1 to <5 years, 26, 118–119, 134–135, 136–137, 273, 274, 275, 277, 296–302, 318–319, 329, 339, 344, 348, 352, 354, 358, 360, 373, 381, 382, 406–409, 410, 411–412, 413, 699–700, 715–724, 776–777, 786–787, 792–793, 798–799, 804–805
container size issues, 279, 519
criteria for inclusion, 38, 373
cultural needs, preferences, and practices considered in, 147–148, 150, 279–280
CVV, 18, 26, 271, 289, 293, 296, 350–353, 356–357, 413–414, 438, 696, 697, 699, 701, 703, 705, 744, 773–774, 786–803, 812–813, 814–815, 820–824, 825, 827, 829, 831, 833, 837, 839, 841, 843, 867, 918, 921–922
eggs, 2, 26, 87–88, 377, 419, 420, 423, 438, 518, 699, 701, 703, 705, 719, 754, 764, 820–844, 922, 925, 926, 940, 943, 944, 984
fish, 110–111, 120, 258, 280, 281, 302, 310, 357, 360–361, 411, 438, 518, 723–724, 733–734, 742, 766, 767, 804–809
food group intakes, 576
food-triggered immune-mediated sensitivities and, 141–145, 150
forms and composition of foods in, 137, 138–139, 149, 272, 281, 782–785
for fully breastfeeding women (VII), 26, 116–117, 130–131, 136, 280, 294, 296–302, 319, 329, 331, 344–345, 349, 353, 355, 357, 359, 360, 381, 406–409, 410, 411–412, 705–706, 715–724, 780–781, 785, 790–791, 796–797, 802–803, 808–809
implementation of most recent package changes, 488
infant cereal, 25, 287, 403, 419, 423, 438, 696, 697, 714, 765, 873, 907, 922, 925, 940, 984
infant formula, 2, 5, 22, 24–25, 33, 75, 139, 181, 207, 286–287, 292–293, 310, 318, 402–403, 419, 420, 423, 434–435, 439, 458, 459, 588, 694–695, 696, 697, 698, 714, 727–729, 748–749, 764, 906–907, 910, 922, 925, 934–935, 940, 976–977, 984
jarred infant food meat, 25, 126, 139, 149, 290, 405, 419, 438, 696, 715, 734–735, 764, 873, 881, 885, 909, 922, 925
jarred infant food vegetables and fruits, 25, 288, 292, 293, 404, 438, 696, 697, 714, 764, 696, 715, 873, 908–909
juice, 2, 12–13, 26, 27, 52, 53, 54, 110, 112, 113, 114, 116, 118, 139, 149, 275, 356–357, 377, 406–407, 419, 423, 438, 488, 699, 701, 703, 705, 719, 741, 765, 766, 767, 774, 798–803, 820–844, 887, 922, 925, 943, 944, 984
Kosher or Halal diets, 146–147, 150
legumes and peanut butter, 12, 26, 30, 92, 273, 274, 281, 362–363, 364–365, 377, 382, 412–413, 419, 423, 438, 699, 701, 703, 705, 724–725, 733, 742, 743, 755, 763, 810–813, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 922, 923, 925, 941, 952–953, 957, 984
marketplace options, 295, 303–304, 307, 506
for medical needs, 24–25, 137, 140–145, 150, 292, 328, 405–406, 698, 735
milks and milk substitutes (dairy), 2, 26–28, 30, 52, 112, 114, 116, 118, 120, 121, 122, 123, 136–137, 138, 143, 145, 150, 276, 277, 278, 296–298, 303–304, 305, 308, 339, 340, 344–345, 407–409, 438, 488, 699, 701, 703, 705, 716–719, 730, 732–733, 734, 741, 751, 752, 753, 765, 766, 767, 773, 776–781, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 941, 943, 944, 951, 955, 984
nutrient levels, 5, 130–135, 242, 258, 306, 307, 310, 344–345, 348–349, 373, 459, 575, 588, 727–728, 731, 732–733, 776–815
nutrients to limit, 111–124
nutrition education, 456
overview, 22–23
participant burdens, 289
participation distribution across, 317–320
postpartum women, 26, 114–115, 130–131, 136, 242, 273, 296–302, 317, 319, 329, 381, 406–407, 408–409, 411–412, 703–704, 715–724
potential areas for modification, 41, 148–150
pregnant and partially breastfeeding women, 26, 112–113, 127–135, 130–131, 294, 296–302, 319, 329, 331, 344, 348–349, 352–353, 354–355, 358–359, 360–361, 381, 406–409, 410, 411–412, 701–702, 715–724, 778–779, 782–783, 784, 788–789, 794–795, 800–801, 806–807, 810–811
redemption rates, 12, 92, 278, 290, 347, 378, 381, 382, 758, 760, 763–768, 773–815
saturated fat limits, 120–122, 126, 131, 131, 133, 135, 218, 340, 344–345, 373, 378, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845
sensitivity analysis, 343, 346, 347, 350, 356–357, 362–363, 773–815
sodium limits, 111, 116–117, 121, 730
specifications for foods, 296–302, 303–304, 305, 714–724, 728–729
substitutions, 23, 279–280, 284, 289, 296, 734–735, 780–781
total sugars limit, 304, 729–730
unsuitable foods for special diets, 143
vegetables and fruits, 26, 271, 272, 273, 289, 296, 354–355, 438, 699, 701, 703, 705, 715–716
vegetarian or vegan diets, 145–146, 150, 518, 724
vendor stocking requirements and burdens, 273, 295, 305
whole grains, 278–280, 284, 300–301, 305, 307–308, 410, 699, 701, 703, 705, 721–723, 731, 733, 742, 763, 792–797, 812–813
WIC-eligible nutritionals, 725
Current Population Survey, 535
D
Dairy foods (see also Cheese; Milks and milk substitutes; Tofu; Yogurt)
dioxins in full-fat foods, 160
Healthy Eating Index, 344–345, 777
sensitivity analysis, 339–340, 341, 343–346, 368, 773, 776–781
Dietary Approaches to Stop Hypertension (DASH) Eating Plan, 85, 473
Dietary guidance (see also Alignment of food packages with DGA; American Academy of Pediatrics; Dietary Guidelines for Americans)
food group intake recommendations, 84–85
Dietary Guidelines for Americans (DGA) (see also Alignment of food packages with DGA)
added sugar limits, 87
cholesterol limits, 87–88
nutrient intake recommendations, 88
redeemed amounts of food groups as proportion of, 820–846
saturated fat limits, 87, 111, 122
shortfall nutrients and nutrients of public health concern, 85–87
sodium limits, 87
Dietary intake analyses (see also Food group intake; Healthy Eating Index; Nutrient intake)
challenges, 170
committee’s analyses versus other published results, 204–205
comparison group design, 206, 527, 677
design of studies, 205–207
food safety considerations, 159–160
generalizability of data to national level, 94, 206–207, 678, 938
interpretation of findings, 166, 196–207, 572
literature and report review, 159–165
measurement issues, 205–206
nutrition-related health priorities, 159
regression discontinuity design, 206, 479, 675–677
sampling, 200
selection bias, 78, 166, 167, 197–199, 201, 206, 207, 479, 587, 675–678
strengths and limitations of NHANES data, 199–204
Dietary intake patterns (see specific foods and nutrients)
Dietary Reference Intakes (see also Alignment of food packages with DRIs)
defined, 565
by population subgroup, 566–569
E
Economic Research Service, 80, 322, 356 n.2, 454, 507, 525, 690, 744, 826, 828, 830, 832, 834, 836, 838, 840, 842, 844, 964
Eggs
alignment with DGA, 84, 113, 114, 116, 118, 191, 247, 249, 253, 256, 377, 382, 825–844
alignment with DRIs, 224
allergies, 7, 142, 143, 150, 284, 700, 702
children 1 to <2 years, 10, 26, 138, 268, 718, 940, 943, 946
children 2 to <5 years, 10, 26, 82, 118, 191, 256, 268, 377, 382, 718, 824, 841, 843, 940, 944, 947
cost considerations, 323, 327, 419, 420, 423, 438, 741, 922, 925, 926, 940, 984
criteria for inclusion, 375
cultural considerations, 392
current food packages, 2, 26, 87–88, 377, 419, 420, 423, 438, 518, 699, 701, 703, 705, 719, 754, 764, 820–844, 922, 925, 926, 940, 943, 944, 984
fully breastfeeding women, 9, 26, 116, 189, 249, 294, 705, 718, 823, 837, 839, 940, 944, 948
health concerns, 87–88
intake patterns, 81, 82, 189, 191, 382
IOM 2006 recommendations, 2, 485, 486, 487
Kosher or Halal options, 147, 150
mother–infant dyad package, 9, 265
nutrient intakes, 84, 556, 741, 742, 754
nutrients profiles and priorities, 224, 242, 247, 249, 253, 256, 735
partially breastfeeding women, 9, 26, 113, 189, 249, 701, 718, 821, 829, 831, 940, 944, 947
postpartum women, 9, 26, 114, 189, 253, 703, 718, 822, 833, 835, 940, 944, 948
pregnant women, 10, 26, 113, 189, 224, 242, 247, 268, 701, 718, 820, 825, 827, 940, 944, 947
prices, 957
public comments, 517
redemption rates, 92, 382, 764, 820–824, 940, 943, 944, 946, 947, 948
regulatory impact analysis, 440, 986
retail sales/market share, 440, 986
revised food packages, 9, 10, 265, 268, 377, 382, 419, 420, 423, 438, 701, 703, 704, 705, 741, 754, 764, 820–844, 922, 925, 926, 940, 946, 947, 948, 984
special medical needs, 518
substitutions, 7, 282, 284, 323, 327, 375, 488, 700, 702, 704
vegan options, 7, 146, 150, 282, 284, 518, 700, 702, 704
Electronic benefit transfer (EBT)
administrative burdens and benefits, 29, 55, 273, 274, 444
calendar validity, 91
cost data, 330
CVV compatibility, 393
and early implementation of proposed food package changes, 398, 872
nationwide implementation, 18, 29, 94, 330, 444, 450, 879
redemption data, 89, 323, 325, 397, 450, 453, 759, 871, 933
research recommendation, 14, 449
and shopping process, 29, 55, 444, 512, 514
UPC database, 29, 53, 55, 272–273, 274
Energy (see also Added sugars; Calories for other uses; Saturated fats)
alignment of packages and intakes with DGA, 39, 87, 112–119, 188, 194, 386, 573, 576
alignment of packages and intakes with DRIs, 110 n.3, 130, 132, 134, 173, 174, 177, 181, 184, 185, 846, 848, 850, 852, 854, 856, 857, 859, 861, 862, 863, 865
complementary foods, 556
current package, 130, 132, 134, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 846, 848, 850, 852, 854, 856, 857, 859, 861, 862, 863, 865
EERs by population subgroup, 130, 132, 134, 169 n.8, 174, 177, 185, 202, 473, 575–576, 591–592, 727
estimation challenges, 168, 202–203, 294, 390, 576
food sources and contributions, 112–119, 179, 181, 184, 185, 281, 294, 386, 708, 709, 890
health concerns, 158, 215, 487
infant formula, 33, 310, 519, 588, 714, 727, 728–729
intake patterns, 45, 80, 112–119, 163, 172, 173, 174, 175, 177, 178–179, 180, 183, 185, 188, 192–193, 202–203, 556, 575–576, 589–590
from other macronutrients, 218
multiple infants or fetuses, 294
NBDQ index and, 671
priority, 218
revised, 278, 294, 344, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 846, 848, 850, 852, 854, 856, 857, 859, 861, 862, 863, 865
sensitivity analysis, 344, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
specifications related to, 302, 310
Environmental Protection Agency (EPA), 110, 120
Estimated Average Requirement (EAR; see also Alignment of food packages with DRIs; Dietary Reference Intakes)
cut-point method, 201, 570, 572
Estimated Energy Requirements (EERs)
intake analysis, 172, 173, 174, 175, 177, 178–179, 180, 181, 183, 184, 185, 202–203, 575–576
by population subgroup, 591–592
Expanded Food and Nutrition Education Program, 457
Expenditures for foods, 65, 66, 67, 69–70, 87, 89
F
Fat (see Saturated fats; Total fat)
Federal government
implementation challenges for 2009 changes, 53
Feeding Infants and Toddlers Study (FITS), 165, 290, 551, 552–556
Fiber, 12, 85, 86, 127, 130, 132, 134, 136, 144, 162, 172, 173, 175, 178, 180, 184, 197, 204, 217, 204, 223, 225, 229, 234, 239, 273, 275, 299, 305, 307, 347, 348, 349, 350, 351, 352, 353, 354, 355, 356, 357, 358, 359, 363, 364, 365, 368, 377, 378, 394, 516, 571, 585, 593, 594, 595, 597, 598, 599, 600, 601, 602, 603, 670, 671, 682, 683, 684, 686, 687, 708, 709, 720, 721, 731, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 845, 847, 849, 851, 853, 855, 857, 859, 861, 862, 865, 867, 887, 890–891, 893
Final Rule, 18, 20, 22, 28, 31, 52, 54, 88, 123, 140–141, 144, 266, 272, 278, 279–280, 293, 295, 303, 304, 305, 307, 309, 474, 487, 488, 528, 695, 697, 700, 725, 728, 730, 731, 733, 748, 869
Fish
administrative burdens, 405, 411, 890, 909, 916, 917
alignment of food packages with DGA, 110–111, 113, 114, 116, 118, 120, 149, 246, 247, 252, 253, 255, 256, 280, 281, 283, 363, 387, 411, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 880
alignment of food packages with DRIs, 357–362, 804–809
allergy considerations, 142, 143, 150
authoritative recommendations, 120, 128, 139, 280, 361, 387, 890, 893
children 1 to <2 years, 10, 26, 268, 281, 283, 291, 292, 302, 327, 412, 413, 421, 436, 437, 697, 723–724, 812–813, 889–890, 916, 917, 923, 940, 946, 949
children 2 to <5 years, 10, 26, 118, 268, 281, 283, 302, 360, 362–363, 364, 388, 412, 413, 421, 436, 437, 697, 723–724, 774, 804–805, 810–811, 841, 843, 889–890, 916, 917, 923, 940, 947, 949
container size, 391
cost considerations, 280–282, 323, 327, 331, 360, 362, 363, 364–365, 368, 405, 411, 419, 421, 423, 436–438, 455–456, 742, 805, 807, 809, 811, 813, 900, 909, 917, 922, 923, 925
criteria for inclusion, 376, 387, 388, 391, 392
current food packages, 26, 30, 110–111, 120, 137, 139, 149, 258, 280, 281, 302, 310, 357, 360–361, 411, 419, 423, 438, 518, 699, 701, 703, 705, 723–724, 733–734, 742, 764, 766, 767, 804–813, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 909, 916, 917, 922, 940, 941, 944
fully breastfeeding women, 9, 26, 92, 110, 116, 137, 149, 265, 280, 281, 283, 302, 340, 357, 361, 362, 411, 412, 705, 723–724, 775, 808–809, 837, 839, 900, 916–917, 940, 944, 948
HEI–2010 scores, 362, 363, 364–365, 805, 811
implementation of 2006 recommendations, 485, 486
infants 6 to <12 mo, 11, 266, 291, 292, 327, 376, 392, 405, 697, 711, 734, 881, 885, 882, 909, 941, 951
market share, 440
mercury concerns, 111, 129, 160, 390
mother–infant dyad, 265
nutrient levels/priorities, 231, 244, 246, 248, 362, 363, 711, 755, 886
partially breastfeeding women, 9, 26, 113, 244, 255, 256, 265, 281, 283, 294, 302, 363, 383, 701, 723–724, 766, 775, 829, 831, 895, 897, 916, 940, 947
postpartum (nonbreastfeeding) women, 9, 26, 114, 252, 253, 265, 283, 302, 412, 436, 437, 703, 723–724, 833, 835, 897–898, 916, 940, 948
pregnant women, 10, 26, 113, 246, 247, 268, 283, 294, 302, 360, 362, 364–365, 388, 412, 436, 437, 701, 723–724, 766, 775, 806–807, 825, 827, 893–894, 897, 916, 940, 947
price, 957
rationale for changes, 5, 516, 518, 885–886, 889–890, 893–894, 895, 897, 898, 900, 904
recommendations, 7, 11, 283, 291
redemption rates, 92, 357, 360–361, 362, 364–365, 392, 405, 733, 755, 758, 764, 766, 767, 804–813, 825, 827, 881, 909, 933, 940, 941, 944, 946, 947, 948, 951
regulatory impact analysis, 405, 411, 412, 413, 419, 421, 423, 436–438, 440, 880, 881, 885–886, 889, 890, 893–894, 895, 897–898, 900, 904, 909, 916, 917, 922, 923, 933, 940, 941, 944, 946, 947, 948, 949, 951, 953, 957, 958, 959, 979, 982, 984, 986, 987
revised food package, 7, 12, 265, 266, 268, 280–282, 283, 289, 291, 292, 294–295, 302, 310, 380, 383, 419, 423, 436–438, 699, 701, 703, 705, 723–724, 804–813, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 885, 909, 916–917, 922, 940, 941, 946, 947, 948
rotation, 265, 268, 281–282, 343, 357, 362–363, 364–365, 412, 413, 436–437, 438, 775, 810–813, 889–890, 893–894, 895, 897–898, 917, 949
sensitivity analysis, 339, 340, 357, 360–363, 368, 774–775, 804–813
sodium limits, 111
species options, 30, 32, 110, 310, 733–734
specifications, 281, 292, 302, 310, 723–724, 889, 890, 893–894, 895, 900, 904, 909, 916–917
substitution options, 7, 30, 146, 150, 266, 281, 291, 292, 323, 327, 376, 392, 405, 518, 697, 711, 734, 881, 885–886
supply and demand, 81
Folate, 85, 86, 87, 127, 131, 133, 135, 136, 137, 144, 158, 170, 171, 176, 182, 197, 204, 217, 226, 230, 235, 273, 280, 307, 342, 347, 348, 350, 353, 355, 357, 359, 504, 520, 568, 571, 573, 604–640, 670, 682, 683, 684, 708, 710, 730, 731, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845, 847, 849, 851, 853, 855, 858, 860, 861, 862, 864, 866, 893, 894
Food Acquisition and Purchase Survey (FoodAPS), 62–63, 65, 95, 447
Food and Drug Administration (FDA), 32 n.12, 110, 111, 120, 124, 140, 144, 159, 160, 161, 178, 242, 280, 296, 297, 298, 300, 301, 302, 303, 305, 307, 448 n.1, 573, 588, 715, 716, 717, 718, 719, 721, 722, 723, 725, 727, 728–729, 734 n.5, 903
Food categories, creating composites for, 321–322
Food consumption patterns (see also specific food groups)
children, by food group, 82
kilocalorie intake patterns, 84, 576
racial/ethnic differences, 164
satisfaction with packages and, 2
women, by food group, 81
Food cost estimation, current and revised packages (see also Regulatory impact analysis)
CPI base year for revised packages, 425, 427–428, 430–431, 954, 956, 959, 960, 961, 964–965, 968
CPI inflation scenarios, 395, 418, 425, 426, 427, 428, 430–431, 964–965, 966–967, 968–969
current food costs, 396
CVV assumptions and, 426–427, 428–431, 962–972, 984–985
by item category, 415, 418, 419–420, 423, 438, 439, 921, 922, 925, 933, 938, 950, 954, 984, 985–986
by items over time, 420, 422–424, 924–926
by items within each food package, 418, 420, 421–422, 921, 923–924
methodology, 315–324, 424–427, 926–961
phased-in differences, 398, 415, 417–418, 419–420, 421–422, 423, 425, 427, 429, 430, 431, 432–435, 436, 437, 478, 870, 872, 905, 920, 921, 922, 923–924, 925, 932, 961–962, 963, 964, 966–972, 973, 974–977, 978, 980–983
prices of food package items and, 395, 396, 397, 405, 419, 424, 425–427, 438, 439, 869, 870, 871, 909, 922, 927, 933, 942, 945, 949–960, 965, 966, 979, 986
redemption data and, 395, 397, 415, 418, 425, 428, 429, 869, 871, 909, 921, 933, 938–945, 946–949, 978, 980–981
shift in fully formula-fed to breastfed dyads anticipated in, 402, 415, 416, 417, 419, 420, 422, 425, 431, 434–436, 438, 439, 876, 905, 906, 919, 920, 922, 924, 926, 931–933, 936–937, 941, 973, 976–978, 980–981, 984, 985
sources of differences, 415, 418–424, 921–926
total cost differences, 396, 415, 416, 418, 421, 422, 424, 429, 430, 432, 434, 437, 870, 905, 919, 921, 923, 924, 926, 963, 968, 970, 972, 974, 976, 980, 982, 983
unadjusted, 396, 398, 415, 416, 417, 419, 420, 423, 481, 870, 872, 905, 919, 920, 922, 924, 925
uncertainties in, 427–436, 960, 962–978
“up to” amount of infant formula and, 399, 401, 403, 431, 432–433, 875, 882, 883, 907, 973, 974–975
WIC program participation levels and, 395, 397 n.1, 398 n.4, 399, 415, 419, 420, 424–425, 435, 869, 870, 871, 872 n.3, 876, 905, 922, 926, 927–931, 932, 934–937, 938, 945 n.15, 977
Food expenditures
changes since 2009 review, 98
committee analysis, 36–37
Food group intakes
2009 revisions and, 162–164
alignment with recommendations, 187–194
analysis by population subgroup, 644–665
by breastfeeding women, 188, 189–190, 648, 652
changes in recommendations, 84–85
by children 1 to <2 years, 82, 190, 192, 654–657
by children 2 to <5 years, 81, 82, 191–192, 193, 658–665
committee process, 36
committee’s analyses versus other published results, 204
complementary foods, 164–165, 191
geographical differences, 164
Healthy Eating Index by, 195, 196
infant food meat, 188, 190, 191, 290
juice, 188, 189, 190, 191, 192, 193, 455, 644–658
kilocalorie intake patterns, 84
milks and milk substitutes, 55, 81, 82, 163, 529–530, 554, 888
of NHANES findings, 187–194
by postpartum women, 188, 189–190, 650–653
by pregnant women, 81, 188, 189–190, 644–647
racial and ethnic differences in purchasing and consumption, 164
Food packages (see Alignment of food packages with DGA; Changes in food packages; Current food packages; Revised food packages; Substitutions in food packages; specific foods and packages)
categorical eligibility, 23
Food Patterns Equivalents Database (FPED), 121, 122, 123, 306, 341, 577, 578, 579
Food Patterns Ingredients Database (FPID), 578
Food safety, 159–161
Food supply, WIC’s influence on, 83
Formula (see Infant formula and formula feeding)
Fresh Fruit and Vegetable Program, 18 n.1
Fruits (see also Vegetables and fruits)
Full nutrition benefit (FNB), 22, 24–25, 75, 179, 181, 265–266, 287, 402–403, 694–697, 727–728, 749, 882, 907
Fully breastfeeding women (see also Breastfeeding women/dyads; Package VII)
adverse health impacts of nutrient inadequacies and excesses, 217
DGA recommendations, 138–139, 189–190
food group intakes, 189–190, 648–653
Nutrient-Based Diet Quality Index score, 197
nutrient intakes, inadequacies, and excesses, 171, 172, 173, 174, 175, 217
G
Gap analysis
breastfeeding women, 229–233, 683
children 1 to <2 years, 239–241, 686
children 2 to <5 years, 239–241, 687
Package II, 243
Package IV-B, 373, 378, 380, 382
postpartum women, 234–238, 684–685
target, 244
Geographical differences in food intakes, 164
Gluten-free foods, 143, 144, 307, 308, 904
Grains (see Breads; Breakfast cereals; Whole grains; specific grains)
H
Health risks (see Nutrition-related health risks)
Healthy Eating Index–2010 (HEI–2010)
added sugars and, 196–197
breakfast cereals, 348–349
children 2 to <5 years, 196, 197, 669
committee’s analyses versus other published results, 205
components and scoring, 666, 667, 670–671
legumes and peanut butter, 363, 368, 811
milks and milk substitutes, 344–345, 777
limitations, 203–204
Nutrient-Based Diet Quality (NBDQ) index scores, 194, 197, 477, 670, 671, 672
saturated fats and, 340, 344–345
within-person variance, 671–672
Healthy food availability score, 96
Healthy, Hunger-Free Kids Act of 2010, 53
Healthy Meals for Healthy Americans Act, 21
Healthy People 2020 goals, 1, 20, 40, 70, 74, 475, 878
I
Implementation of food package changes (see also Regulation of food packages)
challenges of 2009 changes, 52–55, 98, 484, 486–487, 904
Income level/distribution
breastfeeding prevalence, 73
WIC participants, 60–61
Infant cereal (see also Package II)
AAP guidance, 126, 138, 287–288, 884
administrative effects of revisions, 403, 907–908
alignment with dietary guidance, 149, 254, 287–288, 399, 881, 884
alignment with DRIs, 728
for breastfed infants, 8, 264, 518, 696, 765, 873, 880 n.5, 883, 943, 946
cost considerations, 403, 419, 421, 423, 438, 922, 923, 925, 984
criteria for inclusion, 375
current benefit, 25, 287, 403, 419, 423, 438, 696, 697, 714, 765, 873, 907, 922, 925, 940, 984
food safety considerations, 159–160, 161
for formula-fed and partially breastfeeding infants, 8, 264, 697, 765, 873, 880 n.5, 883, 943, 946
introduction, 388
iron fortified, 138, 161, 287–288, 388, 696, 697
nutrient content and priorities, 243, 287, 291, 884
options, 161
prices, 957
redemption rates, 92, 518, 748, 765, 940, 943, 946
regulatory impact analysis, 404, 907–908
revised benefit, 8, 9, 264, 287–288, 291, 403, 419, 421, 518, 696, 714, 765, 880 n.5, 883–884, 907–908, 922, 923, 925, 940, 943, 984
specifications, 714
Infant Feeding Practices Study II, 78, 165, 551, 552–554
Infant food meat
administrative burden 405, 909
alignment with dietary guidance, 126, 149, 254, 388, 881, 885
alignment with DRIs, 291
cost considerations, 327, 405, 419, 423, 438, 746, 909, 922, 925, 984
breastfed infants, 8, 25, 188, 191, 243, 264, 288, 290–291, 292, 388, 405, 690, 696, 873, 951
criteria for inclusion, 327
current benefit, 25, 126, 139, 149, 290, 405, 419, 438, 696, 715, 734–735, 764, 873, 881, 885, 909, 922, 925
defined, 476
fish (canned), substitution for, 7, 11, 266, 291, 292, 327, 376, 392, 405, 436, 438, 697, 711, 734, 881, 885, 882, 909, 941, 951, 979
implementation of 2006 IOM recommendations, 486
intake patterns, 188, 190, 191, 290
introduction, 128, 139, 146, 388
nutrient content and priorities, 128, 188, 243, 288, 711, 734–735, 748
options, 748
prices, 957
redemption rates, 92, 93, 290, 392, 405, 518, 746, 764, 885, 941, 943, 946, 951
regulatory impact analysis, 405, 909
revised benefit, 7, 8, 11, 264, 266, 290–291, 292, 327, 376, 388, 392, 405, 419, 423, 697, 711, 734, 764, 881, 885, 882, 909, 941, 951, 909, 922, 925, 946, 951
specifications, 715
substitutions, 7, 11, 146, 266, 291, 292, 327, 376, 392, 405, 436, 438, 697, 711, 734–735, 881, 885, 882, 909, 941, 951, 979
Infant food vegetables and fruits
AAP guidance, 126, 190, 287, 288, 290–291, 881, 884, 885, 887
administrative burdens, 404–405, 908–909
alignment with dietary guidance, 386, 389, 881
challenges to implementation of 2009 revisions, 53
cost considerations, 289, 404–405, 909, 962, 965, 970
cultural considerations, 392
current benefit, 25, 288, 292, 293, 404, 438, 696, 697, 714, 764, 696, 715, 873, 908–909
CVV substitution, 7, 8, 11, 13, 53, 139, 141 n.9, 147–148, 264, 265, 266, 267–268, 288, 289, 292, 293, 296, 327, 340, 363, 366, 374, 389, 392, 393, 404, 421, 525, 696, 697, 764, 775, 814–815, 881, 884, 885, 901, 908, 909, 941, 965, 970–971
implementation of IOM 2006 recommendations, 484, 486
nutrient content, 708, 709–710, 747
prices, 957
and promotion of full breastfeeding, 884
redemption rates, 92, 941, 943, 946, 965
regulatory impact analysis, 404–405, 908–909
revised benefit, 8, 9, 10, 25, 264, 265, 266, 268, 285–288, 291, 292–293, 310, 363, 366, 404–405, 428, 696, 697, 715, 873, 884, 908–909, 943, 946
sensitivity analysis, 340, 363, 366, 775, 814
specifications, 715
Infant formula and formula feeding (see also Package I; Package II; Package III)
AAP guidance, 128, 146, 264, 519, 728–729, 881, 919
administrative burdens, 402–403, 405–406, 440, 906–907, 910
alignment with DRIs, 727–729
and breastfeeding choice, 5, 20, 74–77, 93, 285
changes since last review, 57, 59, 67, 70, 73, 74–77, 78, 79, 83, 92, 93, 97, 527, 529, 530
cost considerations, 16, 78, 79, 315, 317–318, 320, 321, 330, 331–334, 335, 399, 401, 403, 415, 416, 417, 419, 420, 422, 425, 431, 432–433, 434–435, 460, 746, 875, 882, 883, 906–907, 910, 919, 922, 925, 926, 949, 973, 974–981, 984
current food packages, 2, 5, 22, 24–25, 33, 75, 139, 181, 207, 286–287, 292–293, 310, 318, 402–403, 419, 420, 423, 434–435, 439, 458, 459, 588, 694–695, 696, 697, 698, 714, 727–729, 748–749, 764, 906–907, 910, 922, 925, 934–935, 940, 976–977, 984
dietary guidance, 128, 139, 388, 576
evaluation of requirements, 588
exempt, 25, 140 n.7, 265, 268, 292, 330, 401, 406, 416, 417, 448, 698, 735, 875, 886, 910
first-month options, 5, 74–75, 285–286, 317 n.3, 383, 393, 399, 906, 946, 948
implementation of 2006 recommendations, 486–487
infants 0 to <6 months, 8, 24, 75, 76, 179, 181, 186–187, 264, 285, 318, 324, 328, 399, 400, 402, 432–433, 435, 694, 695, 714, 745, 873, 874, 880, 882–883, 932, 934, 936, 940, 946, 977
infants 6 to <12 months, 8, 24, 136, 179, 181, 186–187, 264, 285, 318, 324, 432–433, 694, 696, 697, 714, 745, 873, 883, 946
iron-fortified, 128, 139, 388, 694, 697
limits to encourage breastfeeding choice, 5, 20, 74–77, 93, 285–286, 331–334, 452–453, 690, 881
marketplace options, 83
nutrient content, 33, 83, 136, 158, 310, 519, 727–729, 748–749
nutrient intakes and priorities, 128, 167, 174–179, 181, 187, 207, 242, 288, 573, 576
nutrition-related health risks, 158, 576
products analyzed, 748–749
proportion of WIC participants, 57, 59, 317–319, 340–341, 366–367, 425, 926, 934–937
ready-to-feed, 24, 25, 179 n.11, 268, 287 n.15, 321, 391, 694, 695, 696, 697, 698, 745, 747, 882, 883, 945, 948, 950, 957, 958
rebates from manufacturers, 53, 78, 79, 140 n.7, 321, 324, 328, 330, 331, 332, 334, 366, 367, 419, 423, 439, 478, 519, 528, 745, 922, 925, 945, 948–949, 950–951, 957, 985
reconsideration in future reviews, 458–459
redemption rates, 92, 93, 320, 747, 748, 764, 765, 940, 943, 945, 946, 948, 950, 980–981
regulatory impact analysis, 402–403, 405–406, 440, 906–907, 910
research potential, 676
revised benefit, 8, 9, 10, 264, 265, 266, 268, 271, 285–288, 291, 292–293, 310, 318, 403, 419, 420, 423, 434–435, 458, 694, 696, 697, 698, 714, 748–749, 881, 882–883, 906–907, 910, 922, 925, 936–937, 940, 946, 948–949
shift from fully formula-fed to breastfed dyads, 402, 415, 416, 417, 419, 420, 422, 425, 431, 434–436, 438, 439, 876, 905, 906, 919, 920, 922, 924, 926, 931–933, 936–937, 941, 973, 976–978, 980–981, 984, 985
soy protein–based, 146
special medical needs, 8, 10, 24, 140–141, 142, 150, 81, 268, 285, 292–293, 330, 405–406, 698, 735, 745, 886, 910
specifications, 20 n.5, 714, 727–729
tailoring amounts of, 22, 74–75, 285, 440, 452–453, 486, 695, 880, 881, 882–886, 907
“up to” amount, 399, 401, 403, 431, 432–433, 875, 882, 883, 907, 973, 974–975
USDA-FNS guidance, 74–76
vegan substitutes, 146
vendor burdens, 402–403, 906–907
Infants (see also Complementary foods and feeding; Infant cereal; Infant food meat; Infant food vegetables and fruits; Infant formula and formula feeding; Package I; Package II; Package III)
AAP recommendations, 32, 40, 83, 109, 126, 242, 244, 254, 287–292, 388, 876–877, 881
added sugars, 133, 175, 178, 207, 217, 219, 290, 714, 715, 858, 860
adverse health impacts of nutrient inadequacies and excesses, 217
cow’s milk, 554
dietary guidance for, 128, 138–139
DRIs for, 132–133, 176, 177, 187
energy requirements, 591
fully breastfed, 24–25, 70, 128, 132–133, 167, 180, 182, 191, 318, 328, 400, 403, 404, 405, 873, 874, 883, 884, 885, 907, 908, 909, 934, 936, 940, 941, 943, 941, 946, 958
fully formula fed, 24–25, 129, 132–133, 167, 174–179, 181, 187, 318, 328, 400, 403, 435, 873, 874, 880, 882, 883, 907, 932, 934, 936, 940, 941, 943, 946, 977
NHANES survey years, 167
nutrient intakes, inadequacies, and excesses, 167, 174–179, 180, 181, 182, 187, 207, 217, 242, 288, 573, 575, 576, 589, 595, 596–599, 614–625
partially breastfed, 24–25, 70, 318, 328, 399, 400, 401, 402, 431, 432, 433, 435, 873, 874, 875, 876, 882, 883, 906, 934, 936, 940, 943, 946, 973, 974, 975, 977
Information Resources, Inc., 279, 304, 320, 425
Intakes (see Dietary intake analyses; Food group intake; Nutrient intake analysis; specific foods and nutrients)
Interim Rule, 2, 22, 23, 31, 34, 440, 488, 527, 548, 578, 869, 878, 986–987
International Lactation Consultant Association, 21
Iowa State University, 63 n.3, 559
PC Software for Intake Distribution Estimation (PC-SIDE), 478, 565, 570, 586
Iron, 45, 86, 87, 127, 128, 129, 130, 132, 134, 136, 137, 139, 144, 146, 158, 161, 165, 168, 170, 171, 174, 176, 177, 178, 179, 180, 181, 182, 183, 185, 187, 188, 197, 201, 204, 207, 217, 218, 224, 235, 242, 243, 280, 287–288, 290, 291, 299, 306, 309, 310, 347, 348, 349, 388, 389, 475, 489, 503, 504, 518, 566, 571, 572, 573, 574, 581, 588, 604–641, 670, 682, 684, 686, 694, 696, 697, 699, 701, 703, 705, 708, 709, 711, 714, 720, 727–728, 730, 731, 734–735, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 845, 847, 849, 851, 854, 856, 857, 859, 861, 862, 863, 865, 884, 885–886
J
Juice
AAP guidance, 13, 118, 126, 129, 137, 149, 190, 254, 275, 841, 842, 843, 844
added sugars, 124, 798, 800, 802
alignment with DGA, 112, 113, 114, 116, 118, 124, 126, 137, 138, 139, 149, 188, 254, 275, 276, 377, 379, 388, 455, 484, 487, 517, 820–844, 880, 887
administrative burdens, 52, 276, 375, 393, 406–407, 911
children 1 to <2 years, 10, 13, 26, 110, 126, 129, 254, 268, 275, 283, 389, 421, 455, 654–658, 699, 719, 765, 886–887, 923, 943, 946
children 2 to <5 years, 10, 13, 26, 110, 118, 129, 268, 275, 283, 358, 388, 389, 421, 658–665, 699, 719, 765, 774, 798–799, 824, 841, 843, 886–887, 923, 944, 947
container size considerations, 52, 53, 54, 275–276, 391, 393, 518, 911
cost considerations, 15, 275 n.7, 327, 356–357, 358–359, 418, 419, 421, 423, 438, 441, 455, 741, 887, 911, 921, 922, 923, 925, 965, 972, 984
criteria addressed, 374, 379, 388, 389, 391, 393
CVV substitution, 7, 12, 13, 149, 227, 232, 236, 265, 267, 269, 275–276, 284, 288, 327, 339, 340, 343, 356–357, 358–359, 368, 374, 392, 393, 406–407, 441, 701, 705, 765, 766, 767, 774, 798–803, 886–887, 891, 895, 897, 901, 911, 921, 941, 962, 965, 972–973
definition and unit, 579
effects of revisions, 523, 526–527, 887, 891, 895, 897, 898, 911
Final Rule, 26
fully breastfeeding women, 9, 26, 116, 283, 356–357, 359, 488, 648–653, 705, 719, 767, 802–803, 823, 837, 839, 898, 941, 944, 948
health concerns, 487, 507, 515
intake distributions and trends, 188, 189, 190, 191, 192, 193, 455, 644–658
Kosher or Halal diets, 147
marketplace options/availability, 52, 53, 81, 96, 391, 526, 887, 901
mother–infant dyads, 265
nutrient analysis and contributions, 227, 232, 236, 357, 455, 556, 750, 798–803
nutrient priorities, 227, 232, 236, 357, 455
nutrition education, 393
partially breastfeeding women (V-B), 9, 26, 112, 283, 421, 701, 766, 829, 831, 895, 941, 944, 947
postpartum women (VI), 9, 26, 114, 275 n.7, 283, 421, 650, 652, 703, 719, 822, 833, 835, 897, 923, 941, 944
preferences and cultural considerations, 89, 392, 517, 526–527
recommendations, 7, 15, 283, 284, 455
redemption rates, 92, 356, 358–359, 523, 741, 750, 758, 764, 765, 766, 767, 798–803, 820, 938, 941, 943–944, 946, 947, 965
regulations/regulatory analysis, 406–407, 911
retail sales/market share, 439–440, 986
revised food packages, 7, 9, 10, 12, 265, 267, 268, 269, 275–276, 283, 284, 339, 340, 343, 356–357, 358–359, 368, 374, 377, 379, 419, 423, 438, 699, 701, 703, 705, 719, 741, 765, 766, 767, 774, 798–803, 820–844, 886–887, 891, 901, 922, 925, 984
sensitivity analysis, 339, 340, 343, 356–357, 358–359, 368, 774, 798–803
special dietary needs (III), 10, 265
specifications, 719
vendor burden, 52, 276, 375, 393, 406–407, 887, 901, 911
vitamin C, 227, 232, 236, 357, 887
K
Kosher or Halal diets
and alignment of food packages with DGA, 143, 146–147, 150
authorization of substitutions, 548
milks and milk substitutes, 146–147, 548
percentage of mothers, 548
L
Lactose intolerance, 27, 28, 40, 145, 150, 267, 269, 270, 282, 476, 515, 700, 702, 704, 706, 887, 888, 892, 896, 897, 898–899, 901, 902
Legumes and peanut butter
administrative burdens, 274, 281, 412–413, 917
alignment with DGA, 110, 112, 114, 116, 118, 149, 246–247, 249, 252, 253, 256–257, 281–282, 377, 382, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 890, 893, 894, 917
alignment with DRIs, 224, 225, 226, 229–230, 231, 232, 234, 235, 236–237, 239, 810–811
children 1 to <2 years, 10, 26, 92, 139, 239, 268, 173, 274, 281, 283, 412–413, 724–725, 755, 763, 884, 890, 941, 943, 945, 946, 952–953, 957
children 2 to <5 years, 10, 26, 92, 118, 239, 268, 273, 274, 281, 283, 364–365, 368, 377, 382, 412–413, 421, 724–725, 755, 763, 775, 810–811, 841, 843, 884, 890, 923, 941, 944, 945, 947, 952–953, 957
cost considerations, 320, 322, 363, 364–365, 413, 419, 421, 423, 438, 742–743, 763, 811, 813, 917, 922, 923, 925, 984
criteria for inclusion, 374, 375
cultural considerations, 7, 148, 274
current food packages, 12, 26, 30, 92, 273, 274, 281, 362–363, 364–365, 377, 382, 412–413, 419, 423, 438, 699, 701, 703, 705, 724–725, 733, 742, 743, 755, 763, 810–813, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 922, 923, 925, 941, 952–953, 957, 984
CVV and, 7, 223, 229, 235, 239, 274, 374
defined, 476
fish rotation with, 265, 268, 281–282, 343, 357, 362–363, 364–365, 412, 413, 436–437, 438, 775, 810–813, 889–890, 893–894, 895, 897–898, 917, 949
forms/options, 7, 13, 223, 224, 225, 226, 229, 234, 246, 252, 256–257, 258, 274, 283, 284, 391, 457, 517, 890, 895, 898, 951
fully breastfeeding women, 9, 26, 92, 116, 229–230, 231, 232, 249, 265, 274, 281, 283, 412–413, 705, 724–725, 755, 763, 837, 839, 899, 941, 944, 948, 952–953, 957
implementation of most recent changes, 488
mother–infant dyad package, 9, 265
nutrients levels/priorities, 223, 224, 225, 226, 229–230, 231, 232, 234, 235, 236–237, 239, 273, 363, 364–365, 455, 735, 755, 810–813, 890, 893
nutrition education or behavioral interventions to improve intakes, 231, 232–233, 234, 236–237, 244, 249, 253
package size considerations, 275, 733
partially breastfeeding women, 9, 26, 92, 112, 229–230, 231, 232, 249, 256–257, 265, 274, 281, 283, 412–413, 699, 701, 702, 724–725, 755, 763, 829, 831, 895, 941, 944, 947, 952–953, 957
postpartum women, 9, 26, 92, 114, 234, 235, 236–237, 252, 253, 265, 274, 281, 283, 412–413, 703, 724–725, 755, 763, 833, 835, 897–898, 941, 944, 945, 947, 952–953, 957
pregnant women, 10, 26, 92, 112, 224, 225, 226, 246–247, 268, 274, 281, 283, 364–365, 412–413, 421, 699, 701, 702, 724–725, 755, 763, 775, 812–813, 825, 827, 893–894, 897, 923, 941, 944, 947, 952–953, 957
redemption rates, 12, 92, 274, 281, 321–322, 323, 362, 363, 364–365, 758, 763, 775, 810–813, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 925, 941, 943, 944, 946, 947, 948
regulatory impact analysis, 412–413, 917–918
revised, 7, 9, 10, 149, 265, 266, 267, 268, 269, 270, 273–274, 281–282, 283, 284, 362–363, 364–365, 377, 382, 412–413, 419, 421, 423, 438, 699, 701, 703, 705, 742–743, 755, 763, 775, 810–813, 825, 829, 831, 833, 835, 837, 839, 841, 843, 922, 941, 952–953, 957, 984
rotation, 273–275, 339, 343, 357, 362–363, 364–365, 763, 775, 810–813, 884, 893, 894
sensitivity analysis, 339, 343, 357, 362–363, 364–365, 775, 810–813
serving equivalents, 579
special medical needs, 143, 268
specifications, 724–725, 884, 893
substitutions allowed, 7, 30, 142, 143, 267, 269, 282, 284, 375, 392, 517, 700, 702, 703, 704, 706, 764
vegetarian and vegan diets, 146, 282, 284, 392, 702, 704, 706
M
Medicaid, 19, 56, 140 n.7, 199, 201, 293, 448, 502, 508, 510, 511, 536, 581, 676–677, 678
Magnesium, 85, 86, 127, 130, 131, 132, 134, 170, 171, 176, 182, 197, 204, 226, 231, 236, 297, 344, 345, 347, 348, 350, 353, 355, 357, 359, 363, 364, 365, 566, 567, 571, 573, 604–642, 670, 682, 683, 685, 708, 709, 717, 713, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 845, 847, 849, 851, 853, 855, 857, 859, 861, 862, 863, 865
Marketplace availability/options
breads, 83, 279, 307–308, 410, 514, 515
breakfast cereals, 307–308, 904
consideration of, 6
current foods, 295, 303–304, 307, 506
expansion since 2006, 2, 80–83, 98
infant formula, 83
Maximum monthly allowance (MMA), 8, 10, 22, 24–27, 141, 179, 181, 264, 266, 268, 287, 477, 694–699, 701, 703, 705, 727, 748, 883, 907, 952, 955
Milks and milk substitutes (see also Cheese; Infant formula; Yogurt)
added sugar limit, 7, 13, 123, 149, 225, 230, 240, 296, 303, 304, 305, 344–345, 346, 376, 379, 386, 716, 776, 778, 780, 900, 902
administrative burdens, 52, 53, 277, 375, 376, 393, 407–408, 888, 912, 978
alignment with DGA, 112, 114, 116, 118, 120, 129, 137, 138, 246, 247, 249, 250, 251, 253, 254, 256, 277–278, 389, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843
alignment with DRIs, 224, 225, 226, 227, 229, 230, 231, 232–233, 239, 240, 773, 776–781
Child and Adult Care Food Program, 120
children 1 to <2 years, 2, 7, 10, 26, 129, 136, 137, 138, 239, 240, 268, 277–278, 283, 296, 339–340, 421, 516, 554, 699, 700, 716, 732, 741, 750–751, 766, 887, 888, 923, 941, 946, 955
children 2 to <5 years, 7, 10, 26, 82, 118, 137, 239, 240, 256, 268, 277–278, 283, 296, 339–340, 344, 699, 732, 741, 750–751, 766, 773, 776–777, 843, 887–888, 941, 944, 947, 951, 955
complementary food, 165, 389, 554, 556
container size considerations (“dangling quart”), 52, 53, 277, 375, 376, 393, 407–408, 888, 912, 978
cost considerations, 323–324, 326, 344–345, 346, 419, 420, 422, 423, 438, 741, 742, 777, 779, 781, 914, 922, 923, 924, 925, 978, 984
criteria for inclusion, 376, 386, 389, 391
cultural considerations and preferences, 13, 89, 150, 392, 526–527, 888, 912
current food packages, 2, 26–28, 30, 52, 112, 114, 116, 118, 120, 121, 122, 123, 136–137, 138, 143, 145, 150, 276, 277, 278, 296–298, 303–304, 305, 308, 339, 340, 344–345, 407–409, 438, 488, 699, 701, 703, 705, 716–719, 730, 732–733, 734, 741, 751, 752, 753, 765, 766, 767, 766, 767, 773, 776–781, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 941, 943, 944, 951, 955, 984
dried/powdered milk, 27, 267, 269, 391, 700, 702, 703, 706, 951
effects of 2009 revisions, 163
evaporated, 27, 267, 269, 296, 700, 702, 703, 706, 716, 951
flavored, 120, 121, 122, 123, 124, 296, 298, 305, 309, 515, 556, 716, 900, 901, 851 n.17
fully breastfeeding women, 9, 26, 116, 229, 230, 231, 232–233, 249, 250, 265, 277, 283, 296, 344–345, 346, 705, 716, 732, 741, 767, 773, 780–781, 837, 839, 841, 897, 898, 941, 944, 948, 954, 955
implementation of 2006 IOM recommendations, 486, 487
infants, 554
intake distributions and trends, 55, 81, 82, 163, 529–530, 554, 888
Kosher or Halal diets, 146–147, 548
lactose-free, 143, 227, 422, 741, 747, 748, 750, 751, 924, 951, 955, 956, 957
lactose intolerance or allergy, 27, 28, 40, 145, 150, 267, 269, 270, 282, 476, 515, 700, 702, 704, 706, 887, 888, 892, 896, 897, 898–899, 901, 902
marketplace options/availability, 96, 527
National School Lunch Program, 120
nutrition education, 55, 145, 232–233, 237
partially breastfeeding women, 9, 26, 112, 229, 230, 231, 232–233, 249, 250, 265, 277, 283, 296, 344, 455, 701, 716, 732, 741, 766, 829, 831, 896, 941, 944, 947, 955
postpartum women, 9, 26, 114, 234, 235, 236, 237, 251, 253, 254, 265, 277, 283, 296, 703, 704, 716, 732, 741, 767, 833, 835, 897, 941, 944, 947, 955
pregnant women, 10, 26, 112, 224, 225, 226, 227, 246, 247, 268, 277, 283, 296, 346, 421, 701, 716, 732, 741, 766, 773, 778–779, 825, 827, 891–892, 923, 941, 944, 947, 955
prices, 341, 426, 950, 951, 954, 955, 956, 957, 958
promoting consumption of, 730
redemption rates, 92, 276, 277, 282, 322, 323, 340, 343, 344–345, 346, 408, 523, 732, 741, 750, 751, 754, 758–759, 766, 767, 776–781, 888, 938, 941, 943, 944, 946, 947, 948, 950, 951, 978, 980–981
reduced fat, 2, 27, 52, 120, 129, 137, 163, 267, 276, 485, 488, 515, 526, 529–530, 554, 700, 702, 703, 706, 730, 732
regulatory impact analysis, 407–411, 419–420, 421, 422, 423, 426, 438, 439–440, 886, 887–888, 891–892, 896, 897, 898–899, 900–902, 912–914, 922, 923, 924, 925, 938, 941, 943, 944, 946, 947, 948, 950, 951, 953–954, 955, 956, 957, 958, 978, 980–981, 984, 986
retail sales/market share, 27, 440, 732, 986
revised food packages, 7, 9, 10, 12, 265, 267, 268, 269, 270, 276–278, 280, 282, 283, 284, 296, 297, 298, 303, 304, 305, 308, 309, 701, 703, 705, 732, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 941, 946, 947, 948, 955, 984
saturated fat limits, 120, 122, 218, 225, 230, 235, 240, 343, 485, 523, 732
sensitivity analysis, 339–340, 341, 343–346, 368, 773, 776–781
special dietary needs, 141, 142, 143, 150, 268, 886
specifications, 31, 52, 88, 120, 121, 122, 123, 124, 296, 298, 305, 309, 488, 556, 716, 732, 851 n.17, 892, 900–901
total sugars, 304
transportation considerations, 12
vegan diet, 145, 146, 888, 892, 896, 897
vendor burden, 52, 53, 375, 376, 387, 393, 407–408, 912
whole milk, 27, 92, 129, 136, 137, 138
Mother–infant dyads
breakfast cereals, 265
CVVs for, 8–9, 26, 264, 288, 422
juice, 265
market value of current versus revised packages, 333
package costs with rebates, 332
revised packages as benefits to, 6–9, 262, 263, 264–267, 271, 285–286, 287, 288
shift from fully formula-fed to breastfed dyads, 402, 415, 416, 417, 419, 420, 422, 425, 431, 434–436, 438, 439, 876, 905, 906, 919, 920, 922, 924, 926, 931–933, 936–937, 941, 973, 976–978, 980–981, 984, 985
N
National Cancer Institute method, 203, 205, 570, 586, 587, 666 n.6, 672
National Health and Nutrition Examination Survey (NHANES) data
breastfeeding, 5–6
complementary feeding study, 552–553
estimation issues, 201–203
food intakes by food group, 5, 81–82, 187–194, 203
income reporting, 201
limitations, 5–6, 166–168, 199–204, 581, 585–587
misclassification of WIC program use, 166–167, 200–201
nutrient intake inadequacies and excesses, 5, 165–187, 201–203, 577–578, 581–583, 584–585
population subgroups, 168
selection bias, 166
serum vitamin D evaluation, 575
strengths, 199–204
survey years by subgroup, 167, 169
What We Eat in America dataset, 571–572, 577
National Immunization Survey, 70, 525
National School Lunch Program, 18 n.1, 56, 120, 299, 305–306, 720
National School Nutrition Program, 732
Niacin, 127, 131, 133, 135, 136, 144, 170 n.9, 171, 176, 182, 238, 348, 353, 355, 357, 359, 361, 362, 363, 364, 365, 568, 571, 573, 604–642, 685, 708, 710, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 846, 848, 850, 852, 854, 856, 857, 859, 861, 862, 864, 866
Nutrient-Based Diet Quality (NBDQ) index scores, 194, 197, 477, 670, 671, 672
Nutrient content (see also Gap analysis)
alignment of packages and intakes with DRIs, 130, 132, 134, 228, 231, 234, 604–641, 845, 848, 849, 851, 853, 855, 857, 859, 861, 862, 863, 864
breakfast cereals, 138, 224, 226, 227, 230, 231, 232–233, 234, 235, 236–237, 238, 280, 306, 307, 309, 347, 348–349, 350, 368, 455, 730, 753–754, 904
current packages, 5, 130–135, 242, 258, 306, 307, 310, 343–366, 373, 459, 575, 588, 727–728, 731, 732–733, 776–815
eggs, 224, 242, 247, 249, 253, 256, 735
infant cereal, 243, 287, 291, 884
infant food meat, 128, 188, 243, 288, 711, 734–735, 748
infant food vegetables and fruits, 708, 747
infant formula, 33, 83, 136, 158, 310, 519, 727–729, 748–749
legumes and peanut butter, 223, 224, 225, 226, 229–230, 231, 232, 234, 235, 236–237, 239, 273, 363, 364–365, 455, 735, 755, 810–813, 890, 893
milks and milk substitution, 224, 225, 226, 227, 229, 230, 231, 232–233, 234, 235, 236, 237, 239, 240, 277, 343, 346, 556, 734
Nutrient intake analysis (see also Gap analysis; specific food groups and nutrients)
AI-only values and, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 183, 184, 187, 204
basis for concern, 574
before and after 2009 package changes, 36, 160–163
best linear unbiased predictor, 670, 672
breastfeeding women, 170, 171, 172, 173, 174, 175, 217, 583–585, 585, 589, 591, 594, 595, 608–609
children 1 to <2 years, 180, 182–183, 184, 185, 186, 217, 590, 599–601, 626–633
children 2 to <5 years, 167, 182, 183–185, 186, 217, 590, 601–603, 634–642
committee’s analyses versus other published results, 204
committee’s task, 36
DRIs by population subgroup, 566–569
EAR cut-point method, 201, 570, 572
effects of 2009 revisions, 162
energy, 172, 173, 174, 175, 177, 178–179, 180, 181, 183, 184, 185, 202–203, 575–576, 589–590
excess intakes, 3, 5, 39, 166, 170, 174, 175, 177–178, 179, 183, 185, 186, 572–573, 574
food pattern food groups, definitions, and example foods, 579–580
Food Patterns Equivalents Database, 121, 122, 123, 306, 341, 577, 578, 579
Food Patterns Ingredients Database, 578
inadequate intakes, 3, 5, 39, 166, 170, 171, 182, 373, 377, 378, 570, 572, 573, 574, 585, 586
infant formula evaluation, 588
infants, 167, 174–179, 180, 181, 182, 187, 207, 217, 242, 288, 573, 575, 576, 589, 595, 596–599, 614–625
limitations of datasets, 581
macronutrients, 172, 173, 175, 177, 178–179, 180, 183, 184, 570, 573, 593–603
methods, 166–170
micronutrients, 170–171, 172, 174, 175, 176, 177–179, 180, 183, 184, 185, 186, 201–202, 572–573, 604–642
NHANES data, 165–187, 577–578, 581–583, 584–587
nutrients selected for, 571–572
patterns, 170, 171, 176, 178, 182, 186, 585, 604–641
postpartum women, 171, 172, 173, 174, 175, 585, 589, 591, 594, 595, 610
pregnant women, 171, 172, 173, 174, 175, 585, 589, 591, 593, 604–607
recommended intakes compared to, 173, 174, 175, 184, 185
sampling and sample size issues, 5, 6, 200, 583, 584–587
statistical comparisons, 587
survey years by subgroup, 582
thresholds for inadequacies and excesses, 166, 170
usual intake distributions, 169, 172, 175–178, 182, 192, 202, 565–570, 589–590, 593–642
vitamin D special case, 185–187, 574–575, 643
WIC population versus WIC-eligible population, 36
women, 170–171, 172, 173, 174, 175, 186
WWEIA dataset, 571–572, 577–578, 581–583, 584–585
Nutrition education, 16, 17, 20, 39, 41, 47, 54–55, 97, 145, 206–207, 231, 232–233, 234, 236–237, 244, 249, 253, 272, 334, 393, 399, 401, 456–457, 525, 542, 543, 875, 876, 878
Nutrition-related health concerns, 86, 158, 159–160, 161, 217, 218, 227, 231, 234, 486, 487, 507, 515, 576
Nutritionals, WIC-eligible, 25, 140, 141, 265, 268, 292, 330, 401, 416, 417, 698, 725, 875, 886, 917, 920, 945, 980
O
Obesity/overweight concerns
childhood, 52, 88, 119, 129, 138, 147, 158–159, 209, 389, 503, 519, 576, 700, 842, 844
and energy content of diet, 202, 215, 487, 519, 576, 700, 730, 842, 944
and WIC eligibility, 878
Overview of WIC program
administrative and participant processes, 90–91
barriers to participation, 93–94
breastfeeding promotion and support, 1, 20–22, 74
current food packages, 22–23, 24–28
CVV introduction, 29
participation rates, 1, 56–57, 98
shopping process, 29
substitutions in food packages, 1, 23, 30–31
P
Package I (infants 0 to 6 months)
alignment with DGA, 126, 132–135, 136
alignment with DRIs, 132–133, 179, 181, 186–187
categorical eligibility, 23, 168, 400
current, 24–25, 132–133, 328, 329, 694–695
formula, 8, 24, 75, 76, 179, 181, 186–187, 264, 285, 318, 324, 328, 399, 400, 402, 432–433, 435, 694, 695, 714, 745, 873, 874, 880, 882–883, 932, 934, 936, 940, 946, 977
for fully formula-fed infants (I-FF), 24, 318, 328, 400, 435, 874, 880, 882, 883, 932, 934, 936, 940, 977
nomenclature, 874
for partially (mostly) breastfed infants (I-BF/FF), 24, 318, 328, 399, 400, 401, 402, 431, 432, 433, 435, 873, 874, 875, 876, 882, 883, 906, 934, 936, 940, 943, 946, 973, 974, 975, 977
revised, 8, 328, 329, 694–695, 881–883
rationale and benefits of changes, 882, 883
saturated fats, 133
Package II (infants 6 to 12 months)
alignment with dietary guidance, 126, 132–135, 136, 149, 254, 287–288, 388, 399, 881, 884
alignment with DRIs, 132–133, 175, 176, 177, 178, 179, 180, 181, 186–187, 291, 566, 568, 728, 814–815, 857–860
categorical eligibility, 23, 168, 400
cereal, 8, 9, 11, 24, 25, 92, 126, 149, 264, 287–288, 291, 403, 404, 419, 421, 438, 518, 696, 697, 714, 748, 765, 880 n.5, 883–884, 907–908, 922, 923, 925, 940, 943, 984
current food packages, 24–25, 132–133, 328, 329, 696–697
CVV, 7, 8, 11, 13, 53, 139, 141 n.9, 147–148, 264, 265, 266, 267–268, 288, 289, 292, 293, 296, 327, 340, 363, 366, 374, 389, 392, 393, 404, 421, 525, 696, 697, 764, 775, 814–815, 881, 884, 885, 901, 908, 909, 941, 965, 970–971
fish substitution for infant food meat, 11, 266, 291, 292, 327, 376, 392, 405, 697, 711, 734, 881, 885, 882, 909, 941, 951
formula, 8, 24, 136, 179, 181, 186–187, 264, 285, 318, 324, 432–433, 694, 696, 697, 714, 745, 873, 883, 946
gap analysis, 243
fully breastfed infants (II-BF), 8, 24, 25, 188, 191, 243, 264, 288, 290–291, 292, 318, 328, 388, 400, 403, 404, 405, 518, 690, 696, 765, 873, 874, 880 n.5, 883, 884, 885, 907, 908, 909, 934, 936, 940, 941, 943, 951, 946, 958
fully formula-fed infants (II-FF), 8, 24, 264, 318, 328, 400, 403, 433, 435, 697, 765, 873, 874, 880 n.5, 883, 907, 932, 934, 936, 940, 941, 943, 946, 977
jarred infant food meat, 7, 8, 11, 25, 188, 191, 243, 264, 266, 288, 290–291, 292, 327, 376, 388, 392, 405, 419, 423, 438, 690, 696, 697, 711, 715, 734–735, 764, 873, 881, 885, 882, 909, 941, 951, 909, 922, 925, 946, 951
jarred infant food vegetables and fruits, 8, 9, 10, 25, 264, 265, 266, 268, 285–288, 291, 292–293, 310, 363, 366, 404–405, 428, 696, 697, 715, 873, 884, 908–909, 943, 946
milks and milk substitutes, 516
nomenclature, 874
nutrient priorities, 218–219, 242, 243, 254, 686
partially (mostly) breastfed infants (II-BF/FF), 8, 24, 264, 318, 328, 400, 403, 697, 765, 873, 874, 880 n.5, 883, 907, 934, 936, 940, 941, 943, 946, 975
revised benefit, 8, 264, 265, 266, 268, 285–289, 290–291, 292–293, 310, 328, 696–697, 883–886
rationale and benefits of changes, 883, 884–886
saturated fats, 133, 814, 858, 860
Package III (participants with special medical needs)
alignment with dietary guidance, 141–152
alignment with DRIs, 181
categorical eligibility, 23, 400
current benefit, 24–25, 137, 140–145, 150, 292, 328, 405–406, 698, 735
CVV, 293
formula, 8, 10, 24, 140–141, 142, 150, 181, 268, 285, 292–293, 330, 405–406, 698, 735, 745, 886, 910
human milk fortifier, 735
jarred infant food vegetables and fruits, 292, 293, 696, 697
legumes and peanut butter, 143, 268
Medicaid coverage of formulas and medical foods, 448
milks and milk substitutes, 141, 142, 143, 150, 268, 886
nomenclature, 874
rationale and benefits of changes, 886
revised benefit, 8, 10, 265, 268, 285, 292–293, 328, 698, 886
nutritionals, WIC-eligible, 25, 140, 141, 265, 268, 292, 330, 401, 416, 417, 698, 725, 875, 886, 917, 920, 945, 980
unsuitable foods for special diets, 143
Package IV-A (children 1 to <2 years)
added sugar limits, 135, 180, 184, 192, 207, 217, 240, 654–657, 715, 716, 720, 861, 862
alignment with DGA, 126, 132–135, 136
alignment with DRIs, 134–135, 861–864
breads, 118, 119, 239, 278–279, 300, 410–411, 421, 422, 699, 721, 841, 843, 888–889, 915, 923, 943, 944, 946, 947
breakfast cereals, 10, 26, 240, 268, 299, 306, 699, 720, 940, 943, 946
categorical eligibility, 23, 400
cheese, 26, 27, 239, 240, 269, 276–277, 298, 408, 556, 700, 718–719, 741, 751, 887
current, 2, 26–28, 118–119, 126, 134–135, 136–137, 273, 274, 275, 277, 296–302, 318–319, 329, 339, 344, 348, 352, 354, 358, 360, 373, 381, 382, 406–409, 410, 411–412, 413, 699–700, 715–724, 776–777, 786–787, 792–793, 798–799, 804–805
eggs, 10, 26, 268, 718, 940, 943, 946
fish, 10, 26, 268, 281, 283, 291, 292, 302, 327, 412, 413, 421, 436, 437, 697, 723–724, 812–813, 889–890, 916, 917, 923, 940, 946, 949
formula, 24–25
juice, 10, 13, 26, 110, 126, 129, 254, 268, 275, 283, 389, 421, 455, 699, 719, 765, 886–887, 923, 943, 946
legumes and peanut butter, 10, 26, 92, 139, 239, 268, 173, 274, 281, 283, 412–413, 724–725, 755, 763, 884, 890, 941, 943, 945, 946, 952–953, 957
milks and milk substitutes, 2, 7, 10, 26, 239, 240, 268, 277–278, 283, 296, 339–340, 421, 699, 700, 716, 732, 741, 750–751, 766, 887, 888, 923, 941, 946, 955
nomenclature, 874
nutrient intake analysis, 180, 182–183, 184, 185, 186
nutrient priorities, 219, 223, 239–241, 242, 254, 255–257, 686
proposed revisions, 886–891
rationale and benefits of changes, 887–891
revised package, 10, 268–270, 271, 272–274, 275, 276, 277–278, 279, 280, 281, 289, 293, 296–300, 305, 306, 329, 699–700
saturated fats, 135, 240, 340, 485, 777, 861, 862, 863
yogurt, 27, 240, 269, 275, 298, 409, 488, 516, 556, 700, 718, 751, 887, 892
Package IV-B (children 2 to <5 years)
added sugar, 82, 109, 120, 125, 135, 149, 180, 184, 191, 193, 195, 196, 204, 207, 217, 218, 219, 223, 240, 344–345, 348, 658–665, 687, 715, 716, 720, 863, 865
alignment with DGA, 118–119, 125, 134–135, 136–137, 841–844
alignment with DRIs, 134–135, 861–864
breads, 118, 119, 239, 278–279, 300, 410–411, 421, 422, 699, 721, 841, 843, 888–889, 915, 923, 943, 944, 946, 947
breakfast cereal, 10, 26, 118, 138, 240, 255, 268, 299, 306, 347, 348, 699, 720, 791, 841, 843, 940, 944, 947
categorical eligibility, 23, 400
cheese, 26, 27, 239, 240, 256, 269, 276–277, 339, 408–409, 718–719, 741, 751–752, 776–777, 887
current, 26–28, 118–119, 329, 699–700
CVV, 10, 15, 26, 118, 239, 255, 256, 268, 269, 271, 273, 283, 340, 350, 351, 352–353, 356, 358–359, 374, 382, 388, 413, 418, 421, 454–456, 488, 699, 765, 773, 786–787, 792–793, 798–801, 820, 824, 841, 843, 867, 890–891
eggs, 10, 26, 118, 256, 268, 377, 382, 718, 824, 841, 843, 940, 944, 947
fish, 10, 26, 118, 268, 281, 283, 302, 360, 362–363, 364, 388, 412, 413, 421, 436, 437, 697, 723–724, 774, 804–805, 810–811, 841, 843, 889–890, 916, 917, 923, 940, 947, 949
food group priorities, 255–257
gap analysis, 373, 378, 380, 382
HEI score, 196, 197, 348, 352, 354, 358, 360, 364, 669
juice, 10, 13, 26, 110, 118, 129, 268, 275, 283, 358, 388, 389, 421, 699, 719, 765, 774, 798–799, 824, 841, 843, 886–887, 923, 944, 947
legumes and peanut butter, 10, 26, 92, 118, 239, 268, 273, 274, 281, 283, 364–365, 368, 377, 382, 412–413, 421, 724–725, 755, 763, 775, 810–811, 841, 843, 884, 890, 923, 941, 944, 945, 947, 952–953, 957
milks and milk substitutes, 7, 10, 26, 118, 239, 240, 256, 268, 277–278, 283, 296, 339–340, 344, 699, 732, 741, 750–751, 766, 773, 776–777, 843, 887–888, 941, 944, 947, 951, 955
nomenclature, 874
nutrient priorities, 216–218, 219, 223, 239–241, 242, 254, 255–257, 687
proposed revisions, 886–891
rationale and benefits of changes, 887–891
revised, 329
saturated fats, 135, 240, 340, 344, 378, 777, 783, 786, 793, 799, 805, 811, 865
sensitivity analysis, 338–340, 341, 342, 344, 346, 347, 348, 350–351, 352, 354, 357, 358, 360, 362–363, 364, 368, 773, 775
Package V-A (pregnant women)
alignment with DGA, 112–113, 125, 127–135, 825–828
alignment with DRI, 127–135, 845–848
breads, 112, 224, 300, 410–411, 701, 721, 825, 827, 829, 831, 892, 896, 914–915, 944, 947
breakfast cereal, 10, 26, 112, 224, 226, 227, 245, 247, 268, 299, 306, 347, 348–349, 701, 720, 791, 827, 940, 944, 947
categorical eligibility, 400
cheese, 26, 27, 28, 224, 225, 227, 246, 247, 269, 276–277, 298, 408–409, 517, 702, 718–719, 741, 742, 752, 887, 892
current, 26, 112–113, 127–135, 130–131, 294, 296–302, 319, 329, 331, 344, 348–349, 352–353, 354–355, 358–359, 360–361, 381, 406–409, 410, 411–412, 701–702, 715–724, 778–779, 782–783, 784, 788–789, 794–795, 800–801, 806–807, 810–811
CVV, 10, 26, 112, 224, 225, 226, 227, 245, 247, 264, 268, 271, 283, 288, 289, 293, 294, 340, 352–353, 356, 358–359, 413–414, 421, 422, 701, 766, 774, 788–789, 794–795, 821, 825, 827, 829, 831, 867, 894, 895–897, 900
eggs, 10, 26, 113, 224, 247, 268, 701, 718, 820, 825, 827, 940, 944, 947
fish, 10, 26, 113, 246, 247, 268, 283, 294, 302, 360, 362, 364–365, 388, 412, 436, 437, 701, 723–724, 766, 775, 806–807, 825, 827, 893–894, 897, 916, 940, 947
HEI score, 348, 352, 354, 358–359, 360, 364–365
juice, 10, 26, 112, 268, 283, 358–359, 421, 644–657, 701, 719, 766, 774, 800–801, 821, 825, 827, 891, 923, 941, 944, 947
legumes and peanut butter, 10, 26, 92, 112, 224, 225, 226, 246–247, 268, 274, 281, 283, 364–365, 412–413, 421, 699, 701, 702, 724–725, 755, 763, 775, 812–813, 825, 827, 893–894, 897, 923, 941, 944, 947, 952–953, 957
milks and milk substitutes, 10, 26, 112, 224, 225, 226, 227, 246, 247, 268, 277, 283, 296, 346, 421, 701, 716, 732, 741, 766, 773, 778–779, 825, 827, 891–892, 923, 941, 944, 947, 955
nomenclature, 874
nutrient priorities, 224–228, 242, 244–246, 377, 682
rationale and benefits of changes, 891–894
revised, 9, 10, 263, 266, 268–270, 271, 272–274, 275, 276, 277, 278, 279, 280, 281, 283, 289, 294, 296–300, 305, 306, 329, 701–702, 891–894
saturated fats, 125, 131, 223, 225, 344, 363, 364–365, 779, 784, 788, 795, 801, 807, 813, 845, 847
sensitivity analysis, 338, 340, 342, 344, 348–349, 351, 352–353, 354, 358–359, 360, 362, 363, 364–365, 773–775
yogurt, 27, 28, 224, 225, 227, 246, 267, 269, 275, 298, 488, 702, 718, 752, 887
Package V-B (partially breastfeeding women)
alignment with DGA, 112–113, 125, 829–832
alignment with DRIs, 130–131, 845–848
breads, 112, 224, 300, 410–411, 701, 721, 825, 827, 829, 831, 892, 896, 914–915, 944, 947
breakfast cereal, 9, 26, 112, 229, 230, 231, 232–233, 248, 265, 306, 701, 720, 829, 831, 940, 944, 947
categorical eligibility, 23, 401
cheese, 26, 27, 28, 229, 230, 231, 249, 250, 267, 276–277, 298, 408–409, 700, 702, 718–719, 741, 742, 752, 896
current, 26, 112–113, 127–135, 294, 296–302, 319, 329, 331, 344, 348–349, 352–353, 354–355, 358–359, 360–361, 381, 406–409, 410, 411–412, 701–702, 715–724, 778–779, 782–783, 784, 788–789, 794–795, 800–801, 806–807, 810–811
eggs, 9, 26, 113, 249, 701, 718, 821, 829, 831, 940, 944, 947
fish, 9, 26, 113, 244, 255, 256, 265, 281, 283, 294, 302, 363, 383, 701, 723–724, 766, 775, 829, 831, 895, 897, 916, 940, 947
food group priorities, 245–247
HEI score, 195
juice, 9, 26, 112, 283, 421, 701, 766, 829, 831, 895, 941, 944, 947
legumes and peanut butter, 9, 26, 92, 112, 229–230, 231, 232, 249, 256–257, 265, 274, 281, 283, 412–413, 699, 701, 702, 724–725, 755, 763, 829, 831, 895, 941, 944, 947, 952–953, 957
milks and milk substitutes, 9, 26, 112, 229, 230, 231, 232–233, 249, 250, 265, 277, 283, 296, 344, 455, 701, 716, 732, 741, 766, 829, 831, 896, 941, 944, 947, 955
nomenclature, 874
nutrient priorities, 12, 221–222, 223, 229–233, 242, 244, 248–250, 253, 254, 684
rationale and benefits of changes, 894–897
revised, 9, 264–265, 317, 329, 381, 388, 389, 401, 416, 420, 421, 422, 693–694, 701–702, 821, 829–832, 845–848, 867, 875, 881, 894–897, 919, 923, 926, 932, 937, 947, 955
saturated fats, 125, 131, 223, 230, 845, 847
yogurt, 230, 231, 250, 267, 275, 298, 488, 702, 718, 751–752, 896
Package VI (postpartum women)
alignment with DGA, 114–115, 125, 130–131, 136, 849–850
alignment with DRIs, 130–131, 136, 851–852
breakfast cereals, 9, 26, 116, 234, 235, 236–237, 238, 251, 253, 265, 299, 306, 703, 720, 833, 835, 940, 944, 947
categorical eligibility, 23, 401
cheese, 26, 27, 28, 234, 235, 251, 253, 267, 276–277, 298, 408–409, 517, 704, 718–719, 741, 742, 752, 897
current, 26, 114–115, 130–131, 136, 242, 273, 296–302, 317, 319, 329, 381, 406–407, 408–409, 411–412, 703–704, 715–724
CVV, 9, 26, 114, 234, 235, 236, 251, 252, 254, 264, 283, 293, 414–415, 421, 422, 703, 774, 822, 833, 835, 898
eggs, 9, 26, 114, 253, 703, 718, 822, 833, 835, 940, 944, 948
fish, 9, 26, 114, 252, 253, 265, 283, 302, 412, 436, 437, 703, 723–724, 833, 835, 897–898, 916, 940, 948
food group priorities, 251–253
gap analysis, 234–238, 684–685
juice, 9, 26, 114, 275 n.7, 283, 421, 650, 652, 703, 719, 822, 833, 835, 897, 923, 941, 944
legumes and peanut butter, 9, 26, 92, 114, 234, 235, 236–237, 252, 253, 265, 274, 281, 283, 412–413, 703, 724–725, 755, 763, 833, 835, 897–898, 941, 944, 945, 947, 952–953, 957
milks and milk substitutes, 9, 26, 114, 234, 235, 236, 237, 251, 253, 254, 265, 277, 283, 296, 703, 704, 716, 732, 741, 767, 833, 835, 897, 941, 944, 947, 955
nomenclature, 874
Nutrient-Based Diet Quality Index score, 197
nutrient priorities, 223, 234–238, 242, 251–253, 254, 377, 684–685
rationale and benefits of changes, 897–898
revised, 9, 234, 251–253, 264–265, 329, 416, 417, 421, 437, 703–704, 822, 833–836, 849–852, 895, 897–898, 919, 920, 923, 926, 947–948, 955, 982
saturated fats, 125, 131, 223, 235, 849, 851
yogurt, 27, 28, 234, 251, 267, 275, 298, 488, 704, 718, 752, 897
Package VII (fully breastfeeding women)
alignment with DGA, 116–117, 125, 229–233, 248–250, 823, 837–840
alignment with DRI, 130–131, 136, 853–856
breads, 116, 117, 230, 300, 410–411, 705, 721, 837, 839, 899, 914–915, 944, 948
breakfast cereals, 9, 26, 116, 229, 230, 231, 232–233, 248, 265, 299, 306, 347, 349, 705, 720, 791, 837, 839, 940, 944, 948
categorical eligibility, 23, 401
cheese, 26, 27, 28, 116, 145, 229, 230, 231, 249, 250, 267, 276–277, 298, 408–409, 420, 421, 422, 486, 488, 705, 706, 718–719, 741, 742, 753, 780–781, 837–840, 898–899, 914, 923, 924, 925, 940, 944, 958
current, 26, 116–117, 130–131, 136, 280, 294, 296–302, 319, 329, 331, 344–345, 349, 353, 355, 357, 359, 360, 381, 406–409, 410, 411–412, 705–706, 715–724, 780–781, 785, 790–791, 796–797, 802–803, 808–809
CVV, 9, 26, 116, 229, 230, 231, 232, 244, 248, 249, 250, 264, 283, 288, 289, 293, 350, 351, 352–353, 356–357, 358–359, 413–414, 420, 421, 445, 705, 767, 774, 790–791, 796–797, 802–803, 823, 837, 839, 867, 898–899
eggs, 9, 26, 116, 249, 294, 705, 718, 823, 837, 839, 940, 944, 948
fish, 9, 26, 92, 110, 116, 137, 149, 265, 280, 281, 283, 302, 340, 357, 361, 362, 411, 412, 705, 723–724, 775, 808–809, 837, 839, 900, 916–917, 940, 944, 948
food group priorities, 248–250
HEI score, 349, 353, 355, 359, 361
juice, 9, 26, 116, 283, 356–357, 359, 488, 705, 719, 767, 802–803, 823, 837, 839, 898, 941, 944, 948
legumes and peanut butter, 9, 26, 92, 116, 229–230, 231, 232, 249, 265, 274, 281, 283, 412–413, 705, 724–725, 755, 763, 837, 839, 899, 941, 944, 948, 952–953, 957
milks and milk substitutes, 9, 26, 116, 229, 230, 231, 232–233, 249, 250, 265, 277, 283, 296, 344–345, 346, 705, 716, 732, 741, 767, 773, 780–781, 837, 839, 841, 897, 898, 941, 944, 948, 954, 955
nomenclature, 874
nutrient priorities, 221–222, 223, 229–233, 242, 244, 248–250, 253, 254, 684
rationale and benefits of changes, 898–904
revised, 9, 229–233, 248–250, 264–265, 276–277, 281, 294, 329, 340, 344–345, 349, 353, 355, 359, 361, 416, 421, 705–706, 733, 780–781, 785, 790–791, 796–797, 802–803, 808–809, 823, 837–840, 853–856, 867, 881, 897, 898–904, 919, 920, 922, 923, 924, 926, 928, 937, 948, 955
saturated fats, 125, 131, 223, 230, 344–345, 781, 785, 791, 797, 803, 809, 853, 855
sensitivity analysis, 338, 340, 344–345, 349, 350, 351, 353, 355, 356–357, 359, 361, 773–775, 780–781, 785, 790–791, 796–797, 802–803, 808–809
yogurt, 27, 28, 230, 231, 250, 267, 275–276, 298, 409, 488, 706, 718, 752–753, 780–781, 898–899
Palatability of nutrient-dense foods, added sugars and, 124, 295, 303, 379, 730
Partially breastfeeding women (see also Package V-B)
adverse health impacts of nutrient inadequacies and excesses, 217
DGA recommendations, 138–139, 189–190
food group intakes, 189–190, 648–653
Nutrient-Based Diet Quality Index score, 197
nutrient intakes, inadequacies, and excesses, 171, 172, 173, 174, 175, 217
Participation in WIC
age of children, 57–58
barriers to, 542–544
breastfeeding trends, 70–77
and changes in food packages since 2006, 55–78
demographics, 57–62
distribution across packages, 317–320
employment status and, 61–62
infant formula-feeding proportion, 57, 59, 317–319, 340–341, 366–367, 425, 926, 934–937
food expenditures, 62–70
incentives/strategies to improve, 542–544
income distribution and, 60–61
physiologic state or feeding mode of women, 57–58, 59
racial and ethnic composition, 58, 60, 61
shopping experience, 94–98
Peanut butter (see also Legumes and peanut butter)
allergies, 7, 142, 267, 269, 282, 284, 517, 700, 703, 706
package size considerations, 275, 733
Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 74
Phosphorus, 86, 87, 127, 130, 132, 134, 136, 144, 170 n.9, 171, 174, 176, 182, 183, 185, 297, 344, 345, 346, 347, 348, 566, 567, 571, 573, 604–642, 708, 709, 717, 731, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 846, 848, 850, 852, 854, 856, 858, 859, 861, 863, 865
Postpartum women (see also Fully breastfeeding women; Package VI)
DGA recommendations, 138–139, 189–190
energy requirements, 591
food group intakes, 188, 189–190, 650–653
nutrient intakes, inadequacies, and excesses, 171, 172, 173, 174, 175, 585, 589, 594, 595, 610
Potassium, 12, 85, 86, 127, 130, 132, 134, 136, 149, 172, 176, 180, 183, 184, 197, 204, 217, 223, 224, 229, 234, 239, 273, 297, 344, 345, 346, 350, 352, 353, 355, 357, 359, 368, 373, 377, 378, 460, 503, 566, 571, 585, 604–642, 671, 672, 680, 683, 684, 686, 687, 708, 709, 717, 731, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 845, 847, 849, 851, 853, 855, 857, 859, 861, 862, 865, 891, 893
Pregnant women (see also Package V-A)
current food package, 26–28
current versus revised packages, 701–702
DGA recommendations, 138–139, 189–190
dietary intake assessment challenges, 170
energy requirements, 591
food group intakes, 81, 188, 189–190, 644–647
Healthy Eating Index, 195, 668
Nutrient-Based Diet Quality Index score, 197
nutrient intakes, inadequacies, and excesses, 171, 172, 173, 174, 175, 589, 593, 604–607
Prices of foods, 320, 321, 341, 426, 950, 951, 952–953, 954, 955, 956, 957, 958, 960, 965
Priorities identified for food packages
added sugar limits, 217, 218, 219, 223–224, 225, 230, 235, 240, 295, 303, 343, 363, 378, 682, 683, 684, 687, 900, 902
alignment of revised packages with DRIs, 12, 377, 379
behavioral approaches, 220, 221, 223, 226, 227, 229, 231, 232, 236, 237, 244, 249, 253–254, 256, 457–458, 689
for breastfeeding women, 217, 221–222, 223, 229–233, 242, 244, 248–250, 253, 254, 684
calcium, 217, 227, 231, 234, 242, 682, 683, 684
for children 1 to <2 years, 217, 219, 223, 239–241, 242, 254, 255–257, 686
for children 2 to <5 years, 216–218, 219, 223, 239–241, 242, 254, 255–257, 687
choline, 217, 224, 242, 377, 379, 460, 682
cost-neutrality constraint, 6, 15, 373
current versus revised packages, 373
decision tree, 3, 5, 215, 216, 219, 220, 221–254, 262, 378, 447, 448, 689
energy from carbohydrate, protein, and fat, 218, 225, 230, 235, 240, 242
fiber, 217, 223, 225, 229–234, 239, 350, 363, 377, 378, 682, 683, 684, 686, 687
folate, 217, 226, 230, 235, 682, 683, 684
food groups, 46, 219–220, 221, 222, 223, 242, 244–254, 271–272, 276, 342–343, 363, 730
gap analysis, 378, 681, 682–687
for infants, 217, 218–219, 242, 243, 254, 686
iron, 217, 218, 224, 235, 242, 243, 682, 684, 686
magnesium, 363
micronutrient intakes above UL, 217, 218, 225, 229, 234, 239, 682–687
micronutrient intakes below AIs, 6, 46, 202, 216, 220, 224, 228, 229, 233, 234, 238, 239, 241, 243, 377, 379, 682–687
micronutrient intakes below EARs, 6, 45, 46, 216, 219, 220, 224, 226–227, 377, 379, 682–687
niacin, 363
nutrient inadequacies and excesses linked to adverse health consequences, 46, 217, 218, 224, 241
nutrients, 46, 202, 215–219, 223–242, 243, 282, 342–343
nutrition education, 220, 221, 222–223, 225, 226, 227, 229, 231, 232, 234, 236, 237, 239, 244, 249, 254, 256, 682
for postpartum women, 217, 223, 234–238, 242, 251–253, 254, 377, 684–685
potential actions for food package revisions, 219–257
potassium, 217, 223, 224, 229, 234, 239, 346, 373, 377, 378, 379, 460, 682, 683, 684, 685, 687
for pregnant women, 217, 224–228, 242, 244–246, 377, 682
rationales, 217, 218, 219, 224–250, 255–257
saturated fat limits, 215, 217, 218, 219, 223, 225, 228, 230, 233, 235, 238, 240, 241, 343, 363, 373, 378, 682, 683, 684, 687
sodium limits, 217, 223–224, 225, 229, 234, 238, 239, 241, 373, 378, 682, 683, 684, 686, 687
translating decision tree into preliminary actions, 222
vitamin A, 346
vitamin D, 217, 218–219, 227, 231, 235, 346, 377, 379, 460, 682, 683, 684
vitamin E, 216, 228, 233, 238, 241, 377
zinc, 217, 218, 227, 232, 237, 242, 243, 682, 683, 685, 686
Process for revising food packages (see also Criteria for inclusion of foods; Nutrient intake analysis; Priorities identified for food packages; Sensitivity analysis)
challenges, 5–6
evidence review strategy, 35, 159–165, 502–507
identification of relevant reports, 507, 511
information collection, 35–36
key questions and study eligibility, 503–506
literature and report review, 35, 159–165, 502, 506, 507, 508–511
MEDLINE search strategy, 508–510
overview, 3–5
public comment review, 37, 514–519
shopping for WIC foods, 37
Protein, 45, 130, 132, 134, 136, 172, 173, 175, 177, 178, 180, 184, 218, 242, 244, 292, 293, 297, 298, 309, 344, 489, 516, 517, 518, 570, 571, 573, 585, 593–603, 708, 709, 717, 718, 719, 776, 778, 780, 782, 784, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 846, 848, 850, 852, 854, 856, 857, 859, 861, 862, 863, 865, 887
Protein foods (see Eggs; Fish; Infant food meat; Legumes and peanut butter)
Q
Quality of WIC participants’ diets (see Healthy Eating Index)
R
Race/ethnicity (see also Cultural considerations)
added sugar consumption, 164
food purchasing and consumption differences, 164
Recommendations for implementation and research, 13–15, 443–456
administrative relief, 14, 445
vendor needs and barriers, 15, 452–453
Recommendations to revised WIC food packages, 6–7, 11, 283–284, 309–310
legumes and peanut butter, 7, 283
Redemption of WIC foods
alignment of intakes with dietary guidance, 41, 124–125, 825–826, 829–830, 833–834, 841–842, 845–846, 853–854, 857–858, 861, 863–864
Altarum redemption distributions, 323, 759–768, 933, 939, 942
barriers to, 93–94, 444, 445, 542–544
breads, 92, 446, 522, 831, 943, 944, 946, 947, 948, 954, 979
breakfast cereal, 92, 307, 347, 348–350, 753, 782–785, 791, 825, 827, 829, 831, 833, 835, 837, 839, 841, 938, 940, 943, 944, 946, 947, 948
calculation/projection of rates, 322–323, 324, 425, 758–762, 933, 939–945, 962–964
changes in packages since 2006 and, 89–94, 524
container/product size and, 408, 888, 912, 979
and costs of revised packages, 11, 315–316, 320, 321–323, 324, 325–326, 328–329, 330, 331, 333, 338, 344–345, 347, 348–349, 350, 351, 352–355, 356, 358–362, 363, 364–365, 395, 397, 415, 418, 425, 428, 429, 739, 741–744, 745, 746, 763–768, 869, 871, 909, 921, 938, 980
cultural considerations, 148, 150, 274, 524
current foods, 12, 92, 278, 290, 347, 378, 381, 382, 758, 760, 763–768, 773–815
CVV and, 16, 44, 92, 94, 113, 115, 117, 119, 272, 322, 350–351, 352–353, 356, 357, 382, 390, 404, 428, 429, 445, 522, 524, 525, 757, 758, 760, 763, 764, 765, 766, 773–774, 775, 786–803, 814–815, 820–824, 831, 835, 839, 841, 908, 941, 962–964, 965
data sources and availability, 320, 321, 325–326, 425, 450, 453, 460, 732, 739, 871, 933, 938–939, 954
defined, 18, 322 n.10, 474, 477, 478
eggs, 92, 382, 764, 820–824, 940, 943, 944, 946, 947, 948
fish, 92, 357, 360–361, 362, 364–365, 392, 405, 733, 755, 804–813, 909, 951
by food group, 92, 380, 382, 384–385, 741–744, 747–751, 753, 754, 755–758, 763–768, 773–775, 825–826, 829–834, 841–842, 845–846, 833–834, 841–842, 845–846, 940–941, 943–948
by food package, 16, 460–461, 776–781, 938–948
forms of food and, 274, 276, 446, 782–785, 890
HEI–2010 score based on, 384–385
incentives for, 457, 460, 542–544, 881, 890
infant cereal, 92, 518, 748, 765, 940, 943, 946
infant food meat, 92, 93, 290, 392, 405, 518, 746, 764, 885, 941, 943, 946, 951
infant food vegetables and fruits, 92, 941, 943, 946, 965
infant formula, 92, 93, 320, 747, 748, 764, 765, 940, 943, 945, 946, 948, 950, 980–981
juice, 356, 358–359, 741, 750, 798–803, 938, 965
legumes and peanut butter, 12, 92, 274, 281, 321–322, 323, 362, 363, 364–365, 758, 763, 775, 810–813, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 925, 941, 943, 944, 946, 947, 948
milks and milk substitutes, 92, 276, 277, 282, 322, 323, 340, 343, 344–345, 346, 408, 523, 732, 741, 750, 751, 754, 758–759, 766, 767, 776–781, 888, 938, 941, 943, 944, 946, 947, 948, 950, 951, 978, 980–981
nutrient intakes based on, 378, 381, 853–854, 867
and nutrient profiles, 321, 344–345, 346, 347, 348–349, 350–351, 352–355, 358–362, 363, 364–365, 368, 739, 747–751, 753, 754, 755–758, 763–768, 776–815
peanut butter, 12, 92, 281, 362, 364–365, 810–813
perceived value of packages and, 41
preferences of participants, 12, 392, 732
and prices for each food package item, 425, 950–956
and qualitative assessment of package changes, 44
quantities of foods and, 340, 344–345, 346, 353–354
and regulatory impact analysis, 395, 397, 415, 418, 425, 428, 429, 869, 871, 909, 921, 933, 938–945, 946–949, 978, 980–981
research recommendations, 14, 15, 16, 445, 449, 450, 451, 452–453
rotation of foods and, 362, 364–365, 810–813
satisfaction of WIC participants with 2009 changes, 524, 525
and sensitivity analysis, 36, 43, 338, 339, 340, 341, 343, 344–365, 758 n.1, 773–815
and shopping behavior, 949–950
shopping experience and, 94, 979
split tender and, 94
trends by category and package, 2, 89, 92–93
vegetable-to-fruit ratio, 16, 272, 322, 350, 351, 354–355, 356, 460, 757–758, 794–797
Regulation of food packages (see also Specifications)
chronology of statutes, 489–490
Final Rule, 18, 20, 22, 28, 31, 52, 54, 88, 123, 140–141, 144, 266, 272, 278, 279–280, 293, 295, 303, 304, 305, 307, 309, 474, 487, 488, 528, 695, 697, 700, 725, 728, 730, 731, 733, 748, 869
implementation of 2006 IOM recommendations, 22–23, 484–487
Interim Rule, 2, 22, 23, 31, 34, 440, 488, 527, 548, 578, 869, 878, 986–987
timeline for implementation of most recent changes, 488
Regulatory impact analysis, current and revised packages (see also Food cost estimates; individual packages)
action, 876–877
added sugar limit, 484
affected parties, 877
alignment with dietary guidance and, 411, 412, 414, 436, 876–877, 879–881, 884, 887, 888, 890, 892, 893, 894, 902, 904, 916, 917, 918, 979
alternatives rejected, 436–438, 978–979, 982–986
background on WIC program, 879–904
bread changes, 419, 421, 422, 423, 438, 888–889, 922, 923, 925, 979, 983, 984
breastfeeding support and incentives and, 881
complementary food changes, 403, 404, 873, 880 n.5, 881, 907, 909
CVV changes, 404, 413–414, 418, 419, 420, 421, 428–431, 438, 890–891, 909, 911, 918, 921–922, 923–924, 926, 962–972, 984–985
economic impacts of proposed revisions, 402–414, 877–905
effects of revisions on stakeholders, 402–414, 905, 906–918
fish additions/changes, 405, 411, 412, 413, 419, 421, 423, 436–438, 440, 880, 881, 885–886, 889, 890, 893–894, 895, 897–898, 900, 904, 909, 916, 917, 922, 923, 933, 940, 941, 944, 946, 947, 948, 949, 951, 953, 957, 958, 959, 979, 982, 984, 986, 987
food package nomenclature 398–399, 400–401, 873–876
infant cereal changes, 404, 907–908
infant formula, 402–403, 405–406, 440, 906–907, 910
juice changes, 406–407, 418, 419, 421, 423, 428, 438, 439–440, 441, 880, 886–887, 891, 895, 897, 898, 901, 911, 921, 922, 923, 938, 941, 943, 944, 947, 948, 957, 960, 961, 962, 965, 972, 984, 986
key considerations, 395–399, 870–876
legume and peanut butter changes, 412–413, 917–918
market analysis, 412, 438–440, 441, 984, 985–987
milks and milk substitution changes, 407–409, 419–420, 421, 422, 423, 426, 438, 439–440, 886, 887–888, 891–892, 896, 897, 898–899, 900–902, 912–914, 922, 923, 924, 925, 938, 941, 943, 944, 946, 947, 948, 950, 951, 953–954, 955, 956, 957, 958, 978, 980–981, 984, 986
nature of the action, 876
need for the action, 876–877
participant categories for food packages, 400–401, 874–875
representativeness of available data, 396–397, 871, 939, 949–950, 954
summary of proposed changes, 399, 402–414, 879–904
“supplemental” concept and, 412, 879–880, 884, 887, 893, 917
timing of implementation, 397–398, 872
vegetables and fruits, 984–985
Retail sales/market share
milks and milk substitutes, 27, 440, 732, 986
Retail stores (see WIC vendors)
Revised food packages (see also Criteria for inclusion of foods; Priorities identified for food packages; Process for revising food packages; Sensitivity analysis)
added sugar limits, 290, 295, 296, 297, 299, 300, 303, 304, 305, 306, 343, 344–345, 346, 363, 364, 365, 720, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
administrative burdens, 6, 7, 222, 310, 730
alignment with dietary guidance, 6, 262, 263, 275, 276, 280, 281–282, 283, 286, 287–292, 294, 298, 299, 301, 302, 304, 305, 308, 309–310, 820
allergy/intolerance options, 267, 269, 270, 280, 284, 298, 309
breads, 7, 22, 224, 225, 235, 239, 267, 270, 278–279, 284, 300, 307–308, 309, 326–327, 376, 393, 411, 419, 421, 422, 423, 438, 446, 699, 700, 701, 705, 721, 825, 827, 829, 831, 837, 839, 841, 843, 923, 925, 946, 947, 948, 957, 958, 984
breakfast cereals, 9, 10, 265, 267, 268, 270, 280, 299, 303, 305–308, 309, 347, 419, 423, 438, 699, 701, 703, 705, 720, 742, 753–754, 791, 827, 831, 835, 839, 841, 843, 922, 925, 940, 946, 947, 948, 957, 984
breastfeeding promotion, 280, 285–287, 288
calories for other uses, 376, 380, 381, 386
children 1 to <2 years, 10, 268–270, 271, 272–274, 275, 276, 277–278, 279, 280, 281, 289, 293, 296–300, 305, 306
children 2 to <5 years, monthly allowances, 10, 268–270, 271, 272–274, 275, 276, 277, 278, 279, 280, 281, 283, 289, 296–300, 305, 306
committee’s overarching strategy, 261–263
cost-neutrality constraints, 262, 263, 271–273, 275 n.7, 280–282
culturally suitable options, 6, 392
CVV, 5, 6, 8–10, 12, 16, 220, 221, 262, 264, 265, 266, 267, 268, 289, 271–273, 274, 275–276, 283, 284, 288, 289–290, 291, 292, 293, 294, 295, 296, 350–351, 515, 517
eggs, 9, 10, 265, 268, 377, 382, 419, 420, 423, 438, 701, 703, 704, 705, 741, 754, 764, 820–844, 922, 925, 926, 940, 946, 947, 948, 984
fish, 9, 10, 265, 266, 268, 280–282, 283, 289, 291, 292, 294–295, 302, 310
forms of foods (canned, dried, fresh, or frozen), 266, 267, 269, 270, 272–273, 274, 281, 283, 284, 289, 292, 295, 296, 307–308
infant cereal, 8, 9, 264, 287–288, 291, 403, 419, 421, 518, 696, 714, 765, 880 n.5, 883–884, 907–908, 922, 923, 925, 940, 943, 984
infant food meat, 7, 8, 11, 264, 266, 290–291, 292, 327, 376, 388, 392, 405, 419, 423, 697, 711, 734, 764, 881, 882, 885, 909, 922, 925, 941, 946, 951
infant formula, 8, 9, 10, 264, 265, 266, 268, 271, 285–288, 291, 292–293, 310, 318, 403, 419, 420, 423, 434–435, 458, 694, 696, 697, 698, 714, 748–749, 881, 882–883, 906–907, 910, 922, 925, 936–937, 940, 946, 948–949
jarred infant foods, 9, 264, 265, 268, 288–289, 290–291, 292, 293
juice, 7, 9, 10, 12, 265, 267, 268, 269, 275–276, 283, 284, 339, 340, 343, 356–357, 358–359, 368, 374, 377, 379, 419, 423, 438, 699, 701, 703, 705, 719, 741, 765, 766, 767, 774, 798–803, 820–844, 886–887, 891, 901, 922, 925, 984
legumes and peanut butter, 7, 9, 10, 149, 265, 266, 267, 268, 269, 270, 273–274, 281–282, 283, 284, 362–363, 364–365, 377, 382, 412–413, 419, 421, 423, 438, 699, 701, 703, 705, 742–743, 755, 763, 775, 810–813, 825, 829, 831, 833, 835, 837, 839, 841, 843, 922, 941, 952–953, 957, 984
marketplace availability considerations, 263, 272, 275–276, 277, 278–279, 280, 282, 291, 295, 297, 298, 301, 302–303, 304, 305, 307–308, 310
medical needs (III), 265, 268, 285, 292–293
milks and milk substitutes, 7, 9, 10, 12, 265, 267, 268, 269, 270, 276–278, 280, 282, 283, 284, 296, 297, 298, 303, 304, 305, 308, 309, 701, 703, 705, 732, 825, 827, 829, 831, 833, 835, 837, 839, 841, 843, 941, 946, 947, 948, 955, 984
modifications of current food specifications, 294–310
mother–infant dyad, 6–9, 262, 263, 264–267, 271, 285–286, 287, 288
multiple fetuses or infants, 266, 294
partially breastfeeding women, 9, 264–265, 317, 329, 381, 388, 389, 401, 416, 420, 421, 422, 701–702, 693–694, 821, 829–832, 845–848, 867, 875, 881, 894–897, 919, 923, 926, 932, 937, 947, 955
peanut butter, 9, 10, 265, 267, 268, 269, 273, 274–275, 281–282, 283, 284
postpartum women, 9, 234, 251–253, 264–265, 329, 416, 417, 421, 437, 703–704, 822, 833–836, 849–852, 895, 897–898, 919, 920, 923, 926, 947–948, 955, 982
pregnant women, 9, 10, 263, 266, 268–270, 271, 272–274, 275, 276, 277, 278, 279, 280, 281, 283, 289, 294, 296–300, 305, 306, 329, 701–702, 891–894
recommendations summarized, 6–7, 11, 283–284, 309–310
redemption considerations, 272, 274, 276, 277, 281 n.13, 282, 290, 291, 307–308, 310
rotation of foods, 265, 268, 273, 281–282
saturated fat limits, 344–345, 346, 363, 364, 373, 378, 379, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845
soy options, 267, 269, 270, 274, 275, 277, 282, 284, 297, 298, 303, 304, 309
“supplemental” concept/criterion and, 262–263, 273–274, 275, 276, 277, 278, 281, 285, 287–288, 290–291, 310
tofu, 267, 269, 270, 297, 308, 309
total sugars specification, 295, 297, 298, 303–304, 309
varieties of foods, 266, 269, 273, 281, 284, 295, 296, 302, 307
vegans/vegetarians, 267, 269, 270, 282, 284, 298, 309
vegetables and fruits, 9, 10, 264, 265, 266, 268, 269, 271–272, 273, 274, 283, 284, 288, 289–290, 291, 292, 293, 295, 296, 310
vendor burdens, 402–414, 906–918
whole grains, 9, 10, 265, 267, 268, 270, 278–280, 282, 284, 299, 300, 302, 305–308, 309
yogurt, 267, 269, 276–277, 278, 282, 284, 298, 302, 303–304, 309
Riboflavin, 127, 131, 133, 136, 171, 176, 297, 344, 345, 346, 347, 348, 349, 353, 568, 571, 604–642, 685, 708, 709, 717, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 810, 813, 814, 846, 848, 850, 852, 854, 856, 857, 859, 861, 862, 864, 866
Rice, food safety considerations, 160
Ross Laboratories Mothers’ Survey, 73
S
Saturated fats (see also Calories for other uses)
alignment with dietary guidance, 109, 120, 122, 131, 133, 135, 215, 219, 240, 386, 573
alignment with DRIs, 131, 133, 135, 173, 225, 230, 235, 682–684, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845, 847, 849, 851, 853, 855, 858, 860, 861, 862, 863, 865
cheese, 120, 122, 138, 225, 230, 235, 240, 340, 345, 346, 485, 523, 777, 779, 781
children 1 to <2 years, 135, 184, 217, 240, 340, 485, 600, 777, 861, 862, 863
children 2 to <5 years, 131, 133, 135, 184, 217, 240, 340, 344, 378, 601–603, 687, 777, 783, 786, 793, 799, 805, 811, 865
content of foods, 708, 709, 731
criteria for inclusion, 376, 386
current food packages, 120–122, 126, 131, 133, 135, 218, 340, 344–345, 373, 378, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845
DGA recommendations, 87, 111, 122
fully breastfeeding women, 125, 131, 223, 230, 344–345, 594, 595, 682, 683, 781, 785, 791, 797, 803, 809, 853, 855
health effects linked to, 217, 218
impacts of changes, 162, 344–345
infants, 133, 217, 523, 595–599, 814, 858, 860
intake patterns/analysis, 172, 173, 180, 184, 204, 457, 523, 571, 574, 593–603
IOM 2006 recommendations, 485
limits in food packages, 218
in milks and milk substitutes, 120, 122, 218, 225, 230, 235, 240, 343, 485, 523, 732, 777, 779, 781
partially breastfeeding women, 125, 131, 223, 230, 594, 595, 682, 683, 845, 847
postpartum women, 125, 131, 223, 235, 594, 595, 682, 684, 849, 851
pregnant women, 125, 131, 223, 225, 344, 363, 364–365, 593, 682, 779, 784, 788, 795, 801, 807, 813, 845, 847
prioritization rationale and preliminary actions, 215, 217, 218, 219, 223, 225, 228, 230, 233, 235, 238, 240, 241, 343, 363, 373, 378, 682, 683, 684, 687
regulations, 298, 299, 720, 721
revised, 344–345, 346, 363, 364, 373, 378, 379, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845
sensitivity analysis, 340, 343, 344–345, 346, 363, 364, 365, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814
soy beverages, 122
specifications, 298, 299, 720, 721
yogurt, 120, 122, 218, 516, 700, 718, 750
School Breakfast Program, 18 n.1, 56, 120, 299, 305–306, 720
Selenium, 127, 130, 132, 134, 136, 171, 174, 176, 177, 178, 182, 185, 186, 344, 360, 361, 362, 566, 572, 573, 604–642, 708, 709, 776, 778, 780, 781, 782, 784, 785, 786, 788, 790, 792, 795, 796, 798, 800, 803, 804, 807, 809, 810, 812, 814, 846, 848, 850, 852, 854, 856, 857, 859, 861, 862, 863, 865
Sensitivity analysis
alternatives to revised versus current packages, 339, 345, 346, 347, 350–351, 356, 357, 362–363
analyses conducted, 340–341
breakfast cereal, 339, 347–350, 368, 773, 782–784, 791
children 2 to <5 years (IV-B), 338–340, 341, 342, 344, 346, 347, 348, 350–351, 352, 354, 357, 358, 360, 362–363, 364, 368, 773, 775
cost effects, 5, 337–367, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814
current packages, 343, 346, 347, 350, 356–357, 362–363, 773–815
CVV, 339, 340, 343, 350–359, 368, 773–774, 775, 786–803, 814–815
dairy adjustment (milk and substitutes), 339–340, 341, 343–346, 368, 773, 776–781
defined, 479
energy, 344, 776, 778, 780, 782, 784, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
evaluation of changes, 346, 350, 351, 356, 357, 362, 363
fish addition, 339, 340, 357, 360–362, 368, 774–775, 804–809
fully breastfeeding women (VII), 338, 340, 344–345, 349, 350, 351, 353, 355, 356–357, 359, 361, 773–775
interpretation of results, 342–343
jarred infant food vegetables and fruits, 340, 363, 366, 775, 814
juice tradeoffs, 339, 340, 343, 356–357, 358–359, 368, 774, 798–803
methodological approach, 337, 339–343
outcome measures, 341
overall findings and conclusions, 368
pregnant women (V-A), 338, 340, 342, 344, 348–349, 351, 352–353, 354, 358–359, 360, 362, 363, 364–365, 773–775
purpose, goals, and limitations, 3, 4, 5, 36, 42, 43, 337, 338–339
redemption rates and, 36, 43, 338, 339, 340, 341, 343, 344–365, 758 n.1, 773–815
revised versus current packages, 343, 346, 347, 350, 356–357, 362–363, 773–815
rotation of peanut butter, legumes, and fish, 339, 343, 357, 362–363, 364–365, 775, 810–813
shift from formula feeding to breastfeeding, 340–341, 366–367
vegetable-to-fruit proportions, 351–352, 354–356
Shopping for WIC foods, 29, 37, 94–98
Sodium limits
alignment with dietary guidance, 111, 116–117, 121, 204, 387
breads, 121, 225, 229–230, 235, 239, 731
breakfast cereals, 225, 229, 234
cheese, 30, 111, 121, 138, 225, 229, 234, 239
current, 111, 116–117, 121, 130, 132, 373, 411, 730
in fish (canned), 111, 302, 411–412
gap analysis, 378, 681–684, 686, 687
and HEI–2010, 96 n.16, 164, 195, 196, 381, 385, 666, 667, 668, 669
infant food meats, 711
intake patterns, 164, 172, 174, 175, 176, 180, 183, 185, 186, 204, 378, 457, 566, 573, 604–640
low-sodium options, 30, 111, 446, 530, 545, 730
in milks and milk substitutes, 121, 225, 229, 239, 308, 379
peanut butter, 30
priorities, 44, 217, 223–224, 225, 229, 234, 238, 239, 241, 373, 378, 682, 683, 684, 686, 687
revised, 373, 378, 379, 380, 385, 387, 389
sensitivity analysis, 344, 345, 776, 778, 781, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
soy beverages, 121
vegetables and fruits, 530, 545, 708, 709–710
Soy beverages
added sugars, 7, 123, 124, 225, 230, 235, 240, 303, 389
cost difference of substitution, 326
culturally suitable option, 392
current packages, 30, 143, 145
defined, 579
marketplace availability, 304
nutrient analysis, 750–751
saturated fat limit, 122
sodium limit, 121
substitution for cow’s milk, 30, 121, 143, 145, 323, 579
Specifications
added sugars, 295, 296, 297, 299, 303, 720
breads, 7, 22, 139, 300, 307–308, 309, 376, 721, 888–889, 892, 896, 899, 903, 914–915
breakfast cereals, 7, 28, 123, 124, 138, 267, 299, 303, 305–307, 309, 347–350, 484, 700, 720, 729–730, 903, 958
current, 296–302, 303–304, 305, 714–724, 728–729
infant cereal, 714
infant formula, 20 n.5, 714, 727–729
juice, 719
legumes and peanut butter, 724–725, 884, 893
milks and milk substitutes, 31, 52, 88, 120, 121, 122, 123, 124, 296, 298, 305, 309, 488, 556, 716, 732, 851 n.17, 892, 900–901
proposed revisions and rationales, 13, 296–303, 714–725
reviewed but unchanged, 725–727
saturated fat limits, 298, 299, 720, 721
Statement of task, 32–33
Statistical Program for Age-adjusted Dietary Assessment (SPADE), 479, 570, 586, 587, 664
Substitutions in food packages
breads, 22, 28, 31, 143, 267, 270, 279, 284, 324, 326–327, 410, 484, 485, 700, 702, 706, 733, 888–889, 892, 896, 899, 903
current, 23, 30–31, 279–280, 284, 289, 296, 734–735, 780–781
eggs, 7, 282, 284, 323, 327, 375, 488, 700, 702, 704
infant food meat substitutes, 7, 11, 146, 266, 291, 292, 327, 376, 392, 405, 436, 438, 697, 711, 734–735, 881, 885, 882, 909, 941, 951, 979
legumes and peanut butter, 30, 7, 142, 143, 267, 269, 282, 284, 375, 392, 517, 700, 702, 703, 704, 706, 764
milks and milk substitutes, 7, 30, 143, 145, 146, 734 (see also Cheese; Soy beverages; Tofu; Yogurt)
Sugars (see Added sugars; Total sugars)
Summer Food Service Program, 18 n.1
Supplemental Nutrition Assistance Program (SNAP), 18 n.1, 29, 56, 63, 95, 167–168, 201, 262, 271, 449, 450, 454, 535, 536, 537, 538, 539, 581 n.4, 587, 678, 690, 878
T
Teff, 13, 267, 270, 279, 284, 300, 308, 324, 326, 411, 480, 515, 700, 702, 706, 722, 731, 881, 888, 889, 892, 896, 899
Temporary Assistance for Needy Families (TANF), 19, 56, 480, 535, 536, 537, 538, 539, 581, 678, 878
Thiamin, 127, 132, 134, 136, 170, 171, 176, 187, 233, 237, 345, 348, 349, 353, 355, 357, 359, 568, 571, 604–642, 683, 685, 708, 709, 777, 779, 781, 783, 784, 785, 786, 788, 791, 793, 795, 797, 798, 801, 803, 805, 807, 809, 810, 813, 814, 846, 848, 849, 851, 853, 855, 857, 859, 861, 862, 864, 866
Tofu, 27–28, 30, 31, 67, 69, 96, 121, 122, 123, 143, 145, 227, 267, 269, 270, 297, 308, 309, 322, 326, 392, 408–409, 485, 488, 700, 702, 704, 706, 717, 741, 750, 902, 913, 951, 955, 956, 981
Total fat, 120, 218, 299, 344, 385, 485, 570, 573, 593, 594–603, 708, 709, 711, 720, 721, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814
Total sugars, 303, 304, 309, 487, 729–730
U
U.S. Bureau of Labor Statistics (BLS), 320 n.6, 744, 746, 931, 935, 937, 954, 958
V
Vegan or vegetarian diets
current foods, 145–146, 150, 518, 724
percentage of mothers, 548
substitutions, 7, 146, 150, 282, 284, 392, 518, 700, 702, 704, 706
Vegetables and fruits (see also Cash value voucher; Infant food vegetables and fruits)
alignment of intakes with dietary guidance, 221, 223–227, 229–232, 234–236, 239, 244, 247–252, 254, 255, 256, 258, 276, 283, 289, 350, 351–352, 354–357, 358–359, 366, 368, 374, 377, 382, 386, 387, 388, 391, 414, 484, 486, 789, 791, 792–797, 801, 803, 821–825, 827, 829, 831, 835, 837, 839, 841, 843, 867, 880, 887, 984
Consumer Price Index, 960
cultural considerations, 7, 13, 147–148, 150, 272, 284, 289, 374, 388, 392, 413–414
current food packages, 26, 139, 271, 272, 273, 289, 296, 351–352, 354–355, 377, 438, 699, 701, 703, 705, 715–716, 756–757, 789, 791, 792–797, 801, 803, 821–825, 827, 829, 831, 835, 837, 839, 841, 843
dietary guidance, 139
forms/options, 7, 28, 53, 223, 224, 226, 235, 239, 266, 269, 272–273, 284, 289–290, 292, 295, 392, 393, 404, 715, 908
food safety considerations, 160
Healthy Eating Index, 196, 352–353, 354–355, 356, 358–359, 374, 793
improving intake patterns, 2, 5, 84
intake patterns, 2, 5, 84, 867
marketplace availability and stocking requirements, 52, 266, 273, 295, 374, 404, 453, 545, 908
nutrient profiles and priorities, 792–797, 867
proportions of vegetables to fruits, 16, 351–356, 457, 460, 792–795, 984
revised food packages, 9, 10, 264, 268, 351–352, 354–356, 377, 382, 438, 699, 701, 703, 705, 715–716, 756–757, 789, 791, 792–797, 801, 803, 821–825, 827, 829, 831, 835, 837, 839, 841, 843, 867
sensitivity analysis, 351–352, 354–356, 789, 791, 792–797, 801, 803
serving equivalent, 579
substitutions allowed, 30
vendor burdens, 54, 266, 269, 273, 284, 295, 405, 413–414, 453, 484, 487, 545, 901, 918, 984
white potatoes, 2, 31, 85, 488
Vendor effects of requirements (see also Administrative burden; Marketplace)
benefits of food package revisions, 52, 55
breads, 279, 383, 410, 542, 889, 914–915
burdens, 6, 52, 276, 310, 393, 406–407, 411, 444, 887, 901, 911, 916
cost containment issues, 53
culturally appropriate foods, 93–94
of current program, 273, 295, 305
decreasing burdens in proposed revisions (Criterion 7), 3, 13, 38, 42, 372, 374–376, 390, 391, 394, 519, 543, 887, 889, 901
demand and supply challenges, 93, 94, 96
EBT system adaptation, 29, 55, 273, 274, 444
implementation challenges for 2009 changes, 2, 52, 53, 54, 55, 88, 90, 91, 93, 94, 95, 96, 97, 98, 545
infant foods, 404–405, 484, 907, 908, 909
infant formula, 402–403, 906–907
juices, 52, 276, 373, 375, 393, 406–407, 887, 901, 911
legumes and peanut butter, 412, 514, 917
low-sodium options, 730
milks and milk substitutes, 52, 53, 375, 376, 387, 393, 407–408, 912
of proposed revisions, 402–414, 906–918
on small stores, 95, 98, 444, 542, 730, 901, 984
stocking requirements, 53, 54, 94, 266, 269, 273, 295, 299, 305, 373, 403–404, 406–407, 413–414, 444, 445, 452–453, 484, 901, 912, 918, 979
vegetables and fruits, 54, 266, 269, 273, 284, 295, 405, 413–414, 453, 484, 487, 545, 901, 918, 984
Vitamin A, 85, 86, 127, 130, 132, 134, 136, 137, 170, 171, 176, 180, 182, 197, 204, 226, 231, 236, 296, 297, 344, 345, 346, 347, 348, 349, 353, 359, 489, 568–569, 571, 585, 604–642, 670, 682, 683, 685, 708, 710, 716, 731, 734, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845, 847, 849, 851, 853, 855, 858, 860, 861, 862, 864, 866, 894
Vitamin B6, 127, 131, 133, 135, 136, 170, 171, 174, 180, 182, 183, 185, 227, 232, 237, 350, 353, 355, 357, 358, 359, 568–569, 571, 573, 604–642, 682, 683, 685, 708, 710, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845, 847, 850, 852, 853, 855, 858, 860, 861, 862, 864, 866
Vitamin B12, 87, 127, 131, 133, 135, 136, 171, 176, 180, 182, 237, 297, 344, 345, 348, 568–569, 571, 585, 604–642, 683, 685, 708, 710, 717, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 846, 847, 848, 850, 852, 854, 858, 860, 861, 862, 864, 866
Vitamin C, 85, 86, 127, 130, 132, 134, 136, 137, 138, 170, 171, 174, 176, 180, 182, 186, 197, 227, 232, 236, 350, 351, 352, 353, 357, 368, 489, 503, 568–569, 571, 573, 604–642, 670, 682, 683, 685, 699, 701, 703, 705, 708, 709, 719, 731, 750, 776, 779, 781, 782, 784, 785, 786, 788, 791, 792, 795, 797, 798, 801, 803, 804, 807, 809, 810, 813, 814, 845, 847, 849, 851, 855, 856, 857, 859, 861, 862, 864, 866, 887, 894
Vitamin D, 12, 85, 86, 88, 127, 128, 130, 132, 134, 136, 137, 145–146, 158, 171, 185–187, 217, 218–219, 227, 231, 235, 296, 297, 302, 344, 345, 346, 377, 460, 503, 518, 568–569, 571, 574–575, 581, 604–642, 643, 670, 682, 683, 684, 708, 710, 716, 717, 730, 731, 732–733, 734, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 845, 848, 849, 851, 853, 855, 858, 860, 861, 862, 864, 866
Vitamin E, 85, 86, 127, 130, 132, 134, 149, 170, 176, 180, 182, 183, 197, 204, 216, 228, 233, 238, 241, 377, 568–569, 571, 573, 604–642, 670, 708, 710, 777, 779, 781, 783, 784, 785, 787, 789, 791, 793, 795, 797, 799, 801, 803, 805, 807, 809, 811, 813, 814, 846, 848, 849, 850, 852, 854, 856, 858, 860, 861, 862, 864, 866
W
What We Eat in America (WWEIA) dataset, 571–572, 577–578, 581–583, 584–585
Whole grains
bread specification, 7, 22, 139, 300, 307–308, 309, 376, 721, 888–889, 892, 896, 899, 903, 914–915
breakfast cereal specification, 7, 28, 138, 267, 299, 305–307, 309, 347–350, 484, 700, 720, 730, 903–904, 958
current packages, 278–280, 284, 300–301, 305, 307–308, 410, 699, 701, 703, 705, 721–723, 731, 733, 742, 763, 792–797, 812–813
infant cereal options, 161, 696, 697
nutrient contributions, 731
Women (see Fully breastfeeding women; Postpartum women; Partially breastfeeding women; Pregnant women)
World Breastfeeding Week, 22 n.8
World Health Organization (WHO), 40
Code for the Marketing of Breastmilk Substitutes, 22 n.8
Y
Yogurt
added sugars limit, 7, 13, 123, 218, 225, 227, 230, 235, 240, 303, 379, 386, 389, 781
and administrative burdens, 13, 277, 408–409, 912
alignment with DGA, 13, 149, 246, 250, 251, 298, 386, 718
alignment with DRI, 224, 225, 227, 230, 231, 234, 240, 704, 776–777, 780–781
allergies and intolerances and, 145, 269, 282, 298, 309, 700, 702, 706, 718, 887, 888, 892, 896, 897, 898–899, 901
children 1 to <2 years, 27, 240, 269, 275, 298, 409, 488, 516, 556, 700, 718, 751, 887, 892
children 2 to <5 years, 27, 80, 82, 240, 256, 269, 275, 298, 339, 409, 488, 700, 718
container size options, 277, 391, 392, 446, 516, 902, 912
cost considerations, 323–324, 326, 346, 422, 741, 777, 781, 924
criteria for inclusion, 375, 376, 379, 386, 389, 391, 392
cultural and preference considerations, 13, 278, 282, 284, 343, 392, 888
current packages, 121, 122, 343, 408–409, 718, 751–753, 912–913
fully breastfeeding women, 27, 28, 230, 231, 250, 267, 275–276, 298, 409, 488, 706, 718, 752–753, 780–781, 898–899
HEI score, 777
implementation of 2006 recommendations, 485, 487, 488
intakes trends, 80, 81, 82, 517
marketplace availability, 392, 514, 516
nutrient levels/priorities, 224, 231, 234, 309, 346, 556, 718, 750, 776–777, 780–781
partially breastfeeding women, 230, 231, 250, 267, 275, 298, 488, 702, 718, 751–752, 896
postpartum women, 27, 28, 234, 251, 267, 275, 298, 488, 704, 718, 752, 897
pregnant women, 27, 28, 224, 225, 227, 246, 267, 269, 275, 298, 488, 702, 718, 752, 887
revised packages, 275–276, 278, 303, 343, 409–410, 718, 751–753, 913–914
saturated fat limits, 120, 122, 218, 516, 700, 718, 750
sensitivity testing, 338, 339–340, 341, 343, 776–777, 780–781
sodium limits, 121
soy-based, 269, 276, 282, 284, 309, 392, 700, 702, 704, 706, 887, 892, 896, 897, 898–899, 901, 902
specifications, 298, 303–304, 309, 718, 887, 896, 897, 901, 902
substitution amounts, 7, 27, 53, 258, 275–276, 282, 284, 391, 408, 485, 516, 751–753, 887, 888, 892, 896, 897, 898
total sugars, 22, 123, 124, 149, 303–304, 376, 386, 389, 392, 487, 516, 718, 902
vegan diets, 7, 145, 269, 282, 298, 309, 700, 702, 704, 706, 718, 887, 888, 892, 896, 897, 898–899, 901
Z
Zinc, 45, 127, 128, 130, 132, 134, 136, 138, 144, 158, 162, 168 n.7, 170, 171, 174, 176, 177–178, 179, 180, 182, 183, 185, 186, 187, 188, 204, 207, 217, 218, 227, 232, 237, 242, 243, 287–288, 290, 291, 344, 345, 347, 348, 349, 350, 388, 518, 566, 572, 573, 581, 586, 604–641, 682, 683, 685, 686, 708, 709, 711, 734, 776, 778, 780, 782, 784, 785, 786, 788, 790, 792, 794, 796, 798, 800, 802, 804, 806, 808, 810, 812, 814, 845, 847, 849, 851, 853, 855, 857, 859, 861, 862, 863, 865, 884, 886
