IOM Committee to Review the WIC Food
Packages
The WIC Program
WIC Food Packages
Time for a Change
Committee to Review the WIC Food Packages
Food and Nutrition Board
• The Special Supplemental Nutrition Program for
Women, Infants, and Children
• Food assistance program for low income families
• Serves about half of all infants and one-fourth of
children
• $3.2 billion in 2003
• Administered by the Food and Nutrition Service
of USDA
WIC Provides:
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Supplemental food packages
Nutrition education
Breastfeeding support
Referrals to health and social services
What are the Food Packages?
• Vouchers or coupons for specific foods
• Seven packages for income-eligible participants:
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I. Young infants
II. Older infants
III. Participants with special dietary needs
IV. Children up to 5 years of age (1 through 4 years)
V. Pregnant or partially breastfeeding women
VI. Postpartum non-breastfeeding women
VII. Fully breastfeeding women
Set of General Slides - July 7, 2005
WIC Provides:
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•
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Supplemental food packages
Nutrition education
Breastfeeding support
Referrals to health and social services
Committee to Review the WIC
Food Packages
• The WIC food packages had not been
systematically revised since WIC’s inception over
30 years ago
• USDA’s Food and Nutrition Service asked the
Food and Nutrition Board of the Institute of
Medicine to conduct the review
• The FNB appointed a 12 member committee
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IOM Committee to Review the WIC Food
Packages
Phase I
Evaluate the diets of the WIC population, and
propose criteria for revising the food
packages.
Released
April 2005
Sources of Information for Evaluating Diets
• Nutrient standards: Dietary Reference Intakes (DRIs)
Application of the DRIs
Compare intakes from national surveys to the DRIs:
• 2005 Dietary Guidelines for Americans (for individuals
age 2 years and older)
• Examine current intakes of low-income groups
eligible for WIC
• Established recommendations for infants and children
less than 2 years of age
• Adjust distributions to remove effect of day to
day variation in intakes (using C-SIDE program
from Iowa State University)
• Nutrition-related health risks
Application of the DRIs
Determine for each nutrient:
• Prevalence of inadequate intakes (proportion less
than the EAR)
• Prevalence of potentially excessive intakes
(proportion above the UL)
• Mean intakes below the AI
• Mean energy intake above or below the EER
• Prevalence of macronutrient intakes outside the
AMDR
Set of General Slides - July 7, 2005
Priorities for Infant Packages
Infants, less than 1 year, Non-Breastfed (receiving
formula)
Š Continue to provide a balanced set of essential nutrients.
Older Infants, 6 through 11 months, Fully Breast-Fed
(not receiving formula)
Š Increase intakes of iron and zinc.
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IOM Committee to Review the WIC Food
Packages
Priorities for Children’s Package
Young Children, 12 through 23 months (1-year-olds)
Š Increase intakes of iron, potassium, vitamin E, and fiber.
Š Decrease intakes of zinc, vitamin A (preformed), and food
energy.
Priorities for Children’s Package
(continued)
Older Children, 2 through 4 years
Š Increase intakes of iron, potassium, vitamin E, and fiber.
Š Decrease intakes of zinc, sodium, vitamin A (preformed),
and food energy.
Š Limit intakes of saturated fat, cholesterol, and added sugars.
Priorities for Women’s Packages
Adolescent and Adult Women of Reproductive
Age
Phase II
Using information from Phase I, recommend
specific changes to the food packages.
Š Increase intakes of a number of nutrients:
calcium
iron
magnesium
potassium
vitamin E
fiber
vitamin A
vitamin C
vitamin D
vitamin B6
folate
Š Decrease intakes of sodium, food energy, and total
fat; limit saturated fat and cholesterol.
Phase I: Develop Criteria to Guide the Revision of the Food Packages
Phase II: Use Criteria to Revise the Current Food Packages
Evaluate Current Packages
Estimate
Costs
Change Quantity
DEVELOP NEW
FOOD PACKAGES
• Cash-value vouchers for fresh fruits and vegetables
– $8 for children
– $10 for women
Consider Public
Comments
Delete Foods
Encourage Consumption of Fruits and
Vegetables
Add Foods
Estimate
Nutrients
• Processed options (e.g., canned, dried)
• Baby-food fruits and vegetables for older infants
• Reduce the amount of juice
RECOMMENDATIONS
FOR IMPLEMENTATION
Set of General Slides - July 7, 2005
– Follow current recommendations for children
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IOM Committee to Review the WIC Food
Packages
Emphasize Whole Grains
Provide Incentives for Breastfeeding
• Cereals must qualify as “whole grain” (using FDA
definition of 51% whole grains).
• Provide less formula for partially breast-fed
infants.
• Additional whole grain foods were added to most
packages.
• Discourage use of formula in the first month for
breast-fed infants.
• A variety of whole grains may be chosen (whole
wheat bread, brown rice, oatmeal, corn tortillas, etc.).
• Increase the market value of the packages for
fully breastfeeding mother/infant pairs.
Current Dietary Guidance for Infants
Lower Saturated Fat
• Complementary foods are provided beginning at age 6
months, rather than at 4 months of age.
• Less cheese allowed as a milk substitute.
• Juice was eliminated in favor of baby food fruits and
vegetables to promote healthy eating patterns.
• Milk must be reduced-fat, lowfat, or non-fat for
women and children over the age of 2 years.
• Baby food meats are provided to fully breast-fed infants
after 6 months of age to provide iron and zinc in forms
that are easily absorbed and utilized by the body.
Cost Neutrality Was Achieved
• Some of the current foods were reduced or
eliminated so new foods could be added.
• Cost of some packages increased while the cost of
others decreased.
• Estimated total cost of all packages remained the
same (approximately $35 /participant / month).
Set of General Slides - July 7, 2005
The entire report is available on-line through
the National Academies Press. The Executive
Summary can be downloaded without charge.
www.nap.edu
Search on “WIC food packages.”
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IOM Committee to Review the WIC Food
Packages
Implementation Plan for
WIC Food Package Changes
• By law, FNS must develop a rule to update the WIC food
packages within 18 months of the report’s release
• Develop a proposed rule for public comment that
incorporates all of the change recommended by the IOM.
(Anticipated date of publication January 2006)
• Issue an interim final rule by the 18 month statutory date
(October 2006)
Set of General Slides - July 7, 2005
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