Families enrolled in the Women, Infants, and Children (WIC) nutrition program will be able to get more fresh fruits and vegetables beginning next month, thanks to changes in the program’s “food packages,” which are outlined in a recently published USDA final rule.
Under the revisions, the cash value of the fruit and vegetable vouchers for children in the program will rise from $6 to $8 per month.
The final rule also allows WIC mothers to receive a voucher for fresh fruits and vegetables instead of jars of baby food for the older babies. In addition, WIC families can add cash to their fruit and vegetable vouchers at the check-out stand to maximize their purchases.
The changes will also allow yogurt as a partial substitute for milk and more whole-grain and fish options for women and children.
Often described as the nation’s premier public-health nutrition program, WIC (the Special Supplemental Nutrition Program for Women, Infants and Children) is celebrating its 40th year. Throughout those four decades, it has succeeded in improving the health of low-income families through nutrition and education. Participants in the program are pregnant women, new mothers, infants and children up to the age of five.
The recent revisions to the food packages are based, for the most part, on recommendations made by the Institute of Medicine (IOM) of the National Academies.
Attesting to the program’s widespread adoption by families, half of the infants in the U.S. are enrolled in WIC, according to USDA.
Through WIC, participating families receive “monthly food packages” geared toward good health, growth and development. The foods are chosen based on USDA’s Dietary Guidelines for Americans and established dietary recommendations for infants and children up to five years of age.
The food packages are actually checks made out for specific food items (not for cash). Participants can go to participating stores and use the checks to “buy” those items.
In selecting foods for the WIC program, key nutrients such as Vitamins A, B, C, D and E, iron, zinc, calcium and fiber are an essential part of the equation. Among the foods the families receive are low-fat milk, whole-grain bread and cereals, tuna, salmon, beans, eggs, peanut butter, soy-based beverages, tofu and fresh produce.
In addition to healthy food, WIC provides nutrition education and services, breast-feeding promotion and education, and access to maternal, prenatal and pediatric health-care services.
The National WIC Association describes it as a “short-term intervention program designed to influence lifetime nutrition and health behaviors in a targeted high-risk population.”
WIC and Food Safety
The U.S. Centers for Disease Control and Prevention recently recognized WIC for playing a role in decreasing childhood obesity by 43 percent among two- to five-year-olds. WIC first added fresh fruits and vegetables to its “food packages” in 1992, and that change was followed by improved dietary intake and the reduction of obesity among WIC children, according to the National WIC Association.
Wende Dolstad, a registered dietician and WIC manager in Skagit County, WA, told Food Safety News this is an especially positive outcome because children who are overweight as preschoolers are more likely to be overweight as teenagers or adults.
Considering the dire health problems associated with obesity — diabetes and heart problems, for example — Dolstad said that eating unhealthy foods could be viewed as a food-safety concern because, in the long term, it can make people sick. In contrast, eating nutritious foods is a good example of food safety because it can help prevent serious health problems.
She said the reason fresh vegetables and fruits are so healthy is that, besides the vitamins and other nutrients they contain, they also add fiber to the diet. Fiber is important because it helps maintain a healthy weight and lowers the risk of diabetes and heart disease.
White potatoes were not included in USDA’s recent revisions, in part because children are already eating enough potatoes. And Dolstad said while potatoes contain nutrients, they don’t contain enough of the targeted nutrients.
To be eligible for WIC, participants must have an income level at or below 185 percent of the poverty level or be on Medicaid. For a family of four, that would be $43,568 annually, according to guidelines effective July, 1, 2013, to June, 30, 2014.
A look at the numbers reveals that 73 percent of WIC participants reside in families with incomes below the poverty level. (For a family of four, the poverty level is $23,550 annually.) According to 2012 data, the average annual income of a participant was $16,842. The majority of WIC families have income from wages. WIC also serves military families.
Handouts from the recent National WIC Association show that, in fiscal year 2013, 8.7 million people participated in the program each month through 10,000 clinics nationwide. Of those, 2 million were infants and 4.6 million were children up to the age of five. (Once children reach their fifth birthday, they are no longer eligible to be in the program.)
This represents a 3-percent decrease from the previous year and the largest one-year decrease since the program began in 1974. According to USDA, it reflects the continued decrease in U.S. births, which began in 2008. Fiscal 2013 spending for the program came to $6.4 million — a 6-percent decrease from the previous fiscal year.
Even so, that’s an astounding increase in participation from 1974, the first year WIC was permanently authorized, when 88,000 people took part. By 1980, participation had increased to 1.9 million; by 1990, 4.5 million; by 2000, 7.2 million, and, by 2010, 9.2 million.
- WIC nutrition education leads to an increased consumption of whole grains, fruits and lower-fat milk;
- WIC children have increased intakes of iron, potassium and fiber;
- WIC participation helps reduce household food insecurity;
- Participation in WIC significantly increases the Healthy Eating Index scores for households;
- WIC interventions can help improve healthful behaviors linked to reducing early childhood overweight;
- WIC infants are in better health than eligible infants not participating in WIC;
- WIC children ages one to two have fewer dental-related Medicaid costs compared to children who do not participate in the program.
Changing Goals, Changing Times
Dolstad, who has worked with the program since 1989, said that, in the 1970s, doctors and politicians realized they were seeing a high percentage of malnourished babies and moms. That led to the decision that something needed to be done to improve their diets, and the WIC program was designed to do that.
Originally, the foods given out were directed to what Dolstad described as “blatant problems” associated with malnutrition, so they contained essential nutrients such as iron and Vitamin C. Milk, peanut butter, cheese and beans were among the foods the participating families received. In time, vouchers and checks for specific foods were given out instead.
It wasn’t long before the benefits of the program began to be seen.
“There was a dramatic improvement in the moms and babies in the program,” Dolstad said, pointing out that healthcare costs decreased as well.
Over time, less emphasis was put on malnutrition because the health of moms and babies was improving, thanks to the help they were receiving in obtaining healthy foods.
But, with increasing awareness of rising obesity rates in children, the program has swung over to nutritional goals to help bring those rates down. It also promotes breastfeeding, which Dolstad said has been associated with declining obesity levels.
“Babies get accustomed to taking in the right amount of calories and the right nutrients,” she said.
According to the National WIC Association, breastfed infants also tend to be healthier because they receive antibodies from the breast milk, which protects them against infection.
In 2012, WIC survey data indicated that 67 percent of WIC infants from six months to 13 months old were breastfed. (The program also provides breastfeeding support groups.)
Dolstad told Food Safety News that she had just returned from the National WIC Association conference.
“There was a good degree of optimism,” she said. “The president’s budget came out, and WIC was supported by Democrats and Republicans alike. It’s a program that has proven itself. It has been able to shift to keep up with changing problems. In focusing on healthy and low-fat foods and physical activity, the WIC staff is helping clients shift their thinking about nutrition and health.”
Even so, Dolstad is quick to say that clients tend to need more than WIC. Food stamps and food banks are other important parts of the equation upon which many participants rely.
“The parents have to work hard to get the nutrition their families need,” she said, pointing out that healthy foods are typically more expensive than foods with fewer nutrients, which is why all of these resources are so important.
A Mother’s Voice
“That’s good news,” was the immediate reaction of former WIC mom Jill Bickel when she heard that WIC families would be able to get more fresh fruits and vegetables. “It will be a big help to families.”
Bickel has a 17-year-old son and a five-year-old daughter, both of whom have benefited from WIC.
“It’s how we’ve gotten to eating healthy foods,” she said. “It helps establish life-long eating habits. My son was never sick, and my daughter still eats a lot of the things I make from the recipes in the cookbook I got from WIC. She loves healthy food.”
Bickel especially appreciates the tips in the WIC cookbook such as how to “hide” healthy foods in meals made from the recipes. Another benefit she appreciates is that, because she rode her bike to WIC appointments, the program even provided her with a bike helmet.
When her daughter turned five about a year ago, she was no longer eligible for the program.
“Our food expenses are a lot higher without WIC,” Bickel said. “The hard part now is that a lot of the healthier foods are so expensive. There are some things we have to do without. If we didn’t have the food bank, there’s no way we could survive.”
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