Objectives: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritionally at-risk low-income pregnant women, infants and children up to 5 years of age with foods tailored to their nutritional needs, along with nutrition education. In 2009, USDA made major revisions to WIC food packages to better conform to expert dietary guidance. Notable changes included increased fruits and vegetables, and lower-fat milk for children 2 years and older. This study uses data from the 2008 and 2016 Feeding Infants and Toddlers Study (FITS) to compare foods consumed by children participating in WIC to foods consumed by children not participating in WIC before and after the food package changes.
Methods: FITS 2008 (n = 3273) and 2016 (n = 3235) are cross-sectional nationally-representative surveys of caregivers of children < 4 years living in the U.S. Trained telephone interviewers collected 24-hour dietary data. Tests of interaction were used to determine whether the trends in consumption of select foods between 2008 and 2016 differed between children who participate in WIC compared to those who do not, while controlling for income and household size.
Results: The percentage of WIC infants (6-11.9 months) eating vegetables increased from 2008 to 2016, but the % eating fruit (including 100% juice) was unchanged. WIC infants shifted from being less likely than non-WIC infants to eat babyfood fruits and vegetables in 2008 to being more likely to eat them in 2016; at the same time, the % of WIC participants consuming non babyfood fruit and vegetables declined. The percentage of WIC children (12-23.9 months) drinking whole milk increased and drinking reduced fat (2%) milk decreased in 2016 compared to 2008; whereas older WIC children (24-47.9 months) were more likely to drink low or nonfat milk and less likely to drink reduced-fat milk.
Conclusions: Babyfood fruits and vegetables, added to the WIC food package in 2009, have become important contributors to WIC infants' fruit and vegetable intakes. In 2016, WIC children were more likely to follow expert advice to shift to lower fat milks at ages 2 and above. Significant changes in the relationship of these food patterns to WIC participation between 2008 and 2016 suggest an important public health role of the revised WIC food packages.
Funding Sources: FITS 2008 and 2016 supported by Nestlé Research Center, Lausanne Switzerland.