Review of WIC Food Packages

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began 40 years ago as a pilot program and has since grown to serve over 8 million pregnant women, and mothers of and their infants and young children. Today the program serves more than a quarter of the pregnant women and half of the infants in the United States, at an annual cost of about $6.2 billion. Through its contribution to the nutritional needs of pregnant, breastfeeding, and post-partum women; infants; and children under 5 years of age; this federally supported nutrition assistance program is integral to meeting national nutrition policy goals for a significant portion of the U.S. population. To assure the continued success of the WIC, Congress mandated that the Food and Nutrition Service of the U.S. Department of Agriculture (USDA) reevaluate the program's food packages every 10 years. In 2014, the USDA asked the Institute of Medicine to undertake this reevaluation to ensure continued alignment with the goals of the Dietary Guidelines for Americans. In this third report, the committee provides its final analyses, recommendations, and the supporting rationale. Table of Contents Front Matter Summary 1 Introduction and the Process for Revising the WIC Food Packages 2 The WIC Program: Changes Since the Last Review and Continuing Challenges 3 Alignment of the Current Food Packages with Dietary Guidance, Special Dietary Needs, and Cultural Eating Practices or Food Preferences 4 Nutrient and Food Group Intakes of WIC Participants 5 Nutrient and Food Group Priorities for the WIC Food Packages 6 The Revised Food Packages 7 Evaluation of Cost 8 Sensitivity Analysis for Food Package Nutrient, Food Group, and Cost Models 9 How the Revised Food Packages Meet the Criteria Specified 10 The Regulatory Impact Analysis (Abridged) 11 Recommendations for Implementation and Research Appendix A: Acronyms and Abbreviations Appendix B: Glossary Appendix C: WIC Food Package Regulation Appendix D: Details of the Committee's Information-Gathering Strategies Appendix E: USDA-Funded Studies of the 2009 Food Package Changes Appendix F: Changes in the WIC Food Packages and Program Participation Appendix G: Barriers to Participation and Redemption Appendix H: Kosher and Halal Substitution Options Appendix I: Complementary Feeding: Summary of Information Reviewed Appendix J: Nutrient and Food Intake of WIC Subgroups: Analytical Methods and Results Appendix K: Study Design Strategies for Reducing the Effects of Selection Bias in Studies Comparing WIC Participants to Others Appendix L: Gap Analysis Appendix M: Behavioral Approaches in WIC as a Potential Action Appendix N: Comparison of Current and Revised Food Packages Appendix O: Specific Nutrient Comparisons Appendix P: Food Specification Detail Appendix Q: Foods and Food Specifications That Were Reviewed, But Not Changed Appendix R: Development of the Food Package Nutrient and Cost Profiles Appendix S: Sensitivity Tests and Results Appendix T: Amounts of Food Groups and Nutrients Provided by the Current, Compared to the Revised WIC Food Packages Appendix U: The Regulatory Impact Analysis (Complete) Appendix V: Committee Biosketches Index