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 ContentsFront MatterSummary1 Introduction and the Process for Revising the WIC Food Packages2 The WIC Program: Changes Since the Last Review and ContinuingChallenges3 Alignment of the Current Food Packages with Dietary Guidance,Special Dietary Needs, and Cultural Eating Practices or FoodPreferences4 Nutrient and Food Group Intakes of WIC Participants5 Nutrient and Food Group Priorities for the WIC Food Packages6 The Revised Food Packages7 Evaluation of Cost8 Sensitivity Analysis for Food Package Nutrient, Food Group, andCost Models9 How the Revised Food Packages Meet the Criteria Specified10 The Regulatory Impact Analysis (Abridged)11 Recommendations for Implementation and ResearchAppendix A: Acronyms and AbbreviationsAppendix B: GlossaryAppendix C: WIC Food Package RegulationAppendix D: Details of the Committee's Information-GatheringStrategiesAppendix E: USDA-Funded Studies of the 2009 Food Package ChangesAppendix F: Changes in the WIC Food Packages and ProgramParticipationAppendix G: Barriers to Participation and RedemptionAppendix H: Kosher and Halal Substitution OptionsAppendix I: Complementary Feeding: Summary of Information ReviewedAppendix J: Nutrient and Food Intake of WIC Subgroups: AnalyticalMethods and ResultsAppendix K: Study Design Strategies for Reducing the Effects ofSelection Bias in Studies Comparing WIC Participants to OthersAppendix L: Gap AnalysisAppendix M: Behavioral Approaches in WIC as a Potential ActionAppendix N: Comparison of Current and Revised Food PackagesAppendix O: Specific Nutrient ComparisonsAppendix P: Food Specification DetailAppendix Q: Foods and Food Specifications That Were Reviewed, ButNot ChangedAppendix R: Development of the Food Package Nutrient and CostProfilesAppendix S: Sensitivity Tests and ResultsAppendix T: Amounts of Food Groups and Nutrients Provided by theCurrent, Compared to the Revised WIC Food PackagesAppendix U: The Regulatory Impact Analysis (Complete)Appendix V: Committee BiosketchesIndex