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Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children and Dietary Intake in Children: Associations With Race and Ethnicity

Published:December 27, 2021DOI:https://doi.org/10.1016/j.amepre.2021.10.017

      Introduction

      Establishing healthy dietary intake in pediatric populations is important for prevention of chronic disease across the lifespan. Federal nutrition assistance programs can support the dietary intake of U.S. children. The objective of this study was to assess the relationship between Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation status and dietary intake within racial and ethnic groups.

      Methods

      Dietary intake of children aged 2–4 years in the cross-sectional National Health and Nutrition Examination Survey 2011–2016 was analyzed in 2021. Multivariable linear regression was used to compare stratum-specific mean estimates for nutrient and food group intake of children participating in Special Supplemental Nutrition Program for Women, Infants, and Children (reference group) with those of nonparticipants who were income eligible and income ineligible (i.e., above income limits) for the WIC program. Significance was set to Bonferroni-corrected p-values.

      Results

      Hispanic WIC participants consumed less added sugar (8.9 [SE=0.5] teaspoons) than their higher-income counterparts (14.6 [SE=1.5] teaspoons, p<0.001). Hispanic WIC participants also consumed more fiber (13.0 [SE=0.6] grams) than income-eligible (11.4 [SE=0.7] grams, p=0.032) and income-ineligible (i.e., higher-income, 9.4 [SE=1.3] grams, p=0.019) nonparticipants, but this was not significant at the Bonferroni-adjusted p-value of 0.01. No differences in dietary intake were observed by WIC participation status for non-Hispanic White and non-Hispanic Black children.

      Conclusions

      Participation in WIC was associated with healthier dietary outcomes among Hispanic children; however, dietary intake of White and Black children was comparable by WIC participation status. Federal nutrition assistance programs should support sound nutrition, an important factor in reducing the risk of chronic disease, in all groups.
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      REFERENCES

        • Craigie AM
        • Lake AA
        • Kelly SA
        • Adamson AJ
        • Mathers JC.
        Tracking of obesity-related behaviours from childhood to adulthood: a systematic review.
        Maturitas. 2011; 70: 266-284https://doi.org/10.1016/j.maturitas.2011.08.005
      1. Dietary guidelines for Americans, 2020–2025.
        U.S. Department of Agriculture, HHS, 2021
        https://dietaryguidelines.gov
        Date accessed: November 4, 2021
        • Liu J
        • Rehm CD
        • Onopa J
        • Mozaffarian D.
        Trends in diet quality among youth in the United States, 1999-2016.
        JAMA. 2020; 323: 1161-1174https://doi.org/10.1001/jama.2020.0878
        • Koleilat M
        • Whaley SE
        • Esguerra KB
        • Sekhobo JP.
        The role of WIC in obesity prevention.
        Curr Pediatr Rep. 2017; 5: 132-141https://doi.org/10.1007/s40124-017-0135-6
        • Schultz DJ
        • Byker Shanks C
        • Houghtaling B
        The impact of the 2009 Special Supplemental Nutrition Program for Women, Infants, and Children food package revisions on participants: a systematic review [published correction appears in J Acad Nutr Diet. 2015;115(11):1886].
        J Acad Nutr Diet. 2015; 115: 1832-1846https://doi.org/10.1016/j.jand.2015.06.381
      2. Oliveira V The food assistance landscape: FY 2018 annual report. Economic information bulletin. Washington, DC: Economic Research Service, U.S. Department of Agriculture https://www.ers.usda.gov/publications/pub-details/?pubid=92895. Published April 2019. Accessed November 4, 2021,

      3. Snapshot - food packages for women, infants and children.
        WIC Works Resource System, U.S. Department of Agriculture, Washington, DC2019 (Published OctoberAccessed May 11, 2021)
        • USDA, Food and Nutrition Service
        WIC infant and toddler feeding practices study-2:third year report.
        USDA, Food and Nutrition Service, Washington, DC2019 (Published August 1Accessed August 25, 2021)
        • Au LE
        • Gurzo K
        • Paolicelli C
        • Whaley SE
        • Weinfield NS
        • Ritchie LD.
        Diet quality of U.S. infants and toddlers 7–24 months old in the WIC Infant and Toddler Feeding Practices study-2 [published correction appears in J Nutr. 2020;150(4):971].
        J Nutr. 2018; 148: 1786-1793https://doi.org/10.1093/jn/nxy192
        • Zimmer MC
        • Vernarelli JA.
        Select food group intake of U.S. children aged 2 to 4 years by WIC participation status and income.
        J Acad Nutr Diet. 2020; 120 (e1): 2032-2038https://doi.org/10.1016/j.jand.2020.07.027
        • Tester JM
        • Leung CW
        • Crawford PB.
        Revised WIC food package and children's diet quality.
        Pediatrics. 2016; 137e20153557https://doi.org/10.1542/peds.2015-3557
        • Jun S
        • Catellier DJ
        • Eldridge AL
        • Dwyer JT
        • Eicher-Miller HA
        • Bailey RL.
        Usual nutrient intakes from the diets of U.S. children by WIC participation and income: findings from the Feeding Infants and Toddlers Study (FITS) 2016.
        J Nutr. 2018; 148: 1567S-1574Shttps://doi.org/10.1093/jn/nxy059
        • Food and Nutrition Service, US
        Department of Agriculture. National- and state-level estimates of WIC eligibility and WIC program reach in 2017.
        Food and Nutrition Service, U.S. Department of Agriculture, Washington, DC2019 (Published December 12Accessed November 4, 2021)
        • Weinfield NS
        • Borger C
        • Au LE
        • Whaley SE
        • Berman D
        • Ritchie LD.
        Longer participation in WIC is associated with better diet quality in 24-month-old children.
        J Acad Nutr Diet. 2020; 120: 963-971https://doi.org/10.1016/j.jand.2019.12.012
        • Anderson CE
        • Whaley SE
        • Crespi CM
        • Wang MC
        • Chaparro MP.
        Every month matters: longitudinal associations between exclusive breastfeeding duration, child growth and obesity among WIC-participating children.
        J Epidemiol Community Health. 2020; 74: 785-791https://doi.org/10.1136/jech-2019-213574
        • Hamner HC
        • Paolicelli C
        • KO Casavale
        WIC participation associated with improved nutrition in children.
        AAP Grand Rounds. 2019; 41: 69https://doi.org/10.1542/gr.41-6-69
        • Hamner HC
        • Paolicelli C
        • Casavale KO
        • Haake M
        • Bartholomew A.
        Food and beverage intake from 12 to 23 months by WIC status.
        Pediatrics. 2019; 143e20182274https://doi.org/10.1542/peds.2018-2274
      4. Hamner HC, Beauregard JL, Li R, Nelson JM, Perrine CG. Meeting breastfeeding intentions differ by race/ethnicity, infant and toddler feeding practices study-2. Matern Child Nutr. 2021;17(2):e13093. https://doi.org/10.1111/mcn.13093.

        • Zimmer MC
        • Rubio V
        • Kintziger KW
        • Barroso C.
        Racial/ethnic disparities in dietary intake of U.S. children participating in WIC.
        Nutrients. 2019; 11: 2607https://doi.org/10.3390/nu11112607
        • Johnson CL
        • Dohrmann SM
        • Burt VL
        • Mohadjer LK.
        National Health and Nutrition Examination Survey: sample design, 2011‒2014.
        Vital Health Stat 2. 2014; : 1-33
      5. About the National Health and Nutrition Examination Survey. NHANES, Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/nhanes/about_nhanes.htm. Updated September 15, 2017. Accessed February 9, 2019.

        • Moshfegh AJ
        • Rhodes DG
        • Baer DJ
        • et al.
        The U.S. Department of Agriculture automated multiple-pass method reduces bias in the collection of energy intakes.
        Am J Clin Nutr. 2008; 88: 324-332https://doi.org/10.1093/ajcn/88.2.324
        • National Center for Health Statistics (U.S.)
        Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey (NHANES): MEC in-person dietary interviewers procedures.
        National Center for Health Statistics (U.S.), Centers for Disease Control and Prevention, Atlanta, GA2012 (Published JanuaryAccessed March 30, 2019)
        • FPED databases
        Agricultural Research Service.
        U.S. Department of Agriculture., 2020
        • Ahuja JK
        • Moshfegh AJ
        • Holden JM
        • Harris E.
        USDA food and nutrient databases provide the infrastructure for food and nutrition research, policy, and practice.
        J Nutr. 2013; 143: 241S-249Shttps://doi.org/10.3945/jn.112.170043
        • Bowman S
        • Clemens J
        • Friday J
        • Lynch K
        • Moshfegh A.
        Food patterns equivalents database 2013–14: methodology and user guide.
        Agricultural Research Service, U.S. Department of Agriculture, Washington, DC2017 (Published MayAccessed April 15, 2020)
        • National Academies of Sciences, Engineering, and Medicine
        Review of WIC food packages: improving balance and choice: final report.
        The National Academies Press, Washington, DC2017https://doi.org/10.17226/23655
        • Bowman SA
        • Clemens JC
        • Shimizu M
        • Friday JE
        • Moshfegh AJ.
        Food patterns equivalents database 2015-2016: methodology and user guide.
        Agricultural Research Service, U.S. Department of Agriculture, Washington, DC2018 (Published SeptemberAccessed July 11, 2021)
        • Heinze G
        • Wallisch C
        • Dunkler D.
        Variable selection – a review and recommendations for the practicing statistician.
        Biom J. 2018; 60: 431-449https://doi.org/10.1002/bimj.201700067
        • Powell ES
        • Smith-Taillie LP
        • Popkin BM.
        Added sugars intake across the distribution of U.S. children and adult consumers: 1977-2012.
        J Acad Nutr Diet. 2016; 116 (e1): 1543-1550https://doi.org/10.1016/j.jand.2016.06.003
        • Bowman SA
        • Clemens JC
        • Friday JE
        • et al.
        Food patterns equivalents intakes by Americans: what we eat in America, NHANES 2003–2004 and 2015–2016.
        Agricultural Research Service, U.S. Department of Agriculture, Washington, DC2018
        • Bailey RL
        • Fulgoni VL
        • Cowan AE
        • Gaine PC.
        Sources of added sugars in young children, adolescents, and adults with low and high intakes of added sugars.
        Nutrients. 2018; 10: 102https://doi.org/10.3390/nu10010102
        • USDA, Food and Nutrition Service
        WIC infant and toddler feeding practices Study-2 fourth year report.
        USDA, Food and Nutrition Service, Washington, DC2020 (Published September 9Accessed November 4, 2021)
        • Herrick KA
        • Fryar CD
        • Hamner HC
        • Park S
        • Ogden CL.
        Added sugars intake among US infants and toddlers.
        J Acad Nutr Diet. 2020; 120: 23-32https://doi.org/10.1016/j.jand.2019.09.007
        • Ritchie LD
        • Whaley SE
        • Crocker NJ.
        Satisfaction of California WIC participants with food package changes.
        J Nutr Educ Behav. 2014; 46 (suppl): S71-S78https://doi.org/10.1016/j.jneb.2014.01.009
        • Zimmer MC
        • Vernarelli JA.
        Changes in nutrient and food group intakes among children and women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children: findings from the 2005-2008 and 2011-2014 National Health and Nutrition Examination Surveys.
        Public Health Nutr. 2019; 22: 3309-3314https://doi.org/10.1017/S1368980019002702
        • Daepp MIG
        • Gortmaker SL
        • Wang YC
        • Long MW
        • Kenney EL.
        WIC food package changes: trends in childhood obesity prevalence.
        Pediatrics. 2019; 143e20182841https://doi.org/10.1542/peds.2018-2841
        • Hamad R
        • Collin DF
        • Baer RJ
        • Jelliffe-Pawlowski LL
        Association of revised WIC food package with perinatal and birth outcomes: a quasi-experimental study.
        JAMA Pediatr. 2019; 173: 845-852https://doi.org/10.1001/jamapediatrics.2019.1706
        • Guan A
        • Hamad R
        • Batra A
        • Bush NR
        • Tylavsky FA
        • LeWinn KZ.
        The revised WIC food package and child development: a quasi-experimental study.
        Pediatrics. 2021; 147e20201853https://doi.org/10.1542/peds.2020-1853
        • Steeves S
        • Acciai F
        • Tasevska N
        • DeWeese RS
        • Yedidia MJ
        • Ohri-Vachaspati P.
        The Special Supplemental Nutrition Program for Women, Infants, and Children spillover effect: do siblings reap the benefits?.
        J Acad Nutr Diet. 2020; 120: 1288-1294https://doi.org/10.1016/j.jand.2020.02.013
        • Robinson C.
        Younger siblings can be good for your health: an examination of spillover benefits from the Supplemental Nutrition Program for Women, Infants, and Children (WIC).
        J Fam Econ Issues. 2013; 34: 172-184https://doi.org/10.1007/s10834-012-9325-0
        • Andreyeva T
        • Luedicke J
        • Middleton AE
        • Long MW
        • Schwartz MB.
        Positive influence of the revised Special Supplemental Nutrition Program for Women, Infants, and Children food packages on access to healthy foods.
        J Acad Nutr Diet. 2012; 112: 850-858https://doi.org/10.1016/j.jand.2012.02.019
        • Zenk SN
        • Odoms-Young A
        • Powell LM
        • et al.
        Fruit and vegetable availability and selection: federal food package revisions, 2009.
        Am J Prev Med. 2012; 43: 423-428https://doi.org/10.1016/j.amepre.2012.06.017
        • Testa A
        • Jackson DB.
        Race, ethnicity, WIC participation, and infant health disparities in the United States.
        Ann Epidemiol. 2021; 58: 22-28https://doi.org/10.1016/j.annepidem.2021.02.005
        • Mah CL
        • Luongo G
        • Hasdell R
        • Taylor NGA
        • Lo BK.
        A systematic review of the effect of retail food environment interventions on diet and health with a focus on the enabling role of public policies.
        Curr Nutr Rep. 2019; 8: 411-428https://doi.org/10.1007/s13668-019-00295-z
        • Chauvenet C
        • De Marco M
        • Leone LA
        • Haynes-Maslow L
        • Ammerman AS.
        The role of food retailers in the promotion of healthful, low-cost products to WIC recipients.
        J Hunger Environ Nutr. 2021; 16: 181-195https://doi.org/10.1080/19320248.2019.1649225
        • USDA
        Food and Nutrition Service Background: revisions to the WIC food package.
        USDA, Food and Nutrition Service, Washington, DC2013 (Published October 10Accessed August 25, 2021)
        • Institute of Medicine
        WIC Food Packages: Time for a Change.
        The National Academies Press, Washington, DC2006https://doi.org/10.17226/11280
        • Subar AF
        • Freedman LS
        • Tooze JA
        • et al.
        Addressing current criticism regarding the value of self-report dietary data.
        J Nutr. 2015; 145: 2639-2645https://doi.org/10.3945/jn.115.219634