Big changes afoot for US women and children’s nutrition program

Fifty years after it was made permanent, the nation's food assistance program for pregnant or birth parents, babies and toddlers has announced it is implementing significant revisions to its food package.

Less fluid milk and more yogurt and cheese. Less fruit juice and more fresh fruits and vegetables. More whole grain and seafood options - the evidence-based science behind these major improvements comes from a report by the National Academies of Sciences, Engineering and Medicine, co-authored by two Cornell faculty.

Administered at the federal level by the U.S. Department of Agriculture (USDA), the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides a monthly prescription of nutritious foods, which participants fill in their local grocery stores. It began in 1972 as a pilot program and has since grown to serve more than half of the infants and a quarter of pregnant people in the United States.

Details of the program's food package changes are drawn from the 1,000-plus page "Review of WIC Food Packages: Improving Balance and Choice: Final Report" released by the Committee to Review WIC Food Packages, chaired by Kathleen Rasmussen, professor emerita in the College of Human Ecology. Angela Odoms-Young, M.S. '94, Ph.D. '99, now the Nancy Schlegel Meinig Associate Professor of Maternal and Child Nutrition in the College of Human Ecology, also served on the committee.

"It's so important that the federal programs are making a move in thinking about what these programs have meant to society," Odoms-Young said. "This shows action between scientific review and community implementation. This is really going to make a difference."

The report strengthens support for long-term breastfeeding, provides foods in amounts that are more consistent with the supplemental nature of the program and encourages fruit and vegetable consumption. It aims to provide participants with a wider variety of foods and to provide WIC state agencies greater flexibility to prescribe and tailor food packages that accommodate special dietary needs and personal and cultural food preferences.

"WIC is a prescription for vulnerable individuals," Rasmussen said. "That prescription should be data-based, so we need to know what benefits women are redeeming and which WIC foods they are consuming."

To set priorities, the committee was tasked with identifying nutrients and food groups consumed in less- or more-than-recommended amounts, Rasmussen said. In short, was the federal program offering too much or not enough of something to young children or adults who are pregnant or have given birth?

The committee found that the current food package provided 100% or more of the recommended intake of several nutrients and food groups. Reducing the package's fluid milk offerings, for example, which women were not using fully, would release funding to purchase other preferred forms of dairy products or increase the program's vegetable, fruit and fish allotments.

The committee also suggested changes to the infant formula benefits, including more realistic "partially breastfeeding" options and an enhanced food package for fully breastfeeding participants.

"To persuade more people to try exclusive breastfeeding, the prior package didn't give an adequate partial benefit," Rasmussen said. For mothers who wanted to do both, the restricted benefit may have pushed more recipients toward formula use, rather than exclusive breastfeeding. "This time we wanted to find a way to incentivize breastfeeding, and we wanted to see more partial breastfeeding," she said.

And then there's the question of what program participants should be eating. The Dietary Guidelines for Americans have been issued every five years since 1980, providing advice on what to eat and drink to meet nutrient needs, promote health and prevent disease.

An example of "science put into action," Odoms-Young said this WIC report marries the latest nutritional guidance with a greater understanding of not only how participants use the program, but how vendors keep store shelves stocked. It comes at a time when Congress and the White House have reframed food assistance as a fix for nutritional inequities rather than merely access to additional calories.

"To have organizations do a scientific review of something to help support the government, where scientists come to the table to facilitate boots-on-the-ground implementation, that is phenomenal if you think about it," Odoms-Young said.

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