In 2009, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) required revisions to improve variety and flexibility in WIC food packages and align them with the 2005 Dietary Guidelines for Americans and the American Academy of Pediatrics infant feeding guidelines. These revisions included:

• New foods: whole-grain bread and cereals, fruit and vegetables (F&V);
• Addition of F&V cash value vouchers;
• Reductions in milk, juice, egg, and cheese;
• Switch from whole milk to 2% milk for children (≥ 2 years old) and women¹.

The aim of this study is to examine associations between WIC revisions and nutritional profiles of packaged food and beverage purchases (PFP) among 4537 low-income households (WIC participants and non-participants) with preschoolers in the US from 2008 to 2014 (3 periods: 2008-2009; 2010-2011 and 2013-2014).

Nutrients profile of purchased foods following WIC revisions

Overall nutrients purchased by the household during each quarter for total PFPs were measured among WIC and non-WIC participants. WIC households have purchased significantly fewer calories from pre-revision to late revision (11% decrease per capita/day). Non-WIC households have also decreased significantly, but smaller, their calories purchase (6% decrease per capita/day).

WIC and non-WIC households have also decreased significantly their sodium purchase (approximately 12% decrease per capita/day for both).

WIC households have declined their total sugar purchase (14.75% decrease per capita/day) due mostly to a significant decrease in sugar sweetened beverages (SSBs) purchase, while non-WIC households had a smaller decrease (10% decrease per capita/day).

Total fat purchased decreased by 10% among WIC households and 5% among non-WIC households.

Meanwhile there were no significant changes for protein or fiber. No significant differences in nutrients purchased in pre- or post-revision periods were found between WIC and non-WIC households.

Amount of select food groups purchased following WIC revisions

• F&V
  Amounts purchased of each food and beverage group were measured for each time period. Figure 1 shows an increased purchase of F&V with no added sugar, fats, oils and/or salt among WIC households. Non-WIC households have also increased their F&V purchases over time.
  
  Figure 1: F&V purchases by WIC households between 2008 and 2014
• Grain items
  No significant increase was seen in purchase of grain items (i.e. bread, rice, tortillas) for both households. Meanwhile, there was a significant decrease among WIC households of daily purchases of refined grain items (23% decrease per capita/day).
• Unhealthy foods

For sugar sweetened beverages (SSB), WIC households decreased 18% their purchases over time while non-WIC households purchased 13% less. No significant differences were found between WIC and non-WIC households in purchases of grain-based desserts, snacks or candy; they both reduced their grain based desserts purchase by 10 % while there was no significant change for both in purchase of sweet or savory snacks, and candy over time.

WIC food package revisions seem to improve nutritional profiles among WIC households, compared to non-WIC households. These findings confirm that updating policies can meaningfully influence WIC participants and their families by making healthier choices among their purchases.

Based on: Ng SW, Hollingsworth BA, Busey EA, Wandell JL, Miles DR, Poti JM. Federal Nutrition Program Revisions Impact Low-income Households’
Food Purchases. Am J Prev 2018; 54(3): 403-412.