For more than 30 years, the WIC program (the Special Supplemental Nutrition Program for Women, Infants, and Children of the United States Department of Agriculture) has provided foods that supplement the diets of millions of low-income women, infants, and children. The WIC program has been very successful, particularly in improving nutrient intakes among participants. In early 2004, the Institute of Medicine formed a committee to review the WIC program’s current supplemental food packages and determine if a redesign could help participating families eat a healthier diet.

The committee considered dietary and health data on low-income women, infants, and children; dietary guidance from the Dietary Reference Intakes and the Dietary Guidelines for Americans; current dietary guidance for feeding infants and young children; and public comments from stakeholders such as WIC program staff, advocacy groups, and WIC participants. The following six criteria were used to revise the food packages:

1. The package reduces the prevalence of inadequate and excessive nutrient intakes in participants.
   
2. The package contributes to an overall dietary pattern that is consistent with the Dietary Guidelines for Americans for individuals two years of age and older.
   
3. The package contributes to an overall diet that is consistent with established dietary recommendations for infants and children less than two years of age, including encouragement of and support for breastfeeding.
   
4. Foods in the package are available in forms suitable for lowincome persons who may have limited transportation, storage, and cooking facilities.
   
5. Foods in the package are readily acceptable, widely available, and commonly consumed; take into account cultural food preferences; and provide incentives for families to participate in the WIC program.
   
6. Foods proposed consider the impacts that changes in the package will have on vendors and WIC agencies.

   The committee’s recommendations were presented in the report, WIC Food Packages: Time for a Change. The report recommended revisions to the food packages that match current dietary guidance for infants and young children, encourage consumption of fruits and vegetables, emphasize whole grains, lower saturated fat, and appeal to diverse populations.

More fruits and vegetables have been added

Families at all income levels should provide more fruits and vegetables to their children in ways that build healthy eating patterns. To help low-income families accomplish this goal, the committee recommended that food packages include baby food fruits and vegetables for older infants, cash-value vouchers for $8 per month for children, and cash-value vouchers for $10 per month for women. The cash-value vouchers would be used to purchase fresh fruits and vegetables and participants could choose from a wide variety of produce. When fresh produce is not feasible, choices of canned, dried, or frozen fruits and vegetables would be allowed. The committee made only one restriction — that white potatoes not be allowed since most Americans do not need encouragement to consume the maximum recommendation of one serving of potatoes per day.

Whole grains are emphasized

The revised food packages emphasize the intake of whole grains in keeping with the Dietary Guidelines for Americans recommendation of at least three servings of whole grains per day. This should increase fiber intakes, which are currently very low among the WIC eligible population. Only whole grain breakfast cereals would be allowed for children and women; many participants’ favorite cereals already qualify as whole grain foods. Many of the food packages would contain additional whole grain options such as whole wheat bread, brown rice, corn tortillas, oatmeal, and barley.

Lower saturated fat

In keeping with current dietary guidance, foods that are high in saturated fat would be reduced. The revised food packages would have: less cheese — only one pound of cheese per month (two pounds for fully breastfeeding women) instead of the 4–5 pounds allowed currently; and for women and children two years and older, milk and yogurt must be fat-reduced (no more than 2% milk fat). Thus saturated fat would be reduced in the packages for participants two years of age and older.

Appeal to diverse populations

The wider variety of foods in the revised packages would increase the appeal to diverse populations. Participants could choose from:

• A wider variety of calcium-rich foods as substitutes for milk—children may choose yogurt, while women may choose yogurt, calcium- and vitamin D-rich soy beverage (“soy milk”), and calcium-rich tofu;
  
• A wide variety of fresh fruits and vegetables;
  
• A wide variety of whole grains, including whole grain breakfast cereals, whole wheat bread, brown rice, and corn tortillas;
  
• Different forms of beans and peas (dry or canned); and
  
• Different types of canned fish, including light tuna and salmon.

Costs are unchanged

The estimated total cost of the WIC food packages would be unchanged because although some foods were added, others were reduced or omitted. The cost of some packages would increase while the cost of others would decrease. These changes were designed to promote healthy dietary behaviors. For example, the attractiveness of the combined packages for breastfeeding mother / infant pairs would be increased.

The committee’s recommended changes in the WIC food packages were implemented by State WIC Programs across the nation beginning with 1 October 2009. The committee’s recommendations have helped WIC lead the way in helping low-income families in America consume healthier diets.