Review of WIC Food Packages: Improving Balance and Choice: Final Report

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.

• Front Matter
• Summary
• 1 Introduction and the Process for Revising the WIC Food Packages
• 2 The WIC Program: Changes Since the Last Review and Continuing Challenges
• 3 Alignment of the Current Food Packages with Dietary Guidance, Special Dietary Needs, and Cultural Eating Practices or Food Preferences
• 4 Nutrient and Food Group Intakes of WIC Participants
• 5 Nutrient and Food Group Priorities for the WIC Food Packages
• 6 The Revised Food Packages
• 7 Evaluation of Cost
• 8 Sensitivity Analysis for Food Package Nutrient, Food Group, and Cost Models
• 9 How the Revised Food Packages Meet the Criteria Specified
• 10 The Regulatory Impact Analysis (Abridged)
• 11 Recommendations for Implementation and Research
• Appendix A: Acronyms and Abbreviations
• Appendix B: Glossary
• Appendix C: WIC Food Package Regulation
• Appendix D: Details of the Committee's Information-Gathering Strategies
• Appendix E: USDA-Funded Studies of the 2009 Food Package Changes
• Appendix F: Changes in the WIC Food Packages and Program Participation
• Appendix G: Barriers to Participation and Redemption
• Appendix H: Kosher and Halal Substitution Options
• Appendix I: Complementary Feeding: Summary of Information Reviewed
• Appendix J: Nutrient and Food Intake of WIC Subgroups: Analytical Methods and Results
• Appendix K: Study Design Strategies for Reducing the Effects of Selection Bias in Studies Comparing WIC Participants to Others
• Appendix L: Gap Analysis
• Appendix M: Behavioral Approaches in WIC as a Potential Action
• Appendix N: Comparison of Current and Revised Food Packages
• Appendix O: Specific Nutrient Comparisons
• Appendix P: Food Specification Detail
• Appendix Q: Foods and Food Specifications That Were Reviewed, But Not Changed
• Appendix R: Development of the Food Package Nutrient and Cost Profiles
• Appendix S: Sensitivity Tests and Results
• Appendix T: Amounts of Food Groups and Nutrients Provided by the Current, Compared to the Revised WIC Food Packages
• Appendix U: The Regulatory Impact Analysis (Complete)
• Appendix V: Committee Biosketches
• Index