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Title: Evaluating the impact of the revised special supplemental nutrition program for Women, Infants, and Children fruit juice allotment on fruit intake, dietary quality, and energy/nutrient intakes among children 1-4 years of age

Author
item NICKLAS, THERESA - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item O'NEIL, CAROL - LOUISIANA STATE UNIVERSITY AGCENTER
item FULGONI III, VICTOR - NUTRITION IMPACT, LLC

Submitted to: International Journal of Child Health and Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/1/2018
Publication Date: 12/11/2018
Citation: Nicklas, T.A., O'Neil, C.E., Fulgoni III, V.L. 2018. Evaluating the impact of the revised special supplemental nutrition program for Women, Infants, and Children fruit juice allotment on fruit intake, dietary quality, and energy/nutrient intakes among children 1-4 years of age. International Journal of Child Health and Nutrition. 7:146-156. https://doi.org/10.6000/1929-4247.2018.07.04.3.
DOI: https://doi.org/10.6000/1929-4247.2018.07.04.3

Interpretive Summary: Twenty-five percent of children 1-4 years of age will receive the Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits at some point in their lives. WIC packages were recently revised to offer foods that better reflect current dietary recommendations and promote healthy weight in WIC participants. The goal of this study was 1) to assess the impact of recent changes in the WIC program on fruit intake, dietary quality, and energy/nutrient intakes; and 2) to model the potential impact of complete removal of fruit juice (FJ) from the WIC package, which has been proposed by some. Dietary data from NHANES 2007-2008, 2011-2012, and 2013-2014 were used. The analyses were performed on two groups of children 1-4 years: a) WIC participants and those who were income-eligible but nonparticipants at the time of the interview. Compared with nonconsumers, the overall nutritional profile of those consuming FJ had significantly higher intakes of energy, vitamins C and B6, potassium, riboflavin, magnesium, iron, and folate and significantly lower intakes of SFA, discretionary fat, and added sugars. Consumption of FJ was also specifically associated with higher intake of whole fruit. Changes in the WIC Program resulted in potential adverse effects on mean intakes of some nutrients but not on the nutrient adequacy or overall diet quality. More studies are needed to confirm these findings.

Technical Abstract: The goals of this study were to assess the impact of recent changes in the WIC allotment on fruit intake, dietary quality/adequacy, energy/nutrient intakes, and potential impact of the complete removal of 100% fruit juice (FJ) from the package. 24-hour recalls from children 1-4 years who were WIC participants or income-eligible nonparticipants in the NHANES 2007-2008 and 2011-2014 (before and after WIC package changes) were analyzed. There were no differences in the Healthy Eating Index-2015 total score; subcomponent scores for "greens and beans" and for "fatty acid ratio" were higher in 2011-2014 than in 2007-2008 in children participating in WIC; scores for "sodium" were higher in 2011-2014 than in 2007-2008 in children not participating in WIC but income-eligible. In WIC participants mean intakes of riboflavin, vitamins B12 and C, and zinc were significantly (p<0.01) lower, and intake of vitamin E was significantly (p<0.01) higher in 2011-2014 compared to 2007-2008. One significant difference in nutrient adequacy in children was that of a lower (p<0.01) percentage of inadequacy for WIC participants for vitamin E and a higher (p<0.01) percentage of inadequacy for WIC participants for vitamin A in 2011-2014 as compared to those in 2007-2008. The elimination of FJ from the WIC food packages resulted in a 38-50% lower total fruit intake and a 4-5% reduction in total HEI-2015 score. Changes in the WIC program resulted in potential adverse effects on mean intakes of some nutrients but not on the nutrient adequacy or overall diet quality. Confirmatory studies are needed.