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Win-Win Policy Changes for WIC & Childhood Obesity Rates

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Recent headlines have highlighted the fact that the rate of childhood obesity has decreased by 43 percent. The federal health survey that caused such headlines said that since 2004, obesity rates for children, age two to five, dropped from 14 to 8 percent in 2012. Some have pointed out the fine details of the study, which showed that obesity rates for the rest of the population remained steady while the rate of obesity actually increased for women over 60 years old. Nonetheless, a decrease in obesity rates is always a positive sign. I admit, when discussing food politics, it is far too easy to focus on problems, rather than solutions and organizations that are improving. So I would like to offer my personal round of applause to the Special Supplemental Women, Infants, and Children (WIC) Feeding Program, which assists this specific age range and deserves some of the credit for these results.

Back in 2009, the WIC program adjusted their food packages to improve the health of their participants, guided by suggestions from the Institute of Medicine. The changes include switching packages to include only 100 percent whole wheat bread, brown rice, whole wheat and corn tortillas for grain options. The amount of juice provided was decreased and the allotment for fruits and vegetables was increased. Whole milk was also replaced by skim or 1 percent milk. Beans, peas, eggs, fatty fish, and legumes are also provided as options in the packages. One of WIC's main goals is to promote breastfeeding, so the food packages were also changed to incentivize exclusive breastfeeding compared to the partial breastfeeding or full formula packages.

Studies have demonstrated that policy change for WIC has made an impact on nutrition, although the data on improved breastfeeding rates has not been definitive. After the 2009 changes, a Friedman School of Nutrition Science and Policy study showed an increase in both exclusive breastfeeding and full formula packages distributed, making the revision impact moot. Policy changes are always impacted by social and cultural factors and these mixed results highlight the need to make our environment more supportive for breastfeeding. In contrast, research has been overwhelmingly positive for improved healthy food access and dietary intake.

The 49,000 WIC vendors were required to stock these new food items, which resulted in improved healthy food access in underserved communities. Availability of brown rice, 100 percent whole wheat breads, and fruit were increased in Connecticut retail stores. Two low-income neighborhoods in Philadelphia had improved access and increased nutrition environment measurement scores with WIC vendors after the policy change. The availability of fruits and vegetables, even culturally specific options, improved in 364 Illinois WIC vendors. One study even demonstrated a modest price decline for fruits and vegetables for all customers at WIC vendors. Overall, 46 percent of WIC vendors supported the policy change too, compared to 18 percent who had a negative perception.

Fifty percent of infants in the United States and the 9 million people overall who use the program each month had improved dietary intake after the policy changes. Among Native Americans, fruit and vegetable consumption increased 4.5 percent and 4.1 percent respectively after the change. Juice purchases decreased by 43 percent after the changes, with only a slight increase in non-WIC voucher purchases. Nearly 3,000 California WIC participants ate more vegetables and whole grains after the 2009 changes. Also, white bread was displaced with brown rice and 100 percent whole wheat breads in participant's diets. Just like the WIC vendors, WIC participants enjoyed the policy changes, which granted more access to fruits, vegetables, and whole grain products.

There are still changes that need to be made to WIC. I would love to see WIC discard their allotment for juice and shift those funds to the produce section, as juice is not a healthy beverage. Similarly, it would be ideal to provide participants with plain yogurt and only real whole grain cereals with very little to no sugar to participants. Regardless of WIC's current imperfections, the program is still taking the beginning steps to improve nutrition. WIC even stuck to their principles and excluded white potatoes as an eligible produce option in recent revisions (in the U.S. we already eat plenty of potatoes).

WIC is just one facet of government food programs we can utilize to support health. These policy changes should help inform the USDA on the beneficial implications of nutrition reform and how they can be applied to improve the health of the 22 million children who depend on the Supplemental Nutrition Assistance Program (commonly referred to as food stamps). Policy change can help to improve childhood obesity rates and any future decrease should attribute some of the success to the win-win program changes being implemented by WIC.