Nutritional changes to WIC program will allow low-income mothers to buy fruits and vegetables

from the Los Angeles Times

Get ready for less fruit juice and cheese: Soon, WIC coupons will cover produce and other healthful foods.

By Susan Bowerman

As food prices spiral higher, the quality of a diet can really suffer. Starchy, sugary, fatty foods are filling and relatively inexpensive compared with fruits, vegetables and lean meats. The effects of a tight budget on food choices are particularly concerning for people who may find healthful foods difficult to afford: low-income mothers and their children.

Soon, they will be getting some overdue help.

For the first time in its 35-year history, the federal Women, Infants and Children (WIC) Supplemental Nutrition Program -- which provides food vouchers to millions of households nationwide -- will, starting October 2009, allow participants to buy fresh fruits and vegetables, whole grains and soy-based products.

It's about time. The mission of the WIC program is to safeguard the health of low-income children up to age 5 as well as pregnant, postpartum and lactating low-income women, who are considered to be at nutritional risk. Since the program's inception in the 1970s, knowledge about nutrition has advanced considerably -- but the WIC food provisions have remained mostly unchanged.

The original list of eligible foods made no provisions for children or pregnant women to obtain fruits and vegetables. There were no fresh fruits, only juice. Fresh carrots were the sole vegetable that could be purchased with WIC vouchers, but only by lactating mothers. (Vouchers could also be used to purchase whole milk, dried beans or peanut butter, certain fortified cereals, and up to two dozen eggs and 3 pounds of cheese a month.)

In 2003, concerned by rising obesity rates and WIC participants' poor diet quality, the U.S. Department of Agriculture commissioned the Institute of Medicine (which advises the government on medical matters) to suggest modifications to the existing food packages. The institute's report, released in 2005, recommended sweeping changes in the food program. They were approved by the USDA in December.

The foods that will qualify next year are more consistent with the government's Dietary Guidelines for Americans, which emphasize the importance of including fruits, vegetables, whole grains and fat-free or low-fat dairy products on the menu.

They'll also be more in line with the messages long provided in WIC's nutrition education classes.

This should be a relief to WIC's health educators, who stress to participants the importance of consuming more produce and whole grains -- even though the program hasn't helped participants obtain these items.

By far the most significant change will be the provision of cash-value vouchers, redeemable at regular grocery stores and farmers markets, that can be used to buy fruits and vegetables -- items that often go by the wayside when a food budget is stretched to the limit.

Only about 10% of Americans consume the recommended amounts of fruits and vegetables.

A typical American family spends 15% to 18% of its food budget on produce. But, according to a survey published in November in the Journal of the American Dietetic Assn., a low-income family would need to spend 43% to 70% of its food budget on fruits and vegetables to meet the dietary guidelines.

The new WIC plan also will allow the purchase of whole-grain products such as breads, oatmeal and brown rice -- in contrast to the old package, which allowed only fortified cereals, which were not necessarily whole-grain.

The government's dietary guidelines call for at least three daily servings of whole grains to reap the benefits of their fiber, vitamins, minerals and phytonutrients. But the average person doesn't consume even one.

In other WIC changes, whole-milk purchases will be allowed only for the youngest children -- those older than 2 will get milk that's 2% fat or less -- and the amounts of cheese, eggs and fruit juice that can be purchased will be reduced. These changes are geared at reducing dietary saturated fat and cholesterol, and calorie-laden beverages such as fruit juice.

The changing ethnic composition and dietary preferences of WIC participants is being acknowledged too -- the number of Latino participants has doubled since 1988, and the number of Asian participants has grown sharply. Families will now be able to use vouchers to buy items such as soy milk, tofu and whole-grain flour or corn tortillas.

Susan Bowerman is a registered dietitian and assistant director of the UCLA Center for Human Nutrition.