Proposed Revisions in the WIC Food Packages: A Review of the Evidence

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On November 17, 2022, the U.S. Department of Agriculture (USDA), announced major food package revisions, the first in over a decade, to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).  Among the proposed changes are suggestions to remove juice from the food packages, reduce the maximum allowance for milk, and require that all breakfast cereal contain whole grain as the first ingredient. In response to these proposed changes, Dr. Harry Zhang conducted a literature review entitled “A Summary of Evidence Related to Key Food Groups Targeted in the Proposed WIC Revisions.” Literature published between January 1, 2009, and October 31, 2022 was reviewed to examine how the proposed WIC food package changes might impact participants’ consumption behaviors. A public comment period is open through February 21, 2023. USDA encourages individuals and organizations to weigh in on the WIC package revisions.

More restrictions on 100% juice may further reduce participants’ consumption

Following the 2009 food package revision, which reduced the 100% juice allowance, the consumption of 100% juice was reduced among WIC children. The evidence reviewed suggests that offering juice in the WIC package alone may lead to increased consumption due to the perception of juice being healthy if WIC approves it. Thus, additional reductions in the juice quantity provided via WIC may be warranted. 

The 2009 WIC food revision significantly shifted participants’ milk consumption towards more low-fat milk consumption

 Evidence suggests that less than a third of participants fully redeem the monthly allowance for milk. Although WIC participants prefer whole milk to other non-whole milk varieties (reduced fat, 1%, or skim), the restriction of whole milk in the 2009 WIC food package significantly shifted participants’ milk consumption to the lower-fat varieties. The number of participants consuming reduced-fat, low-fat milk, or skim milk significantly increased after the 2009 WIC revision, while the percentage of participants consuming whole milk significantly decreased, especially in children.

Requiring cereals to be whole grain-rich offers more nutritional value without compromising participant choices

The proposed WIC food revision requiring all breakfast cereals to meet the new criteria for whole grains raised concerns among some stakeholders that this requirement might remove corn or rice-based cereals, which could be culturally insensitive and limit the purchasing options of Hispanic populations. While the evidence on this topic is limited, existing research suggests that cereal consumption of Hispanic WIC participants does not differ from non-Hispanic participants in terms of their consumption of whole grain-rich breakfast cereal.

Implications for the proposed rule and what you can do to make your voice heard!

In general, the evidence supports the proposed WIC food package changes for juice, milk, and cereal.

  • Removing 100% juice from the WIC package may further change participants’ consumption behavior, although more research is needed on the association between reductions in 100% fruit juice intake and health outcomes.  Nutrition counseling provided by WIC currently recommends reducing or not serving children 100% fruit juice. The WIC food package should reflect the guidance parents and caregivers received from trusted professionals.
  • Further reducing the milk allowance may not significantly change participants’ view of the food package since the full redemption rate of milk was relatively low, but the proposed changes could have significant positive impacts on participants’ consumption behaviors, especially for low-fat milk.
  • Requiring whole grain-rich criteria for all cereal may help address inadequate consumption of whole grains and reduce excess consumption of refined grains among WIC participants. Shifting the criteria from the current whole-grain nutrient claim criteria to instead requiring the first ingredient of a product to be a whole grain may also allow for the inclusion of different types of whole-grain cereal, such as corn- or rice-based products. Concerns regarding the lack of culturally appropriate grains for Hispanic individuals are not reflected in the literature. Organizations such as Salud America! support the proposed rule to make all cereals whole grain-rich due to the potential positive impact that the change could have on the diets of the Hispanic population.

The USDA will accept comments on the proposed changes until February 21, 2023. Evidence-based comments can inform the USDA’s decisions on the final WIC food package, which can impact the nutrient intake and dietary quality of millions of low-income women, infants, and children in the U.S. You can view the full set of recommended changes here and submit your comment here.

About the Grantee:

This blog post is based on a commissioned paper written by the team led by Qi (Harry) Zhang of Old Dominion University. Qi (Harry) Zhang is a Co-Chair of the HER NOPREN WIC Learning Collaborative and a leading researcher in the WIC field.