Longer WIC participation is associated with higher diet quality and consumption of WIC-eligible foods among children 2-5 years old.

Abstract

Background: Few studies have evaluated trends in diet quality across early childhood including the extent to which foods and beverages available in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Package contribute to children's diets.

Objective: The objective was to examine across ages 2-5 years: (1) trends in Healthy Eating Index-2020 (HEI-2020) total and component scores; (2) differences in mean HEI-2020 scores by WIC participation duration; and (3) contributions of the top 5 contributing foods or beverages to HEI-2020 component scores by WIC duration.

Design: This was a secondary analysis of a nationally representative sample of the WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2) conducted between 2013-2019.

Participants: /setting: 980 WIC ITFPS-2 participants (weighted n=403,726) were included.

Main outcome measures: The outcomes were HEI-2020 scores and top contributing foods to HEI-2020 components.

Statistical analyses: Multivariate regression was conducted to examine HEI-2020 scores by WIC duration (high, intermediate, and low groups). The top 5 contributors to HEI-2020 components were averaged across ages 2-5 and compared across WIC duration groups.

Results: For all participants combined, the mean HEI-2020 total scores were similar across ages 2 through 5. Children with high WIC duration had higher total HEI-2020 scores compared to children with low WIC duration from ages 2-5 (mean±SE, 58.1±0.7 vs. 55.6±1.1, p=0.03). The percentage contributions of many of the WIC-eligible foods to HEI-2020 components were higher in the high WIC duration group compared to low WIC duration group, including higher intake of dried beans, unsweetened breakfast cereals, whole grain breads, and 1% milk; the high WIC duration group also had lower intake of sweetened breakfast cereals and 2% milk.

Conclusion: Findings illustrate how WIC-eligible foods contribute to higher diet quality scores: when children participate in WIC longer, their diets are better aligned with national dietary guidelines.