WIC food-package changes align with decline in obesity risk

Michael G Burke

An evaluation of national and state-level trends in obesity prevalence among 2- to 4-year-old participants in the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) found that the changes in the 2009 WIC food packages to better align with dietary guidelines are associated with a decline in the risk of obesity among these children.

Investigators compared population trends in obesity prevalence in the selected age group from 2000 to 2014 using a study design that accounted for state-level differences, race or ethnicity, poverty trends, and trends in macrosomia and high maternal prepregnancy body mass index (BMI) among WIC participants.

The package change was associated with a reversal of the increasing trend in obesity prevalence among WIC participants observed from 2000 until the package change in 2009. After 2009, childhood obesity prevalence among 2- to 4-year-old WIC participants shifted from a 0.23 percentage point annual increase to a 0.34 percentage point annual decrease. Furthermore, changes in sociodemographic and other obesity risk factors did not account for this change in the trend in obesity prevalence (Daepp MIG, et al. Pediatrics. 2019;143[5]:e20182841).

Thoughts from Dr Burke

The 2009 changes to the WIC package included additional allowances for fruits and vegetables; reductions in how much juice and cheese were covered; requiring low-fat or skim milk after the first 2 years of life; and requiring whole-grain instead of refined-grain products. I am convinced that progress in preventing and treating obesity requires large community-wide public health measures like this one. Similar efforts include taxing sugar-sweetened beverages and addressing the availability of healthy food in food deserts.