WIC’s New Food Choices: WIC’s New Food Choices: Helping to Change the Helping to Change the
NeighborhoodNeighborhood
WIC’s New Food Choices: WIC’s New Food Choices: Helping to Change the Helping to Change the
NeighborhoodNeighborhoodMichele Y. van Eyken, MPH, RD
Assistant Director
Nutrition and Program Services
California WIC Program
While You Enjoy Your Meal…..
A Bit about WIC WIC Foods– Changing for Health Working with WIC Vendors
WIC-authorized vendor facts Local Vendor Liaison Initiative
Collaboration with WIC and CX3
CX3 survey additions to assist WIC WIC LVL survey information Future possibilities
Supplemental Nutrition Program
Eligibility: Category: Pregnant, breastfeeding and new
mothers, infants and children up to the 5th birthday
Income: Up to 185 percent of poverty• Example - $3,184 per month for a family of 4 or• Enrolled in Food Stamp Program, CalWorks and/or
Medi-Cal Nutritional risk: Determined with a nutrition
assessment Residency: California
Supplemental Nutrition Program
Services to 1.4 million women, infants and children each month– one million families
60 percent of all infants born in the State Nearly 80 percent of the estimated eligible
population is enrolled 1 of every 6 WIC participants in the U.S. lives in
California Purchasing power: $86 M of food per month;
6.6 M checks No State General funds
California WIC Facts:
Supplemental Nutrition Program
In California, the Department of Public Health
(CDPH) administers: Provided by 82 local agencies
• Half local health departments
• Half community-based organizations
Available at 675 WIC centers Delivered by 3,600 professional,
paraprofessional and support staff “Face-to-face” service delivery at
enrollment and throughout eligibility period
Program Services
Nutrition Education and Breastfeeding Support• Individual and group• Newest adult learning
methods Referrals to Health and
Social Services• 92% of infants and children
have health coverage
Program Services
Food Instruments (“checks” for healthy foods)• Checks to purchase specific foods at any of 3,900
WIC authorized retail food stores statewide• Average value is $62 per month per participant
Current Food Package
What’s the Big News?
30 Years– It’s Time for a Change!
Since 1974 there have been
• Changes in the WIC program and population it serves
• Changes in the food supply and food consumption
• Changes in diet-related health risks
• Changes in nutrition knowledge and dietary guidance– but…
• NO significant changes in the foods WIC provides
The IOM Review
In 2003, USDA commissioned a scientific panel of experts through the Institute of Medicine (IOM) to conduct a review of WIC foods in two phases:
Phase I: Evaluate the diets of the WIC population, and propose criteria for revising the foods
Phase II: Using information from Phase I to recommend specific changes to the foods
The IOM Review
Recommendations must be• cost-neutral, i.e., some current foods
were reduced or eliminated so new foods could be added and the total cost of all packages is the same
• workable for nationwide distribution and store check-out,
• not a burden to administer, and • culturally suitable.
IOM Recommendations, 2005
Overarching Themes:
Encourage consumption of fruits and vegetables
Emphasize whole grains Provide incentives for breastfeeding Be consistent with current dietary
guidance for infants and young children
Reduce saturated fat Increase participant choice
Food Package Rules, 2007
CURRENT FOODS: Formulas Milk Cereal (infant & adult) Juice Eggs Cheese Dried Beans or Peanut
Butter Tuna Carrots
NEW/REVISED FOODS: All current foods plus:
Fruits and Vegetables Whole Wheat Bread or
other Whole Grains Soy-beverage & Tofu Light Tuna, Salmon,
Sardines, Mackerel Canned Beans Infant Foods
Food Package Rules– Infants
Revised Food Packages for Formula-fed Infants Formula amounts tied to feeding
practice and age of infant:
Half current amount starting at
6 months. Infant cereal and baby food fruits
and vegetables starting at 6 months Juice eliminated until first birthday
Food Package Rule– Breastfeeding Dyads
Partially breastfed infants receive less formula to encourage mothers to breast feed more;
Fully breastfeeding mothers receive most variety and largest quantity of food;
Fully breastfeeding infants over 6 months receive larger quantities of baby food fruits and vegetables; also baby food meat.
• Provide Breastfeeding Incentives and Support
Food Package Rules– Women and Children
Half the juice for children and women Adds whole grain breads and
other cultural options, such as tortillas,
brown rice, bulgur Adds fish choices for breast feeding mothers Half the milk and must be
low-fat (except for children under two)
Half the eggs and cheese
Food Package Rules– Women and Children
Add Fruits and Vegetables Cash value-vouchers for fruits and
vegetables for: Children - $6 Women - $8 Exclusively Breastfeeding - $10
Participants may choose from a wide variety of fruits and vegetables– only white potatoes excluded
Fresh required; frozen and canned allowed as substitutes for women and children and dried for women
Impact on Participants
Provides more diverse and balanced food packages Provides greater variety and choice Offers choices consistent with Dietary Guidelines for
Americans Includes more culturally appropriate foods Supports improved nutrient intakes Addresses nutrition-related concerns (e.g. obesity,
low breastfeeding rates)
Better Nutrition!
Impact on Vendors
Under new rules, WIC vendors are required to: Stock new WIC foods, including fruits and
vegetables and whole grains Redeem cash-value vouchers for fruit and
vegetables May experience change in sales of
current and new foods Responsible for training of store
personnel and revisions to operations
Why are New Foods a Priority?
Opportunity to: Improve the nutrition and health of WIC
families Enhance WIC’s nutrition education Better support breastfeeding Increase access to healthy foods,
especially in small stores Strengthen partnerships with vendors
and with other nutrition programs and services for WIC families
CA WIC-Authorized Vendors
CA WIC-Authorized Vendors
3,900 retail grocery outlets statewide 40 corporate chains with 2,050 stores 300 independent grocery stores (2-6 stores) 1050 neighborhood stores (owner-operated) 560 “Above 50 Percent”
stores-- > half of food income is derived from WIC Checks
State Vendor Activities
Enter into “contracts” with vendors as WIC-authorized vendors
Provide training on WIC rules Monitor for compliance with
stocking and other requirements Disqualify and conduct appeal
hearings Very limited technical assistance
Collaboration with CX3
Expertise in “store detailing”, “point-of-sale” nutrition education, marketing
Survey tool to assess the neighborhood environment for healthy food
Fall 2007: Added additional questions to CX3 survey to help assess store readiness to implement new WIC foods;
New WIC Vendor Partnership
Initiated in February 2008 Funding for “Local Vendor Liaison” All 82 local WIC agencies Starting with Neighborhood stores–
one store, one owner Eventually will reach
all 3,900 stores
New Vendor Partnership Phase One: “Getting to Know You”
Meet and greet, provide WIC materials, listen NEW! Survey store for readiness for new foods
Phase Two: Prepare for WIC Food Changes Provide materials PROBLEM! WIC staff cannot provide business consulting
due to perceived conflict of interest WIC staff cannot promote stores to apply to be WIC-
authorized Opportunity for CX3 partnership
Phase Three: Continue partnership
Survey Tool– Sample Questions
Survey Tool– Sample Questions
Survey Tool– Sample Questions
Survey Tool– Sample Questions
Survey Tool– Results to Date
In the first two weeks, 17 visits Introduced most to the up-coming
food changes Most have fruits and vegetables, at
least 2 types of each About 2/3 have a “good selection”
(not defined) of fruits and vegetables Most have baby food F, V and meats Fewer have low-fat/ skim milk This was a very small sample
WICI-CX3 Partnerships?
Identify overlap– and gaps– between Food Stamp-eligible stores in low-income census tracts and WIC-authorized vendors?
Full CX3 survey for all WIC vendors? LVL- Network Retail Coordinator
collaboration? Regional meetings on vendor-retail
visiting, TA, issues, education, policy?
Healthy foods in low-income neighborhoods!
California’s Process
1. Understand the Food Package Rule (2007)
2. Gather Information from stakeholders (6/2007- 8/2008)
Participants WIC Staff WIC-authorized Vendors Food manufacturers Other forums and meetings– like this one
3. Make policy decisions (7-9/2008)
California’s Process
4. Develop implementation plan (7-9/2008) Systems and procedural changes Training and Technical Assistance– WIC staff,
vendors, participants
5. Communicate policy decisions and plan with stakeholders (10-12/2008)
6. Work with stakeholders and partners
7. Implement by October 1, 2009
8. Provide comments to USDA by 2/2010
New WIC Food Package