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2 Nutrient and Food Priorities for the WIC Food Packages
Pages 46-73

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From page 46...
... This chapter summarizes nutrient and food priorities that the committee took into account when redesigning the WIC food packages with the goal of improving the nutrition of WIC participants. NUTRIENT PRIORITIES Assessing nutrient adequacy involves determining the extent to which the diets of WIC-income-eligible subgroups meet nutrient requirements without being excessive.
From page 47...
... Details on the methods and results of the analysis of nutrient adequacy are provided in Appendix C -- Nutrient Intake of WIC Subgroups. Estimated Adequacy of Micronutrient Usual Intakes Overall, fully formula-fed WIC infants had adequate intakes of micronutrients and macronutrients.
From page 48...
... Calcium, Potassium, and Fiber Usual Intakes Calcium intakes appear to be adequate for formula-fed WIC infants and WIC children but low for pregnant, lactating, and non-breastfeeding
From page 49...
... DATA SOURCES: Intake data are from 1994­1996 and 1998 Continuing Survey of Food Intake by Individuals (FSRG, 2000) ; data set does not include intake from dietary supplements (e.g., multivitamin and mineral preparations)
From page 50...
... in Appendix C -- Nutrient Intake of WIC Subgroups. DATA SOURCES: Intake data are from 1994­1996 and 1998 Continuing Survey of Food Intake by Individuals (FSRG, 2000)
From page 51...
... Usual Food Energy Intakes Both the mean and median reported usual intakes of food energy of WIC infants and children exceeded the comparable percentiles of the energy requirement distributions (Table 2-4)
From page 52...
... Saturated fat, however, is a nutrient of concern with regard to excessive intake; 91 percent of WIC children ages 2 through 4 years had saturated fat intakes above the recommended range of less than 10 percent of total food energy (Table 2-5)
From page 53...
... (n = 105) Protein %AMDR 1.5 1.0 <0.1 <0.1 Carbohydrate, total %AMDR 2.8 1.1 0.2 0.1 Added Sugars %>25% of food energy na 2.9 7.3 20.4 Fat, total %AMDR 5.5 10.4 24.5 4.9 Fat, saturateda %>10% of food energy na 91.0 80.9 96.2 aThe dietary guidance in this table for saturated fat is a part of the Dietary Guidelines for Americans (DHHS/USDA, 2005)
From page 54...
... c UL for pregnant women 14­44 y / lactating women 14­44 y. NOTES: n = sample size; na = not applicable; ND = not determined, UL not determined due to lack of data of adverse effects; UL = Tolerable Upper Intake Level; %>Guidance = percentage with usual intake greater than the applicable dietary guidance (e.g., cholesterol intake should not exceed 300 mg/d)
From page 55...
... . Dietary guidance for cholesterol is from the American Heart Association (AHA, 2004)
From page 56...
... · Sizeable proportions of subgroups have saturated fat intakes above the dietary guidance to consume less than 10 percent of total food energy as saturated fat: 91 percent of WIC children ages 2 through 4 years; 81 percent of pregnant and lactating women; and 96 percent of non-breastfeeding postpartum women. About one-third of pregnant and lactating women had usual cholesterol intakes that exceeded the recommended limit of 300 milligrams per day.
From page 57...
... Nonetheless, given the very high prevalence of inadequacy for some micronutrients -- vitamin E and magnesium in particular -- and the low intakes of calcium, it is unlikely that underreporting of food intakes could explain fully the apparent inadequacies in the intakes of these nutrients. For WIC children, mean food energy intakes were considerably larger than the mean EER for low-income children 1 through 4 years of age.
From page 58...
... Estimates of Upper Levels The committee recognized that it would not be feasible to revise the food packages in ways that would substantially reduce the prevalence of excessive intakes for all nutrients with a UL. The zinc and vitamin A ULs for infants and children are particularly problematic because high proportions of the population exceed these ULs.
From page 59...
... · WIC Infants Under 1 Year of Age, Non-Breastfed -- No nutrients were identified with a high risk of inadequacy. Priority nutrients related to risk of excessive intakes in non-breastfed infants are zinc, preformed vitamin A, and food energy.
From page 60...
... Nutrients that may be excessive in the diets of young children are zinc, preformed vitamin A, sodium, food energy, and saturated fat. · Pregnant, Lactating, and Non-Breastfeeding Postpartum Women-Priority nutrients identified as lacking are calcium, magnesium, vitamin E, potassium, and fiber.
From page 61...
... , a large body of literature suggests that WIC foods contribute to the adequacy of iron intake among low-income women, infants, and children (Yip et al., 1987; Rush et al., 1988c, 1988d; Batten et al., 1990; Rose et al., 1998; Pehrsson et al., 2001; Sherry et al., 2001; Siega-Riz et al., 2004)
From page 62...
... in complementary foods become very important for fully breast-fed infants. · Calcium Intake and Lead Exposure -- Studies of calcium intakes and exposure to lead suggest that adequate calcium intake has an added benefit of decreasing blood lead levels in pregnant women and lactating women (Hertz-Picciotto et al., 2000; Hernandez-Avila et al., 2003)
From page 63...
... These nutrition-related health risks are summarized in Table 2-7. FOOD GROUP PRIORITIES To determine whether specific foods or types of food should receive priority in the redesign of WIC food packages, the committee reviewed information about dietary guidance, amounts of foods consumed by groups that potentially are eligible for the WIC program, and the amounts of foods in current WIC food packages.
From page 64...
... It also gives the mean number of teaspoons of added sugars consumed. To allow comparison of the means with the newly released dietary guidance, Table 2-8 also shows the daily amount specified in the revised USDA food pattern for 1,000 to 1,600 kilocalories (which covers the energy range for most young children)
From page 65...
... · Children -- Intakes tend to be low in whole grains and in dark green leafy vegetables, deep yellow vegetables, and cooked dry beans and peas rather than vegetables in general. · Women -- Intakes tend to be low in whole grains, dark green leafy vegetables, deep yellow vegetables, cooked dry beans and peas, fruits, and milk and milk products.
From page 66...
... . cThree whole grain one ounce-equivalents per day is the minimum amount specified by the Dietary Guidelines Advisory Committee regardless of the total number of servings of grain (DHHS/USDA, 2004)
From page 67...
... . Daily amounts in revised USDA patterns were obtained from "Appendix A-2" of the Dietary Guidelines for Americans 2005 (DHHS/USDA, 2005, pg.
From page 68...
... Low-Income Children Younger Than 2 Years of Age To identify food-related priorities for infants and children younger than 2 years of age, the committee obtained descriptive information about their food intakes and examined the data in relation to objectives in Healthy People 2010 (DHHS, 2000a, 2000b) and to widely accepted dietary guidance from the American Academy of Pediatrics, the American Dietetic Association, and other selected sources (see Table 2-9)
From page 69...
... Feeding Other Foods to Infants and Young Children Source Introduce semisolid complementary foods gradually Kleinman, 2000; WHO, beginning around 6 months of age.a 2001a, 2002; AAP, 2005 Introduce single-ingredient complementary foods, AAP, 2004 one at a time for a several day trial. Introduce a variety of semisolid complementary WHO, 2001a foods throughout ages 6­12 mo.
From page 70...
... The Section on Breastfeeding acknowledges that the Committee on Nutrition supports introduction of complementary foods between 4 and 6 months of age when safe and nutritious complementary foods are available." · Regarding exclusive breastfeeding of infants -- "Complementary foods rich in iron should be introduced gradually beginning around 6 months of age." · Regarding exclusive breastfeeding of infants -- "Introduction of complementary feedings before 6 months of age generally does not increase total caloric intake or rate of growth and only substitutes foods that lack the protective components of human milk." DATA SOURCES: Dietary guidance is from: the American Academy of Pediatrics (AAP, 1992a, 1992b, 1997, 1998, 1999, 2001a, 2001b, 2004, 2005; Kleinman, 2000) ; the American Dietetic Association (ADA, 1999c, 2004)
From page 71...
... and vegetables, and infrequent exposure to new foods. · Examination of foods in the current WIC packages shows that there is room for improvement to become more consistent with current dietary guidance.
From page 72...
... b The Tolerable Upper Intake Level applies only to preformed vitamin A (i.e., retinol) ingested from the combined sources of animal-derived foods, fortified foods, and dietary supplements (IOM, 2001)
From page 73...
... Sodium, Cholesterol, and Vitamin A, preformed,b and Added sugars Food energy Increase intakes of whole Decrease intakes of: Limit intakes of: grains, a variety of Sodium, Saturated fat, nonstarchy vegetables, Food energy, and Cholesterol, fruit, and fat-reduced Total fat Trans fatty acids,c and milk products. Added sugars cTrans fatty acids have not specifically been identified as a hazard for infants and children, and thus are shown in the table as nutrients to limit only in the diets of adolescents and adults (IOM, 2002/2005)


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