Review of WIC Food Packages Improving Balance and Choice: Final Report (2017) / Chapter Skim
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8 Sensitivity Analysis for Food Package Nutrient, Food Group, and Cost Models
8 Sensitivity Analysis for Food Package Nutrient, Food Group, and Cost Models
Pages 337-370
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From page 337... ...
Changes in food quantities, as well as changes in assumptions regarding redemption rates, substitutions within food categories, and shifts in participation were tested. Including sensitivity analyses of the revised food packages adds to the analyses discussed in Chapters 6 and 7 (the rationale for the revised food packages and the cost analysis)
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From page 338... ...
In contrast to the Regulatory Impact Analysis (see Chapter 10) which projects cost effects of the revised food packages for fiscal years 2018 through 2022, the cost effects presented in this chapter reflect the effects of individual food category changes to specific food packages, one at a time, based on 2015 costs only.
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From page 339... ...
METHODOLOGICAL APPROACH TO SENSITIVITY ANALYSIS Overview of the Approach The starting point for the committee's sensitivity analysis was the nutrient profile and cost estimates for the current food packages, and redemption data for WIC foods (see Chapter 7 for a description of the methodology and all assumptions applied)
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From page 340... ...
to evaluate the option to substitute a CVV in place of infant food vegetables and fruits. The committee developed a list of sensitivity tests that took into consideration which changes to the revised food packages (or assumptions applied, such as those for redemption rates)
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. As was done for the nutrient profiles of the current and revised food packages (initially described in Chapter 3)
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From page 342... ...
so this analysis represents the estimated effect of the food packages on a large proportion of participants.1 Second, the DGA food patterns (which are used in the calculation of the HEI–2010) apply only to individuals 2 years of age and older and therefore are not applicable to younger children or infants.
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From page 343... ...
Revised packages compared to the current packages When the quantity of dairy foods in the food packages is changed by including an additional yogurt substitution, levels of added sugars increase but levels of saturated fat decrease because milk amounts are reduced and, for some tests, there is less cheese in the average package (see Table 8-1)
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From page 344... ...
vitamin D -- -- −$4.29 −$2.18 S-2 no substitutions (only (−) added sugars, saturated fat fluid milk)
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From page 345... ...
e The committee created a tool to estimate the HEI for children ages 2 to less than 5 years considering the revised package change or test. To do this, the difference between the redeemed amounts of the HEI components for the current food package and the redeemed amounts of the HEI components for the test food package were added to the median intake estimated using NHANES 2011–2012.
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From page 346... ...
The HEI–2010 dairy score for food package IV-B does not change appreciably. For women, however, increased redemption will not compensate for the reduced quantities of dairy in their revised food packages because calcium, potassium, phosphorus, riboflavin, vitamin A, and vitamin D all are lower in one or both of the tested packages.
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From page 347... ...
. Revised packages compared to the current packages Across all food packages that were evaluated, the revised package change to all whole grainrich cereals resulted in higher levels of zinc.
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, and Fully Breastfeeding Women (VII) a Adjustments Package WIC Average Appendix S Food Food (Amount and Food HEI Per-Participant Per-Participant Table Category Package Redemption Rate)
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; HEI = Healthy Eating Index–2010; NA = unable to calculate change in HEI score for any but food package IV-B; WG = whole grain-rich. Nutrient and food group composition of the food packages were based on the assumptions outlined in Appendix R
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From page 350... ...
The change in the overall average per-participant cost ranges from +$0.26 to +$1.03. Alternatives to the revised packages compared to the current packages In addition to the nutrients noted above for the revised food package tests, magnesium, potassium, copper, vitamin B6, folate, and choline also increased as the dollar value of the CVV increased beyond that proposed for the revised food package.
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From page 351... ...
Evaluation The CVV in the revised packages increased the level of fiber and vitamin C in all packages tested, compared to the current food packages. Given that the CVV permits participants a large degree of flexibility in selecting vegetables and fruits, the specific nutrients and nutrient levels contributed by the CVV will vary.
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From page 352... ...
total fruit, whole fruit, NA +$4.26 +$0.41 S-9 85% vitamin C total vegetables
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From page 353... ...
total vegetables, total NA +$25.26 +$0.83 S-10 75% potassium, copper, fruit, whole fruit vitamin C, thiamin, riboflavin, niacin, vitamin B6, folate, choline, vitamin A NOTES: -- = indicates that no changes were in the range of more than approximately ± 8%; (+) = increased amount (an increased amount for saturated fat, added sugars, and sodium is undesirable)
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, and Fully Breastfeeding Women (VII) a Adjustments Package WIC Average Appendix S Food (Amount and Per-Participant Per-Participant Table Package Redemption Rate)
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From page 355... ...
total fruit, NA +$17.76 +$0.58 S-13 50/50 vegetable/fruit potassium, copper, whole fruit, vitamin C, thiamin, total vegetables niacin, vitamin B6, folate, choline NOTES: (+) = increased amount (an increased amount for saturated fat, added sugars, and sodium is undesirable)
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From page 356... ...
Evaluation For the higher CVV, shifting CVV redemption to an equal proportion of vegetables and fruits does not result in large shifts in the level of essential nutrients in the revised food packages. However, the food groups contributed by the packages do shift from total fruits to total vegetables with a corresponding increase in the vegetable component of the HEI–2010.
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From page 357... ...
A further increase in the CVV may compensate for reduced vitamin C from juice and increase the level of other nutrients as well as increase total vegetables, total fruit, and whole fruit. Although the costs per food package for both the revised packages and additional tests vary widely, the effects on the overall average per-participant food costs are smaller because the largest increases in the CVV are for a package that represents approximately 3 percent of participants (fully breastfeeding women)
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From page 358... ...
, and Fully Breastfeeding Women (VII) a Adjustments Package WIC Average Appendix S Food (Amount and Per-Participant Per-Participant Table Package Redemption Rate)
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From page 359... ...
total NA +$17.29 +$0.57 S-16 +$41 CVV potassium, copper, vitamin vegetables, C, thiamin, niacin, vitamin total fruit, B6, folate, choline, vitamin whole fruit A NOTES: (+) = increased amount (an increased amount for saturated fat, added sugars, and sodium is undesirable)
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, and Fully Breastfeeding Women (VII) a Adjustments Package WIC Average Appendix S Food (Amount and Per-Participant Per-Participant Table Package Redemption Rate)
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For current food packages in which no fish is provided, the seafood food group is noted as increasing. d The committee created a tool to estimate the HEI for children ages 2 to less than 5 years considering the revised package change or test.
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Alternatives to the revised packages compared to the current packages For the food packages evaluated, the redemption rate for fish was both increased and decreased. At a higher rate of redemption (79 percent)
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From page 363... ...
Evaluation The rotation of peanut butter, legumes, and fish in the revised food packages potentially reduces the level of fiber, magnesium, copper, and niacin, but it also reduces the amount of saturated fat and added sugars in the food packages. Inclusion of fish in the rotation achieved the addition of the DGA seafood food group to the packages where it was previously not included.
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From page 364... ...
seafood NA −$0.64 −$0.06 S-21 legumes/mo, 53%; magnesium, (−) total vegetables; −12 oz peanut butter/mo; copper, niacin, beans; total +3.3 oz fish/mo added sugars, protein; nuts, saturated fat seeds, and soy
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From page 365... ...
c Food group noted corresponds to the appropriate food group or subgroup from the Dietary Guidelines for Americans. For current food packages in which no fish is provided, the seafood food group is noted as increasing.
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From page 366... ...
The sensitivity tests were applied to food packages IV-B, V-A, and VII, and assessed the degree to which changes to the quantities of foods and other assumptions applied in the committee's food package model affect nutrients, food groups, and costs. The analyses conducted evaluated both major changes to the current food packages to create the revised food packages, as well as additional tests that altered quantities of food amounts in the packages and the assumptions applied to create the revised food packages.
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From page 367... ...
123.00 43.57 120.04 42.52 118.26 41.89 II (6 to <12 mo, FF, BF, FF/BF) 115.37 51.37 113.28 50.63 112.02 50.19 Average food package (I–VII)
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From page 368... ...
However, the overall HEI–2010 score changes less than 1%. Changes in substitutions The nutrients provided and the costs of the food packages within food categories depend on participants' selection among the options offered such as their selection of dairy substitution options.
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From page 369... ...
2016. Dietary Guidelines for Americans 2015–2020.
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