Dietary Risk Assessment in the WIC Program reviews methods used to determine dietary risk based on failure to meet Dietary Guidelines for applicants to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Applicants to the WIC program must be at nutritional risk to be eligible for program benefits. Although “dietary risk” is only one of five nutrition risk categories, it is the category most commonly reported among WIC applicants.

This book documents that nearly all low-income women in the childbearing years and children 2 years and over are at risk because their diets fail to meet the recommended numbers of servings of the food guide pyramid. The committee recommends that all women and children (ages 2-4 years) who meet the eligibility requirements based on income, categorical and residency status also be presumed to meet the requirement of nutrition risk. By presuming that all who meet the categorical and income eligibility requirements are at dietary risk, WIC retains its potential for preventing and correcting nutrition-related problems while avoiding serious misclassification errors that could lead to denial of services for eligible individuals.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON DIETARY RISK ASSESSMENT IN THE WIC PROGRAM
• FOOD AND NUTRITION BOARD
• Acknowledgments
• Executive Summary
• 1. Introduction
  • THE WIC PROGRAM
  • NUTRITION RISK CRITERIA
  • DIETARY RISK
  • THE CHARGE TO THE COMMITTEE AND THE STUDY PROCESS
  • ORGANIZATION OF THE REPORT
• 2. Dietary Assessment Tools in WIC
  • PURPOSES OF DIETARY DATA COLLECTION
  • DIETARY ASSESSMENT TOOLS CURRENTLY USED BY WIC PROGRAMS
  • ELIGIBILITY CRITERIA IN USE
  • SUMMARY
• 3. Using the Dietary Guidelines as the Basis of Dietary Risk Criteria
  • THE DIETARY GUIDELINES, WIC, AND NATIONAL GOALS
  • WHICH DIETARY GUIDELINES SHOULD BE TARGETED?
• 4. Framework for Evaluating Tools to Assess Dietary Risk
  • DESIRABLE CHARACTERISTICS OF AN ASSESSMENT TOOL
  • SUMMARY
• 5. Food-Based Assessment of Dietary Intake
  • A FOCUS ON USUAL INTAKE
  • OVERVIEW OF RESEARCH-QUALITY DIETARY METHODS FOR ESTIMATING FOOD OR NUTRIENT INTAKE
  • METHODS TO COMPARE FOOD INTAKES WITH THE DIETARY GUIDELINES
  • CONCLUSIONS REGARDING FOOD-BASED DIETARY ASSESSMENT METHODS FOR ELIGIBILITY DETERMINATION
• 6. Assessment of Physical Activity
  • CHALLENGES IN ASSESSING PHYSICAL ACTIVITY
  • METHODS TO ASSESS PHYSICAL ACTIVITY
  • CONCLUSIONS REGARDING THE ROLE OF PHYSICAL ACTIVITY ASSESSMENT FOR ELIGIBILITY DETERMINATION
  • RECOMMENDATIONS FOR FUTURE RESEARCH
• 7. Behavioral Indicators of Diet and Physical Activity
  • THE CONCEPT OF BEHAVIORAL INDICATORS
  • BEHAVIORAL INDICATORS OF DIET
  • BEHAVIORAL INDICATORS OF PHYSICAL ACTIVITY
  • CONCLUSIONS REGARDING THE USE OF BEHAVIORAL INDICATORS FOR ELIGIBILITY DETERMINATION
• 8. Evidence of Dietary Risk Among Low-Income Women and Children
  • NUTRITIONAL VULNERABILITY OF GROUPS SERVED BY WIC
  • RESULTS FROM RELEVANT DIETARY INTAKE STUDIES
  • ASSOCIATIONS OF FOOD INTAKE WITH INCOME
  • SUMMARY OF EVIDENCE SUGGESTING DIETARY RISK
• 9. Findings and Recommendations
  • FINDINGS
  • RECOMMENDATION
  • CONCLUDING REMARK
• 10 References
• A Allowed Nutrition Risk Criteria
• B Workshop Agenda and Presentations
• C Biographical Sketches of Committee Members

Support for this project was provided by the Food and Nutrition Service, U.S. Department of Agriculture. The views presented in this report are those of the Institute of Medicine Committee on Dietary Risk Assessment in the WIC Program and are not necessarily those of the funding agency.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.