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  • This activity was supported by Grant No. Department of Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. The National Academy of Sciences was established in by an act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology.

    Members are elected by their peers for outstanding contributions to research. Marcia McNutt is president. The National Academy of Engineering was established in under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation.

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    Members are elected by their peers for extraordinary contributions to engineering. Mote, Jr. The National Academy of Medicine formerly the Institute of Medicine was established in under the charter of the National Academy of Sciences to advise the nation on medical and health issues.

    Members are elected by their peers for distinguished contributions to medicine and health. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions.

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    The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Reports document the evidence-based consensus of an authoring committee of experts.

    Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and committee deliberations.

    Reports are peer reviewed and are approved by the National Academies of Sciences, Engineering, and Medicine. Proceedings chronicle the presentations and discussions at a workshop, symposium, or other convening event.

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    The statements and opinions contained in proceedings are those of the participants and have not been endorsed by other participants, the planning committee, or the National Academies of Sciences, Engineering, and Medicine. For information about other products and activities of the National Academies, please visit nationalacademies.

    Bickford, Jr. JOHN A. Department of Agriculture, Economic Research Service. This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge.

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    The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:.

    Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Diane F. They were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered.

    Responsibility for the final content of this report rests entirely with the authoring committee and the institution. Summary and Organization of This Report.

    Alignment with the Dietary Reference Intakes. Identifying Nutrient Priorities. Identifying Food Group Priorities. Results from Use of the Decision Tree. Methods Used to Estimate Costs.

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    Results and Discussion: Program Costs. Comparing Cost Incentives for Breastfeeding. Purpose, Goals, and Limitations of Sensitivity Testing. Methodological Approach to Sensitivity Analysis. Recommendations for Implementation of the Revised Food Packages.

    Priorities for Funding Outside Cost-Neutrality. Considerations for the Next Review. G Barriers to Participation and Redemption. H Kosher and Halal Substitution Options. O Specific Nutrient Comparisons. P Food Specification Detail.

    S Sensitivity Tests and Results. V Committee Biosketches. The Special Supplemental Nutrition Program for Women, Infants, and Children WIC began 40 years ago as a pilot program and has since grown to serve more than 8 million pregnant women, and mothers and their infants and young children.

    Through its contribution to the nutritional needs of pregnant, breastfeeding, and postpartum women; infants; and children under 5 years of age, this federally supported nutrition assistance program is integral to meeting national nutrition policy goals for a significant portion of the U.

    This complex task included consideration of whether or not WIC participants should be permitted to purchase white potatoes with the cash value voucher CVV , a part of the benefit package that provides access to vegetables and fruits. In its first of three reports, published early in , the committee recommended that white potatoes be allowed as a WIC-eligible vegetable for purchase with the CVV.

    The second report of this series, published in , provided a summary of the work of phase I of the study as well as the analytical underpinnings for phase II.

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    This is the third and final report in this series. The revised food packages were constrained to be cost neutral with the current food packages, which means that any increases in the costs of components of the packages or allowed substitutions had to be balanced by corresponding decreases in costs elsewhere.

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    This required the committee to be creative in responding to its charge to align the packages with the DGA. When making these revisions, the committee considered the supplemental nature of the WIC program and used a systematic approach.

    The committee was able to make changes to the packages that improve their alignment with the DGA and, thus, the dietary balance of the packages. The committee was able to improve the number of substitution options included in the packages and, thus, the choices available to participants to meet their cultural and personal preferences.

    The revised packages increase the cash value voucher for all participants, although the amounts differ by food package, and include fish in nearly all food packages.

    In addition, the committee provided enhanced support for breastfeeding, both exclusive and partial breastfeeding, along with greater flexibility for breastfeeding in the first 30 days after delivery. This report is the first review of the WIC food packages to contain a regulatory impact analysis.

    This may permit USDA to move more rapidly to implement the changes proposed. It is noteworthy that the regulatory impact analysis not only shows that the revisions to the food packages should be cost neutral when implemented but also that they are projected to provide substantial cost savings over time, savings that could be used to make further nutritional improvements to the food packages.

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    The committee is grateful to the speakers in its data-gathering workshops who gave valuable insights as well as their time to assist the committee with its task. Lastly, the committee is indebted to the many WIC staff members who gave their time and expertise to help committee members better understand administration of and participation in the WIC program.

    It exists thanks to the hard work of many individuals. Committee members volunteered many hours of their time to this work. Their collaborative spirit as well as careful thinking and writing are to be commended. The committee was supported in its work by several consultants. Suzanne Murphy provided critical insights based on her experience in leading the committee that produced the first major reevaluation of the WIC food packages, published in Her sage advice is much appreciated.

    Mei Chung.

    Rose Gladstein assisted with the regulatory impact analysis. John A. To accomplish this task numerous staff members at the National Academies of Sciences, Engineering, and Medicine supported the work of the committee.

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  • She was assisted by Meghan Quirk after March , who led the regulatory impact analysis. Bernice Chu assisted with literature reviews and data management, and Ambar Saeed dealt with administrative logistics.

    Alice Vorosmarti assisted with literature reviews and other data-oriented tasks. The committee owes them all a debt of gratitude for their hard work and professionalism. The Special Supplemental Nutrition Program for Women, Infants, and Children WIC began 40 years ago as a pilot program and has since grown to serve over 8 million pregnant women, and mothers of and their infants and young children.

    Through its contribution to the nutritional needs of pregnant, breastfeeding, and post-partum women; infants; and children under 5 years of age; this federally supported nutrition assistance program is integral to meeting national nutrition policy goals for a significant portion of the U. In this third report, the committee provides its final analyses, recommendations, and the supporting rationale.

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