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This book reviews the scientific basis for nutrition risk criteria used to establish eligibility for participation in the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The volume also examines the specific segments of the WIC population at risk for each criterion, identifies gaps in the scientific knowledge base, formulates recommendations regarding appropriate criteria, and where applicable, recommends values for determining who is at risk for each criterion. Recommendations for program action and research are made to strengthen the validity of nutrition risk criteria used in the WIC program.
The updated nutrition services standards represent a wide range of performance practices used in the delivery of quality WIC nutrition services. These standards supercede the 1988 nutrition services standards.
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. Today the program serves more than a quarter of the pregnant women and half of the infants in the United States, at an annual cost of about $6.2 billion. 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.S. population. To assure the continued success of the WIC, Congress mandated that the Food and Nutrition Service of the U.S. Department of Agriculture (USDA) reevaluate the program's food packages every 10 years. In 2014, the USDA asked the Institute of Medicine to undertake this reevaluation to ensure continued alignment with the goals of the Dietary Guidelines for Americans. In this third report, the committee provides its final analyses, recommendations, and the supporting rationale.
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. Today the program serves more than a quarter of the pregnant women and half of the infants in the United States, at an annual cost of about $6.2 billion. 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.S. population. To assure the continued success of the WIC, Congress mandated that the Food and Nutrition Service of the U.S. Department of Agriculture (USDA) reevaluate the program's food packages every 10 years. In 2014, the USDA asked the Institute of Medicine to undertake this reevaluation to ensure continued alignment with the goals of the Dietary Guidelines for Americans. This, the second report of this series, provides a summary of the work of phase I of the study, and serves as the analytical underpinning for phase II in which the committee will report its final conclusions and recommendations.
Ensuring that the food provided to children in schools is consistent with current dietary recommendations is an important national focus. Various laws and regulations govern the operation of school meal programs. In 1995, Nutrition Standards and Meal Requirements were put in place to ensure that all meals offered would be high in nutritional quality. School Meals reviews and provides recommendations to update the nutrition standard and the meal requirements for the National School Breakfast and Lunch Programs. The recommendations reflect new developments in nutrition science, increase the availability of key food groups in the school meal programs, and allow these programs to better meet the nutritional needs of children, foster healthy eating habits, and safeguard children's health. School Meals sets standards for menu planning that focus on food groups, calories, saturated fat, and sodium and that incorporate Dietary Guidelines for Americans and the Dietary Reference Intakes. This book will be used as a guide for school food authorities, food producers, policy leaders, state/local governments, and parents.
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.
What foods should Americans eat to promote their health, and in what amounts? What is the scientific evidence that supports specific recommendations for dietary intake to reduce the risk of multifactorial chronic disease? These questions are critically important because dietary intake has been recognized to have a role as a key determinant of health. As the primary federal source of consistent, evidence-based information on dietary practices for optimal nutrition, the Dietary Guidelines for Americans (DGA) have the promise to empower Americans to make informed decisions about what and how much they eat to improve health and reduce the risk of chronic disease. The adoption and widespread translation of the DGA requires that they be universally viewed as valid, evidence-based, and free of bias and conflicts of interest to the extent possible. However, this has not routinely been the case. A first short report meant to inform the 2020 review cycle explored how the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints. This second and final report recommends changes to the DGA process to reduce and manage sources of bias and conflicts of interest, improve timely opportunities for engagement by all interested parties, enhance transparency, and strengthen the science base of the process.
Food choices and eating habits are learned from many sources. The school environment plays a significant role in teaching and modeling health behaviors. For some children, foods consumed at school can provide a major portion of their daily nutrient intake. Foods and beverages consumed at school can come from two major sources: (1) Federally funded programs that include the National School Lunch Program (NSLP), the School Breakfast Program (SBP), and after-school snacks and (2) competitive sources that include vending machines, "a la carte" sales in the school cafeteria, or school stores and snack bars. Foods and beverages sold at school outside of the federally reimbursable school nutrition programs are referred to as “competitive foods” because they compete with the traditional school lunch as a nutrition source. There are important concerns about the contribution of nutrients and total calories from competitive foods to the daily diets of school-age children and adolescents. Nutrition Standards for Foods in Schools offers both reviews and recommendations about appropriate nutrition standards and guidance for the sale, content, and consumption of foods and beverages at school, with attention given to foods and beverages offered in competition with federally reimbursable meals and snacks. It is sure to be an invaluable resource to parents, federal and state government agencies, educators and schools, health care professionals, food manufacturers, industry trade groups, media, and those involved in consumer advocacy.
Presents physical activity guidelines and tools emphasizing health promotion, disease prevention, and early recognition of physical activity issues and concerns of infants, children, and adolescents. Designed for use by physicians, nurses, dietitians, and health educators to screen and assess the physical activity levels of infants, children, and adolescents and to provide anticipatory guidance on physical activity to families.