Select Food Group Intake of US Children Aged 2 to 4 Years by WIC Participation Status and Income

Background Food group and nutrient priorities for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Package IV for children aged 2 to 4 years were described in the 2017 review of the WIC Food Package. Research has evaluated priority nutrient intake, but priority food group intake remains unknown. Objectives To compare mean intake of priority food groups/subgroups of WIC children to WIC-eligible nonparticipants and higher income children. Further, we hoped to assess differences in percent contribution of food subgroups to total food group intake by WIC participation status and income. Design Cross-sectional study conducted using data from the 2011-14 National Health and Nutrition Examination Survey. Participants/setting One thousand forty-seven children aged 2 to 4 years. Main outcome measures Mean intake reported in cup equivalents and ounce equivalents. We also looked at mean percent that food subgroups contributed to total intake within a food group. Analyses were performed for high and low priority food groups/subgroups: high = seafood, total vegetables, dark green vegetables, red/orange vegetables, whole grains, and nuts/seeds/soy; low = total starchy vegetables, other vegetables, legumes computed as vegetables, total dairy, and total protein foods. Statistical analyses performed Multivariable linear regression analysis was used evaluate the relationship between income/WIC participation and mean intake/percent food subgroups contributed to total food group intake. Results Among low-income WIC-eligible children, participation in WIC was associated with greater mean intake of red/orange vegetables (0.18 +/- 0.03 vs 0.01 +/- 0.06 c equivalents; P < 0.05) and legumes (0.07 +/- 0.01 vs 0.01 +/- 0.02 c equivalents; P < 0.01). No differences in mean intake were observed between WIC children and higher income children. Grain intake of WIC children was composed of a higher percentage of whole grains (19.1% +/- 1.6% vs 13.2% +/- 1.5%; P < 0.01) compared with higher income children. The percent vegetable subgroups contributed to total vegetable intake varied by income; no differences were observed for dairy or protein subgroups. Conclusions Among low-income children, participation in WIC was associated with greater intake of certain vegetables. Participation in WIC may also help close the diet quality gap between low-income and higher income children for priority foods targeted by the WIC food package. Future research should explore socioeconomic disparities in intake of nutrient-poor foods.