The effect of the 2009 WIC food package change on childhood obesity varies by gender and initial weight status in Los Angeles County

Abstract Objective: To determine whether a previously reported association between the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) food package change and reduced child obesity risk among WIC-participating children in Los Angeles County holds across levels of family income and neighborhood poverty. Design: Analysis of prospectively collected WIC administrative data. The outcome was obesity at age 4 (BMI-for-age≥95th percentile). Poisson regression was applied to a matched sample (N=79,502) to determine if the association between the WIC food package change and child obesity was modified by family income (<50% federal poverty level [FPL], 50-100% FPL, >100% but <185% FPL) and neighborhood poverty. Setting: Los Angeles County, California. Participants: Children who participated in WIC in Los Angeles County between 2003 and 2016; children were grouped as receiving the old WIC food package (2003-2009) or the new WIC food package (2010-2016). Results: Receiving the new WIC food package (i.e. post-2009) was associated with 7-18% lower obesity risk across all family income categories Neither family income nor neighborhood poverty significantly modified the association between the WIC food package and child obesity. However, certain subgroups seemed to benefit more from the food package change than others. In particular, boys from families with income above poverty but residing in the poorest neighborhoods experienced the greatest reductions in obesity risk (RR=0.77; 95%CI=0.66-0.88). Conclusions: The WIC food package revisions were associated with reduced childhood obesity risk among all WIC-participating families in Los Angeles County, across levels of income-eligibility and neighborhood poverty.

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The 2009 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package change and children's growth trajectories and obesity in Los Angeles County

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy347 ◽

2019 ◽

Vol 109 (5) ◽

pp. 1414-1421 ◽

Cited By ~ 3

Author(s):

M Pia Chaparro ◽

Catherine M Crespi ◽

Christopher E Anderson ◽

May C Wang ◽

Shannon E Whaley

Keyword(s):

Los Angeles ◽

Los Angeles County ◽

Growth Trajectories ◽

Obesity Risk ◽

Supplemental Nutrition ◽

Nutrition Program ◽

Full Dose ◽

Food Packages ◽

Food Package ◽

Supplemental Nutrition Program

ABSTRACT Background In 2009, for the first time since the program's inception in 1974, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) changed their food packages, providing food options better aligned with the 2005 Dietary Guidelines for Americans. Objective The aim of this study was to evaluate whether the 2009 WIC food package change was associated with changes in growth trajectories from age 0 to 4 y or obesity at age 4 among children who participated in WIC in Los Angeles County between 2003 and 2016. Methods Children were grouped into 1 of 4 exposure groups: full-dose, new food package group (participating in WIC from birth to age 4, post 2009, N = 70,120), full-dose, old food package group (participating from birth to age 4, pre 2009, N = 85,871), late-dose, new food package group (participating from age 2 to 4 y, post 2009, N = 8386), and late-dose, old food package group (participating from age 2 to 4 y, pre 2009, N = 18,241). Children were matched across groups on gender, race/ethnicity, maternal education and language, family income, and initial weight status, and matched analyses were performed. Longitudinal growth trajectories were modeled using piecewise linear spline mixed models, and differences in obesity at age 4 were compared using Poisson regression models. Results Children receiving a full dose of the new food package had healthier growth trajectories and a lower obesity risk at age 4 than children receiving a full dose of the old food package (RR [95% CI]: 0.88 [0.86, 0.91] for boys, 0.90 [0.87, 0.93] for girls). Boys, but not girls, in the late-dose, new food package group had a lower obesity risk at age 4 compared with boys in the late-dose, old food package group (RR = 0.89, 95% CI = 0.81, 0.98). Conclusions The WIC food package change appears to be associated with improved childhood obesity outcomes. These findings are important in informing policymakers considering further improvements to the WIC food packages.

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