Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX, USA.
Am J Clin Nutr. 2022 Oct 6;116(4):1030-1037. doi: 10.1093/ajcn/nqac141.
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritional assistance to low-income women and children in the United States. The WIC food package was revised to align more closely to dietary recommendations in October 2009. The revised package included more fruits, vegetables, whole grains, and low-fat milk.
The objective of this study was to examine the association of the revised WIC package with anemia indicators and iron intake in children.
A quasi-experimental difference-in-difference design compared anemia and iron intake variables between WIC (n = 1497 and n = 1626 for anemia and iron intake variables, respectively) and WIC-eligible nonparticipating children (n = 1183 and n = 1322 for anemia and iron intake variables, respectively), aged 2-5 y, before and after the 2009 revisions. The NHANES 2003-2008 and 2011-2018 data represented the period pre- and post-2009 revisions, respectively.
The 2009 package revisions were significantly associated with reduced probability of anemia (-4.3% points; 95% CI: -7.5, -1.1% points) and nonthalassemic microcytic anemia (-1.7% points; 95% CI: -3.3, -0.1% points) in children from WIC-participating households. The revised WIC package also was significantly related to higher nutrient adequacy ratio (0.04; 95% CI: 0.02, 0.07) and greater probability of meeting the RDA (12.1% points; 95% CI: 3.2, 21.0% points) for iron among WIC participants.
This study found that the WIC 2009 revisions were associated with lower probability of nonthalassemic microcytic anemia and better adequacy of dietary iron intake, thereby suggesting the beneficial impact of WIC revisions on iron deficiency anemia in children. The current study findings suggest that nutritional policies could play a crucial role in supporting the health of vulnerable children in the United States.
妇女、婴儿和儿童特别补充营养计划（WIC）为美国低收入妇女和儿童提供营养援助。WIC 食品包于 2009 年 10 月进行了修订，以更紧密地符合饮食建议。修订后的套餐包括更多的水果、蔬菜、全谷物和低脂牛奶。
本研究旨在探讨修订后的 WIC 套餐与儿童贫血指标和铁摄入量的关系。
准实验性差异-差异设计比较了 WIC（贫血和铁摄入量变量分别为 1497 和 1626）和 WIC 合格非参与者（贫血和铁摄入量变量分别为 1183 和 1322）儿童的贫血和铁摄入量变量，年龄在 2-5 岁之间，分别在 2009 年修订前后。NHANES 2003-2008 和 2011-2018 数据分别代表 2009 年前和后。
2009 年套餐修订与来自 WIC 参与家庭的儿童贫血（-4.3%；95%CI：-7.5，-1.1%）和非地中海贫血小细胞性贫血（-1.7%；95%CI：-3.3，-0.1%）的可能性降低显著相关。修订后的 WIC 套餐还与 WIC 参与者的营养素充足率（0.04；95%CI：0.02，0.07）和满足 RDA（12.1%；95%CI：3.2，21.0%）的铁的可能性增加显著相关。
本研究发现，WIC 2009 年修订与非地中海贫血小细胞性贫血的可能性降低和膳食铁摄入量的更好充足率有关，这表明 WIC 修订对儿童缺铁性贫血有有益影响。本研究结果表明，营养政策在美国支持弱势儿童健康方面可以发挥关键作用。
