Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, United States.
Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States.
J Nutr. 2023 Nov;153(11):3317-3326. doi: 10.1016/j.tjnut.2023.08.021. Epub 2023 Aug 20.
An objective of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is to improve maternal diet quality, but its effectiveness remains unclear. Better understanding how WIC participation shapes women's diet quality is crucial given that maternal diet plays a critical role in determining mothers' and children's short- and long-term overall health.
This study aimed to compare the diet quality of WIC-participating women to WIC-eligible nonparticipating women and higher-income pregnant and postpartum women using a nationally representative sample.
This was a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) 2011-2018 cycles. Women aged 20 to 44 with at least one 24-h recall and complete data on pregnancy and postpartum status and WIC participation were included (n = 626). Diet quality was evaluated using the Healthy Eating Index-2015 (HEI-2015). Multivariable Tukey-adjusted linear models were used to compare HEI-2015 total and component scores between groups. Models were adjusted for age, pregnancy and postpartum status, breastfeeding status, race and ethnicity, and food security.
Most women were postpartum and not pregnant (75%), nonbreastfeeding (60%), identified as non-Hispanic White (58%), and food secure (64%). WIC participants, WIC-eligible nonparticipants, and income-ineligible women had mean Total HEI-2015 scores of 52.7 (95% confidence interval [CI]: 50.6, 54.8), 54.2 (95% CI: 51.6, 56.7), and 55.0 (95% CI: 51.8, 58.2), respectively. There were no differences between groups for total and most component scores. Income-ineligible women had better Fatty Acids scores (5.7; 95% CI: 5.0, 6.4) than WIC participants (4.7; 95% CI: 4.1, 5.3; P < 0.05). WIC-eligible nonparticipants had better Refined Grains scores (6.0; 95% CI: 5.3, 6.6) than WIC participants (5.0; 95% CI: 4.4, 5.6; P < 0.05).
Overall diet quality was similar across WIC and income groups. Lower HEI-2015 component scores for WIC participants compared with WIC-eligible nonparticipants warrant further exploration. Research evaluating WIC's impact on maternal diet quality is needed to ensure continued support for low-income women's health.
妇女、婴儿和儿童特别补充营养计划（WIC）的目标之一是改善产妇的饮食质量，但它的有效性仍不清楚。鉴于产妇饮食在决定母亲和儿童短期和长期整体健康方面起着至关重要的作用，更好地了解 WIC 参与如何塑造妇女的饮食质量至关重要。
本研究旨在使用全国代表性样本，比较 WIC 参与者与 WIC 有资格但未参与的非参与者以及高收入孕妇和产后妇女的饮食质量。
这是对 2011-2018 年全国健康和营养检查调查（NHANES）的横断面分析。纳入了年龄在 20 至 44 岁之间、至少有一份 24 小时回忆且完整记录了妊娠和产后状态以及 WIC 参与情况的女性（n=626）。使用健康饮食指数-2015（HEI-2015）评估饮食质量。使用多变量 Tukey 调整后的线性模型比较组间 HEI-2015 总分和分量得分。模型调整了年龄、妊娠和产后状态、母乳喂养状态、种族和民族以及粮食安全状况。
大多数女性处于产后而非怀孕状态（75%）、非母乳喂养状态（60%）、非西班牙裔白人（58%）和粮食安全状态（64%）。WIC 参与者、WIC 有资格但未参与的人和收入不合格的女性的总 HEI-2015 得分分别为 52.7（95%置信区间 [CI]：50.6，54.8）、54.2（95% CI：51.6，56.7）和 55.0（95% CI：51.8，58.2）。各组之间的总分和大多数分量得分均无差异。收入不合格的女性的脂肪分数（5.7；95% CI：5.0，6.4）优于 WIC 参与者（4.7；95% CI：4.1，5.3；P<0.05）。WIC 有资格但未参与的女性的精制谷物分数（6.0；95% CI：5.3，6.6）优于 WIC 参与者（5.0；95% CI：4.4，5.6；P<0.05）。
WIC 和收入组之间的总体饮食质量相似。与 WIC 有资格但未参与的非参与者相比，WIC 参与者的 HEI-2015 分量得分较低，这值得进一步探讨。需要评估 WIC 对产妇饮食质量的影响的研究，以确保继续支持低收入妇女的健康。
