[Federal Register: September 15, 2003 (Volume 68, Number 178)]
[Proposed Rules]
[Page 53903-53910]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr15se03-12]
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[[Page 53903]]
DEPARTMENT OF AGRICULTURE
Food and Nutrition Service
7 CFR Part 246
RIN 0584-AD39
Special Supplemental Nutrition Program for Women, Infants and
Children (WIC): Revisions to the WIC Food Packages
AGENCY: Food and Nutrition Service (FNS), USDA.
ACTION: Advanced notice of proposed rulemaking.
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SUMMARY: The WIC Program provides supplemental food packages designed
to provide specific nutrients critical to growth and development. WIC
food packages and nutrition education are the chief means by which WIC
affects the dietary quality and habits of participants. WIC food
packages were designed to supplement participants' diets with
nutritionally dense foods that prevent iron-deficiency anemia;
complement the eating patterns of pre-school children; and address the
special nutrition requirements of pregnant and breastfeeding women. The
WIC food packages were last revised in 1980. While WIC has been
successful in many areas, obesity and inappropriate dietary patterns
have become significant concerns for many in WIC's target population.
In this Notice, the Department is soliciting public comments on
redesigning the food packages offered through the WIC Program to
determine if the WIC food packages should be revised to better improve
the nutritional intake, health and development of participants; and, if
so, what specific changes should be made to the food packages. The
Department plans to enlist independent technical experts via the
Institute of Medicine's Food and Nutrition Board to review available
science and comments submitted in response to this Notice and to
develop recommendations on revising the WIC food packages for the
Department's consideration. The Department will use comments received
through the Notice and the Food and Nutrition Board recommendations to
develop a proposed rule.
DATES: To be assured of consideration, comments must be postmarked on
or before December 15, 2003.
ADDRESSES: Comments should be sent to Patricia Daniels, Director,
Supplemental Food Programs Division, Food and Nutrition Service, USDA,
3101 Park Center Drive, Room 520, Alexandria, Virginia 22302. Comments
on this Notice should be clearly labeled ``Revisions to the WIC Food
Packages.'' Comments which are not within the scope of this Notice
should not be included. All written comments will be available for
public inspection during regular business hours (8:30 a.m. to 5 p.m.,
Monday through Friday) at the above address.
FOR FURTHER INFORMATION CONTACT: Debra Whitford, Branch Chief, Policy
and Program Development Branch, Supplemental Food Programs Division, at
the address indicated in the ADDRESS section or at (703) 305-2746
during regular business hours (8:30 a.m. to 5 p.m.), Monday through
Friday.
SUPPLEMENTARY INFORMATION:
I. Procedural Matters
Executive Order 12866
This action has been determined to be significant and was reviewed
by the Office of Management and Budget under Executive Order 12866.
Paperwork Reduction Act of 1995
This action does not contain reporting or record keeping
requirements subject to approval by the Office of Management and Budget
in accordance with the Paperwork Reduction Act of 1995 (44 U.S.C.
3507).
Executive Order 12372
This program is listed in the Catalog of Federal Domestic
Assistance Programs under No. 10.570, and is subject to the provisions
of Executive Order 12372, which requires intergovernmental consultation
with State and local officials (7 CFR part 3015, subpart V, and final
rule-related notices published at 48 FR 29114, June 24, 1983, and 49 FR
22676, May 31, 1984).
Civil Rights Impact Analysis
FNS has reviewed this action in accordance with the Department
Regulation 4300-4, ``Civil Rights Impact Analysis,'' to identify and
address any major civil rights impact this Notice might have on
minorities, women, and persons with disabilities. FNS has determined
that this action presents no civil rights impact on minorities and
other protected classes, nor does it present any barrier to program
access or participation. With this action the Department is soliciting
comments from the public on redesigning the WIC food packages to better
meet the needs of WIC's diverse participants.
Federalism Summary Impact Statement
Executive Order 13132 requires Federal agencies to consider the
impact of their regulatory actions on State and local governments.
Where such actions have federalism implications, agencies are directed
to provide a statement describing the agency's considerations called
for under section (6)(b)(2)(B) of Executive Order 13132.
Prior Consultation With State Officials
Over the years the Department has received numerous requests from
WIC State agencies and participants to modify the current food packages
to permit greater substitution of foods or introduction of additional
foods. These requests have come from formal and informal discussions
and with State and local officials on an ongoing basis regarding
program implementation and food package policy issues, and from written
proposals submitted to FNS by WIC State agencies to allow modifications
and/or substitutions to the WIC food packages.
Need To Issue This Notice
Through this Notice, the Department is soliciting public comments
on redesigning the food packages offered through the WIC Program to
determine if the WIC food packages should be revised to better meet the
nutritional needs of participants and, if so, what specific changes
should be made to the food packages. The Department believes that
public comment is necessary to inform decisions and to bolster the
scientific and programmatic integrity of any rule that is proposed as a
result of this process.
[[Page 53904]]
Executive Order 12998
This action has been reviewed under Executive Order 12998, Civil
Justice Reform. This action is not intended to have preemptive effect
with respect to any State or local laws, regulations or policies that
conflict with its provisions or that would otherwise impede its full
implementation.
II. References
(1) Study of WIC Participant and Program Characteristics, 2000.
Available at Internet site: http://www.fns.usda.gov/oane/MENU/Published/WIC/WIC.HTM <http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log=linklog&to=http://www.fns.usda.gov/oane/MENU/Published/WIC/WIC.HTM>
.
(2) Review of the Nutritional Status of WIC Participants (CNPP),
December 1999. Available at Internet site: http://www.usda.gov/cnpp/Pubs/Wic/ <http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log=linklog&to=http://www.usda.gov/cnpp/Pubs/Wic/>
(3) Nutrition and Your Health: Dietary Guidelines for Americans,
Fifth Edition, USDA and U.S. Department of Health and Human Services,
Washington, DC, 2000. Available at Internet site: http://www.usda.gov/cnpp/Pubs/DG2000/ <http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log=linklog&to=http://www.usda.gov/cnpp/Pubs/DG2000/>
(4) WIC and the Nutrient Intake of Children (ERS), Food Assistance
and Nutrition Research Report No. FANRR5, April 2000. Available at
Internet site: http://www.ers.usda.gov/publications/fanrr5/ <http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log=linklog&to=http://www.ers.usda.gov/publications/fanrr5/>
(5) Institute of Medicine. Dietary Reference Intakes. Panel on
Macronutrients (Energy, Carbohydrate, Fiber, Fat, Fatty Acids,
Cholesterol, Protein, and Amino Acids (September 5, 2002, 936 pp.))
(6) Institute of Medicine. Dietary Reference Intakes. Panel on
Micronutrients (Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper,
Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and
Zinc (2002, 800 pp.))
(7) Institute of Medicine. Dietary Reference Intakes. Standing
Committee on the Scientific Evaluation of Dietary Reference Intakes
(Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (1997, 448
pp.))
(8) Institute of Medicine. Dietary Reference Intakes. Dietary
Antioxidants and Related Compounds (Vitamin C, Vitamin E, Selenium, and
Carotenoids (2000, 529 pp.))
(9) Institute of Medicine. Dietary Reference Intakes. Panel on
Folate, Other B Vitamins, and Choline (Thiamin, Riboflavin, Niacin,
Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline
(2000, 592 pp.))
(10) WIC Program Regulations Pertaining to Supplemental Food [7 CFR
246.10] available at Internet site: http://www.fns.usda.gov/wic/PDFfiles/WICRegulations-7CFR246.pdf <http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log=linklog&to=http://www.fns.usda.gov/wic/PDFfiles/WICRegulations-7CFR246.pdf>
(11) FNS Instruction 804-1 ``WIC Program--Food Package Design:
Administrative Adjustments and Nutrition Tailoring.''
(12) Standard reference values for nutrients in foods are available
from USDA, Agricultural Research Service, Nutrient Data Bank, http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl <http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log=linklog&to=http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl>
III. General Background
Since the creation of the WIC Program in the 1970's, and the last
revision of the WIC food packages in the early 1980's, much has been
learned about the nutritional needs of pregnant women, infants, and
preschool aged children. In recent years the ability of the WIC Program
to meet nutritional needs of WIC participants through its food packages
and nutrition education has received growing attention. Significant
interest in updating the food packages based on new information about
the needs of low-income women, infants, and children has been voiced by
WIC Program administrators, the medical and scientific communities,
advocacy groups, and Congress.
Authorizing legislation requires that the supplemental foods
provided by WIC contain nutrients known to be lacking in the diets of
the target population [see the Child Nutrition Act, as amended (CNA),
section 17(b)(14), (42 U.S.C. 1786)]. Indeed, because of the WIC
Program and the larger nutrition safety net, progress has been made in
filling many of these nutrient gaps. However, nutritional science and
the Dietary Guidelines for Americans have evolved, and the overall
nutritional needs and consumption patterns of WIC's target population
have changed. The Department acknowledges the continuing advances in
nutritional research since the current food packages were established
in 1980. Recommended dietary practices are constantly evolving in
response to new knowledge and may hold significant implications for the
WIC Program. Food technology has also advanced substantially, resulting
in a large number of new products.
With this Notice, the Department is seeking guidance on issues/
questions concerning revisions to the WIC food packages that would
address the nutritional needs of the WIC population given current
scientific information and consumption patterns. The food package
recommendations should not increase the cost or administrative burden
to the WIC Program nor change the supplemental nature of the Program.
Any modifications to the WIC food packages should be based on
scientific evidence.
IV. Program Background
The authorizing legislation for the WIC Program, section 17 of the
CNA established the WIC Program to provide supplemental foods and
nutrition education to low income pregnant, breastfeeding, and
postpartum women, infants, and children up to age 5 who are at
nutritional risk. Nutritional risk is determined by a competent
professional authority and includes conditions such as inadequate
weight gain during pregnancy; history of inappropriate growth patterns
in infants and children; anemia; and inadequate dietary patterns.
Sections 17(a) and (b)(14) of the CNA (42 U.S.C. 1786(a) and
(b)(14)) clearly established the WIC Program as ``supplemental'' in
nature; that is, the WIC supplemental foods are not intended to provide
a complete diet but are designed to provide specific nutrients
determined by nutritional research to be lacking in the diets of the
WIC population. WIC was never intended to be a primary source of food,
nor of general food assistance. Rather, WIC benefits are intended to
meet the special nutritional needs of a very specific population. In
addition to WIC, the Department administers a variety of other
complementary nutrition assistance programs that work together to
provide a more complete diet to low-income persons. Low-income families
can, and frequently do, receive benefits from more than one of these
programs. The largest of these programs, the Food Stamp Program,
provides general food assistance intended to increase the food buying
power of low-income households.
In addition to food assistance, WIC provides nutrition education,
including breastfeeding promotion and support, and information about
the dangers of alcohol, tobacco and other drug use to participants. The
nutrition education provided by WIC enables participants to make
informed decisions in choosing foods that, together with the
supplemental foods contained in the WIC food packages, can meet their
total dietary needs. The intent is to help participants to continue
healthful dietary practices after leaving the Program.
WIC is a unique nutrition assistance program in that it also serves
as an adjunct to good health care during critical times of growth and
development to prevent the occurrence of health problems and to improve
the health status of Program participants. Numerous studies have shown
that WIC
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is cost effective and successful in improving the health and
nutritional status of its clients.
For example, WIC has played an important role in improving birth
outcomes and containing health care costs.1,2 A series of
reports published by USDA based on linked 1988 WIC and Medicaid data on
over 100,000 births found that Medicaid eligible pregnant women in 5
States who participated in WIC during their pregnancies had:
[sbull] Longer pregnancies;
[sbull] Fewer premature births;
[sbull] Lower incidence of moderately low and very low birth weight
infants; 3
[sbull] Fewer infant deaths;
[sbull] A greater likelihood of receiving prenatal care; and
[sbull] Savings in health care costs from $1.77 to $3.13 for each
dollar spent on WIC.4,5,6
Studies have also found WIC to have a positive effect on children's
diet and diet-related outcomes such as:
[sbull] Higher mean intakes of iron, vitamin C, thiamin, niacin and
vitamin B6, without an increase in food energy intake, indicating an
increase in the nutrient density of the diet; 7
[sbull] Positive effects on the intakes of ten nutrients without an
adverse effect on fat or cholesterol; 8
[sbull] More effective than other cash income or food stamps at
improving preschoolers' intake of key nutrients; 8 and
[sbull] Decline in the rate of iron deficiency anemia from 7.8
percent in 1975 to 2.9 percent in 1985 which the Centers for Disease
Control and Prevention attributed to both a general improvement in iron
nutrition and participation in WIC and other public nutrition
programs.2,9
However, a comprehensive evaluation of the WIC program has not been
completed in over 15 years.
References
1. Gordon, Anne; and Lyle Nelson. Characteristics and Outcomes
of WIC Participants and Nonparticipants: Analysis of the 1988
National Maternal and Infant Health Survey. Alexandria, Virginia:
U.S. Department of Agriculture, March 1995.
2. 7. U.S. General Accounting Office, ``Early Intervention:
Federal Investments Like WIC Can Produce Savings,'' Document HRD 92-
18, Washington, DC, April 1992.
3. Kowaleski-Jones, L. and GJ Duncan. Effects of Participation
in the WIC Program on Birth Weight: Evidence from the National
Longitudinal Survey of Youth. American Journal of Public Health Vol
92: 799-804. May 2002.
4. Devaney, Barbara, Linda T. Bilheimer, and Jennifer Schore.
The Savings in Medicaid Costs for Newborns and Their Mothers from
Prenatal Participation in the WIC Program. Alexandria, Virginia:
U.S. Department of Agriculture, October 1990.
5. Devaney, Barbara. Very Low Birthweight Among Medicaid
Newborns in Five States: The Effects of Prenatal WIC Participation.
Alexandria, Virginia: U.S. Department of Agriculture, September 1992
6. Devaney, Barbara, and Allen Schirm. Infant Mortality Among
Medicaid Newborns in Five States: The Effects of Prenatal WIC
Participation. Alexandria, Virginia: U.S. Department of Agriculture,
May 1993.
7. U.S. Department of Agriculture Food and Nutrition Service.
The National WIC Evaluation: An Evaluation of the Special
Supplemental Food Program for Women, Infants, and Children. Vol. 1:
Summary. Alexandria, Virginia: U.S. Department Agriculture, 1987.
8. Rose, D., Habicht, J-P., and Devaney, B.: ``Household
Participation in the Food Stamp and WIC Programs Increases the
Nutrient Intakes of Preschool Children,'' Journal of Nutrition,
128:548-555, March 1998.
9. Oliveira, Victor, Elizabeth Racine, Jennifer Olmsted and
Linda M. Ghelfi. The WIC Program: Background, Trends, and Issues.
Alexandria, Virginia: U.S. Department of Agriculture, September
2000.
V. History and Development of WIC Food Packages
Early legislation for the WIC Program, Public Law 92-433 (1972)
through Public Law 94-105 (1975), specifically identified protein,
iron, calcium and Vitamins A and C as nutrients of particular concern
for WIC participants. However, Public Law 95-627, enacted in November
1976, deleted the reference to these nutrients. Instead, it defined
supplemental foods as those foods containing nutrients determined by
nutritional research to be lacking in the diets of pregnant,
breastfeeding and postpartum women, infants, and children, as
prescribed by the Secretary of Agriculture. The Program direction
announced by that law remains in effect today (section 17(b)(14) of the
CNA, 42 U.S.C. 1786(b)(14)). The law also directs the Secretary in
section 17(f)(11) of the CNA (42 U.S.C. 1786(f)(11)) to assure that, to
the degree possible, the fat, sugar, and salt content of WIC foods is
appropriate.
The law provides substantial latitude to the Department in
designing WIC food to supply nutrients lacking in the diets of the WIC
eligible population. Historically, the Department has based its
prescriptions of WIC foods on sound nutritional research and input from
State and local agencies, the health and scientific communities,
industry and the general public.
In anticipation of the passage of Public Law 95-627, the
Department, in October 1978, assembled a WIC Food Package Advisory
Panel composed of State health officials, representatives of the
nutrition community and advocacy groups, to review the original food
packages and recommend changes. Panel recommendations included
retaining high-quality protein, iron, calcium, and vitamins A and C as
the targeted nutrients in the WIC Program and expanding the number of
available packages. Based on the Panel's recommendations and an
evaluation by the Department of the available nutrition research on the
nutrient, fat, sugar and salt content of the WIC foods, the Department
proposed retaining high-quality protein, iron, calcium, and vitamins A
and C as the targeted nutrients in the WIC Program and expanding the
number of available packages in 1979 (44 FR 69254-69270, November 30,
1979). Based on public response to proposed rules in 1979, new WIC food
package regulations were published in 1980 (45 FR 74854, November 12,
1980) that are consistent with Public Law 95-627.
These food package requirements appear in 7 CFR 246.10 of the WIC
Program regulations. The 1980 rule established six different monthly
packages: Food Package I for infants 0-3 months; Food Package II for
infants 4-12 months; Food Package III for children and women with
special dietary needs; Food Package IV for children 1-5 years of age;
Food Package V for pregnant and breastfeeding women; and Food Package
VI for nonbreastfeeding postpartum women. The Department created an
additional food package in 1992 (57 FR 56231, November 27, 1992). This
enhanced food package, Food Package VII, is designed for breastfeeding
women who elect not to receive infant formula through WIC for their
infants.
Authorized WIC foods include iron-fortified infant formula, iron-
fortified cereals, vitamin C-rich 100 percent fruit and/or vegetable
juice, calcium/protein-rich milk and cheese, protein/iron-rich eggs,
protein-rich peanut butter or dried beans/peas, and physician-
prescribed formula/medical foods for participants with certain special
dietary needs. The enhanced package for breastfeeding women increases
allowable amounts of juice, cheese, peanut butter and dry beans/peas,
and also allows protein-rich tuna fish and carrots that provide beta-
carotene (precursor to vitamin A) and dietary fiber. All WIC foods are
nutrient dense, economical, administratively manageable for WIC State
agencies; readily available in retail stores; offer variety and
versatility; have broad appeal; and generally can be apportioned into
daily servings.
VI. Recent Science and National Dietary Guidance
During the last decade, science has provided new information on the
[[Page 53906]]
nutritional needs of Americans, including WIC's target population. As
discussed previously, the WIC Program has focused historically on
supplying participants with protein and four important micronutrients:
Vitamins A and C, calcium, and iron. More recently nutrition research
has identified other micronutrients of potential concern, such as folic
acid, zinc, vitamin B6 and magnesium. In addition, dietary causes of
chronic disease have been more clearly identified. The 2000 Dietary
Guidelines for Americans provide advice, based on current scientific
and medical knowledge, for healthy Americans ages 2 years and over
about food choices that promote health and prevent disease. New Dietary
Reference Intakes (DRI's) have recently been established by the
Institute of Medicine, Food and Nutrition Board as guidelines for
nutrient intake in the U.S. population. The next update of the Dietary
Guidelines for Americans, to be completed in 2005, will reflect the new
DRI's.
VII. Nutrition Risk and Demographic Changes in WIC's Population
WIC applicants must be determined to be at nutritional risk to meet
eligibility requirements for the WIC Program. Nutrition risk means
nutritionally-related medical conditions (e.g., anemia, inappropriate
growth or weight gain pattern) or dietary deficiencies (e.g.,
inadequate or inappropriate nutrient intake) that impair or endanger
health. According to the WIC Participant and Program Characteristics
2000 report, 56.3% of WIC participants are identified as having a
dietary deficiency.
Obesity has become one of the most serious health problems in the
United States, with direct implications for the health of WIC program
participants. The National Center for Health Statistics revised growth
charts, when used with WIC data from 1992 to 1998, show that overweight
prevalence among children enrolled in WIC increased 20 percent over
this 6-year period. Data from the early 1990s indicated that the
prevalence of overweight in WIC children is similar to that of non-WIC
children. WIC program data show that a majority of overweight WIC
children have nutritional risks in addition to being overweight, i.e.,
inadequate or inappropriate nutrient intake, anemia. A challenge facing
the WIC program is to determine how it can most successfully improve
the eating habits of low-income children.
The ethnic composition of the WIC Program has been changing
steadily since 1992; the percentage of Hispanic enrollees has risen,
while percentages of black and white (non-Hispanic) enrollees have
decreased. The current racial/ethnic enrollment is: 37.4 percent White,
35.3 percent Hispanic, 21.9 percent Black, 3.3 percent Asian or Pacific
Islanders, and 1.4 percent American Indian or Alaskan Natives. Low-
income populations, including WIC participants, are faced with numerous
barriers to good nutrition and to nutrition assistance. For populations
of different cultures, especially those who have recently arrived in
the United States and who lack orientation to service delivery here,
the barriers to assistance can be of such magnitude as to adversely
affect their health and well-being. To achieve the best overall
outcomes the WIC community must give special consideration to its
approach in delivering culturally appropriate, quality benefits to
these growing subpopulations.
VIII. Requests for Revisions to the WIC Food Packages
Over the years the Department has received numerous requests from
WIC State agencies and participants to modify the current food packages
to permit greater substitution of foods or introduction of additional
foods. Requests for revisions to the WIC food packages have also been
received from Congress and other organizations with interests in the
welfare of WIC participants. The focus of suggested changes is on
improving outcomes for WIC recipients. For example:
[sbull] Congress has requested a WIC food package rule that
includes fruits and vegetables and that allows for cultural food
accommodations.
[sbull] The National Advisory Council on Maternal, Infant, and
Fetal Nutrition, in its 1992, 1996 and 2002 Reports to Congress,
recommended better accommodation of the nutritional and cultural needs
of WIC participants.
[sbull] In 1999, the National WIC Association (then the National
Association of WIC Directors (NAWD)) published a position paper
entitled ``NAWD WIC Food Prescription Recommendations.'' NAWD made
three recommendations designed to reframe the WIC food packages and one
recommendation on research and policy analysis in support of the WIC
food packages. Consistency with the Dietary Guidelines for Americans
and allowing flexibility to provide culturally appropriate foods were
among the recommendations.
[sbull] In an April 30, 2002, statement entitled ``Reauthorization
of USDA Child Nutrition and WIC Programs,'' the American Dietetic
Association recommended that WIC food packages be flexible to address
cultural food practices and choices and participants' nutrition needs,
consistent with national guidelines.
The Department wishes to consider these and other requests and in
this notice solicits affordable, scientifically-based recommendations
as well as other suggestions from the public for revisions to the WIC
food packages that will improve the nutritional intake, health and
development of participants.
IX. Design of the WIC Food Packages
The seven current WIC food packages were designed to help
accomplish the following: Supplement participants' diets with
nutritionally dense foods that follow current medical and nutritional
guidance; complement the eating patterns of preschool children; and
address the special requirements of pregnant and breastfeeding women.
The WIC food packages were initially designed and adopted with regard
to a set of fundamental considerations. These considerations should be
taken into account when commenting on the issues presented in this
Notice. The factors to be considered are discussed below.
1. Nutritional Risk
The provision of supplemental foods containing nutrients determined
by research to be lacking in the diets of the WIC population is the
cornerstone of the Program. Nutrient requirements are particularly high
during times of rapid growth, development and replenishment. Therefore,
the WIC population, composed of pregnant, breastfeeding and postpartum
women, infants and children, represents individuals whose nutritional
needs are among the highest and most critical for optimal growth and
development. Ensuring optimal nutrient intakes during these vulnerable
periods of life is paramount to prevent both immediate and long-term
adverse health outcomes. Consequently, recommendations should reflect
current nutritional science and assure that the various packages
supplement the nutrition needs of WIC's at-risk population with
nutrient-dense economical foods the recipients should be encouraged to
acquire and/or continue to acquire with their own resources.
WIC foods should make a significant nutritional contribution to the
diets and health of Program participants. Current nutritional science
may reveal changing nutritional needs, and evolving needs in the
population suggesting changes to the food packages. Addressing the
nutritional needs is imperative if WIC is to remain an effective
health-related
[[Page 53907]]
program. Congressional intent as evidenced both in statutory and
legislative report language has continually emphasized that the WIC
should provide foods and nutrients that current research demonstrates
are lacking in the diets of WIC participants [Senate Report 106-288,
Senate Report 107-41, Section 17(b)(14) of the CNA, 42 U.S.C.
1786(b)(14)]. However, WIC's success in providing important nutrients
should not lead to the conclusion that WIC should no longer provide
them. Accordingly, changes to the food package should weigh the risk
and consequences of dietary inadequacy and make changes expected to
maximize the positive outcomes on WIC recipient nutritional status,
health and development.
2. Fat, Sugar, and Salt Content
As discussed previously, consideration of the fat, sugar and salt
content of foods in the WIC food packages is required by section
17(f)(11) of the CNA. Several changes made to the WIC food packages in
the 1980 rulemaking responded specifically to this mandate. For
example, the Department established a limit on the amount of sugar
allowable in WIC approved cereals. By regulation, WIC cereals per dry
ounce must contain no more than 6 grams of sugar. This specification
applies to added sugars and to those naturally occurring in ingredients
such as dried fruits used in the cereal.
FNS policy guidance permits WIC State agencies to issue low-fat,
low-cholesterol and low-sodium forms of WIC cheeses, as well as low-
fat, nonfat and lactose-free milks. The Department encourages local
program administrators to tailor the WIC food packages to meet the
individual nutritional needs of participants and, when appropriate, to
adjust the types of WIC foods prescribed to help reduce the amount of
fat, cholesterol, sodium and sugar the WIC food packages contribute to
the diet. Through WIC nutrition education, participants also receive
advice on how to further moderate their intakes of fat, cholesterol,
sodium and sugar and how to include adequate amounts of vegetables,
fruits and whole grain products in their diets.
3. Cost
In addition to the criteria specified in legislation, a prime
consideration in the design of the WIC food packages is cost.
Efficiency in providing supplemental foods is important because
increases in the total cost of the food packages reduce the number of
participants served by the program. The packages are designed to
encourage further cost control by permitting State and local agencies
the flexibility to specify lower cost food brands, forms of foods,
types and container sizes within regulatory parameters.
4. Practicality and Administrative Feasibility
In addition to meeting nutritional objectives, all WIC food
packages are designed to address a number of practical considerations
that reflect participant and Program needs. For example, the WIC foods
are readily available in retail food stores, offer variety and
versatility to participants in the ways these foods can be used in an
overall diet, are nutrient-dense, can be easily divisible into servings
on a daily basis, and have broad appeal. Additionally, all WIC food
packages are individual food prescriptions which, in order to have the
full effect in improving a participant's nutritional status, are
intended to be consumed only by the participant and not by other family
members.
The packages should be administratively manageable for State and
local agencies and vendors. That is, they should be clearly describable
and easily understood by both participants and vendors. WIC food
packages are designed to strike a balance between acceptable, nutrient
dense, readily available, low-cost food items, and administrative
feasibility. This means that although there are certainly some foods
that would be particularly beneficial for and appealing to WIC
participants, the WIC Program is not always capable, within the
limitations of its current structure, of easily delivering such foods.
Also, WIC is limited in its ability to offer a wide range of food
options since, from a management standpoint, each food option added to
the food package magnifies the difficulties and increases the cost of
program management and accountability. These practical considerations
are necessarily a key consideration in the design of WIC food packages.
5. Food Package Flexibility and Meeting Participants' Special Needs
Food package flexibility regarding the quantities of foods provided
by WIC food packages and participants' cultural eating patterns and
nutritional needs are considerations in the design of the food
packages. State and local agencies can tailor the quantities of foods
provided by the food packages to better meet participants' special
nutritional needs. Additionally, they are permitted flexibility in
designing their food packages within the parameters of Program
regulations. Commenters should be aware that the quantities in all WIC
food packages are expressed as maximum levels. However, State and local
agencies have the authority to tailor quantities according to the needs
of individual participants or categories of participants when based on
a sound nutritional rationale. These tailoring provisions established
in Program regulations (7 CFR 246.10) and supplemented by FNS
Instruction 804-1 ``WIC Program--Food Package Design: Administrative
Adjustments and Nutrition Tailoring,'' are designed to permit State and
local agencies to implement their own nutrition policies and
philosophies within the parameters of food package requirements.
X. Review Considerations/Parameters
The principles outlined above (and discussed elsewhere in this
Notice) constitute a framework upon which WIC food packages have been
developed. The Department encourages commenters to present their
recommendations in the context of their potential effects on the
recipients that receive the affected food package(s) and their
responsiveness to these principles or to alternate principles which the
commenter believes should be considered. Further, comments ideally
should include justification in terms of current nutritional research.
Responses to this notice should be developed with serious regard to
the dietary needs of the WIC-eligible population, the supplemental
nature of the program, the critical impact of the cost of program
services, and the need to maximize the overall effect of the Program
for WIC recipients. In addition, the Department encourages commenters
to submit suggestions with the following considerations in mind: (1)
Cultural and ethnic food preferences; (2) commercial availability,
variety and appeal of foods; (3) versatility in food preparation; (4)
feasibility of apportionment into daily servings for an individual over
a month's time; (5) State and local agency flexibility to design the
food prescription; (6) administrative feasibility and manageability by
the State and local agencies and vendors; and (7) burden and incentive
for participants, potential participants, and their families.
The following charts provide an overview of the foods currently
offered in the food packages, including allowable substitutions,
minimum Federal requirements and data on key nutrients in a selection
of WIC-type foods. The charts may be helpful when commenting on issues
such as the
[[Page 53908]]
amount of food provided by, or the allowable substitutions for, the
current foods or nutrients provided in the WIC food packages.
Chart 1.--WIC Food Packages
[Maximum monthly allowance]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Pregnant & Nonbreastfeeding
Children/women with breastfeeding women postpartum women (up Breastfeeding women
Foods Infants 0-3 mo. Infants 4-12 mos. special dietary needs Children 1-5 yrs. (up to 1 yr. to 6 mos. enhanced package 1
postpartum) postpartum)
(I) (II) (III) (IV) (V) (VI) (VII)
----------------------------------
Infant Formula (concentrated 403 fl. oz. 403 fl. oz. 403 fl. oz.\3\ ..................... .....................
liquid) \2\.
Juice (reconstituted frozen) \4\. ..................... 96 fl. oz.\5\ 144 fl. oz. 288 fl. oz. 288 fl. oz. 192 fl. oz. 336 fl. oz.
Infant Cereal.................... ..................... 24 oz. ..................... ..................... ..................... .................... ....................
Cereal (hot or cold)............. ..................... ..................... 36 oz. 36 oz. 36 oz. 36 oz. 36 oz.
Milk \6\ (whole, low-or fat free; ..................... ..................... ..................... 24 qt. 28 qt. 24 qt. 28 qt.
or lactose free).
Cheese \7\....................... ..................... ..................... ..................... ..................... ..................... .................... 1 lb.
Eggs \8\......................... ..................... ..................... ..................... 2\1/2\ doz. 2\1/2\ doz. 2\1/2\ doz. 2\1/2\ doz.
Dried Beans/Peas and/or Peanut ..................... ..................... ..................... 1 lb. or 18 oz. 1 lb. or 18 oz. .................... 1 lb. and 18 oz.
butter.
Tuna (canned).................... ..................... ..................... ..................... ..................... ..................... .................... 26 oz.
Carrots (fresh) \9\.............. ..................... ..................... ..................... ..................... ..................... .................... 2 lbs.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Available to breastfeeding women whose infants do not receive infant formula from WIC.
\2\ 8 pounds powdered per 403 fluid ounces concentrate; or 26 fluid ounces ready-to-feed per 13 ounces concentrate may be substituted.
\3\ Additional formula available up to 52 fluid ounces concentrate, 1 pound powder, or 104 fluid ounces ready-to-feed.
\4\ 92 fluid ounces single strength juice may be substituted per 96 fluid ounces reconstituted frozen.
\5\ Infant juice may be substituted at the rate of 63 fluid ounces per 92 fluid ounces of single strength juice.
\6\ Fat free, low-fat, and full fat milk are allowed, as are lactose free and low-lactose milks. Goat's milk is also allowed.
\7\ Cheese may be substituted at a rate of 1 pound per 3 quarts of fluid milk with a 4 pound maximum.
\8\ Dried egg mix can be substituted at a rate of 1.5 pounds per 2 dozen fresh eggs, or 2 pounds per 2\1/2\ dozen fresh eggs.
\9\ Frozen carrots may be substituted pound for pound; canned maybe substituted at a rate of 16-20 ounces per 1 pound fresh.
Chart 2.--WIC Food Packages
[Minimum requirements and allowable foods]
----------------------------------------------------------------------------------------------------------------
Minimum requirements and
General Foods Nutrients allowable foods
----------------------------------------------------------------------------------------------------------------
Milk........................................ Calcium........................... Cow's milk, must conform to 21
CFR part 131 FDA standard of
identity or Goat's milk:
pasteurized fluid whole milk,
lowfat, reduced fat, skim,
fat free or nonfat milk, that
contains 400 International
Units of vitamin D per quart
(or reconstituted fluid quart
for evaporated and dry/
powdered milks); and 2000
International Units of
vitamin A per quart (or
reconstituted quart for
evaporated and dry/powdered
milks) if the milk is lowfat,
reduced fat, skim, fat free
or nonfat milk.
Cheese...................................... Calcium........................... Domestic cheese (pasteurized
processed American, Monterey
Jack, Colby, Cheddar, Swiss,
Brick, Muenster, Provolone,
Mozzarella part-skim or
whole; or a cheese that is a
blend of any of these
cheeses). These same types of
cheeses labeled low, free,
reduced, less, or light in
the nutrients of sodium, or
fat, or cholesterol are also
authorized.
Eggs........................................ Protein........................... Fresh shell domestic hens'
eggs or dried egg mix made
from shell, liquid, whole
eggs that have been
pasteurized and dried.
Beans....................................... Protein........................... Mature dry beans or peas,
including but not limited to:
lentils; black, navy, kidney,
garbanzo, soy, pinto, and
mung beans; and Crowder, cow,
split and black-eye peas.
Peanut Butter............................... Protein........................... Creamy or chunky, regular or
reduced fat and conforms to
FDA, Standard of Identity for
peanut butter as defined by
21 CFR Sec. 164.150.
Cereal...................................... Iron.............................. Includes ready-to-eat and
instant and regular hot
cereals as defined by FDA (21
CFR Part 170.3(n)(4)) that
also contain a minimum of 28
milligrams of iron per 100
grams of dry cereal and not
more than 21.2 grams of
sucrose and other sugars per
100 grams of dry cereal (6
grams per dry ounce).
Infant Cereal............................... Iron.............................. Contains a minimum of 45
milligrams of iron per 100
grams of dry cereal. Infant
cereals containing infant
formula, milk, fruit, or
other non-cereal ingredients
are not authorized.
Juice....................................... Vitamin C......................... Must be pasteurized 100
percent fruit and/or
vegetable juice or blends of
these juices and contain a
minimum of 30 milligrams of
vitamin C per 100 milliliters
juice. Juices fortified with
other nutrients that also
meet the minimum WIC
requirements are allowable.
Infant Juice................................ Vitamin C......................... Must be pasteurized 100
percent fruit juice and
contain a minimum of 30
milligrams of vitamin C per
100 milliliters juice.
Carrots..................................... Vitamin A......................... Raw, canned or frozen. Mature
raw; canned and frozen
carrots containing only the
mature root of the carrot
plant packed in water.
Tuna........................................ Protein........................... Canned white, light, dark or
blended tuna packed in water
or oil, including solid and
solid pack; chunk, chunks and
chunk style; flake and
flakes; and grated.
[[Page 53909]]
Infant Formula.............................. Iron.............................. All authorized infant formulas
must meet the definition and
requirements for an infant
formula established by FDA,
DHHS; citations section
201(z) Federal Food Drug and
Cosmetic Act (21 U.S.C.
321(z)) and requirements
under section 412 of 21
U.S.C. 350a and regulations
at 21 CFR parts 106 and 107.
Designed for enteral
digestion via an oral or tube
feeding. Iron fortification
level must be 10 milligrams
per liter.
Exempt Infant Formula....................... .................................. Infant formulas must meet the
requirements for an exempt
infant formula under section
412(h) of the Federal Food,
Drug, and Cosmetic Act (21
U.S.C. 350 a(h)) and the
regulations at 21 CFR parts
106 and 107.
Medical Foods............................... .................................. Certain enteral products that
are specifically formulated
to provide nutritional
support for individuals with
a diagnosed medical
condition, when the use of
conventional foods is
precluded, restricted or
inadequate.
----------------------------------------------------------------------------------------------------------------
Chart 3.--Nutritional Content of Current Food Packages--Nutrients Provided per Day
[Nutrient yields for entire package, assuming selection of whole milk and legumes. A number of dairy and other options are typically available.]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Energy Protein Fiber Sat Chol. Folate B12 Iron Zinc
Current WIC food packages Kcal g g Fat g Fat g mg E AE A RE B6 mg [mu]g [mu]g C mg Ca mg Mag mg mg mg
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Children--Package IV........................................... 853 42.5 5.4 32.3 18.0 319 1.9 840 1.3 264 5.1 106 1,058 217 13.4 6.0
Pregnant and Breastfeeding Women--Package V.................... 933 46.8 5.4 36.7 20.7 336 2.0 880 1.3 270 5.6 107 1,214 234 13.5 6.5
Postpartum Women--Package VI................................... 763 38.4 2.9 32.1 17.9 319 1.7 822 1.2 217 5.1 73 1,018 184 11.7 5.5
Breastfeeding Women--Package VII............................... 1,119 61.3 8.6 43.2 23.8 353 2.7 1,782 1.5 315 6.2 126 1,356 279 15.6 7.8
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Notes.--Nutrients analyzed, in order of appearance: Energy, Protein, Dietary Fiber, Total Fat, Saturated Fat, Cholesterol, Vitamin E, Vitamin A, Vitamin B6, Folate, Vitamin B12, Vitamin C,
Calcium, Magnesium, Iron and Zinc. All packages assume single strength orange juice for juice, Post Oat Flakes for cereal, Great Northern Beans for legumes, American cheese for cheese, and
whole milk. Daily nutritional values are derived through dividing monthly WIC allotments by 30 days.
Chart 4.--Some Key Nutrients in a Selection of WIC-Type Foods
[Data from USDA, Agricultural Research Service, Nutrient Data Bank, http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl <http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log=linklog&to=http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl>]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Sat
Food item Serving size Energy Protein Fiber Fat fat Chol E AE A RE B6 mg Folate B12 C mg Ca mg Mag Iron Zinc
kcal mg mg mg mg mg mg mg mg mg mg
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Dairy:
Milk, 3.5 to 3.8% fat...................... 1 cup 150 8.0 0.0 8.1 5.1 33 0.2 76 0.1 12 0.9 2 291 33 0.1 0.9
Milk, 3.5 to 3.8% fat, calcium fort........ 1 cup 151 8.1 0.0 8.2 5.1 33 0.2 76 0.1 12 0.9 2 1,033 33 0.1 0.9
Milk, low-fat or skim 1% fat.... 1 cup 85 8.3 0.0 0.4 0.3 4 0.1 149 0.1 13 0.9 2 301 28 0.1 1.0
Milk, calcium fortified, 1 % 1 cup 103 8.1 0.0 2.6 1.6 10 0.1 146 0.1 13 0.9 2 550 34 0.1 1.0
fat.
Milk, skim or nonfat....................... 1 cup 86 8.4 0.0 0.4 0.3 4 0.1 149 0.1 13 0.9 2 302 28 0.1 1.0
Cheese, American........................... 1.5 oz. 152 9.2 0.0 11.9 7.5 34 0.2 104 0.0 5 0.4 0 267 12 0.3 1.3
Cheese, Brick.............................. 1.5 oz. 158 9.9 0.0 12.6 8.0 40 0.2 128 0.0 9 0.5 0 286 10 0.2 1.1
Cheese, Natural Cheddar.................... 1.5 oz. 171 10.6 0.0 14.1 9.0 45 0.2 118 0.0 8 0.4 0 307 12 0.3 1.3
Cheese, Cheddar/Colby, low-fat............. 1.5 oz. 74 10.4 0.0 3.0 1.8 9 0.0 27 0.0 5 0.2 0 176 7 0.2 0.8
Cheese, Colby.............................. 1.5 oz. 167 10.1 0.0 13.7 8.6 40 0.1 117 0.0 8 0.4 0 291 11 0.3 1.3
Cheese, Monterey Jack...................... 1.5 oz. 159 10.4 0.0 12.9 8.1 38 0.1 108 0.0 8 0.4 0 317 11 0.3 1.3
Mozzarella, whole.......................... 1.5 oz. 120 8.3 0.0 9.2 5.6 33 0.1 102 0.0 3 0.3 0 220 8 0.1 0.9
Mozzarella, part-skim...................... 1.5 oz. 119 11.7 0.0 7.3 4.6 23 0.2 81 0.0 4 0.4 0 311 11 0.1 1.3
Mozzarella, non-fat........................ 1.5 oz. 63 13.5 0.8 0.0 0.0 8 0.1 86 0.0 4 0.4 0 375 14 0.1 1.7
Juice:
Orange juice, unsweetened \1\.............. 3/4 cup 78 1.1 0.4 0.3 0.0 0 0.2 34 0.2 34 0.0 64 15 21 0.8 0.1
OJ, sweetened.............................. 3/4 cup 98 1.1 0.4 0.3 0.0 0 0.2 33 0.2 33 0.0 62 15 20 0.8 0.1
OJ, frozen, unsweetened, reconstituted-- 3/4 cup 84 1.3 0.4 0.1 0.0 0 0.4 7 0.1 82 0.0 73 17 19 0.2 0.1
09215.
OJ, frozen, sweetened, reconstituted....... 3/4 cup 85 1.3 0.4 0.1 0.0 0 0.2 15 0.1 83 0.0 73 20 19 0.2 0.1
OJ, canned, unsweetened--09207............. 3/4 cup 78 1.1 0.4 0.3 0.0 0 0.2 17 0.2 34 0 64 15 21 0.8 0.1
Grape juice, frozen, sweetened, 3/4 cup 44 0.4 0.2 0.2 0.1 0 0.1 0 0.1 2 0 45 8 8 0.2 0.1
reconstituted, C added--09137.
Cereal:
Total Corn Flakes--08246................... 1 oz 106 1.7 0.7 0.5 0.1 0 19.0 121 1.9 378 5.7 57 945 7 17.0 14.2
Oatmeal Squares--08214..................... 1 oz 107 3.1 2.0 1.2 0.3 0 0.8 84 2.8 223 0 3 57 33 8.6 2.1
Grape-Nuts--08329.......................... 1 oz. 102 3.1 2.5 0.5 0.1 0 na 109 0.2 49 0.7 0 10 28 7.9 0.6
Oat Bran Flakes--08258..................... 1 oz. 99 3.1 3.7 1.0 0.2 0 0.3 222 2.0 381 5.7 5.7 15 43 7.9 3.5
Cheerios--08013............................ 1 oz. 105 3.1 2.6 1.7 0.3 0 0.2 142 0.5 189 1.4 5.7 94 38 7.7 3.5
Oatmeal, reg. & instant, dry--08120........ 1 oz. 109 4.5 3.0 1.8 0.3 0 0.2 0 0.0 9 0 0 15 42 1.2 0.9
Oatmeal, reg. & inst., cooked--08180....... 3/4 cup 109 4.6 0.5 1.8 0.3 0 na 0.0 0 7 0 0 14 42 1.2 0.9
Cream of Wheat, cooked--08169.............. 3/4 cup 100 2.8 1.3 0.4 0.1 0 na 0 0.0 45 0 0 38 8 7.7 0.2
[[Page 53910]]
Cream of Wheat, dry--08102................. 1 oz. 105 3.0 1.1 0.4 0.1 0 0.0 0 0.0 34 0 0 40 8 8.1 0.2
Tuna:
Tuna, canned, oil pack..................... 2 oz. 112 16.5 0.0 4.7 0.9 10 0.7 13 0.1 3 1.2 0 7 18 0.8 0.5
Tuna, canned, water pack................... 2 oz. 66 14.5 0.0 0.5 0.1 17 0.3 10 0.2 2 1.7 0 6 15 0.9 0.4
Legumes:
Lentils, cooked from dry................... 1/2 cup 92 7.2 6.3 0.3 0.0 0 0.1 1 0.1 144 0.0 1 15 29 2.7 1.0
Beans, Great Northern, navy from dried..... 1/2 cup 121 8.5 5.5 0.3 0.1 0 0.2 0 0.1 70 0.0 0 78 55 3.2 1.2
Peas, crowder, field, black eyed from dried 1/2 cup 97 6.5 5.5 0.4 0.1 0 0.2 2 0.1 175 0.0 0 20 45 2.1 1.1
Eggs:
Egg, whole, large.......................... 1 egg 75 6.2 0.0 5.0 1.6 213 0.5 96 0.1 24 0.5 0 25 5 0.7 0.6
Egg, scrambled from dried.................. 1/2 cup 229 10.0 0.0 20.4 4.9 356 2.7 174 0.1 27 0.7 0 54 10 1.4 1.1
Peanut Butter: Peanut butter................. 2 TBS 190 8.1 1.9 16.3 3.3 0 3.2 0 0.1 24 0.0 0 12 51 0.6 0.9
Vegetables: Carrots, raw..................... 1 cup 47 1.1 3.3 0.2 0.0 0 0.5 3094 0.2 15 0.0 10 30 17 0.6 0.2
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XI. Review Issues
The Department carefully considered how best to present the issues
in this Notice. The following questions address the types of issues the
Department is interested in receiving comments on; however, commenters
may address additional issues that are within the scope of this review.
Some of the questions below are focused on ideas for regulatory or
policy redirection; others simply are seeking information on better
ways to meet needs within current requirements.
The Department believes that this review will benefit from the
broadest possible scope of public input with minimal Departmental
direction. Therefore, the following issues proposed for consideration
are broadly stated without Departmental comment. Within the context of
these broad issues, commenters are encouraged to state their responses
as specifically as possible. Comments that are not within the scope of
this Notice will not be considered and therefore should not be
included. Please be sure to include the rationale and/or scientific
basis underlying the suggested changes.
1. Please indicate what elements of the WIC food packages you would
keep the same and why.
2. What changes, if any, are needed to the types of foods currently
authorized in the WIC food packages? If you recommend additions or
deletions to the types of foods currently offered, please discuss
recommended quantities and cost implications.
3. Should the quantities of foods in the current WIC food packages
be adjusted? If yes, by how much and why? Please discuss cost
implications.
4. Recognizing that the WIC Program is designed to provide
supplemental foods that contain nutrients known to be lacking in the
diets of the target population, what nutrients should be established as
priority nutrients for each category of WIC participant, e.g., pregnant
women, children 1-5, etc.? Please provide the scientific rationale for
them.
5. Keeping in mind that foods provided by WIC are designed to be
supplemental, can the WIC food packages be revised (beyond what is
allowed under current regulations) to have a positive effect on
addressing overweight concerns? If so, how? Please be specific.
6. Are there other concerns that affect foods issued through the
WIC food packages that should be considered in designing the food
packages? For example, should WIC provide options to address allergies
(the American Dietetic Association notes that the most common food
allergies are to milk, eggs, peanuts, soybeans, tree nuts, fish,
shellfish and wheat), cultural patterns or food preferences?
7. What data and/or information (please cite sources) should the
Department consider in making decisions regarding revisions to the WIC
food packages, e.g., nutritional needs of the population, ethnic food
consumption data, scientific studies, acculturation practices, and
participant surveys, etc.?
8. Recognizing that current legislation requires WIC food packages
to be prescriptive, should participants be allowed greater flexibility
in choosing among authorized food items? If so, how?
9. How can WIC food packages best be designed to effectively meet
nutritional needs in culturally and ethnically diverse communities?
10. Should WIC State agencies be afforded more or less flexibility
in designing WIC food packages? Please explain.
11. The WIC program's overall goal is to achieve the greatest
improvement in health and development outcomes for WIC participants,
achieved partly by providing food that targets nutrients determined to
be lacking or consumed in excess in the diets of the WIC population. In
addition to targeting these food nutrients, food selection criteria
should address necessary operational concerns for the foods--for
example, cost effectiveness; appeal to recipients; convenient and
economical package sizes; complexity/ burden for the WIC administrative
structure to manage; etc. It would be helpful if commenters would
identify/recommend WIC food selection criteria, describe how the
criteria interact, indicate their relative weighting or importance, and
provide supporting rationale.
Authority: 42 U.S.C. 1786.
Dated: September 10, 2003.
Eric M. Bost,
Under Secretary for Food, Nutrition and Consumer Services.
[FR Doc. 03-23498 Filed 9-12-03; 8:45 am]
BILLING CODE 3410-30-P
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