New York children participating in a federal nutrition program had healthier eating behaviors and lower rates of obesity two years after improvements to the program were undertaken, according to a study published online today in Obesity, the official journal of the Obesity Society.
In 2009 all 50 states rolled out sweeping changes to the menu of foods available through the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC, which reaches nearly half of all infants born in the United States. New York was the first state in the nation to roll out the new package of food vouchers, which added vegetables, fruits, and whole grains, substituted low-fat for whole milk, and reduced fruit juices. The New York State WIC program also added healthy lifestyle promotion, such as increasing physical activity and reducing screen time, as a core service.
To assess the impact of the changes, researchers analyzed 3.5 million New York State WIC records from before and after the January 2009 changes in the food package. The study was conducted by researchers from Columbia University’s Mailman School of Public Health, the New York State Department of Health, and Public Health Solutions, a New York-based nonprofit.
Most encouraging for those concerned about reversing the childhood obesity epidemic were the observed differences in the proportion of obese children. After the changes in WIC programming, there was a 6% decline in obesity among 1 year-olds, from 15.1 to 14.2%, and 3% among 2-4 year-olds, from 14.6 to 14.2%.
“The new WIC food package was designed to promote healthier eating choices for children and we are excited by results that show it is helping to reduce pediatric obesity,” State Health Commissioner Nirav R. Shah, MD, MPH, said. “New York was the first state to implement the new WIC food package and is the first to report that changing the foods provided to children under the program helped to improve their eating behavior and achieve healthier weights. Changing WIC foods does change what children eat.”
When compared to children in the “old” WIC, children in the “new” WIC had more healthy behaviors and were less likely to be overweight or obese. For instance:
Low/nonfat milk consumption was up by 4.5% in 2-4 year-old children.
Steady increases in daily consumption of any fruits, vegetables, and whole grains were seen in 1-4-year-olds.
Proportions of 2-4-year-olds with 2 or fewer hours of television or other screen time increased by 2.5%, while the proportion of children under age 2 with no screen time increased by 33%.
Mothers who initiated breastfeeding jumped by 7%, from 72.2 to 77.5%.
“In the two years after the changes to WIC were rolled out in New York State, an estimated 2,300 more New York children were normal weight, not overweight or obese,” says first author Mary Ann Chiasson, DrPH, Vice President of Research and Evaluation at Public Health Solutions; and Associate Professor of Clinical Epidemiology (in Medicine) at Columbia’s Mailman School of Public Health and the College of Physicians and Surgeons.
While early childhood obesity levels had plateaued before the new changes in the WIC program, these results suggest that the new WIC food package may be contributing to further reductions in obesity risk.
“The new WIC food package appears to be having the hoped for effect of promoting healthy eating, building a foundation for healthy choices about diet, exercise, and other healthful habits,” says Sally Findley, PhD, Professor of Clinical Population and Family Health and Sociomedical Sciences at Columbia’s Mailman School.
“If you help keep kids at normal weight during early childhood, they are much more likely to stay at normal weight throughout childhood and beyond,” continues Dr. Findley, adding that preventing obesity in young children is especially important given that it is linked with risk for adult obesity and a constellation of related health problems from diabetes to cardiovascular disease.
The study results are part of a larger assessment of the impact of New York’s changes to WIC in 2009. Ongoing studies include elements such as control for background characteristics of enrolled children and for the potential additional effects of other city or state programs affecting healthy eating or exercise patterns in this age group.
Additional co-authors include Jackson Sekhobo, PhD, Director of Research and Evaluation, Division of Nutrition, New York State Department of Health, and Lynn Edmunds, DrPH, Senior Research Scientist, Evaluation and Analysis Unit, Division of Nutrition, New York State Department of Health; Roberta Scheinmann, MPH, and Adefunke Faly, MPH, at Public Health Solutions; and Natasha McLeod of Columbia’s Mailman School.
Funding for the study was provided by the Robert Wood Johnson Foundation and the New York State Health Foundation. The authors declare no competing interests.
Timothy S. Paul
Columbia University’s Mailman School of Public Health