Nutrition and Health of Low-income Populations: Changes Over Time

Transcription

1 Nutrition and Health of Low-income Populations: Changes Over Time Jackson P. Sekhobo, PhD, MPA Methods & Approaches to the of WIC Food Packages: IOM Phase I Data Gathering Workshop March 12 13, 2015, Washington, DC March 6, 2015

2 2 Presentation Outline NY CHANGES PREGNANCY INFANCY EARLY CHILDHOOD Implementation of the new WIC food package Low-fat dairy Whole grains Fruits & Veg Delayed solids Reduced juice Enhanced BF package Culturally acceptable foods Adequate pregnancy weight gain Rapid weight gain birth to 1 year High weight for length at 1 year Dietary behaviors Fruits Vegetables Whole grains Low-fat milk BMI at 2 & 3 yrs. 2

3 3 NYS Food Package Changes NY CHANGES PREGNANCY INFANCY EARLY CHILDHOOD Implementation of the new WIC food package Low-fat dairy Whole grains Fruits & Veg Delayed solids Reduced juice Enhanced BF package Culturally acceptable foods Adequate pregnancy weight gain Rapid weight gain birth to 1 year High weight for length at 1 year Dietary behaviors Fruits Vegetables Whole grains Low-fat milk BMI at 2 & 3 yrs. 3

4 4 Conceptual Framework for the of WIC Food Packages PREGNANCY INFANCY EARLY CHILDHOOD Supplemental foods Nutrition education BF peer counselors Referrals Baby foods BF support Nutrition education Growth monitoring Supplemental foods Nutrition education Healthy lifestyles Growth monitoring Weight Status Weight gain Gestational age Birth weight Infant feeding decision Smoking cessation Rate of weight gain Breastfeeding initiation and duration Delayed introduction of complimentary foods Physical activity Use of low-fat/fat free milk Dietary behaviors Physical activity Reduced screen time Weight status Contextual factors: Family, school, and neighborhood level 4

5 5 WIC Food Packages should be assessed in Context 5

6 6 Pregnancy NY CHANGES PREGNANCY INFANCY EARLY CHILDHOOD Implementation of the new WIC food package Low-fat dairy Whole grains Fruits & Veg Delayed solids Reduced juice Enhanced BF package Culturally acceptable foods Adequate pregnancy weight gain Rapid weight gain birth to 1 year High weight for length at 1 year Dietary behaviors Fruits Vegetables Whole grains Low-fat milk BMI at 2 & 3 yrs. 6

7 7 Prevalence of Adequate Pregnancy Weight Gain Before and After New Food Packages OR yr 1.04 (1.02,1.06) Prevalence (%) st 2nd 3rd Postpartum Trimester of Maternal Enrollment

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9 9 Infancy NY CHANGES PREGNANCY INFANCY EARLY CHILDHOOD Implementation of the new WIC food package Low-fat dairy Whole grains Fruits & Veg Delayed solids Reduced juice Enhanced BF package Culturally acceptable foods Adequate pregnancy weight gain Rapid weight gain birth to 1 year High weight for length at 1 year Dietary behaviors Fruits Vegetables Whole grains Low-fat milk BMI at 2 & 3 yrs. 9

10 10 Prevalence (%) of Rapid Infant Weight Gain - Before and After New Food Packages 58 OR yr 0.57 (0.56,0.58) Prevalence (%) st 2nd 3rd Postpartum Trimester of Maternal Enrollment

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12 12 Prevalence (%) of High Weight-for-Length at 1 yr. - Before and After New Food Packages OR yr 0.92 (0.90,0.93) Prevalence (%) st 2nd 3rd Postpartum Total Trimester of Maternal Enrollment Birth to 2 y NHANES 9.5 ( ) NHANES 8.1 ( ) 12

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14 14 Early Childhood NY CHANGES PREGNANCY INFANCY EARLY CHILDHOOD Implementation of the new WIC food package Low-fat dairy Whole grains Fruits & Veg Delayed solids Reduced juice Enhanced BF package Culturally acceptable foods Adequate pregnancy weight gain Rapid weight gain birth to 1 year High weight for length at 1 year Dietary behaviors Fruits Vegetables Whole grains Low-fat milk BMI at 2 & 3 yrs. 14

15 15 Percent of 1-Yr Old Children Consuming Fruits, Vegetables, or Whole Grains Daily - Before and After New Food Packages 100% 90% 80% 70% NHANES % 91.1% 91.4% 92.3% NHANES % 84.1% 85.0% 86.6% 60% 50% 61.4% 62.2% 62.5% 40% 30% 20% 10% 0% Fruit Vegetable Whole Grain

16 16 Percent of 2 & 3 yr. Old Children Consuming Low-fat Milk - After New Food Packages Percentage year olds year olds 16

17 17 Obesity & Extreme Obesity among 2007 & 2010 cohorts at 2 and 3-years of age 18.0 OR yr 0.93 (0.90,0.96) Prevalence (%) OR yr 0.96 (0.92,0.99) OR yr 0.93 (0.90,0.97) OR yr 0.93 (0.89,0.96) years 3 years 2 years 3 years Obesity Extreme Obesity

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20 20 Putting It Altogether: Differences in RIWG were the most pronounced and occurred across all regions of the State. This evidence suggests a program-wide impact. The delayed introduction of solids and the addition of fruits & vegetables during the first year likely contributed to this impact. 20

21 21 Acknowledgments: Lynn Edmunds, DrPH, MS, RD Mark Giddings, BS MaryEllen Murphy, BS 21