Importance of WIC in Improving Fruit and Vegetable Consumption. Laurence Grummer-Strawn WIC Leadership Forum Washington, DC March 5, 2013

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1 Importance of WIC in Improving Fruit and Vegetable Consumption Laurence Grummer-Strawn WIC Leadership Forum Washington, DC March 5, 2013

2 Nutrition behaviors

3 Nutrition Underconsumed nutrients Folate Magnesium Potassium Dietary fiber Vitamins A, C, and K

4 Disease Prevention Heart Disease Stroke Hypertension Diabetes Cancer

5 Coronary Heart Disease Risk Reduction Heart Disease Stroke Hypertension >5 servings of FV/day ==> 17% reduced risk of CHD (meta-analysis of 13 cohorts) J Human Hypertension, Diabetes Cancer 4% reduction in CHD risk for each additional portion/day of FV intake (meta-analysis of 13 cohorts) J Nutr, 2006

6 Stroke and Hypertension Heart Disease Diabetes Stroke Hypertension Cancer >5 servings of FV/day ==> 26% reduced risk of stroke 3-5 servings of FV/day ==> 11% reduced risk of stroke Lancet, 2006 Highest quartile of fruit intake ==> 79% lower odds of being hypertensive (among overweight) J Human Hypertension, 2010

7 Cancers Heart Disease Stroke Higher intake of FV reduced risk of overall cancer Cancer Epidemiol Biomarkers Prev Diabetes Hypertension Cancer 20-70% lower risk of cancers of digestive tract between the highest and lowest levels of vegetable intake Nutr and Cancer 2009 Case studies: lower risk of breast cancer Am J Epidemiol, Int J Cancer, 2009.

8 Diabetes Heart Disease Diabetes Stroke Hypertension Cancer 22% reduced risk of diabetes for highest versus lowest quintile of FV intake 30% reduced risk associated with fruit alone 20% for vegetables Arch Intern Med % lower risk associated with a 3-serving-per-day increase of fruit 9-12% reduction with a 1-servingper-day increase in green leafy vegetables Diabetes Care, 2008

9 Energy intake

10 Reduce overall energy intake Promote satiety Allow to consume more Improve weight status High ED Day Low ED day Each meal contains 1575 kcal/d

11 Policy documents

12 Recommended intake Age (years) Vegetables Fruits (cups) (cups) Children ½ 1 to 1½ Females ½ ½ 1½ ½ ½ 1½ ½ Males ½ 1½ ½ 2

13 Percent Percent of U.S. adults who consumed vegetables at least three times a day Education Income Behavioral Risk Factor Surveillance System, 2009

14 Percent Percent of infants consuming vegetables at least twice a day, by age and participation in WIC Infant not on WIC Infant on WIC Age of infant (months) Infant Feeding Practices Study II

15 Percent Percent of infants consuming fruits at least twice a day, by age and participation in WIC Infant not on WIC Infant on WIC Age of infant (months) Infant Feeding Practices Study II

16 Percent Percent of 6 year olds consuming vegetables and fruits at least twice a day, by participation in WIC Non-WIC WIC Non-WIC WIC Vegetables Fruits Age of infant (months) Infant Feeding Practices Study II

17 Percent consuming at 6 years of age Correlation between consumption at 12 months and consumption at 6 years of age 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Vegetables <1X / day 1 - <2X / day > 2X / day <1X / day Fruits 1 - <2X / day > 2X / day Consumption at 12 months of age <1X / day 1 - <2X / day > 2X / day Infant Feeding Practices Study II

18 Intervention Guide Food policy councils Access and availability in retail stores Farm-to-institution programs Farmers markets Community supported agriculture Access to f&v in workplace cafeterias Access to f&v at meetings and events Community and home gardens Fruit and vegetable activities in schools Emergency food programs

19 Access to Healthy Food USDA, HHS, Treasury Focus on Food Deserts Loans, grants, promotion Evaluation and research

20 Source: Gleason et al, 2011 Access to Healthy Food

21 Food Service Guidelines Health and Sustainability Guidelines for Federal Concessions and Vending Operations Key component of state funding Working with 17 federal departments in National Prevention Council Implementation in DOD, HHS, and GSA Developing Operational Guide

22 Let s Move!

23 Farm-to-Preschool Collaboration with Natl Farm-to- School Network

24 Monitoring NHANES BRFSS YRBS NYPANS HealthStyles State Indicator Report Healthier Food Retail Farmers Markets School/child care rules Farm-to-school Food policy councils

25 Guidelines for Birth-24 Dietary Guidelines begin at age 2 years USDA & HHS gathering science for birth-24 months Workshops to define key issues

26 Communications Products promotable Clarification Expansion to meals

27 National Fruit & Vegetable Alliance NANA

28 WIC Call to Action Strengthen counseling on fruits and vegetables Carefully examine CVV program Begin process of food package revision Strengthen requirements for WIC vendors Create/participate in coalitions

29 THANK YOU!