Assessing the Revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Packages by Surveying Native American WIC Participants and Administering a Metabolic, Dietary Study of the Revised and Original WIC Food Packages



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WIC food packages are undergoing major revisions to accommodate the unique requirements of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the twenty-first century. This dissertation is an evaluation of the impact of the revised WIC food packages through national-level surveys obtaining data before and after food package changes. In addition, a community-level metabolic/dietary study of obese women consuming either the original or revised food packages was performed. Since WIC has never revamped its entire program before, this is an opportunity to learn more about the impact of the revisions on WIC participants across the country, including Native Americans from Indian Tribal Organizations (ITOs).

The National Food and Nutrition food frequency questionnaire (NATFAN) evaluates food and consumption practices of WIC participants, including Native Americans, for both the original and revised WIC food packages. The baseline surveys (NATFAN') were administered before the 2009 rollout of the revised WIC food packages (dates varied by state program). The post-rollout surveys (NATFAN'') were administered spring through winter of 2010-2011, and at least six months after the implementation of the revised WIC food packages. Hierarchical linear modeling, with restricted maximum likelihood approximation, was used to evaluate 100% juice, fruit, and vegetable frequency of consumption based upon NATFAN' and NATFAN'', including samples from states, territories, and ITOs. This research is important because it was national in scope and analyzed nutritional behaviors of a Native American subpopulation of WIC that is seldom documented in national nutrition research.

For the metabolic/diet study, obese women 185% of the poverty level were given the original or revised WIC food packages (n=3). Three venous blood serum collections (0, 6, 12 weeks) were biomarker tested (cholesterol, glucose, C-reactive protein, etc.) in lipid and metabolic panels. Three, seventy-two hour dietary recalls were also assessed to determine fruit and vegetable consumption changes over the course of the study. This phase was important because it focused on the individual's actual consumption behaviors of specific WIC foods dispensed in the WIC food packages and assessed how such consumption affected the health of the individual.