(OR13-06-25) Fruit and Vegetable Intake and Diet Quality of Children by Massachusetts WIC Enrollment Status

Objectives: Children 1-4 years old enrolled in the Massachusetts WIC program receive a cash value benefit (CVB) of $26 per month for fruits and vegetables. This study’s objective was to evaluate differences in fruit and vegetable intake and diet quality by WIC enrollment status two years after this CVB amount (an increase over its original level of $11 per month) was made permanent in Massachusetts.

Methods: Dietary data were collected cross-sectionally among 278 WIC-eligible children 1-4 years old in Massachusetts. Mean fruit and vegetable intake (cup-equivalents) was assessed via parent-reported 24-hour dietary recalls using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24); 77.7% completed a second 24-hour recall. Meanwhile, the frequency of fruit and vegetable intake, as well as overall diet quality scores, were derived from a previously validated tool: the rapid Prime Diet Quality Score screener for Kids (rPDQS-Kids; range 0-30 points). Families not enrolled in WIC were also asked to describe why they did not use WIC. Multivariable linear regression models compared dietary outcomes between WIC children and non-enrolled children, adjusting for children’s age, sex, race, ethnicity, and household income.

Results: Of the 278 children, 240 were enrolled in WIC and 38 were not. Most common reasons for non-participation in WIC were poor in-store retail experiences (e.g., stigma, complicated processes) and transportation barriers. Compared to WIC children, non-WIC children consumed fruits 4.7 (95%CI: -8.1,-1.3) times less (p=0.007) and vegetables 3.8 (95%CI: -6.6,-9.3) times less in a week (p=0.010). However, average mean intake on a given day was not significantly different [e.g., -0.7 (95%CI: -1.7,0.3) less cup-equivalents of fruit, p=0.131]. Children not enrolled in WIC consumed diets that scored 3.3 (95%CI: -5.8,-0.9; p=0.009) points lower in rPDQS-Kids total diet quality score relative to children enrolled in WIC.

Conclusions: Two years after the CVB increase was made permanent in Massachusetts, non-enrollment in WIC was associated with less frequent fruit and vegetable consumption and lower total diet quality. Removing barriers to WIC enrollment may improve children’s diets.

Funding Sources: This research was supported by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation (Grant # 283-5114).