importance of wic in improving fruit and vegetable …...cancers •higher intake of fv reduced risk...
TRANSCRIPT
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Importance of WIC in Improving Fruit and Vegetable Consumption
Laurence Grummer-Strawn
WIC Leadership Forum
Washington, DC
March 5, 2013
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Nutrition behaviors
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Nutrition
•Underconsumed nutrients –Folate
–Magnesium
–Potassium
–Dietary fiber
–Vitamins A, C, and K
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Disease Prevention
Heart Disease Stroke
Hyper-tension
Cancer Diabetes
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Coronary Heart Disease Risk Reduction
• >5 servings of FV/day ==> 17% reduced risk of CHD
– (meta-analysis of 13 cohorts)
J Human Hypertension, 2007.
• 4% reduction in CHD risk for each additional portion/day of FV intake
– (meta-analysis of 13 cohorts) J Nutr, 2006
Heart Disease Stroke
Hyper-tension
Cancer Diabetes
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Stroke and Hypertension
• >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
Heart Disease Stroke
Hyper-tension
Cancer Diabetes
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Cancers
• Higher intake of FV reduced risk of overall cancer
– Cancer Epidemiol Biomarkers Prev. 2008
• 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, 2010. Int J Cancer, 2009.
Heart Disease Stroke
Hyper-tension
Cancer Diabetes
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Diabetes
• 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 2008
• 18-26% lower risk associated with a 3-serving-per-day increase of fruit
9-12% reduction with a 1-serving- per-day increase in green leafy vegetables
– Diabetes Care, 2008
Heart Disease Stroke
Hyper-tension
Cancer Diabetes
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Energy intake
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Each meal contains
1575 kcal/d
Low ED day
High ED Day
Reduce overall energy intake
Promote satiety
Allow to consume “more”
Improve weight status
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Policy documents
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Recommended intake
Age (years) Vegetables (cups)
Fruits (cups)
Children 2-3 1 1
4-8 1½ 1 to 1½
Females 9-13 2 1½
14-18 2½ 1½
19-30 2½ 2
31-50 2½ 1½
51+ 2 1½
Males 9-13 2½ 1½
14-50 3 2
51+ 2½ 2
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Percent of U.S. adults who consumed vegetables at least three times a day
0
5
10
15
20
25
30
35
Percen
t
Education Income
Behavioral Risk Factor Surveillance System, 2009
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Percent of infants consuming vegetables at least twice a day, by age and participation in WIC
0
10
20
30
40
50
60
70
2 3 4 5 6 7 9 10.5 12
Percen
t
Age of infant (months)
Infant not on WIC
Infant on WIC
Infant Feeding Practices Study II
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Percent of infants consuming fruits at least twice a day, by age and participation in WIC
0
10
20
30
40
50
60
70
2 3 4 5 6 7 9 10.5 12
Percen
t
Age of infant (months)
Infant not on WIC
Infant on WIC
Infant Feeding Practices Study II
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Percent of 6 year olds consuming vegetables and fruits at least twice a day, by participation in WIC
0
5
10
15
20
25
30
35
40
45
50
Vegetables Fruits
Percen
t
Age of infant (months)
Infant Feeding Practices Study II
Non-WIC WIC WIC Non-WIC
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Correlation between consumption at 12 months and consumption at 6 years of age
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
<1X /
day
1 -
<2X / day
> 2X /
day
<1X /
day
1 -
<2X / day
> 2X /
day Percen
t co
nsu
min
g a
t 6
years
of
ag
e
Consumption at 12 months of age
<1X / day
1 - <2X / day
> 2X / day
Infant Feeding Practices Study II
Vegetables Fruits
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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
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Access to Healthy Food
• USDA, HHS, Treasury
• Focus on Food Deserts
• Loans, grants, promotion
• Evaluation and research
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Access to Healthy Food
Source: Gleason et al, 2011
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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
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Let’s Move!
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Farm-to-Preschool
• Collaboration with Natl Farm-to-School Network
• www.farmtopreschool.org
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Monitoring
• NHANES
• BRFSS
• YRBS
• NYPANS
• HealthStyles
• State Indicator Report
Healthier Food Retail
Farmers Markets
School/child care rules
Farm-to-school
Food policy councils
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Guidelines for Birth-24
• Dietary Guidelines begin at age 2 years
• USDA & HHS gathering science for birth-24 months
• Workshops to define key issues
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Communications
• Products promotable –Clarification
–Expansion to meals
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National Fruit & Vegetable Alliance
NANA
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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
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THANK YOU!