Recent studies have assessed diet quality of low-income U.S. children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but differences by race/ethnicity remain unknown. We assessed racial/ethnic disparities in nutrient intake from dietary sources (not supplements) among children participating in WIC, with a focus on priority nutrients and food groups for future WIC food package revisions, as described in a recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM). We used data from the 2011–2014 National Health and Nutrition Examination Surveys (NHANES) and multivariable linear regression analysis to evaluate relationships between race/ethnicity and nutrient/food group intake of children participating in WIC. All data were analyzed using SAS 9.4 survey procedures, accounting for the complex survey design of the NHANES. Compared to non-Hispanic White children, Hispanic children had diets with better nutrient distribution and lower dietary energy density, while non-Hispanic Black children had diets with poorer nutrient intake. Hispanic children had higher potassium and fiber intake, and consumed more legumes, while non-Hispanic Black children had lower calcium and vitamin D intake, higher sodium intake, and lower total dairy intake, compared to non-Hispanic White children. These findings can inform WIC nutrition education messages and future food package revisions.

Diet quality in the United States is improving over time but remains poor. Food outlets influence diet quality and represent the environments in which individuals make choices about food purchases and intake. The objective of this study was to use the Healthy Eating Index-2015 (HEI-2015) to evaluate the quality of foods consumed from the four major outlets where food is obtained—stores, full-service restaurants, quick-services restaurants, and schools—and to assess changes over time. This cross-sectional study used 24 h dietary recall data from eight cycles (2003–2004 to 2017–2018) of the National Health and Nutrition Examination Survey (NHANES). Linear trend estimation was used to test for changes in HEI scores over time, and balanced repeated replicate weighted linear regression was used to test for differences in total and component scores between types of food outlets. Overall, Americans are not consuming a mix of foods from any major category of food outlet that aligns with dietary guidelines. The total score for schools (65/100 points) and stores (62/100 points) was significantly higher than full-service (51/100 points) and quick-service (39/100 points) restaurants (p < 0.0001). HEI scores significantly improved over time for schools (p < 0.001), including an increase in whole grains from less than 1 point in 2003–2004 to 7 out of 10 points in 2017–2018. In 2017–2018, schools received the maximum score for total fruits, whole fruits, and dairy. Continued research on strategies for improving the quality of foods consumed from restaurants and stores is warranted.

Objective: To use nationally representative data to evaluate changes in nutrient and food intakes among children and women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) before v. after implementation of the 2009 food package revisions.Design: Cross-sectional study using National Health and Nutrition Examination Survey (NHANES) data. NHANES survey cycles were pooled to assess nutrient/food group intakes among household WIC participants pre- (2005–2008) v. post- (2011–2014) implementation of the 2009 food package revisions.Setting: Information regarding WIC participation and 24 h diet recalls were collected at NHANES examination.Participants: Children 24–59 months old and women 19–50 years of age in households receiving WIC benefits in the NHANES 2005–2008 and 2011–2014.Results: Comparison of WIC participants’ dietary intake pre- and post-revision demonstrated changes in mean population intakes of both nutrients and food groups. The food package revisions were associated with increased intakes of fibre (P = 0·004 children, P = 0·013 women) and whole grains (P = 0·001 children, P = 0·087 women). For children only, vegetable intake shifted to higher consumption of legumes (P = 0·013) and decreased intake of starchy vegetables (P = 0·042). No significant changes were observed for dairy or fruit intake of children or women.Conclusions: The study provides insight to what goals of the package revisions were achieved. The findings can inform future food package revisions.