Adding fruits & veggies to government program no tall order

Steve - this is great reporting from one of our favorites.

By Andrew Martin
Washington Bureau

March 26, 2006

WASHINGTON -- If there is a major theme in the federal government's latest nutrition advice, it is to eat more fruits and vegetables.

But to date, politics and budgetary concerns have prevented the government from taking its own medicine when it comes to a program that is supposed to provide crucial nutrients to poor women and children.

The Department of Agriculture is weighing a proposal to add fruits, vegetables and whole grains to the food packages that are offered in the Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC for short.

As logical as that may sound, the decision is hardly a given.

The WIC food packages now include such things as infant formula, juice, milk, cheese, eggs and peanut butter. But previous attempts to revise the WIC packages have hit a wall in part because of opposition from powerful food lobbies, such as the dairy industry, that wanted to maintain the status quo.

Shirley Watkins, undersecretary of agriculture for food, nutrition and consumer services in the Clinton administration, said her attempts to add fruits and vegetables to the program were quickly quashed.

`No scientific evidence'

"There were a lot of companies that didn't want anything done to the food packages, but we had WIC recipients that really wanted change," Watkins said. "We were trying to make changes for the 25th anniversary of the WIC program, but we just could not move that forward.

"We were told there was no scientific evidence," she said. But she said the Dietary Guidelines for Americans--published every five years by the USDA and the Department of Health and Human Services to represent the latest science on nutrition--were enough evidence for her. "We had lobbyists coming in. We knew as we pushed forward, they were pushing in any direction to keep us from moving."

What is different this time is that the USDA sought some additional ammunition--in the form of a study completed last spring by the quasi-governmental Institute of Medicine--that should have made the changes more palatable. The institute recommended that fruits and vegetables be added to the WIC program and less milk and eggs offered.

Currently, the only fruits and vegetables offered in the WIC food packages are fresh carrots, but only for pregnant women. The Institute of Medicine proposed giving WIC recipients monthly vouchers--$8 for children, $10 for women--to buy fresh fruits or vegetables.

But because the institute's mandate was to make changes without adding costs, its proposal calls for reductions in the amount of milk, juice and eggs that would be offered.

Under the current program, young children receive WIC vouchers for about 9 ounces of vitamin C-rich juice per day and 3 cups of milk. If the changes are adopted, the children would get 4 ounces of vitamin C-rich juice per day and 2 cups of milk.

In addition, their monthly allowance for eggs would be reduced from 2 to 2 1/2 dozen eggs to one dozen, while their allocation of iron-fortified cereal would remain the same each month, 36 ounces, except that it would be whole grain.

The USDA is drafting regulations to change the WIC program that were supposed to be completed months ago. Suanne Buggy, a spokeswoman for the USDA's Food, Nutrition and Consumer Services, said her agency was nearing the end of the review process, but she declined to provide a more specific timetable.

Keith Collins, the USDA's chief economist, disputed that lobbyists blocked previous attempts to change the package. Rather, Collins said it was due to internal disagreement on whether the revisions met the needs of WIC participants.

"The issue is not transparent [that fruits and vegetables are good] because the statutory goal of the program is to address the deficient nutrients of the WIC population," Collins said in an e-mail. "So what are the target nutrients? How deficient is the population in them? What is the best way to address these deficiencies?"

But Suzanne Murphy, a professor at the Cancer Research Center of Hawaii and chairwoman of the Institute of Medicine WIC study, said current guidelines provide WIC participants with more milk and dairy than federal nutrition guidelines recommend. For instance, WIC provides pregnant women with coupons to buy 3 1/2 cups of milk per day while the USDA's Food Guide Pyramid suggests 3 cups daily.

Besides, Murphy said, national surveys made it clear that women in the program don't want all the dairy products that are provided by WIC.

Other proponents argue that the changes are a no-brainer that should have been instituted years ago.

"We are squarely behind the Institute of Medicine's proposal to increase fresh fruits and vegetables," said Rev. Douglas Greenaway, executive director of the National WIC Association, a non-profit group that represents state and local agencies that administer WIC. In 2000 his group recommended changes that included more fresh fruits and vegetables.

"Every food group has a voice in Washington," he said, "and everyone wants to protect their particular piece of the food package."

Supporters of the dairy industry argue that WIC participants need the nutrients that the dairy servings provide.

"We are opposed to just rubber-stamping the [institute] recommendations," said Chip Kunde, senior vice president at the International Dairy Foods Association, a trade group. "We don't have a problem adding [fruits and vegetables]. They just shouldn't come at the expense of dairy."

Rep. Gil Gutknecht (R-Minn.) made a similar pitch in an Oct. 24 letter to Agriculture Secretary Mike Johanns.

"I do not believe severe cutbacks of dairy availability in the WIC program are justified," Gutknecht said. "I ask that USDA propose a rule which reflects the department's own judgment of appropriate food package components and continues to acknowledge the role dairy plays as a cornerstone of the WIC food package."

The WIC program was started as a pilot project in 1972 amid mounting evidence that low-income children suffered from anemia and inadequate growth, conditions that could affect learning ability. Based on the nutrition science at the time, seven food packages were created for specific groups, such as infants or breast-feeding women, and the idea of each was to provide foods that included needed nutrients such as vitamin C, iron, protein and calcium.

WIC participants typically are given vouchers that can be used to purchase specific food items at participating stores.

Program serves 8 million

The program now serves about 8 million woman, children and infants a month and has an annual budget in excess of $5 billion.

A small program was created in 1992 to provide some WIC participants with vouchers for fresh fruits and vegetables at farmers' markets, but it is only available in summer months. In 2004, 2.5 million WIC participants received the farmers' markets vouchers.

Lorelei DiSogra, vice president of nutrition and health for the United Fresh Fruit and Vegetable Association, said it was remarkable that such modest and logical changes would create controversy. Nonetheless, she said the delays in setting new policy are making her nervous.

"Many of us are getting a little antsy about this," she said.