Evaluating the association of the increase in the WIC cash value benefit on the diversity of MyPlate fruits and vegetables redeemed and consumed by children in low-income households

Abstract

BackgroundFruits and vegetables (FV) are a critical source of nutrients, yet U.S. children are not meeting the Dietary Guidelines for Americans (DGA). The monthly FV cash value benefit (CVB) included in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)’s food package to support child FV intake (FVI) received a substantial increase for economic relief during the COVID-19 pandemic. ObjectiveTo evaluate how an expansion of the monthly WIC CVB for the purchase of FV for WIC children ages 1-4 years is associated with diversity in FV redeemed, and how changes in redeemed FV are related to FVI. MethodsCaregivers representing 1,463 WIC-participating children recruited from Los Angeles County, California completed surveys during the CVB augmentation (T1: CVB=$9/mo; T2=$35/mo; T3=$24/mo). Redeemed price look-up codes (PLUs), corresponding to a food item, were assigned to its corresponding MyPlate FV group. Multivariable generalized estimating equation regression models assessed changes in amount and diversity of FV redemption across MyPlate groups, and associations between changes in FV diversity and changes in FVI. ResultsSlightly over half of all households were food insecure (55%), half of children were female (52%), and most were Hispanic (78%). Compared to T1, significant increases in the number of PLUs and dollars redeemed were observed in most MyPlate FV groups. From T1 to T2, significant increases in diversity scores were observed for total fruit (β=1.6 pts; 95%CI: 1.4, 1.7), total vegetable (β=3.6 pts; 95%CI: 3.4, 3.9), and total FV (β=7.8 pts; 95%CI: 7.4, 8.2). Similarly, diversity score increases were observed at T3 compared to T1. Changes in FV diversity redeemed were not associated with changes in FVI. ConclusionDuring the CVB augmentation, WIC participants redeemed a greater amount and variety of FV according to DGA MyPlate recommendations, supporting its permanent increase.