Excessive intake of sugar-sweetened beverages (SSB) may increase children’s risk of obesity, type 2 diabetes, tooth decay and other negative health outcomes. Many of these outcomes are disproportionately higher in low-income households, including those who participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).  In addition to the benefits of nutritious foods, WIC also provides nutrition education about the importance of healthful beverages. The purpose of this study was to determine the association between the duration of WIC participation and children’s intake of SSB and water.  This cross-sectional study included a triennial phone survey conducted by WIC in Los Angeles County, CA of WIC participants (n=11,578) including children, 4 to 59 months of age, and their mothers. The survey included validated questions about child consumption of water and a variety of SSB. Outcomes reported were 1) daily servings of SSB, 2) daily servings of water, and 3) daily servings of specific types of SSB. Results showed children in families with 2 years of WIC participation reported significantly fewer daily servings of SSB, fruit flavored drinks, soda and water compared to children of families with 1 year of WIC participation (P<0.05). Protective associations between total SSB, fruit-flavored drinks and soda were significant and increased in magnitude through 10 years of WIC participation.

Study strengths: This study was conducted in Los Angeles County, which enrolls the largest number of WIC participants in the US.  The results are consistent with previous research showing that WIC participation improves diet quality among children. Additionally, this study used validated questions to assess beverage consumption.

Study limitations: Causal relationships cannot be established here due to the cross-sectional design. Most participants in this study were Hispanic, and results may not be generalizable to other WIC populations.  Finally, nutrition education exposure was not measured.  WIC participation served as an estimate for nutrition education.

What this means for your practice:  This, like many other studies provide evidence regarding the benefits of WIC.  Providing information about this valuable community resource to parents and guardians of children ages zero to five can have long-lasting health impact on the entire family.  The finding that as WIC participation increased, water consumption decreased was unexpected and suggests that parents/guardians of young children may benefit from education about the importance of water for hydration and health. Be on the lookout for our ‘Healthy Drink Prescription Pad’ in your next toolkit mailing. Like a written prescription for medication, providers may use this to give parents a written document with specific steps they can take to improve kids’ intake of water and other healthful beverages.

Original citation: Anderson, C. E., O’Malley, K., Martinez, C. E., Ritchie, L. D., & Whaley, S. E. (2022). Longer Family Participation in WIC is Associated with Lower Childhood Sugar-Sweetened Beverage Intake. Journal of Nutrition Education and Behavior, 54 (3), 239-248.

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