WIC and non-WIC Infants and Children Differ in Usage of Some WIC-Provided Foods.

Background: USDA's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides expert-chosen supplemental foods to improve the diets and health of low-income infants and children <5 y of age, but dietary behaviors of WIC participants are not well characterized. Objective: The purpose of this analysis was to examine differences in food consumption patterns between WIC participants and nonparticipants. Methods: FITS 2016 is a nationwide cross-sectional study of children <4 y (n = 3235). Data were weighted to provide US population-representative results. Children were categorized as WIC participants or nonparticipants, with the latter divided into lower- and higher-income nonparticipants. Group differences were assessed via the Wald test (demographics) and Rao-Scott modified chi-square test (breastfeeding prevalence). Differences in percentage consuming WIC-provided and selected other foods between WIC participants and nonparticipants were evaluated with the use of ORs and 95% CIs. Results: WIC infants were less likely to breastfeed than were higher-income nonparticipants at 0-5.9 mo (45% compared with 74%) and less likely than both nonparticipant groups at 6-11.9 mo (30% compared with 49-60%). WIC 6- to 11.9-mo-olds were more likely to consume infant cereals and vegetables than were lower-income nonparticipants. WIC 12 to 23.9-mo-olds were more likely to drink whole milk (which WIC provides at this age) than were nonparticipants (72% compared with 59-64%), whereas WIC participants 24-47.9 mo were more likely to drink low- and nonfat milks (which WIC provides at this age) than were nonparticipants (45% compared with 13-22%). WIC participants 6-47.9 mo were more likely to drink juice than were nonparticipants. Conclusions: Continued improvements in early dietary patterns are warranted for WIC and non-WIC children. Breastfeeding among WIC participants is a continuing challenge. Findings suggest that baby-food cereals, vegetables, and fruits (all provided by WIC) contribute importantly to WIC infants' diets, whereas WIC children are more likely to use lower-fat milks after 2 y of age than are non-WIC participants.

Food Consumption Patterns of Infants and Toddlers: Findings from the Feeding Infants and Toddlers Study (FITS) 2016.

Background: The prevalence of obesity and type 2 diabetes continues to increase. These conditions disproportionately affect minorities and are associated with poor nutrition early in life. Current food-consumption patterns can inform pending dietary guidelines for infants and toddlers. Objective: The aim of this study was to describe infant feeding, complementary feeding, and food and beverage consumption patterns of 0- to 23.9-mo-olds in the general population. Methods: The Feeding Infants and Toddlers Study 2016 is a cross-sectional survey of caregivers of children aged <4 y. Dietary data were collected from a national random sample by using a 24-h dietary recall (n = 3235). The percentage of children consuming foods from >400 food groups was calculated. Differences in the percentage consuming between Hispanic, non-Hispanic white, and non-Hispanic black children aged 0-23.9 mo were evaluated with the use of ORs and 95% CIs. Results: Eighty-three percent of 0- to 23.9-mo-olds (n = 2635) were ever breastfed, 34% of 0- to 3.9-mo-olds (n = 305) and 15% of 4- to 5.9-mo-olds (n = 295) were exclusively breastfed, and 24% of 12- to 14.9-mo-olds (n = 412) consumed breast milk on the day of the recall. Complementary foods were more likely to be introduced before 4 mo in formula-fed infants (27%) than in infants who did not consume formula (5%). Half of 4- to 5.9-mo-olds consumed iron-fortified infant cereal, but few consumed iron-rich meats. Among toddlers (12-23.9 mo; n = 1133), >20% consumed no servings of fruit or vegetables on the day of the recall, approximately half consumed 100% fruit juice, and one-quarter to one-third consumed a sugar-sweetened beverage (SSB). Conclusions: Breastfeeding initiation and duration have improved, but exclusivity remains low. Low consumption of iron-rich foods, fruit, and vegetables and lack of variety in vegetable consumption are problems. Efforts to reduce the consumption of SSBs and 100% fruit juice are warranted in early childhood.

The Feeding Infants and Toddlers Study (FITS) 2016: Study Design and Methods.

Background: Diet and feeding patterns during the infant, toddler, and preschool years affect nutrient adequacy or excess during critical developmental periods. Understanding food consumption, feeding practices, and nutrient adequacy or excess during these periods is essential to establishing appropriate recommendations aimed at instilling healthy eating behaviors in children. Objective: The objective of the 2016 Feeding Infants and Toddlers Study (FITS 2016) was to update our knowledge on the diets and feeding patterns of young children and to provide new data in related areas such as feeding behaviors, sleep, physical activity, and screen use. This article describes the study design, data collection methods, 24-h dietary recall (24-h recall) protocol, and sample characteristics of FITS 2016. Methods: FITS 2016 is a cross-sectional study of caregivers of children aged <4 y living in the 50 states and Washington, DC. Data collection occurred between June 2015 and May 2016. A recruitment interview (respondent and child characteristics, feeding practices, physical activity, screen use, and sleep habits) was completed by telephone or online. This was followed by a feeding practices questionnaire and the 24-h recall conducted by telephone. A second 24-h recall was collected for a random subsample of 25% of the total sampled population. Results: Among the 4830 recruited households with an age-eligible child, 3248 (67%) completed the 24-h recall. The respondents were more likely to be white, less likely to be Hispanic, and more highly educated than the US population of adults in households with a child <4 y of age. The sample was subsequently calibrated and weighted, and the distribution of respondents was compared with known population distributions. Conclusions: FITS 2016 provides data based on sound methods that can inform researchers, policymakers, and practitioners about the food and nutrient intakes of young children. New findings may also be compared with previous FITS studies.