Fresh fruits, vegetables and bread are among the new food items making their way into the diets of New Orleans' roughly 24,000 participants in the U.S. Department of Agriculture's Supplemental Nutrition Program for Women, Infants and Children (WIC). This September, along with several other new changes to WIC's food packages, a new separate voucher began subsidizing $8 to $10 per month in fresh produce for each low-income mother, dependent on the amount she breastfeeds, as well as $6 for each child.
This may not sound like much, but Marie Dalme, chief dietician at New Orleans Children's Hospital, is thrilled with WIC's many new changes. Dalme, who estimates 85 percent of her child patients use WIC, says, "It's hard to make healthy choices on a low income. You may be wary of foods that spoil. You worry they'll go bad before you eat them, so you don't buy fresh fruits and vegetables. Now WIC recipients will at least have vegetables in their homes.
"It's especially great that these new vouchers don't dictate what produce you have to get," Dalme adds. "People can get what they prefer."
Keisha Johnson, 35, and Willie Deese, 36, started receiving WIC in September while living in Mississippi. Recently relocated to New Orleans, Johnson is partially breastfeeding her infant, and says WIC pays for all the condensed milk needed to supplement her child's diet, an amount Deese estimates at nearly $250 per month. The new voucher buys anything in the produce section, even pre-cut vegetable packages, bagged salads and fruit in plastic containers. The only exempt vegetable is the white potato — though the voucher does cover sweet potatoes. Denise Harris, assistant chief of nutrition services in the Office of Public Health at the Louisiana Department of Health and Hospitals, the organization that administers the WIC program in Louisiana, explains, "The USDA studied the population and found vegetable intake sorely lacking — except in regard to white potatoes. Everyone eats enough potatoes, it turned out. So WIC concentrated its efforts on other vegetables. Sweet potatoes happen to have essential vitamin A."
WIC's new enhanced food packages also are meant as an incentive for low-income mothers to initiate and continue breastfeeding, even if they don't breastfeed exclusively. WIC now uses the amount of breastfeeding in a family to delineate who receives what, and how much. Pregnant, partially and completely breastfeeding women now receive peanut butter, for instance. And while all infants now get pureed fruits and vegetables, exclusively breastfed infants receive pureed meats as well. Whole grains have also been added in the form of brown rice, bread and farina for prenatal and breastfeeding women and children one to five years old.
Unlike food stamps, WIC's supplemental food packages are prescribed to target specific nutritional areas during specific human developmental stages. So for the first time WIC is now offering substitutions and healthier alternatives to some of its regular items: participants with wheat allergies can substitute brown rice for bread, and canned salmon is now offered as a substitute for tuna. In a nod to lower-fat options as well, low-fat cheese is now optional, and cow's milk can be swapped for soymilk. WIC has also completely eliminated juice for infants six to 12 months of age, replacing these nutritionally questionable beverages with roughly 32 jars of fruits and veggies per month.
Jihad Hamad, 23, who works at his father's WIC-approved Brothers Discount Market in Central City, is cynical about how much good the new changes will do. He says his WIC customers "will take the produce because they have to. But they don't want real fruit, they just want the juice." Brothers Discount has participated in the WIC program for 10 years, and is one of New Orleans many WIC-approved corner stores now obligated to stock a minimum of fruits and vegetables — potentially a big deal for New Orleanians who relied on their local corner stores even before many of their big neighborhood supermarkets were flooded.
Harris says a few local stores have dropped out because of the change, but not a large number. Brothers Discount previously stocked tomatoes and cabbage. "But we got more variety recently because WIC made us," Hamad says, pointing to new boxes of cantaloupe, avocado, grapes and plantains in his store. But unlike Johnson, Hamad isn't impressed with WIC's new packages for babies. "I have a little baby myself," he says, "and 31 cans of food would be nothing to her."
"WIC is not designed to give people all the food they need for a balanced diet," Dalme points out. "The amount of food is definitely not enough to feed a child for a whole month." She says the addition of grains, vegetables and low-fat dairy options makes the program "education as much as it is assistance. With these improvements in WIC we won't see an immediate decrease in obesity, but we're bringing education into the households, hopefully at least exposing kids to some healthier foods and the idea of a truly balanced diet."
Long before the Department of Health and Human Services' Dietary Guidelines for Americans in 2005 officially declared vegetables to be the most important part of any healthy diet, most of us knew this to be true. So what took WIC so long?
Since 1972, WIC has provided nutrition education and medical referrals to low-income pregnant women, mothers and children. In 1980, the last major revisions to WIC food packages were made, with small changes made in 1992 to encourage breastfeeding. In 2005, the USDA commissioned a report from the Institute of Medicine to suggest these newest changes, but it wasn't until December 2007 that the USDA published interim rules ordering WIC vouchers restructured nationwide. New York was the first state to roll out the new changes with several other states following, until finally the new WIC packages were implemented in New Orleans in September 2009, one month before the federal government's deadline to act.
"I know it sounds like it took a long time, but there was so much effort that had to take place first," Harris says. "This was a huge, tremendous wholesale change. It has taken a long time simply to navigate all the policies in Louisiana. Any time we change a policy within a federal program, we have to get everything approved, then we start training the approximately 700 grocery store owners, and all the various WIC clinics' staffs. Plus the Web-based computer system we use had to undergo some very big software changes. And when you're first rolling something like this out, the point is not to just be aggressive and quick. You don't want to have to do it over. You want to do it right the first time."
For Johnson, the changes have already been visible. "I also have a 10-year-old, and before she wouldn't eat any vegetables," she says. "So I used to not buy much vegetables. But since WIC added the vegetables in September, I been buying her some green beans to try, and now she actually likes them. So we're healthier because of WIC."