Prenatal and Postnatal Fruit and Vegetable Intake Among US Women: Associations with WIC Participation
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Prenatal and Postnatal Fruit and Vegetable Intake Among US Women: Associations with WIC Participation Tiffany L. Stallings1 • Julie A. Gazmararian2 • Michael Goodman2 David Kleinbaum2
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Ó Springer Science+Business Media New York 2016
Abstract Objective Evaluate variation in fruit and vegetable intake by Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation and poverty status among pregnant, and postpartum women participating in the Infant Feeding Practice Study II (IFPSII). Methods IFPSII (2005–2007) followed US women from third trimester through 1 year postpartum through mailed questionnaires measuring income, WIC participation, breastfeeding; and dietary history questionnaires (DHQ) assessing prenatal/postnatal fruit and vegetable consumption. Poverty measurements used U.S. Census Bureau Federal Poverty thresholds to calculate percent of poverty index ratio (PIR) corresponding to WIC’s financial eligibility (B185 % PIR). Comparison groups: WIC recipients; WIC eligible (B185 % PIR), but non-recipients; and women not financially WIC eligible ([185 % PIR). IFPSII participants who completed at least one DHQ were included. Intake variation among WIC/poverty groups was assessed by Kruskal–Wallis tests and between groups by Mann–Whitney Wilcoxon tests and logistic regression. Mann–Whitney Wilcoxon tests examined postnatal intake by breastfeeding. Results Prenatal vegetable intake significantly varied by WIC/poverty groups (p = 0.04) with WIC recipients reporting significantly higher intake than women not financially WIC eligible (p = 0.02); association remained & Tiffany L. Stallings [email protected] 1
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significant adjusting for confounders [odds ratio 0.66 (95 % confidence interval: 0.49–0.90)]. Prenatal fruit and postnatal consumption did not significantly differ by WIC/poverty groups. Postnatal intake was significantly higher among breastfeeding than non-breastfeeding women (fruit: p \ 0.0001; vegetable: p = 0.006). Conclusions for Practice Most intakes did not significantly differ by WIC/poverty groups and thus prompts research on WIC recipient’s dietary behaviors, reasons for non-participation in WIC, and the influence of the recent changes to the WIC food package. Keywords Fruit consumption Vegetable consumption Pregnancy Postpartum Breastfeeding Poverty WIC
Significance What is already known on this subject? The WIC program provides nutritional assistance to low-income pregnant and postpartum women. Before 2009, fruit juice and carrots were the fruits and vegetables WIC provided. Prenatal vegetable intake varies by WIC/poverty status, but this relationship among postpartum women is unexamined. What does this study add? Among women participating in IFPSII (2005–2007), prenatal vegetable intake also significantly varied by WIC/poverty status. Among postnatal women, fruit and vegetable consumption did not vary by WIC/poverty status, but intake was significantly higher among breastfeeding than non-breastfeeding women.
Department of Environmental and Oc
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