Takeaways
- No significant prepandemic differences in fruit intake, vegetable intake, or overall diet quality were found between WIC participants and income-eligible nonparticipants.
- Higher food insecurity among WIC-enrolled toddlers did not translate to poorer dietary intake, suggesting the program may help stabilize nutrition for higher-risk families.
- Diet quality was suboptimal across all groups, indicating a broader need to improve nutritional intake among young children regardless of WIC participation status.
A cross-sectional analysis of prepandemic diet quality found no significant differences in fruit intake, vegetable intake, or overall diet quality between toddlers and young children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and income-eligible nonparticipants. The findings, published in JAMA Pediatrics, establish an updated baseline for evaluating child nutrition outcomes.1
WIC provides supplemental nutrition, breastfeeding support, nutrition education, and referrals to families with low incomes. In 2021, COVID-19–related waivers increased the cash-value benefit for fruits and vegetables, prompting a need for more current baseline data prior to these changes.2
How did WIC participation relate to fruit, vegetable, and overall diet quality?
The study used prepandemic National Health and Nutrition Examination Survey data from 2017 to March 2020. Parents or caregivers reported demographics, food security, WIC participation, and dietary intake for toddlers aged 1 to <2 years and children aged 2 to 4 years. As noted in the report, “study participants gave written informed consent; all NHANES procedures were approved by the National Center for Health Statistics institutional review board.”
Children were categorized as current WIC participants or income-eligible nonparticipants (≤185% of the federal poverty level). Primary outcomes included fruit consumption, vegetable consumption, and Healthy Eating Index (HEI) scores.
After exclusions, the sample included 122 toddlers and 247 children. Among toddlers, 106 were WIC participants, and 16 were nonparticipants; among children aged 2 to 4 years, 201 were WIC participants, and 46 were nonparticipants.
Food insecurity was more common among toddlers participating in WIC (33.0% vs 18.8%). Despite this, dietary intake patterns were similar. Toddlers consumed a mean of 0.8 cup equivalents of fruit and 0.4 cup equivalents of vegetables daily, with an average HEI score of 57.9. Children consumed 1.0 cup equivalents of fruit, 0.5 cup equivalents of vegetables, and had an HEI score of 54.9.
WIC participation was not significantly associated with any dietary differences. As stated in the study, “WIC participation was not significantly associated with differences in any dietary outcomes.” Sensitivity analyses, including expanded datasets and alternative model specifications, produced consistent findings.
What factors may explain similar diet quality between WIC participants and nonparticipants?
The authors noted that although WIC participation is linked to positive health outcomes in other research, these findings align with previous analyses reporting minimal differences in dietary intake between groups. According to the study, “similar intakes, despite higher food insecurity among WIC participants, suggest that WIC may protect dietary intake among families at greater risk.” The study also reported that “suboptimal diet quality scores across WIC participants and nonparticipants alike highlight the need for improvement for all children.”
Limitations included small sample sizes, especially among income-eligible nonparticipants, and missing dietary or participation data that may reduce representativeness. The authors noted the need for future analyses examining prepandemic nutrition trends among additional WIC-served populations, including women and partially breastfed infants.
References
- Zimmer M, Zhan J, Gago C, Fung TT, Leung CW, Kenney EL. Prepandemic National Estimates of Toddler and Child Diet Quality by WIC Participation Status. JAMA Pediatrics. Published online November 24, 2025. doi:https://doi.org/10.1001/jamapediatrics.2025.4498
- US Department of Agriculture. WIC COVID-19 waivers. Accessed November 25, 2025. https://www.fns.usda.gov/disaster-assistance/wic-covid-19-waivers
