Altarum Institute Policy Roundtable Cosponsored by the National WIC Association

1. Altarum Institute Policy RoundtableCosponsored by the National WIC Association Can WIC Play a Role in Stemming the Childhood Obesity Epidemic?

2. Is WIC an Active Partner in Stemming Childhood Obesity? Patti Hauser, RD, CD, MPA Wisconsin State WIC Director NWA Board Chair

3. Is there really a problem? Nationally Women (20-39 yrs): 3 x Children (2-5 yrs): 2 x Predict by 2015 75% of adults 24% children The US is in the midst of an obesity epidemic. For the past 30 years, obesity has increased in all segments of the population regardless of age, gender or ethnicity. Among women of childbearing age, the percentage of obesity nearly tripled from 12/3% in 1980 to 34% in 2008 In children 2-5 years old, the prevalence more than doubled, increasing from 5% in 1980 to 12.4% in 2006. Researchers predict that if the rate of overweight and obesity continues to grow at the current pace, 75% of adults and about 24% of children will be overweight or obese by 2015. The US is in the midst of an obesity epidemic. For the past 30 years, obesity has increased in all segments of the population regardless of age, gender or ethnicity. Among women of childbearing age, the percentage of obesity nearly tripled from 12/3% in 1980 to 34% in 2008 In children 2-5 years old, the prevalence more than doubled, increasing from 5% in 1980 to 12.4% in 2006. Researchers predict that if the rate of overweight and obesity continues to grow at the current pace, 75% of adults and about 24% of children will be overweight or obese by 2015.

4. WIC�s Challenge Disproportionate affect in WIC Non-Hispanic black: 78.2 % Mexican American women: 76.9% Income < poverty: 2 x * Hispanics and blacks make up 62 percent of WIC caseload There is no evidence that women and children enrolled in WIC are more likely to be overweight compared to the general US population. There is, however, evidence that overweight and obesity disproportionately affect ethnic minority groups and low income populations. Recent data indicates that the prevalence of overweight and obesity was highest among non-Hispanic blacks (78.2%) and Mexican American women (76.9%) compared to Non-Hispanic white women: 61.2% And women with incomes below the poverty level were more than twice as likely to be obese compared to women in higher incomes. Since WIC serves low income women and children, there will obviously be a disproportionate affect on the WIC population. There is no evidence that women and children enrolled in WIC are more likely to be overweight compared to the general US population. There is, however, evidence that overweight and obesity disproportionately affect ethnic minority groups and low income populations. Recent data indicates that the prevalence of overweight and obesity was highest among non-Hispanic blacks (78.2%) and Mexican American women (76.9%) compared to Non-Hispanic white women: 61.2% And women with incomes below the poverty level were more than twice as likely to be obese compared to women in higher incomes. Since WIC serves low income women and children, there will obviously be a disproportionate affect on the WIC population.

5. Opportunities in WIC Who and when Quality nutrition education Nutritious foods Adjunct to health services While WIC has a disproportionate share of the obesity problem, we are uniquely positioned to take on the challenge. The structure of WIC plays an important role; who we serve, what we do for them, and when we see them. Women, Infants and Children � Pregnant, Breastfeeding and Postpartum Women, Infants, and Children up to age 5 (or preschool). Before, During and After Pregnancy is a critical time because *children whose mothers were obese during early pregnancy were 2.5 times more likely to be overweight during their preschool years; and about 70% of overweight children will become overweight adults. WIC serves women after they deliver (to achieve a healthy weight before their next pregnancy) and during the pregnancy (to have an ideal weight gain during the pregnancy). During the pregnancy, WIC also promotes breastfeeding and educates the mom on successful breastfeeding in the first couple of weeks. WIC then serves the breastfeeding mom up to a year, as long as she continues to breastfeed. Infants and young children: establish healthy eating patterns early in life, introduction of solids, weaning from bottle Certify every six months; weight and measure; calculate BMI, review eating habits; additional nutrition education at least once during that period; more for high risk Quality nutrition education that participant centered and focused on behavior change; reinforced at every visit Nutritious foods: new food packages include fruits and vegetables, low fat milk� Adjunct and referral to health services: While WIC has a disproportionate share of the obesity problem, we are uniquely positioned to take on the challenge. The structure of WIC plays an important role; who we serve, what we do for them, and when we see them. Women, Infants and Children � Pregnant, Breastfeeding and Postpartum Women, Infants, and Children up to age 5 (or preschool). Before, During and After Pregnancy is a critical time because *children whose mothers were obese during early pregnancy were 2.5 times more likely to be overweight during their preschool years; and about 70% of overweight children will become overweight adults. WIC serves women after they deliver (to achieve a healthy weight before their next pregnancy) and during the pregnancy (to have an ideal weight gain during the pregnancy). During the pregnancy, WIC also promotes breastfeeding and educates the mom on successful breastfeeding in the first couple of weeks. WIC then serves the breastfeeding mom up to a year, as long as she continues to breastfeed. Infants and young children: establish healthy eating patterns early in life, introduction of solids, weaning from bottle Certify every six months; weight and measure; calculate BMI, review eating habits; additional nutrition education at least once during that period; more for high risk Quality nutrition education that participant centered and focused on behavior change; reinforced at every visit Nutritious foods: new food packages include fruits and vegetables, low fat milk� Adjunct and referral to health services:

6. Breastfeeding � an Investment in Healthy Weight Breastfeeding promotion and support Breastfeeding Peer Counseling Program New Food Packages NWA Breastfeeding Summit and National Plan Thank you to the WIC appropriators and USDA in recognizing the importance of the Breastfeeding Peer Counselor Program by increasing national funding from about $15 million to $80 million. The longer an infant breastfeeds, the greater chance for a healthy weight. New food packages support breastfeeding by giving fully breastfeeding moms more food, and fully breastfed babies twice the infant fruits and vegetables that non-or partially breastfed babies get, in addition to infant meats. Thank you to the WIC appropriators and USDA in recognizing the importance of the Breastfeeding Peer Counselor Program by increasing national funding from about $15 million to $80 million. The longer an infant breastfeeds, the greater chance for a healthy weight. New food packages support breastfeeding by giving fully breastfeeding moms more food, and fully breastfed babies twice the infant fruits and vegetables that non-or partially breastfed babies get, in addition to infant meats.

7. WIC Recommendations Provide worksite wellness Educate on healthy eating Educate on physical activity Collaborate Utilize mass media Promote research Support public policy * NWA: The Role of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the Prevention of Maternal and Childhood Overweight and Obesity (2008; Updated summary February 2010) NWAPaper: WIC: Preventing Maternal and Childhood Overweight and Obesity Collaborate: CDC Nutrition and Physical Activity grants ARRA Community Prevention and Wellness SNAP-ed Departments of Public Instruction, Head Start, Childcare NWAPaper: WIC: Preventing Maternal and Childhood Overweight and Obesity Collaborate: CDC Nutrition and Physical Activity grants ARRA Community Prevention and Wellness SNAP-ed Departments of Public Instruction, Head Start, Childcare

8. Thank you ! Patti Hauser WI Division of Public Health 1 W Wilson Street, Madison WI 53701 608-266-3821 Patti.hauser@wisconsin.gov