[Federal Register: September 15, 2003 (Volume 68, Number 178)]
[Proposed Rules]               
[Page 53903-53910]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr15se03-12]                         

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Proposed Rules
                                                Federal Register
________________________________________________________________________

This section of the FEDERAL REGISTER contains notices to the public of 
the proposed issuance of rules and regulations. The purpose of these 
notices is to give interested persons an opportunity to participate in 
the rule making prior to the adoption of the final rules.

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[[Page 53903]]



DEPARTMENT OF AGRICULTURE

Food and Nutrition Service

7 CFR Part 246

RIN 0584-AD39

 
Special Supplemental Nutrition Program for Women, Infants and 
Children (WIC): Revisions to the WIC Food Packages

AGENCY: Food and Nutrition Service (FNS), USDA.

ACTION: Advanced notice of proposed rulemaking.

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SUMMARY: The WIC Program provides supplemental food packages designed 
to provide specific nutrients critical to growth and development. WIC 
food packages and nutrition education are the chief means by which WIC 
affects the dietary quality and habits of participants. WIC food 
packages were designed to supplement participants' diets with 
nutritionally dense foods that prevent iron-deficiency anemia; 
complement the eating patterns of pre-school children; and address the 
special nutrition requirements of pregnant and breastfeeding women. The 
WIC food packages were last revised in 1980. While WIC has been 
successful in many areas, obesity and inappropriate dietary patterns 
have become significant concerns for many in WIC's target population. 
In this Notice, the Department is soliciting public comments on 
redesigning the food packages offered through the WIC Program to 
determine if the WIC food packages should be revised to better improve 
the nutritional intake, health and development of participants; and, if 
so, what specific changes should be made to the food packages. The 
Department plans to enlist independent technical experts via the 
Institute of Medicine's Food and Nutrition Board to review available 
science and comments submitted in response to this Notice and to 
develop recommendations on revising the WIC food packages for the 
Department's consideration. The Department will use comments received 
through the Notice and the Food and Nutrition Board recommendations to 
develop a proposed rule.

DATES: To be assured of consideration, comments must be postmarked on 
or before December 15, 2003.

ADDRESSES: Comments should be sent to Patricia Daniels, Director, 
Supplemental Food Programs Division, Food and Nutrition Service, USDA, 
3101 Park Center Drive, Room 520, Alexandria, Virginia 22302. Comments 
on this Notice should be clearly labeled ``Revisions to the WIC Food 
Packages.'' Comments which are not within the scope of this Notice 
should not be included. All written comments will be available for 
public inspection during regular business hours (8:30 a.m. to 5 p.m., 
Monday through Friday) at the above address.

FOR FURTHER INFORMATION CONTACT: Debra Whitford, Branch Chief, Policy 
and Program Development Branch, Supplemental Food Programs Division, at 
the address indicated in the ADDRESS section or at (703) 305-2746 
during regular business hours (8:30 a.m. to 5 p.m.), Monday through 
Friday.

SUPPLEMENTARY INFORMATION:

I. Procedural Matters

Executive Order 12866

    This action has been determined to be significant and was reviewed 
by the Office of Management and Budget under Executive Order 12866.

Paperwork Reduction Act of 1995

    This action does not contain reporting or record keeping 
requirements subject to approval by the Office of Management and Budget 
in accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. 
3507).

Executive Order 12372

    This program is listed in the Catalog of Federal Domestic 
Assistance Programs under No. 10.570, and is subject to the provisions 
of Executive Order 12372, which requires intergovernmental consultation 
with State and local officials (7 CFR part 3015, subpart V, and final 
rule-related notices published at 48 FR 29114, June 24, 1983, and 49 FR 
22676, May 31, 1984).

Civil Rights Impact Analysis

    FNS has reviewed this action in accordance with the Department 
Regulation 4300-4, ``Civil Rights Impact Analysis,'' to identify and 
address any major civil rights impact this Notice might have on 
minorities, women, and persons with disabilities. FNS has determined 
that this action presents no civil rights impact on minorities and 
other protected classes, nor does it present any barrier to program 
access or participation. With this action the Department is soliciting 
comments from the public on redesigning the WIC food packages to better 
meet the needs of WIC's diverse participants.

Federalism Summary Impact Statement

    Executive Order 13132 requires Federal agencies to consider the 
impact of their regulatory actions on State and local governments. 
Where such actions have federalism implications, agencies are directed 
to provide a statement describing the agency's considerations called 
for under section (6)(b)(2)(B) of Executive Order 13132.

Prior Consultation With State Officials

    Over the years the Department has received numerous requests from 
WIC State agencies and participants to modify the current food packages 
to permit greater substitution of foods or introduction of additional 
foods. These requests have come from formal and informal discussions 
and with State and local officials on an ongoing basis regarding 
program implementation and food package policy issues, and from written 
proposals submitted to FNS by WIC State agencies to allow modifications 
and/or substitutions to the WIC food packages.

Need To Issue This Notice

    Through this Notice, the Department is soliciting public comments 
on redesigning the food packages offered through the WIC Program to 
determine if the WIC food packages should be revised to better meet the 
nutritional needs of participants and, if so, what specific changes 
should be made to the food packages. The Department believes that 
public comment is necessary to inform decisions and to bolster the 
scientific and programmatic integrity of any rule that is proposed as a 
result of this process.

[[Page 53904]]

Executive Order 12998

    This action has been reviewed under Executive Order 12998, Civil 
Justice Reform. This action is not intended to have preemptive effect 
with respect to any State or local laws, regulations or policies that 
conflict with its provisions or that would otherwise impede its full 
implementation.

II. References

    (1) Study of WIC Participant and Program Characteristics, 2000. 
Available at Internet site: http://www.fns.usda.gov/oane/MENU/Published/WIC/WIC.HTM
.
    (2) Review of the Nutritional Status of WIC Participants (CNPP), 
December 1999. Available at Internet site: http://www.usda.gov/cnpp/Pubs/Wic/
    (3) Nutrition and Your Health: Dietary Guidelines for Americans, 
Fifth Edition, USDA and U.S. Department of Health and Human Services, 
Washington, DC, 2000. Available at Internet site: http://www.usda.gov/cnpp/Pubs/DG2000/
    (4) WIC and the Nutrient Intake of Children (ERS), Food Assistance 
and Nutrition Research Report No. FANRR5, April 2000. Available at 
Internet site: http://www.ers.usda.gov/publications/fanrr5/
    (5) Institute of Medicine. Dietary Reference Intakes. Panel on 
Macronutrients (Energy, Carbohydrate, Fiber, Fat, Fatty Acids, 
Cholesterol, Protein, and Amino Acids (September 5, 2002, 936 pp.))
    (6) Institute of Medicine. Dietary Reference Intakes. Panel on 
Micronutrients (Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, 
Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and 
Zinc (2002, 800 pp.))
    (7) Institute of Medicine. Dietary Reference Intakes. Standing 
Committee on the Scientific Evaluation of Dietary Reference Intakes 
(Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (1997, 448 
pp.))
    (8) Institute of Medicine. Dietary Reference Intakes. Dietary 
Antioxidants and Related Compounds (Vitamin C, Vitamin E, Selenium, and 
Carotenoids (2000, 529 pp.))
    (9) Institute of Medicine. Dietary Reference Intakes. Panel on 
Folate, Other B Vitamins, and Choline (Thiamin, Riboflavin, Niacin, 
Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline 
(2000, 592 pp.))
    (10) WIC Program Regulations Pertaining to Supplemental Food [7 CFR 
246.10] available at Internet site: http://www.fns.usda.gov/wic/PDFfiles/WICRegulations-7CFR246.pdf
    (11) FNS Instruction 804-1 ``WIC Program--Food Package Design: 
Administrative Adjustments and Nutrition Tailoring.''
    (12) Standard reference values for nutrients in foods are available 
from USDA, Agricultural Research Service, Nutrient Data Bank, http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl

III. General Background

    Since the creation of the WIC Program in the 1970's, and the last 
revision of the WIC food packages in the early 1980's, much has been 
learned about the nutritional needs of pregnant women, infants, and 
preschool aged children. In recent years the ability of the WIC Program 
to meet nutritional needs of WIC participants through its food packages 
and nutrition education has received growing attention. Significant 
interest in updating the food packages based on new information about 
the needs of low-income women, infants, and children has been voiced by 
WIC Program administrators, the medical and scientific communities, 
advocacy groups, and Congress.
    Authorizing legislation requires that the supplemental foods 
provided by WIC contain nutrients known to be lacking in the diets of 
the target population [see the Child Nutrition Act, as amended (CNA), 
section 17(b)(14), (42 U.S.C. 1786)]. Indeed, because of the WIC 
Program and the larger nutrition safety net, progress has been made in 
filling many of these nutrient gaps. However, nutritional science and 
the Dietary Guidelines for Americans have evolved, and the overall 
nutritional needs and consumption patterns of WIC's target population 
have changed. The Department acknowledges the continuing advances in 
nutritional research since the current food packages were established 
in 1980. Recommended dietary practices are constantly evolving in 
response to new knowledge and may hold significant implications for the 
WIC Program. Food technology has also advanced substantially, resulting 
in a large number of new products.
    With this Notice, the Department is seeking guidance on issues/
questions concerning revisions to the WIC food packages that would 
address the nutritional needs of the WIC population given current 
scientific information and consumption patterns. The food package 
recommendations should not increase the cost or administrative burden 
to the WIC Program nor change the supplemental nature of the Program. 
Any modifications to the WIC food packages should be based on 
scientific evidence.

IV. Program Background

    The authorizing legislation for the WIC Program, section 17 of the 
CNA established the WIC Program to provide supplemental foods and 
nutrition education to low income pregnant, breastfeeding, and 
postpartum women, infants, and children up to age 5 who are at 
nutritional risk. Nutritional risk is determined by a competent 
professional authority and includes conditions such as inadequate 
weight gain during pregnancy; history of inappropriate growth patterns 
in infants and children; anemia; and inadequate dietary patterns.
    Sections 17(a) and (b)(14) of the CNA (42 U.S.C. 1786(a) and 
(b)(14)) clearly established the WIC Program as ``supplemental'' in 
nature; that is, the WIC supplemental foods are not intended to provide 
a complete diet but are designed to provide specific nutrients 
determined by nutritional research to be lacking in the diets of the 
WIC population. WIC was never intended to be a primary source of food, 
nor of general food assistance. Rather, WIC benefits are intended to 
meet the special nutritional needs of a very specific population. In 
addition to WIC, the Department administers a variety of other 
complementary nutrition assistance programs that work together to 
provide a more complete diet to low-income persons. Low-income families 
can, and frequently do, receive benefits from more than one of these 
programs. The largest of these programs, the Food Stamp Program, 
provides general food assistance intended to increase the food buying 
power of low-income households.
    In addition to food assistance, WIC provides nutrition education, 
including breastfeeding promotion and support, and information about 
the dangers of alcohol, tobacco and other drug use to participants. The 
nutrition education provided by WIC enables participants to make 
informed decisions in choosing foods that, together with the 
supplemental foods contained in the WIC food packages, can meet their 
total dietary needs. The intent is to help participants to continue 
healthful dietary practices after leaving the Program.
    WIC is a unique nutrition assistance program in that it also serves 
as an adjunct to good health care during critical times of growth and 
development to prevent the occurrence of health problems and to improve 
the health status of Program participants. Numerous studies have shown 
that WIC

[[Page 53905]]

is cost effective and successful in improving the health and 
nutritional status of its clients.
    For example, WIC has played an important role in improving birth 
outcomes and containing health care costs.1,2 A series of 
reports published by USDA based on linked 1988 WIC and Medicaid data on 
over 100,000 births found that Medicaid eligible pregnant women in 5 
States who participated in WIC during their pregnancies had:
    [sbull] Longer pregnancies;
    [sbull] Fewer premature births;
    [sbull] Lower incidence of moderately low and very low birth weight 
infants; 3
    [sbull] Fewer infant deaths;
    [sbull] A greater likelihood of receiving prenatal care; and
    [sbull] Savings in health care costs from $1.77 to $3.13 for each 
dollar spent on WIC.4,5,6
    Studies have also found WIC to have a positive effect on children's 
diet and diet-related outcomes such as:
    [sbull] Higher mean intakes of iron, vitamin C, thiamin, niacin and 
vitamin B6, without an increase in food energy intake, indicating an 
increase in the nutrient density of the diet; 7
    [sbull] Positive effects on the intakes of ten nutrients without an 
adverse effect on fat or cholesterol; 8
    [sbull] More effective than other cash income or food stamps at 
improving preschoolers' intake of key nutrients; 8 and
    [sbull] Decline in the rate of iron deficiency anemia from 7.8 
percent in 1975 to 2.9 percent in 1985 which the Centers for Disease 
Control and Prevention attributed to both a general improvement in iron 
nutrition and participation in WIC and other public nutrition 
programs.2,9
    However, a comprehensive evaluation of the WIC program has not been 
completed in over 15 years.

References

    1. Gordon, Anne; and Lyle Nelson. Characteristics and Outcomes 
of WIC Participants and Nonparticipants: Analysis of the 1988 
National Maternal and Infant Health Survey. Alexandria, Virginia: 
U.S. Department of Agriculture, March 1995.
    2. 7. U.S. General Accounting Office, ``Early Intervention: 
Federal Investments Like WIC Can Produce Savings,'' Document HRD 92-
18, Washington, DC, April 1992.
    3. Kowaleski-Jones, L. and GJ Duncan. Effects of Participation 
in the WIC Program on Birth Weight: Evidence from the National 
Longitudinal Survey of Youth. American Journal of Public Health Vol 
92: 799-804. May 2002.
    4. Devaney, Barbara, Linda T. Bilheimer, and Jennifer Schore. 
The Savings in Medicaid Costs for Newborns and Their Mothers from 
Prenatal Participation in the WIC Program. Alexandria, Virginia: 
U.S. Department of Agriculture, October 1990.
    5. Devaney, Barbara. Very Low Birthweight Among Medicaid 
Newborns in Five States: The Effects of Prenatal WIC Participation. 
Alexandria, Virginia: U.S. Department of Agriculture, September 1992
    6. Devaney, Barbara, and Allen Schirm. Infant Mortality Among 
Medicaid Newborns in Five States: The Effects of Prenatal WIC 
Participation. Alexandria, Virginia: U.S. Department of Agriculture, 
May 1993.
    7. U.S. Department of Agriculture Food and Nutrition Service. 
The National WIC Evaluation: An Evaluation of the Special 
Supplemental Food Program for Women, Infants, and Children. Vol. 1: 
Summary. Alexandria, Virginia: U.S. Department Agriculture, 1987.
    8. Rose, D., Habicht, J-P., and Devaney, B.: ``Household 
Participation in the Food Stamp and WIC Programs Increases the 
Nutrient Intakes of Preschool Children,'' Journal of Nutrition, 
128:548-555, March 1998.
    9. Oliveira, Victor, Elizabeth Racine, Jennifer Olmsted and 
Linda M. Ghelfi. The WIC Program: Background, Trends, and Issues. 
Alexandria, Virginia: U.S. Department of Agriculture, September 
2000.

V. History and Development of WIC Food Packages

    Early legislation for the WIC Program, Public Law 92-433 (1972) 
through Public Law 94-105 (1975), specifically identified protein, 
iron, calcium and Vitamins A and C as nutrients of particular concern 
for WIC participants. However, Public Law 95-627, enacted in November 
1976, deleted the reference to these nutrients. Instead, it defined 
supplemental foods as those foods containing nutrients determined by 
nutritional research to be lacking in the diets of pregnant, 
breastfeeding and postpartum women, infants, and children, as 
prescribed by the Secretary of Agriculture. The Program direction 
announced by that law remains in effect today (section 17(b)(14) of the 
CNA, 42 U.S.C. 1786(b)(14)). The law also directs the Secretary in 
section 17(f)(11) of the CNA (42 U.S.C. 1786(f)(11)) to assure that, to 
the degree possible, the fat, sugar, and salt content of WIC foods is 
appropriate.
    The law provides substantial latitude to the Department in 
designing WIC food to supply nutrients lacking in the diets of the WIC 
eligible population. Historically, the Department has based its 
prescriptions of WIC foods on sound nutritional research and input from 
State and local agencies, the health and scientific communities, 
industry and the general public.
    In anticipation of the passage of Public Law 95-627, the 
Department, in October 1978, assembled a WIC Food Package Advisory 
Panel composed of State health officials, representatives of the 
nutrition community and advocacy groups, to review the original food 
packages and recommend changes. Panel recommendations included 
retaining high-quality protein, iron, calcium, and vitamins A and C as 
the targeted nutrients in the WIC Program and expanding the number of 
available packages. Based on the Panel's recommendations and an 
evaluation by the Department of the available nutrition research on the 
nutrient, fat, sugar and salt content of the WIC foods, the Department 
proposed retaining high-quality protein, iron, calcium, and vitamins A 
and C as the targeted nutrients in the WIC Program and expanding the 
number of available packages in 1979 (44 FR 69254-69270, November 30, 
1979). Based on public response to proposed rules in 1979, new WIC food 
package regulations were published in 1980 (45 FR 74854, November 12, 
1980) that are consistent with Public Law 95-627.
    These food package requirements appear in 7 CFR 246.10 of the WIC 
Program regulations. The 1980 rule established six different monthly 
packages: Food Package I for infants 0-3 months; Food Package II for 
infants 4-12 months; Food Package III for children and women with 
special dietary needs; Food Package IV for children 1-5 years of age; 
Food Package V for pregnant and breastfeeding women; and Food Package 
VI for nonbreastfeeding postpartum women. The Department created an 
additional food package in 1992 (57 FR 56231, November 27, 1992). This 
enhanced food package, Food Package VII, is designed for breastfeeding 
women who elect not to receive infant formula through WIC for their 
infants.
    Authorized WIC foods include iron-fortified infant formula, iron-
fortified cereals, vitamin C-rich 100 percent fruit and/or vegetable 
juice, calcium/protein-rich milk and cheese, protein/iron-rich eggs, 
protein-rich peanut butter or dried beans/peas, and physician-
prescribed formula/medical foods for participants with certain special 
dietary needs. The enhanced package for breastfeeding women increases 
allowable amounts of juice, cheese, peanut butter and dry beans/peas, 
and also allows protein-rich tuna fish and carrots that provide beta-
carotene (precursor to vitamin A) and dietary fiber. All WIC foods are 
nutrient dense, economical, administratively manageable for WIC State 
agencies; readily available in retail stores; offer variety and 
versatility; have broad appeal; and generally can be apportioned into 
daily servings.

VI. Recent Science and National Dietary Guidance

    During the last decade, science has provided new information on the

[[Page 53906]]

nutritional needs of Americans, including WIC's target population. As 
discussed previously, the WIC Program has focused historically on 
supplying participants with protein and four important micronutrients: 
Vitamins A and C, calcium, and iron. More recently nutrition research 
has identified other micronutrients of potential concern, such as folic 
acid, zinc, vitamin B6 and magnesium. In addition, dietary causes of 
chronic disease have been more clearly identified. The 2000 Dietary 
Guidelines for Americans provide advice, based on current scientific 
and medical knowledge, for healthy Americans ages 2 years and over 
about food choices that promote health and prevent disease. New Dietary 
Reference Intakes (DRI's) have recently been established by the 
Institute of Medicine, Food and Nutrition Board as guidelines for 
nutrient intake in the U.S. population. The next update of the Dietary 
Guidelines for Americans, to be completed in 2005, will reflect the new 
DRI's.

VII. Nutrition Risk and Demographic Changes in WIC's Population

    WIC applicants must be determined to be at nutritional risk to meet 
eligibility requirements for the WIC Program. Nutrition risk means 
nutritionally-related medical conditions (e.g., anemia, inappropriate 
growth or weight gain pattern) or dietary deficiencies (e.g., 
inadequate or inappropriate nutrient intake) that impair or endanger 
health. According to the WIC Participant and Program Characteristics 
2000 report, 56.3% of WIC participants are identified as having a 
dietary deficiency.
    Obesity has become one of the most serious health problems in the 
United States, with direct implications for the health of WIC program 
participants. The National Center for Health Statistics revised growth 
charts, when used with WIC data from 1992 to 1998, show that overweight 
prevalence among children enrolled in WIC increased 20 percent over 
this 6-year period. Data from the early 1990s indicated that the 
prevalence of overweight in WIC children is similar to that of non-WIC 
children. WIC program data show that a majority of overweight WIC 
children have nutritional risks in addition to being overweight, i.e., 
inadequate or inappropriate nutrient intake, anemia. A challenge facing 
the WIC program is to determine how it can most successfully improve 
the eating habits of low-income children.
    The ethnic composition of the WIC Program has been changing 
steadily since 1992; the percentage of Hispanic enrollees has risen, 
while percentages of black and white (non-Hispanic) enrollees have 
decreased. The current racial/ethnic enrollment is: 37.4 percent White, 
35.3 percent Hispanic, 21.9 percent Black, 3.3 percent Asian or Pacific 
Islanders, and 1.4 percent American Indian or Alaskan Natives. Low-
income populations, including WIC participants, are faced with numerous 
barriers to good nutrition and to nutrition assistance. For populations 
of different cultures, especially those who have recently arrived in 
the United States and who lack orientation to service delivery here, 
the barriers to assistance can be of such magnitude as to adversely 
affect their health and well-being. To achieve the best overall 
outcomes the WIC community must give special consideration to its 
approach in delivering culturally appropriate, quality benefits to 
these growing subpopulations.

VIII. Requests for Revisions to the WIC Food Packages

    Over the years the Department has received numerous requests from 
WIC State agencies and participants to modify the current food packages 
to permit greater substitution of foods or introduction of additional 
foods. Requests for revisions to the WIC food packages have also been 
received from Congress and other organizations with interests in the 
welfare of WIC participants. The focus of suggested changes is on 
improving outcomes for WIC recipients. For example:
    [sbull] Congress has requested a WIC food package rule that 
includes fruits and vegetables and that allows for cultural food 
accommodations.
    [sbull] The National Advisory Council on Maternal, Infant, and 
Fetal Nutrition, in its 1992, 1996 and 2002 Reports to Congress, 
recommended better accommodation of the nutritional and cultural needs 
of WIC participants.
    [sbull] In 1999, the National WIC Association (then the National 
Association of WIC Directors (NAWD)) published a position paper 
entitled ``NAWD WIC Food Prescription Recommendations.'' NAWD made 
three recommendations designed to reframe the WIC food packages and one 
recommendation on research and policy analysis in support of the WIC 
food packages. Consistency with the Dietary Guidelines for Americans 
and allowing flexibility to provide culturally appropriate foods were 
among the recommendations.
    [sbull] In an April 30, 2002, statement entitled ``Reauthorization 
of USDA Child Nutrition and WIC Programs,'' the American Dietetic 
Association recommended that WIC food packages be flexible to address 
cultural food practices and choices and participants' nutrition needs, 
consistent with national guidelines.
    The Department wishes to consider these and other requests and in 
this notice solicits affordable, scientifically-based recommendations 
as well as other suggestions from the public for revisions to the WIC 
food packages that will improve the nutritional intake, health and 
development of participants.

IX. Design of the WIC Food Packages

    The seven current WIC food packages were designed to help 
accomplish the following: Supplement participants' diets with 
nutritionally dense foods that follow current medical and nutritional 
guidance; complement the eating patterns of preschool children; and 
address the special requirements of pregnant and breastfeeding women. 
The WIC food packages were initially designed and adopted with regard 
to a set of fundamental considerations. These considerations should be 
taken into account when commenting on the issues presented in this 
Notice. The factors to be considered are discussed below.

1. Nutritional Risk

    The provision of supplemental foods containing nutrients determined 
by research to be lacking in the diets of the WIC population is the 
cornerstone of the Program. Nutrient requirements are particularly high 
during times of rapid growth, development and replenishment. Therefore, 
the WIC population, composed of pregnant, breastfeeding and postpartum 
women, infants and children, represents individuals whose nutritional 
needs are among the highest and most critical for optimal growth and 
development. Ensuring optimal nutrient intakes during these vulnerable 
periods of life is paramount to prevent both immediate and long-term 
adverse health outcomes. Consequently, recommendations should reflect 
current nutritional science and assure that the various packages 
supplement the nutrition needs of WIC's at-risk population with 
nutrient-dense economical foods the recipients should be encouraged to 
acquire and/or continue to acquire with their own resources.
    WIC foods should make a significant nutritional contribution to the 
diets and health of Program participants. Current nutritional science 
may reveal changing nutritional needs, and evolving needs in the 
population suggesting changes to the food packages. Addressing the 
nutritional needs is imperative if WIC is to remain an effective 
health-related

[[Page 53907]]

program. Congressional intent as evidenced both in statutory and 
legislative report language has continually emphasized that the WIC 
should provide foods and nutrients that current research demonstrates 
are lacking in the diets of WIC participants [Senate Report 106-288, 
Senate Report 107-41, Section 17(b)(14) of the CNA, 42 U.S.C. 
1786(b)(14)]. However, WIC's success in providing important nutrients 
should not lead to the conclusion that WIC should no longer provide 
them. Accordingly, changes to the food package should weigh the risk 
and consequences of dietary inadequacy and make changes expected to 
maximize the positive outcomes on WIC recipient nutritional status, 
health and development.

2. Fat, Sugar, and Salt Content

    As discussed previously, consideration of the fat, sugar and salt 
content of foods in the WIC food packages is required by section 
17(f)(11) of the CNA. Several changes made to the WIC food packages in 
the 1980 rulemaking responded specifically to this mandate. For 
example, the Department established a limit on the amount of sugar 
allowable in WIC approved cereals. By regulation, WIC cereals per dry 
ounce must contain no more than 6 grams of sugar. This specification 
applies to added sugars and to those naturally occurring in ingredients 
such as dried fruits used in the cereal.
    FNS policy guidance permits WIC State agencies to issue low-fat, 
low-cholesterol and low-sodium forms of WIC cheeses, as well as low-
fat, nonfat and lactose-free milks. The Department encourages local 
program administrators to tailor the WIC food packages to meet the 
individual nutritional needs of participants and, when appropriate, to 
adjust the types of WIC foods prescribed to help reduce the amount of 
fat, cholesterol, sodium and sugar the WIC food packages contribute to 
the diet. Through WIC nutrition education, participants also receive 
advice on how to further moderate their intakes of fat, cholesterol, 
sodium and sugar and how to include adequate amounts of vegetables, 
fruits and whole grain products in their diets.

3. Cost

    In addition to the criteria specified in legislation, a prime 
consideration in the design of the WIC food packages is cost. 
Efficiency in providing supplemental foods is important because 
increases in the total cost of the food packages reduce the number of 
participants served by the program. The packages are designed to 
encourage further cost control by permitting State and local agencies 
the flexibility to specify lower cost food brands, forms of foods, 
types and container sizes within regulatory parameters.

4. Practicality and Administrative Feasibility

    In addition to meeting nutritional objectives, all WIC food 
packages are designed to address a number of practical considerations 
that reflect participant and Program needs. For example, the WIC foods 
are readily available in retail food stores, offer variety and 
versatility to participants in the ways these foods can be used in an 
overall diet, are nutrient-dense, can be easily divisible into servings 
on a daily basis, and have broad appeal. Additionally, all WIC food 
packages are individual food prescriptions which, in order to have the 
full effect in improving a participant's nutritional status, are 
intended to be consumed only by the participant and not by other family 
members.
    The packages should be administratively manageable for State and 
local agencies and vendors. That is, they should be clearly describable 
and easily understood by both participants and vendors. WIC food 
packages are designed to strike a balance between acceptable, nutrient 
dense, readily available, low-cost food items, and administrative 
feasibility. This means that although there are certainly some foods 
that would be particularly beneficial for and appealing to WIC 
participants, the WIC Program is not always capable, within the 
limitations of its current structure, of easily delivering such foods. 
Also, WIC is limited in its ability to offer a wide range of food 
options since, from a management standpoint, each food option added to 
the food package magnifies the difficulties and increases the cost of 
program management and accountability. These practical considerations 
are necessarily a key consideration in the design of WIC food packages.

5. Food Package Flexibility and Meeting Participants' Special Needs

    Food package flexibility regarding the quantities of foods provided 
by WIC food packages and participants' cultural eating patterns and 
nutritional needs are considerations in the design of the food 
packages. State and local agencies can tailor the quantities of foods 
provided by the food packages to better meet participants' special 
nutritional needs. Additionally, they are permitted flexibility in 
designing their food packages within the parameters of Program 
regulations. Commenters should be aware that the quantities in all WIC 
food packages are expressed as maximum levels. However, State and local 
agencies have the authority to tailor quantities according to the needs 
of individual participants or categories of participants when based on 
a sound nutritional rationale. These tailoring provisions established 
in Program regulations (7 CFR 246.10) and supplemented by FNS 
Instruction 804-1 ``WIC Program--Food Package Design: Administrative 
Adjustments and Nutrition Tailoring,'' are designed to permit State and 
local agencies to implement their own nutrition policies and 
philosophies within the parameters of food package requirements.

X. Review Considerations/Parameters

    The principles outlined above (and discussed elsewhere in this 
Notice) constitute a framework upon which WIC food packages have been 
developed. The Department encourages commenters to present their 
recommendations in the context of their potential effects on the 
recipients that receive the affected food package(s) and their 
responsiveness to these principles or to alternate principles which the 
commenter believes should be considered. Further, comments ideally 
should include justification in terms of current nutritional research.
    Responses to this notice should be developed with serious regard to 
the dietary needs of the WIC-eligible population, the supplemental 
nature of the program, the critical impact of the cost of program 
services, and the need to maximize the overall effect of the Program 
for WIC recipients. In addition, the Department encourages commenters 
to submit suggestions with the following considerations in mind: (1) 
Cultural and ethnic food preferences; (2) commercial availability, 
variety and appeal of foods; (3) versatility in food preparation; (4) 
feasibility of apportionment into daily servings for an individual over 
a month's time; (5) State and local agency flexibility to design the 
food prescription; (6) administrative feasibility and manageability by 
the State and local agencies and vendors; and (7) burden and incentive 
for participants, potential participants, and their families.
    The following charts provide an overview of the foods currently 
offered in the food packages, including allowable substitutions, 
minimum Federal requirements and data on key nutrients in a selection 
of WIC-type foods. The charts may be helpful when commenting on issues 
such as the

[[Page 53908]]

amount of food provided by, or the allowable substitutions for, the 
current foods or nutrients provided in the WIC food packages.

                                                                                   Chart 1.--WIC Food Packages
                                                                                   [Maximum monthly allowance]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                     Pregnant &         Nonbreastfeeding
                                                                                  Children/women with                           breastfeeding women   postpartum women (up   Breastfeeding women
              Foods                   Infants 0-3 mo.       Infants 4-12 mos.    special dietary needs    Children 1-5 yrs.         (up to 1 yr.            to 6 mos.        enhanced package 1
                                                                                                                                    postpartum)            postpartum)
                                   (I)                    (II)                   (III)                  (IV)                   (V)                    (VI)                  (VII)
----------------------------------
Infant Formula (concentrated       403 fl. oz.            403 fl. oz.            403 fl. oz.\3\         .....................  .....................
 liquid) \2\.
Juice (reconstituted frozen) \4\.  .....................  96 fl. oz.\5\          144 fl. oz.            288 fl. oz.            288 fl. oz.            192 fl. oz.           336 fl. oz.
Infant Cereal....................  .....................  24 oz.                 .....................  .....................  .....................  ....................  ....................
Cereal (hot or cold).............  .....................  .....................  36 oz.                 36 oz.                 36 oz.                 36 oz.                36 oz.
Milk \6\ (whole, low-or fat free;  .....................  .....................  .....................  24 qt.                 28 qt.                 24 qt.                28 qt.
 or lactose free).
Cheese \7\.......................  .....................  .....................  .....................  .....................  .....................  ....................  1 lb.
Eggs \8\.........................  .....................  .....................  .....................  2\1/2\ doz.            2\1/2\ doz.            2\1/2\ doz.           2\1/2\ doz.
Dried Beans/Peas and/or Peanut     .....................  .....................  .....................  1 lb. or 18 oz.        1 lb. or 18 oz.        ....................  1 lb. and 18 oz.
 butter.
Tuna (canned)....................  .....................  .....................  .....................  .....................  .....................  ....................  26 oz.
Carrots (fresh) \9\..............  .....................  .....................  .....................  .....................  .....................  ....................  2 lbs.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Available to breastfeeding women whose infants do not receive infant formula from WIC.
\2\ 8 pounds powdered per 403 fluid ounces concentrate; or 26 fluid ounces ready-to-feed per 13 ounces concentrate may be substituted.
\3\ Additional formula available up to 52 fluid ounces concentrate, 1 pound powder, or 104 fluid ounces ready-to-feed.
\4\ 92 fluid ounces single strength juice may be substituted per 96 fluid ounces reconstituted frozen.
\5\ Infant juice may be substituted at the rate of 63 fluid ounces per 92 fluid ounces of single strength juice.
\6\ Fat free, low-fat, and full fat milk are allowed, as are lactose free and low-lactose milks. Goat's milk is also allowed.
\7\ Cheese may be substituted at a rate of 1 pound per 3 quarts of fluid milk with a 4 pound maximum.
\8\ Dried egg mix can be substituted at a rate of 1.5 pounds per 2 dozen fresh eggs, or 2 pounds per 2\1/2\ dozen fresh eggs.
\9\ Frozen carrots may be substituted pound for pound; canned maybe substituted at a rate of 16-20 ounces per 1 pound fresh.


                                           Chart 2.--WIC Food Packages
                                   [Minimum requirements and allowable foods]
----------------------------------------------------------------------------------------------------------------
                                                                                     Minimum requirements and
                General Foods                              Nutrients                      allowable foods
----------------------------------------------------------------------------------------------------------------
Milk........................................  Calcium...........................  Cow's milk, must conform to 21
                                                                                   CFR part 131 FDA standard of
                                                                                   identity or Goat's milk:
                                                                                   pasteurized fluid whole milk,
                                                                                   lowfat, reduced fat, skim,
                                                                                   fat free or nonfat milk, that
                                                                                   contains 400 International
                                                                                   Units of vitamin D per quart
                                                                                   (or reconstituted fluid quart
                                                                                   for evaporated and dry/
                                                                                   powdered milks); and 2000
                                                                                   International Units of
                                                                                   vitamin A per quart (or
                                                                                   reconstituted quart for
                                                                                   evaporated and dry/powdered
                                                                                   milks) if the milk is lowfat,
                                                                                   reduced fat, skim, fat free
                                                                                   or nonfat milk.
Cheese......................................  Calcium...........................  Domestic cheese (pasteurized
                                                                                   processed American, Monterey
                                                                                   Jack, Colby, Cheddar, Swiss,
                                                                                   Brick, Muenster, Provolone,
                                                                                   Mozzarella part-skim or
                                                                                   whole; or a cheese that is a
                                                                                   blend of any of these
                                                                                   cheeses). These same types of
                                                                                   cheeses labeled low, free,
                                                                                   reduced, less, or light in
                                                                                   the nutrients of sodium, or
                                                                                   fat, or cholesterol are also
                                                                                   authorized.
Eggs........................................  Protein...........................  Fresh shell domestic hens'
                                                                                   eggs or dried egg mix made
                                                                                   from shell, liquid, whole
                                                                                   eggs that have been
                                                                                   pasteurized and dried.
Beans.......................................  Protein...........................  Mature dry beans or peas,
                                                                                   including but not limited to:
                                                                                   lentils; black, navy, kidney,
                                                                                   garbanzo, soy, pinto, and
                                                                                   mung beans; and Crowder, cow,
                                                                                   split and black-eye peas.
Peanut Butter...............................  Protein...........................  Creamy or chunky, regular or
                                                                                   reduced fat and conforms to
                                                                                   FDA, Standard of Identity for
                                                                                   peanut butter as defined by
                                                                                   21 CFR Sec.   164.150.
Cereal......................................  Iron..............................  Includes ready-to-eat and
                                                                                   instant and regular hot
                                                                                   cereals as defined by FDA (21
                                                                                   CFR Part 170.3(n)(4)) that
                                                                                   also contain a minimum of 28
                                                                                   milligrams of iron per 100
                                                                                   grams of dry cereal and not
                                                                                   more than 21.2 grams of
                                                                                   sucrose and other sugars per
                                                                                   100 grams of dry cereal (6
                                                                                   grams per dry ounce).
Infant Cereal...............................  Iron..............................  Contains a minimum of 45
                                                                                   milligrams of iron per 100
                                                                                   grams of dry cereal. Infant
                                                                                   cereals containing infant
                                                                                   formula, milk, fruit, or
                                                                                   other non-cereal ingredients
                                                                                   are not authorized.
Juice.......................................  Vitamin C.........................  Must be pasteurized 100
                                                                                   percent fruit and/or
                                                                                   vegetable juice or blends of
                                                                                   these juices and contain a
                                                                                   minimum of 30 milligrams of
                                                                                   vitamin C per 100 milliliters
                                                                                   juice. Juices fortified with
                                                                                   other nutrients that also
                                                                                   meet the minimum WIC
                                                                                   requirements are allowable.
Infant Juice................................  Vitamin C.........................  Must be pasteurized 100
                                                                                   percent fruit juice and
                                                                                   contain a minimum of 30
                                                                                   milligrams of vitamin C per
                                                                                   100 milliliters juice.
Carrots.....................................  Vitamin A.........................  Raw, canned or frozen. Mature
                                                                                   raw; canned and frozen
                                                                                   carrots containing only the
                                                                                   mature root of the carrot
                                                                                   plant packed in water.
Tuna........................................  Protein...........................  Canned white, light, dark or
                                                                                   blended tuna packed in water
                                                                                   or oil, including solid and
                                                                                   solid pack; chunk, chunks and
                                                                                   chunk style; flake and
                                                                                   flakes; and grated.

[[Page 53909]]


Infant Formula..............................  Iron..............................  All authorized infant formulas
                                                                                   must meet the definition and
                                                                                   requirements for an infant
                                                                                   formula established by FDA,
                                                                                   DHHS; citations section
                                                                                   201(z) Federal Food Drug and
                                                                                   Cosmetic Act (21 U.S.C.
                                                                                   321(z)) and requirements
                                                                                   under section 412 of 21
                                                                                   U.S.C. 350a and regulations
                                                                                   at 21 CFR parts 106 and 107.
                                                                                   Designed for enteral
                                                                                   digestion via an oral or tube
                                                                                   feeding. Iron fortification
                                                                                   level must be 10 milligrams
                                                                                   per liter.
Exempt Infant Formula.......................  ..................................  Infant formulas must meet the
                                                                                   requirements for an exempt
                                                                                   infant formula under section
                                                                                   412(h) of the Federal Food,
                                                                                   Drug, and Cosmetic Act (21
                                                                                   U.S.C. 350 a(h)) and the
                                                                                   regulations at 21 CFR parts
                                                                                   106 and 107.
Medical Foods...............................  ..................................  Certain enteral products that
                                                                                   are specifically formulated
                                                                                   to provide nutritional
                                                                                   support for individuals with
                                                                                   a diagnosed medical
                                                                                   condition, when the use of
                                                                                   conventional foods is
                                                                                   precluded, restricted or
                                                                                   inadequate.
----------------------------------------------------------------------------------------------------------------


                                                       Chart 3.--Nutritional Content of Current Food Packages--Nutrients Provided per Day
                        [Nutrient yields for entire package, assuming selection of whole milk and legumes. A number of dairy and other options are typically available.]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                 Energy  Protein   Fiber            Sat    Chol.                          Folate    B12                            Iron    Zinc
                   Current WIC food packages                      Kcal      g        g     Fat g   Fat g    mg     E  AE   A RE    B6 mg   [mu]g   [mu]g   C mg    Ca mg  Mag mg    mg      mg
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Children--Package IV...........................................     853     42.5     5.4    32.3    18.0     319     1.9     840     1.3     264     5.1     106   1,058     217    13.4     6.0
Pregnant and Breastfeeding Women--Package V....................     933     46.8     5.4    36.7    20.7     336     2.0     880     1.3     270     5.6     107   1,214     234    13.5     6.5
Postpartum Women--Package VI...................................     763     38.4     2.9    32.1    17.9     319     1.7     822     1.2     217     5.1      73   1,018     184    11.7     5.5
Breastfeeding Women--Package VII...............................   1,119     61.3     8.6    43.2    23.8     353     2.7   1,782     1.5     315     6.2     126   1,356     279    15.6     7.8
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Notes.--Nutrients analyzed, in order of appearance: Energy, Protein, Dietary Fiber, Total Fat, Saturated Fat, Cholesterol, Vitamin E, Vitamin A, Vitamin B6, Folate, Vitamin B12, Vitamin C,
  Calcium, Magnesium, Iron and Zinc. All packages assume single strength orange juice for juice, Post Oat Flakes for cereal, Great Northern Beans for legumes, American cheese for cheese, and
  whole milk. Daily nutritional values are derived through dividing monthly WIC allotments by 30 days.


                                                                  Chart 4.--Some Key Nutrients in a Selection of WIC-Type Foods
                                    [Data from USDA, Agricultural Research Service, Nutrient Data Bank, http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                            Sat
                  Food item                            Serving size         Energy  Protein  Fiber   Fat    fat    Chol  E  AE   A  RE  B6 mg  Folate   B12    C mg   Ca mg   Mag    Iron   Zinc
                                                                             kcal      mg      mg     mg     mg     mg                           mg      mg                    mg     mg     mg
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Dairy:
  Milk, 3.5 to 3.8% fat......................  1 cup                           150     8.0     0.0    8.1    5.1     33    0.2      76    0.1      12    0.9      2     291     33    0.1    0.9
  Milk, 3.5 to 3.8% fat, calcium fort........  1 cup                           151     8.1     0.0    8.2    5.1     33    0.2      76    0.1      12    0.9      2   1,033     33    0.1    0.9
  Milk, low-fat or skim 1% fat....  1 cup                            85     8.3     0.0    0.4    0.3      4    0.1     149    0.1      13    0.9      2     301     28    0.1    1.0
  Milk, calcium fortified,  1 %     1 cup                           103     8.1     0.0    2.6    1.6     10    0.1     146    0.1      13    0.9      2     550     34    0.1    1.0
   fat.
  Milk, skim or nonfat.......................  1 cup                            86     8.4     0.0    0.4    0.3      4    0.1     149    0.1      13    0.9      2     302     28    0.1    1.0
  Cheese, American...........................  1.5 oz.                         152     9.2     0.0   11.9    7.5     34    0.2     104    0.0       5    0.4      0     267     12    0.3    1.3
  Cheese, Brick..............................  1.5 oz.                         158     9.9     0.0   12.6    8.0     40    0.2     128    0.0       9    0.5      0     286     10    0.2    1.1
  Cheese, Natural Cheddar....................  1.5 oz.                         171    10.6     0.0   14.1    9.0     45    0.2     118    0.0       8    0.4      0     307     12    0.3    1.3
  Cheese, Cheddar/Colby, low-fat.............  1.5 oz.                          74    10.4     0.0    3.0    1.8      9    0.0      27    0.0       5    0.2      0     176      7    0.2    0.8
  Cheese, Colby..............................  1.5 oz.                         167    10.1     0.0   13.7    8.6     40    0.1     117    0.0       8    0.4      0     291     11    0.3    1.3
  Cheese, Monterey Jack......................  1.5 oz.                         159    10.4     0.0   12.9    8.1     38    0.1     108    0.0       8    0.4      0     317     11    0.3    1.3
  Mozzarella, whole..........................  1.5 oz.                         120     8.3     0.0    9.2    5.6     33    0.1     102    0.0       3    0.3      0     220      8    0.1    0.9
  Mozzarella, part-skim......................  1.5 oz.                         119    11.7     0.0    7.3    4.6     23    0.2      81    0.0       4    0.4      0     311     11    0.1    1.3
  Mozzarella, non-fat........................  1.5 oz.                          63    13.5     0.8    0.0    0.0      8    0.1      86    0.0       4    0.4      0     375     14    0.1    1.7
Juice:
  Orange juice, unsweetened \1\..............  3/4 cup                          78     1.1     0.4    0.3    0.0      0    0.2      34    0.2      34    0.0     64      15     21    0.8    0.1
  OJ, sweetened..............................  3/4 cup                          98     1.1     0.4    0.3    0.0      0    0.2      33    0.2      33    0.0     62      15     20    0.8    0.1
  OJ, frozen, unsweetened, reconstituted--     3/4 cup                          84     1.3     0.4    0.1    0.0      0    0.4       7    0.1      82    0.0     73      17     19    0.2    0.1
   09215.
  OJ, frozen, sweetened, reconstituted.......  3/4 cup                          85     1.3     0.4    0.1    0.0      0    0.2      15    0.1      83    0.0     73      20     19    0.2    0.1
  OJ, canned, unsweetened--09207.............  3/4 cup                          78     1.1     0.4    0.3    0.0      0    0.2      17    0.2      34      0     64      15     21    0.8    0.1
  Grape juice, frozen, sweetened,              3/4 cup                          44     0.4     0.2    0.2    0.1      0    0.1       0    0.1       2      0     45       8      8    0.2    0.1
   reconstituted, C added--09137.
Cereal:
  Total Corn Flakes--08246...................  1 oz                            106     1.7     0.7    0.5    0.1      0   19.0     121    1.9     378    5.7     57     945      7   17.0   14.2
  Oatmeal Squares--08214.....................  1 oz                            107     3.1     2.0    1.2    0.3      0    0.8      84    2.8     223      0      3      57     33    8.6    2.1
  Grape-Nuts--08329..........................  1 oz.                           102     3.1     2.5    0.5    0.1      0     na     109    0.2      49    0.7      0      10     28    7.9    0.6
  Oat Bran Flakes--08258.....................  1 oz.                            99     3.1     3.7    1.0    0.2      0    0.3     222    2.0     381    5.7    5.7      15     43    7.9    3.5
  Cheerios--08013............................  1 oz.                           105     3.1     2.6    1.7    0.3      0    0.2     142    0.5     189    1.4    5.7      94     38    7.7    3.5
  Oatmeal, reg. & instant, dry--08120........  1 oz.                           109     4.5     3.0    1.8    0.3      0    0.2       0    0.0       9      0      0      15     42    1.2    0.9
  Oatmeal, reg. & inst., cooked--08180.......  3/4 cup                         109     4.6     0.5    1.8    0.3      0     na     0.0      0       7      0      0      14     42    1.2    0.9
  Cream of Wheat, cooked--08169..............  3/4 cup                         100     2.8     1.3    0.4    0.1      0     na       0    0.0      45      0      0      38      8    7.7    0.2

[[Page 53910]]


  Cream of Wheat, dry--08102.................  1 oz.                           105     3.0     1.1    0.4    0.1      0    0.0       0    0.0      34      0      0      40      8    8.1    0.2
Tuna:
  Tuna, canned, oil pack.....................  2 oz.                           112    16.5     0.0    4.7    0.9     10    0.7      13    0.1       3    1.2      0       7     18    0.8    0.5
  Tuna, canned, water pack...................  2 oz.                            66    14.5     0.0    0.5    0.1     17    0.3      10    0.2       2    1.7      0       6     15    0.9    0.4
Legumes:
  Lentils, cooked from dry...................  1/2 cup                          92     7.2     6.3    0.3    0.0      0    0.1       1    0.1     144    0.0      1      15     29    2.7    1.0
  Beans, Great Northern, navy from dried.....  1/2 cup                         121     8.5     5.5    0.3    0.1      0    0.2       0    0.1      70    0.0      0      78     55    3.2    1.2
  Peas, crowder, field, black eyed from dried  1/2 cup                          97     6.5     5.5    0.4    0.1      0    0.2       2    0.1     175    0.0      0      20     45    2.1    1.1
Eggs:
  Egg, whole, large..........................  1 egg                            75     6.2     0.0    5.0    1.6    213    0.5      96    0.1      24    0.5      0      25      5    0.7    0.6
  Egg, scrambled from dried..................  1/2 cup                         229    10.0     0.0   20.4    4.9    356    2.7     174    0.1      27    0.7      0      54     10    1.4    1.1
Peanut Butter: Peanut butter.................  2 TBS                           190     8.1     1.9   16.3    3.3      0    3.2       0    0.1      24    0.0      0      12     51    0.6    0.9
Vegetables: Carrots, raw.....................  1 cup                            47     1.1     3.3    0.2    0.0      0    0.5    3094    0.2      15    0.0     10      30     17    0.6    0.2
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

XI. Review Issues

    The Department carefully considered how best to present the issues 
in this Notice. The following questions address the types of issues the 
Department is interested in receiving comments on; however, commenters 
may address additional issues that are within the scope of this review. 
Some of the questions below are focused on ideas for regulatory or 
policy redirection; others simply are seeking information on better 
ways to meet needs within current requirements.
    The Department believes that this review will benefit from the 
broadest possible scope of public input with minimal Departmental 
direction. Therefore, the following issues proposed for consideration 
are broadly stated without Departmental comment. Within the context of 
these broad issues, commenters are encouraged to state their responses 
as specifically as possible. Comments that are not within the scope of 
this Notice will not be considered and therefore should not be 
included. Please be sure to include the rationale and/or scientific 
basis underlying the suggested changes.
    1. Please indicate what elements of the WIC food packages you would 
keep the same and why.
    2. What changes, if any, are needed to the types of foods currently 
authorized in the WIC food packages? If you recommend additions or 
deletions to the types of foods currently offered, please discuss 
recommended quantities and cost implications.
    3. Should the quantities of foods in the current WIC food packages 
be adjusted? If yes, by how much and why? Please discuss cost 
implications.
    4. Recognizing that the WIC Program is designed to provide 
supplemental foods that contain nutrients known to be lacking in the 
diets of the target population, what nutrients should be established as 
priority nutrients for each category of WIC participant, e.g., pregnant 
women, children 1-5, etc.? Please provide the scientific rationale for 
them.
    5. Keeping in mind that foods provided by WIC are designed to be 
supplemental, can the WIC food packages be revised (beyond what is 
allowed under current regulations) to have a positive effect on 
addressing overweight concerns? If so, how? Please be specific.
    6. Are there other concerns that affect foods issued through the 
WIC food packages that should be considered in designing the food 
packages? For example, should WIC provide options to address allergies 
(the American Dietetic Association notes that the most common food 
allergies are to milk, eggs, peanuts, soybeans, tree nuts, fish, 
shellfish and wheat), cultural patterns or food preferences?
    7. What data and/or information (please cite sources) should the 
Department consider in making decisions regarding revisions to the WIC 
food packages, e.g., nutritional needs of the population, ethnic food 
consumption data, scientific studies, acculturation practices, and 
participant surveys, etc.?
    8. Recognizing that current legislation requires WIC food packages 
to be prescriptive, should participants be allowed greater flexibility 
in choosing among authorized food items? If so, how?
    9. How can WIC food packages best be designed to effectively meet 
nutritional needs in culturally and ethnically diverse communities?
    10. Should WIC State agencies be afforded more or less flexibility 
in designing WIC food packages? Please explain.
    11. The WIC program's overall goal is to achieve the greatest 
improvement in health and development outcomes for WIC participants, 
achieved partly by providing food that targets nutrients determined to 
be lacking or consumed in excess in the diets of the WIC population. In 
addition to targeting these food nutrients, food selection criteria 
should address necessary operational concerns for the foods--for 
example, cost effectiveness; appeal to recipients; convenient and 
economical package sizes; complexity/ burden for the WIC administrative 
structure to manage; etc. It would be helpful if commenters would 
identify/recommend WIC food selection criteria, describe how the 
criteria interact, indicate their relative weighting or importance, and 
provide supporting rationale.

    Authority: 42 U.S.C. 1786.

    Dated: September 10, 2003.
Eric M. Bost,
Under Secretary for Food, Nutrition and Consumer Services.
[FR Doc. 03-23498 Filed 9-12-03; 8:45 am]

BILLING CODE 3410-30-P