title: Differences in energy and micronutrient intakes among Central Texas WIC infants and toddlers after the package change.
abstract: OBJECTIVE
  To assess nutrient intakes after the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) package changes within an at-risk, majority Hispanic population of WIC infants and toddlers in Central Texas.
  
  
  METHODS
  For this cross-sectional observational study, Nutrition Data System for Research was used to collect 24-hour recalls of infants and toddlers from a sample of caregivers in 2009 and 2011. Usual nutrient intakes were estimated and compared with Dietary Reference Intakes using the National Cancer Institute method. Mean single-day nutrient intakes were compared using Mann-Whitney tests.
  
  
  RESULTS
  Subjects were children ages 4-24 months (2009, n = 84; 2011, n = 120). After the package change, usual energy intakes exceeded recommended levels for infants (79% in excess of Estimated Energy Requirement), but fell below recommended levels for toddlers (88% below Estimated Energy Requirement). Also after the package change, mean usual intake of vitamin D was below the Estimated Average Requirement for toddlers (6.54 vs 10 μg), and mean usual intakes of vitamin A and zinc exceeded the Tolerable Upper Intake Level for all groups.
  
  
  CONCLUSIONS
  Whereas lower energy intake may reduce obesity risk, in toddlers, lower energy intake increases risk for micronutrient deficiencies. Recommendations include culturally appropriate education and reinstatement of previous milk allotment in the toddler package.
authors.affiliation: School of Family and Consumer Sciences, Texas State University, San Marcos, TX.
authors.forename: Hannah E B
authors.initials: HE
authors.lastname: Thornton
authors.affiliation: School of Family and Consumer Sciences, Texas State University, San Marcos, TX. Electronic address: scrixell@txstate.edu.
authors.forename: Sylvia H
authors.initials: SH
authors.lastname: Crixell
authors.affiliation: School of Family and Consumer Sciences, Texas State University, San Marcos, TX.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Reat
authors.affiliation: School of Family and Consumer Sciences, Texas State University, San Marcos, TX.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Von Bank
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000706:statistics & numerical data; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004034:Diet Surveys; D002149:Energy Intake; D005260:Female; D063105:Food Assistance; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D013781:Texas; D014801:Vitamin A; D014807:Vitamin D; D055815:Young Adult
chemical_list: D014801:Vitamin A; D014807:Vitamin D
keywords: Hispanic; WIC package change; child; energy; vitamin A; vitamin D; zinc