Why did WIC tarry in making its menu healthier?

A colleague of mine, Dave Wasson, came back from a reporting conference once and passed on a bit of wisdom he had picked up: "If you ever hear someone say that something is a win-win, you know that someone is losing big time."

I have made that phrase a maxim that has never steered me wrong.

When I saw the head of the United Fresh Produce Association, Tom Stenzel, say in a press release that changes to the USDAs Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were "a win-win for WIC moms and kids across the United States and for the entire produce industry," I was suspicious.

WIC remains a linchpin program for more than 9 million low-income mothers and young children by providing vouchers to cover staples like meat, cheese and milk. The types of foods authorized under WIC stayed mostly the same for the past 35 years.

Now, if you believe the hype, WIC has made its menu much healthier, by adding fruits, vegetables and whole-grain foods and cutting down on the amount of dairy products.

The coverage of the announcement of the WIC changes over the past week has been overwhelmingly positive.

Here's my first question: why did this take so long? And I don't mean why did it take 35 years. I mean why did the USDA announce in 2006 that the changes would start in 2007 only to take an additional two years? Something happened in those two years that I have no doubt would make for a very interesting story.

Here's one possible reason, suggested by my colleague here at ReportingonHealth, Barbara Feder Ostrov: "I wonder if subsidized milk and cheese producers screamed bloody murder about this."

She wrote about the changes in August 2006 while at the San Jose Mercury News:

While the changes are not expected to take effect until late 2007, they could have a profound impact on California's children: 60 percent of all newborn infants in the state are served through the food program called WIC, an acronym for the Special Supplemental Nutrition Program for Women, Infants and Children. In high-cost Santa Clara County, nearly 32,000 women and children benefit from the monthly food vouchers of about $38 per person. Heavy on eggs, cheese and cow's milk, the current group of WIC foods eligible for subsidy has long been criticized for contributing to obesity and overlooking current nutritional science.

Right after the changes were first proposed, the two biggest dairy trade associations, the National Milk Producers Federation (NMPF) and the International Dairy Foods Association (IDFA) complained that the changes would be a lose-lose, not a win-win. Women wouldn't be getting enough of their necessary nutrients from milk and cheese.

That was In February 2009, the agency finally stopped handing out vouchers to cover whole milk for all children under 5. Now, only kids under 2 could have their whole milk paid for.

But, wait a minute. Didn't the American Academy of Pediatrics say that whole milk wasn't so good for young kids? That it, in fact, was contributing to the country's obesity epidemic?

Indeed it did. In July 2008, the AAP said that for kids who were at risk of being overweight, meaning that they have overweight parents or already are eating a high-calorie diet, 2 percent milk should be the standard, starting at age 1. And for all kids, 1% or skim milk should be started at age 2. Many pediatricians now recommend 2% or 1% for all kids, regardless of their obesity risk. (Breastfeeding, of course, is the chief recommendation for infants.)

What other concessions were made?

Somebody needs to do a little digging into how the recommendations were made and what sort of health-focused recommendations were shoved off the table to make the whole package a "win-win." A good starting point is this table comparing the old and new programs as they finally shook out in 2009. Then look back at the original recommendations.

Then take a look at the people on the advisory committees that generated the recommendations. (You can find bios of all the members on page 375 of this document.) Who started on the panel? Who left before the rules were finished? Who parted company with the recommendations before the rules were implemented? What do those folks have to say? And what sort of ties to industry do they all have?

Read through what the industry had to say about the proposed rule. Then read the health professionals comments, and comments from public interest groups.

Health writers need to use the same scrutiny here that great health writers like Rebecca Ruiz at Forbes and Mary MacVean at the Los Angeles Times have used to expose the "Smart Choices" food labeling program. Ruiz writes:

Most people don't consider chocolate popsicles, sugary cereal and bagels filled with cream cheese as healthy foods. But it's no surprise that a new labeling program underwritten by 14 major food companies--including Kellogg, Kraft and Unilever--says otherwise.

Between 2008 and 2009, the 14 corporations paid a combined $1.47 million to fund the development of Smart Choices, a labeling initiative that stamps a green seal of approval on the front of food packaging to indicate healthier fare to consumers. Unilever's Fudgsicles, Kellogg's vitamin-enriched Froot Loops and Kraft's Bagel-fuls all now bear the Smart Choices label. (A 60-calorie Fudgsicle may be low in fat, but has almost no nutritional value and contains three different types of sugar.)

It would be nice to see that sort of top on a story about WIC 2.0. Maybe Antidote is way out in the weeds here, and it will turn out that the new program is truly a win-win. Prove me wrong.