Peer-reviewed article

Cross-Sectional Evaluation of WIC Participation Status and Massachusetts Children's Nutrition after the Cash-Value Benefit Increase.

Zimmer M, Mozaffarian RS, Rimm EB, Gago CM, Fung TT et al. · 19 Jun 2026

Abstract

Background The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) increased the Cash-Value Benefit (CVB) for fruits and vegetables in 2021. Although WIC participants reported increased purchasing, consumption, and variety of fruits and vegetables after the CVB increase, it is unknown whether this resulted in higher fruit and vegetable intake relative to nonparticipants. Objective The objective of this study was to estimate differences in fruit and vegetable behaviors and total diet quality by WIC participation status in a convenience sample of children aged 1 to 4 years who participated in the Understanding Pandemic WIC-Waivers: Access, Redemption, Disparities (UPWARD) study. Design This was a cross-sectional study. Participants/setting From January 2024 to February 2025, caregivers of 280 Massachusetts children proxy-reported their child's intake after the CVB increase via a frequency-based dietary screener and 24-hour recalls. Main outcome measures Primary outcomes were fruit and vegetable frequency of consumption (times per week) and mean daily intake (cup-equivalents). Secondary outcomes were diet quality scores using the Healthy Eating Index-2020 (HEI-2020) (range, 0-100 points). Statistical analyses Inverse probability weighted regression models evaluated the association between WIC participation status and dietary outcomes. Results WIC-participating children aged 1 to 4 years consumed fruits a mean (SE) of 4.0 (1.2) more times per week (P < .01) and consumed 0.6 (0.4) cups more fruits per day (P < .001) than nonparticipating children. WIC children also consumed vegetables a mean (SE) of 2.5 (0.9) more times per week (P < .01), although there was no difference in vegetable intake (mean [SE], -0.02 [0.3] cup-equivalents; P > .05), There were no differences in toddler or child diet quality by WIC participation status, although power was limited in these age-stratified models. Conclusions After the CVB increase, WIC-participating children consumed fruits and vegetables more often and consumed higher quantities of fruits than nonparticipants.