WASHINGTON, DC — A $5.2 billion government food program for low-income pregnant women and young mothers and their children may make the first significant changes in 30 years.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which serves more than half of all the infants in the United States, could increase the amount of healthy foods such as fruits, vegetables and whole grains and cut back on items such as juice, whole milk, eggs and cheese, according to a report recently released from the federally chartered Institute of Medicine. A committee of economists, pediatricians and other experts spent 15 months on a 300-page report outlining the suggested modifications to the program.

“When the program was established, there was more of a problem with undernutrition,” said Helen Jensen, professor at Iowa State University in Ames, IA, and committee member. “There are still some participants who aren't getting enough in terms of calories, but we have increasing problems with obesity. The idea is to have packages that meet the nutritional needs and don't contribute to excess calories.”

Jensen estimated that in an average month the WIC program has about 7.9 million participants. If implemented, these changes would have a major impact on the diets of the target population in the United States, she said.

To qualify for the WIC program, the participants must meet the income eligibility guidelines of $19,000 for a family of four or be considered at a nutritional risk. The program varies in different parts of the country, but WIC participants generally use itemized vouchers or checks to obtain specific foods at grocery stores.

Due to the emphasis on fruits and vegetables in the 2005 Dietary Guidelines for Americans, the committee advised the government to issue cash vouchers for fresh produce totaling $10 for each woman and $8 for each child. The program would also allow participants to buy baby food jars of fruits and vegetables for infants over six months old.

“At the moment, the only fruit in the current packages is fruit juice,” said Suzanne Murphy, chair of the committee. “When we made our recommendations, we relied very strongly on the new dietary guidelines, which emphasize the importance of fresh fruits and vegetables.”

Changes include the ability to buy a variety of fruits and vegetables and substitute yogurt or soy milk for regular milk or whole-grain bread for other whole-grain products such as cereal. By substituting some of the milk, eggs and cheese with the fresh produce, the cost for the WIC packages will remain relatively the same after the changes have been implemented.

The committee released the report in April, and the USDA now has 18 months to review the proposal and make changes to the WIC program. Before implementing the changes nationwide, the committee recommended that the government test the changes in a pilot program.

“What we think will be an incentive encouraging people to do certain behavior may cause changes in undesirable ways,” Jensen said. “We need to understand how the fresh fruit and vegetable system will work before rolling it out nationwide.”