Because there are clear health and nutrition risks associated with selected inappropriate dietary patterns, there is interest in improving, standardizing, and simplifying the tools used for obtaining and assessing information on food intake, dietary patterns, and nutritional quality, particularly for children ages 2-4 years who may be eligible to participate in WIC. Therefore, the Harvard School of Public Health will collaborate with the Department of Health or the Department of Public Health in North Dakota, Missouri, and Massachusetts and with the Division of Nutrition Control and Prevention, to study three uses of the validated Harvard food frequency questionnaire (HFFQ) for children 1 to 5 years of age participating in WIC. The focus of the tool to be developed is for use with children 2-4 years of age who may be eligible for WIC. Specifically, the project will:

• evaluate and improve the output of the HFFQ to better facilitate nutrition education, food package decisions, and referrals;
• design, implement, and evaluate the use of aggregate nutrition data for program planning and evaluation at the State and national levels by aggregating diet assessment and administrative data from WIC programs in collaborating States;
• examine relations between diets of ages 2 to 4 and childhood obesity as measured by excess adiposity among 4-year-old children, using prospective data collected through the WIC program.

We hypothesize that a high-fat diet leads to greater childhood obesity and that a diet high in fruits, vegetables, and fiber is associated with lower levels of obesity. Building on the food pyramid, health outcomes from this work, and other sources will define diet quality for this age group. Guidance will be provided throughout the work by forming a national advisory board with members from the National Association of WIC Directors, the Centers for Disease Control and Prevention and the U.S. Department of Agriculture.

A cooperative assistance agreement was awarded to the Harvard School of Public Health in fiscal 1998 to conduct research to improve assessment, policy analysis, and health outcomes on dietary intake. The cost of this work is $490,209. The project is expected to be completed in August, 2001.