Methodological challenges in performing targeting: assessing dietary risk for WIC participation and education

This paper summarizes recent evaluations of indicators of dietary risk used to determine eligibility and nutrition education and counseling within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The concept of dietary risk relates to an inadequate dietary pattern or a failure to adhere to the food guide pyramid and, within WIC, is typically assessed based on an individual's intake from a 24-h recall or FFQ. Available evidence suggests, however, that even with a high-quality technique, substantial error exists in these data at the level of the individual, making the likelihood of misclassification high. Such data, with appropriate statistical procedures, can provide valid information at the group or the population level, and this is a future area for indicator development and incorporation into the management of WIC and other nutrition education programs addressing dietary risk.