Unable to defeat childhood obesity with public relations campaigns, state health officials are going to start using their power to force parents to buy healthier items.
Beginning Thursday, families enrolled in the WIC nutrition program - for women, infants and children - will find that their coupons are no longer good for the same quantities of some of the items they were getting for free before. Most notably, the milk, cheese and juices that formed much of the basis of the diet will be available in much smaller amounts.
And mothers and children older than 2 will be able to get only fat-free and low-fat milk.
The list instead will include more whole grains. WIC families will be able to get soy-based beverages and tofu. Canned tuna and salmon will now be an acceptable purchase.
And for the first time ever, there will be specific allocations for fresh fruits and vegetables.
Acting state Health Director Will Humble said the change will mean a lot more healthy Arizona children.
The guidelines to qualify for WIC are fairly generous: A family of three can have income up to $33,875 and remain eligible; the figure for a family of four is $40,794.
What that means, Humble said, is about 190,000 Arizona families are getting WIC coupons. That's close to 60 percent of all families with children age 5 and younger.
"We're finally able to do something about obesity besides just preaching to people to get some exercise and eat right," he said. Humble said WIC foods are a "pretty significant" source of nourishment in homes of eligible families.
"With this change in the WIC menu, we have the opportunity to really hard-wire healthier eating habits into little kids, and into families that have little kids."
The change, said Humble, reflects a new focus on the problem.
"The WIC menu was really derived at a time in the '70s when hunger was a major public health issue," he explained. That's why the list of eligible foods was focused on "foods that are decent foods but, in general, have quite a bit of fat and a lot of sugar."
"It was a lot of cheese," Humble said.
"Over the last 30 years, we've seen a transition from when hunger was the major public health issue to today, when obesity is a far bigger public health issue," he explained. Hence, the need for a different menu.
The cheese won't be gone. But the purchases will be limited to a single 16-ounce package each time.
The amount of milk available also will be less, as will what Humble called "sugary juices."
"In exchange, we'll be asking people to make healthier choices with their WIC coupons," he said.
Humble said it's going to take some time for the changes to have an effect. The first hurdle, he said, is convincing people to use those coupons for fresh fruits and vegetables.
He said it will take some time for parents to figure out what their children will and will not eat. Humble said the state hopes to help out a bit with recipes "so that they know how to use garbanzo beans, so that they know how to use asparagus, so they know how to use artichokes."
"Unless you know what to do with them, you can't present them in a way that's going to be tasty to your family," he continued. "And they might not eat it."
While the change in what WIC coupons will buy will make healthier foods available, it can't actually force recipients to always make better choices.
For example, at least half of the items on the new list of acceptable cereals must be made with whole grains. But that list still includes other items like corn flakes and puffed corn balls.
But Karen Sell, chief of the bureau of nutrition and physical activity for the health department, said these are preferable to other breakfast alternatives, ranging from high-sugar cereals to bacon and ham.
The change also will affect retailers: In order to be able to continue accepting WIC coupons, some smaller stores had to start carrying fresh fruits and vegetables.
"Some of them had to change their business strategy and order produce and fruits that they have never ordered before," he said. That's important because those coupons cannot be redeemed for canned items.
The new standards today also actively encourage new mothers to breast-feed their newborns.
"If we can verify that they're going through the breast-feeding process, they can actually qualify for additional coupons," Humble said. "So we're trying to incentivize moms, not just because it's the right thing to do but because they can actually get more WIC coupons."