October 9, 2012 — Researchers offer policy recommendations to better address dual challenges of food insecurity and obesity in low-income Americans
More than 44.7 million Americans — roughly one in seven — receive benefits to purchase food from the Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp Program. SNAP is designed to alleviate hunger and provide nutritious food to its beneficiaries. However, a new study by Harvard School of Public Health (HSPH) researchers has found that SNAP participants’ diets are actually worse than those of low-income adults not participating in the program and that, while few low-income adults were found to be meeting dietary guidelines, SNAP participants consumed fewer whole grains and more potatoes, red meat, and sugary beverages than eligible nonparticipants.
“SNAP is a vital program with the potential to influence the diets of millions of vulnerable Americans. Unfortunately, our study suggests that the current diets of SNAP participants may be contributing, in part, to the high rates of obesity and obesity-related complications in this population,” said Cindy Leung, who conducted the research while earning her doctorate at HSPH. “Further consideration needs to be given to policies to create incentives for SNAP participants to access and purchase healthier foods, and to limit the purchase of unhealthy food with SNAP benefits.”
The study was published online October 3, 2012, in the American Journal of Clinical Nutrition.
Leung and her colleagues conducted a comprehensive dietary analysis of 3,835 non-elderly adults with a household income less than 130% of the federal poverty level (the federal eligibility level for SNAP). They used data collected between 1999-2008 by the National Center for Health Statistics and dietary recommendations from the 2010 Dietary Guidelines for Americans, the American Heart Association, and the Dietary Reference Intakes. At the time of the survey, 24% of low-income adults in the study population received SNAP benefits.
Diets Fall Short of National Recommendations
The researchers found that very few low-income adults consumed recommended amounts of whole grains, fruit, vegetables, fish, and nuts/seeds/legumes. Many met or exceeded recommended limits for processed meats, sweets and bakery desserts, and sugar-sweetened beverages. SNAP participants consumed 39% fewer servings of whole grains, 44% percent more servings of fruit juice, 56% more servings of potatoes, and 46% more servings of red meat than low-income adults not receiving SNAP benefits, even after adjusting for demographic differences between the two groups. Among women, SNAP participants consumed 71% more servings of regular soda than did nonparticipants. Among non-Hispanic whites, SNAP participation was associated with 60% higher regular soda consumption. SNAP participants also had worse overall dietary quality than nonparticipants as measured by the Alternate Healthy Eating Index, a measure of dietary quality previously developed by HSPH researchers to predict chronic disease risk.
Although more research is needed to better understand how diet is affected by SNAP participation, the researchers theorize that SNAP participants may spend their allotments on cheaper, nutrient-poor food, rather than on nutrient-rich food that can be more expensive, in order to maximize their grocery budget.
SNAP to Health
Senior author Walter Willett, Fredrick John Stare Professor of Epidemiology and chair of the Department of Nutrition at HSPH, along with Leung and HSPH Lecturer Lilian Cheung, also contributed to the SNAP to Health! report, which was released in July 2012 and presented at a Congressional briefing. The report, written in collaboration with the Center for the Study of the Presidency and Congress under the direction of Susan Blumenthal, former U.S. assistant surgeon general (who delivered a Dean’s Distinguished Lecture on obesity at HSPH last year), identified recommendations for improvements to SNAP that would help to make healthy eating an easier choice for participants. These include lowering the cost of healthy food for participants and strengthening stocking standards for SNAP-certified retailers to include a greater variety of healthy food. The authors argue for maintaining current funding levels for SNAP, and call for the U.S. Department of Agriculture to partner with other government agencies to promote research, policy change, technological innovation, and evaluation to improve nutrition as well as to prevent adverse health consequences among SNAP beneficiaries.
“The time has come for a strategic, coordinated, public health-driven strategy for SNAP. To not move in this direction is an enormous missed opportunity to meet two dire needs in this country—food insecurity and obesity—in one fell swoop,” Willett said.
Healthy Food Environment: Food Assistance Programs (HSPH’s Obesity Prevention Source)