Supplemental Nutrition Assistance Program Participation Is Associated with an Increase in Household Food Security in a National Evaluation,

Mabli, James; Ohls, Jim

doi:10.3945/jn.114.198697

Cited by 128 publications

(106 citation statements)

References 15 publications

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“…33,34 It is unclear why the proportion of households with low or very low food security was reduced less in the control arm compared with the other conditions. Increased food purchasing power is a potential explanation for the arms in which a financial incentive was provided, but does not explain the differences in change in food security between the restriction and control arms.…”

Section: Discussionmentioning

confidence: 99%

Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program

et al. 2016

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IMPORTANCEStrategies to improve the nutritional status of those participating in the Supplemental Nutrition Assistance Program (SNAP) are of interest to policymakers. OBJECTIVE To evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in a food benefit program improves the nutritional quality of participants' diets.DESIGN, SETTING, AND PARTICIPANTS Lower income participants (n = 279) not currently enrolled in SNAP were randomized to 1 of 4 experimental financial food benefit conditions: (1) incentive (30% financial incentive for fruits and vegetables purchased using food benefits);(2) restriction (not allowed to buy sugar sweetened beverages, sweet baked goods, or candies with food benefits); (3) incentive plus restriction (30% financial incentive on fruits and vegetables and restriction of purchase of sugar sweetened beverages, sweet baked goods, or candy with food benefits); or (4) control (no incentive or restrictions on foods purchased with food benefits). Participants in all conditions were given a study-specific debit card where funds were added every 4 weeks for a 12-week period. Outcome measures were collected at baseline and in the final 4 weeks of the experimental period. MAIN OUTCOMES AND MEASURESPrimary outcomes (from 24-hour dietary recalls) included intake of energy, discretionary calories, and overall diet quality. RESULTSA number of favorable changes were observed in the incentive plus restriction condition that were significantly different from changes in the control condition. These included (1) reduced intake of energy (−96 kcal/d, standard error [SE], 59.9); (2) reduced intake of discretionary calories (−64 kcal/d, SE 26.3); (3) reduced intake of sugar sweetened beverages, sweet baked goods, and candies (−0.6 servings/d, SE 0.2); (4) increased intake of solid fruit (0.2 servings/d, SE 0.1); and (5) improved Healthy Eating Index score (4.1 points, SE 1.4). Fewer improvements were observed in the incentive only and restriction only arms. CONCLUSIONS AND RELEVANCEA food benefit program that pairs incentives for purchasing more fruits and vegetables with restrictions on the purchase of less nutritious foods may reduce energy intake and improve the nutritional quality of the diet of participants compared with a program that does not include incentives or restrictions.CLINICAL TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02643576

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Section: Discussionmentioning

confidence: 99%

Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program

et al. 2016

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“…Given the impact of food security on an individual’s health, health care organizations and providers, especially primary care providers, should consider screening and targeting food security as part of the standard of care, provided that this is done using a patient and family-centered approach and with consideration of available resources for referral to a social worker or social service program when appropriate (Garg et al, 2016). The Supplemental Nutrition Assistance Program (colloquially known as the Food Stamp Program or SNAP) is a well-established and highly successful infrastructure to reduce rates of food insecurity throughout the U.S. (Mabli and Ohls, 2015) Further research into the sociodemographic, cultural, and economic determinants of food insecurity is warranted. Additionally, controlled studies examining the effectiveness of screening programs to identify and address food insecurity in clinical practice should also be carried out.…”

Section: Discussionmentioning

confidence: 99%

Food insecurity and cardiovascular health: Findings from a statewide population health survey in Wisconsin

Saiz

Aul

Malecki

et al. 2016

Preventive Medicine

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Background The social and economic environment has become a major area of interest regarding the determinants of cardiovascular health. Among markers of economic distress, food insecurity has been found associated with metabolic disorders, dyslipidemia, and obesity, but no previous studies have examined its association with overall cardiovascular health. Methods and results We conducted a cross-sectional analysis among 2935 participants in the Survey of the Health of Wisconsin (SHOW), a statewide population-based representative sample. The presence of food insecurity was determined by an affirmative answer to the question “In the last 12 months, have you been concerned about having enough food for you or your family?” Cardiovascular health (CVH) was defined based on the American Heart Association Life’s Simple 7 criteria and classified as “poor,” “intermediate,” or “ideal” using previously published criteria. “Good” CVH was defined as having no poor in any of the seven criteria (any amount of intermediate or ideal). Crude and adjusted odds ratios (OR) of good CVH according to presence of food insecurity were calculated using logistic regression models. Overall, food insecurity was associated with a decreased likelihood of good CVH (OR 0.53; 95% Confidence Interval 0.31 to 0.92; p = 0.02). This association persisted in models controlling for age, gender, race, and urbanization. Conclusions Participants who were food insecure were significantly less likely to have good CVH compared to participants who were food secure. Even though this study cannot confirm causality, these results suggest that food insecurity might be one of several socio-economic barriers contributing to poor CVH.

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“…4–6 The program's impact on dietary quality and intake is less clear. The previous systematic review of SNAP outcomes conducted by the U.S. Department of Agriculture (USDA) in 2004 found little to no impact on dietary intake, including food energy and macronutrients.…”

Section: Contextmentioning

confidence: 99%

Dietary Quality of Americans by Supplemental Nutrition Assistance Program Participation Status

Andreyeva

Tripp

Schwartz

2015

American Journal of Preventive Medicine

213

143

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Context The Supplemental Nutrition Assistance Program (SNAP) is an effective component in reducing food insecurity in the U.S. In the discussion of strategies to also help SNAP participants maximize diet quality, it is important to know their current dietary patterns and food choices. This paper provides a systematic review of recent U.S. studies on dietary quality, food consumption, and spending among SNAP participants as compared to income-eligible and higher-income nonparticipants. Evidence acquisition The review, completed in 2014, summarized studies that were peer-reviewed, published between January 2003 and August 2014, and provided data on dietary quality and intake of SNAP participants and nonparticipants. Evidence synthesis Twenty-five studies were included in this review. Daily caloric, macro-nutrient, and micronutrient intake of SNAP participants did not differ systematically from those of income-eligible nonparticipants; however, differences in dietary quality emerged. Adult SNAP participants scored lower on the Healthy Eating Index than either group of nonparticipants. Children's diets were similar among SNAP participants and low-income nonparticipants, but were less nutritious than diets of higher-income children. The evidence regarding sugar-sweetened beverage consumption was mixed, with most studies indicating significantly higher beverage intake among SNAP participants compared with higher-income nonparticipants, but no difference compared to income-eligible nonparticipants. Conclusions SNAP effectively alleviates food insecurity in terms of caloric, macronutrient, and micronutrient intake. Still, SNAP participants are struggling more than income-eligible and higher-income nonparticipants to meet key dietary guidelines. Future policies should ensure that this vital food assistance program addresses diet quality while reducing food insecurity.

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Supplemental Nutrition Assistance Program Participation Is Associated with an Increase in Household Food Security in a National Evaluation,

Cited by 128 publications

References 15 publications

Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program

Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program

Food insecurity and cardiovascular health: Findings from a statewide population health survey in Wisconsin

Dietary Quality of Americans by Supplemental Nutrition Assistance Program Participation Status

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