Dietary intake and dietary quality of low-income adults in the Supplemental Nutrition Assistance Program

Abstract

Background: The Supplemental Nutrition Assistance Program (SNAP) aims to alleviate hunger among its beneficiaries by providing benefits to purchase nutritious foods.

Objective: We conducted a comprehensive dietary analysis of low-income adults and examined differences in dietary intake between SNAP participants and nonparticipants.

Design: The study population comprised 3835 nonelderly adults with a household income ≤130% of the federal poverty level from the 1999-2008 NHANES. The National Cancer Institute method was used to estimate the distributions of usual intake for dietary outcomes. Relative differences in dietary intake by SNAP participation were estimated with adjustment for sociodemographic characteristics and household food security.

Results: Few low-income adults consumed recommended amounts of whole grains, fruit, vegetables, fish, and nuts/seeds/legumes. Conversely, many low-income adults exceeded recommended limits for processed meats, sweets, and bakery desserts and sugar-sweetened beverages. Approximately 13-22% of low-income adults did not meet any food and nutrient guidelines; virtually no adults met all of the guidelines. Compared with nonparticipants, SNAP participants consumed 39% fewer whole grains (95% CI: -57%, -15%), 44% more 100% fruit juice (95% CI: 0%, 107%), 56% more potatoes (95% CI: 18%, 106%), 46% more red meat (95% CI: 4%, 106%), and, in women, 61% more sugar-sweetened beverages (95% CI: 3%, 152%). SNAP participants also had lower dietary quality scores than did nonparticipants, as measured by a modified Alternate Healthy Eating Index.

Conclusion: Although the diets of all low-income adults need major improvement, SNAP participants in particular had lower-quality diets than did income-eligible nonparticipants.

FIGURE 1.

Proportion of low-income SNAP participants (n = 924) and income-eligible nonparticipants (n = 2929) with daily dietary intakes meeting 10 food and nutrient guidelines. Recommendations included those for whole grains (≥3 servings/d), fruit (≥4 servings/d), vegetables (≥5 servings/d), fish/shellfish (≥2 servings/wk), nuts/seeds/legumes (≥4 servings/wk), processed meats (≤2 servings/wk), sugar-sweetened beverages (≤4 servings/wk), SFA (<7% energy), sodium (1500–2300 mg/d for ages 20–50 y, 1300–2300 mg/d for ages 51–65 y), and potassium (≥4700 mg/d). Recommendations for whole grains, fruit, vegetables, and sugar-sweetened beverages were taken from the 2010 Dietary Guidelines for Americans. Recommendations for fish/shellfish, nuts/seeds/legumes, processed meats, and SFA were taken from the 2006 American Heart Association. Recommendations for sodium and potassium were taken from the Dietary Reference Intake's Estimated Average Requirements. SNAP, Supplemental Nutrition Assistance Program.