scholarly journals Diet Quality and Associations with Food Security among Women Eligible for Indiana Supplemental Nutrition Assistance Program-Education

2020 ◽  
Vol 150 (8) ◽  
pp. 2191-2198
Author(s):  
Rebecca L Rivera ◽  
Yumin Zhang ◽  
Qi Wang ◽  
Melissa K Maulding ◽  
Janet A Tooze ◽  
...  

ABSTRACT Background The diet quality among adults receiving nutrition education lessons through Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is currently unknown. Objectives The objectives of this study were to characterize the diet quality of Indiana SNAP-Ed-eligible women; estimate their mean usual intake of fruits, vegetables, dairy, and whole grains compared to Dietary Guidelines for Americans (DGA) recommendations; and determine if these dietary outcomes differed by food security status. Methods SNAP-Ed paraprofessionals recruited participants from August 2015 to May 2016 for this secondary analysis of cross-sectional data collected as the baseline assessment for a randomized controlled trial. Participants were SNAP-Ed-eligible women aged ≥18 y interested in nutrition education lessons. Dietary outcomes were assessed by one or two 24-h dietary recalls. The Healthy Eating Index (HEI)-2010 was used to characterize diet quality. Mean usual intake of food groups was estimated using the National Cancer Institute Method. Food security status was classified using the US Household Food Security Survey Module. Data were analyzed in October 2019. Results Mean ± SEM HEI-2010 total score was 42 ± 0.9 for the study sample. Mean ± SE usual intake of servings of fruits (0.61 ± 0.08 cups [144.32 ± 18.93 mL]), vegetables [1.4 ± 0.10 cups (331.2 ± 23.66 mL)], dairy [1.5 ± 0.11 cups (354.88 ± 26.02 mL)], and whole grains [0.48 ± 0.06 ounces (13.61 ± 1.70 g)] did not differ by food security subgroup. Mean HEI-2010 total score was significantly higher by 4.8 ± 2.0 points for the food-secure than for the food-insecure subgroup (P = 0.01). Mean HEI-2010 component scores were 1.1 ± 0.5 points higher for whole grain (P = 0.01) and 1.0 ± 0.5 points higher for dairy (P = 0.05) in the food-secure than in the food-insecure subgroup. The proportions of the study sample not meeting the DGA recommendations for food group intake were ≥85% for both food-secure and -insecure subgroups. Conclusions Indiana SNAP-Ed-eligible women reported poor diet quality, highlighting their need for nutrition interventions aiming to improve food security and diet as per DGA recommendations in low-income populations.

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Fangfang Zhang ◽  
Junxiu Liu ◽  
Colin D Rehm ◽  
Parke Wilde ◽  
Jerold R Mande ◽  
...  

Introduction: Unhealthful diet is one of the top contributors to the chronic disease burden in the U.S. There are growing concerns that socioeconomic disparities exist in Americans’ diets and this disparity may have widened over time. Aim: To characterize trends in dietary intake of key food groups and nutrients among low-income Americans who participated in the Supplemental Nutrition Assistance Program (SNAP), and assess whether disparities in U.S. diets have persisted, improved, or worsened over time. Methods: Nationally representative sample of 6,162 adults aged 20 years or older who participated in SNAP, 6,692 income-eligible nonparticipants, and 25,842 higher-income nonparticipants from 8 National Health and Nutrition Examination Survey (NHANES) cycles (1999-2014). Exposures are calendar year and SNAP participation status. Survey-weighted, energy-adjusted mean scores and proportion meeting the American Heart Association (AHA) 2020 Strategic Impact Diet Goals (5 primary components: fruits/vegetables, whole grains, fish/shellfish, sugar-sweetened beverages (SSBs), sodium; 3 secondary components: nuts/seeds/legumes, processed meats, saturated fat). Intakes of individual food groups and nutrients were also assessed. Results: From 2003-2004 to 2013-2014 among SNAP participants with data on two-day dietary recall, primary diet score (maximum of 50) modestly increased (15.6 to 16.6; P-trend =0.03) while the secondary diet score (maximum of 80 points) did not change (31.5 to 32.1; P-trend =0.11). The proportion of SNAP participants having a poor diet decreased from 74.3% to 68.6%, the proportion having an intermediate-quality diet increased from 25.5% to 31.2%, and the proportion of having an ideal diet remained unchanged (0.2%.). Among primary components, changes were strongest for SSBs (-0.43 servings/d, P-trend=0.001) and whole grains (+0.25 servings/d, P-trend<0.001). Compared to higher-income nonparticipants and income-eligible nonparticipants, SNAP participants had weaker improvements in both primary and secondary diet scores. From 1999-2000 to 2013-2014, disparities persisted for most dietary components, worsened for nuts/seeds and added sugars, and weakened for sodium. Conclusion: Despite some improvements in diet quality, SNAP participants still fall far short of meeting the AHA Goals for a healthful diet, and dietary disparities persisted or worsened for most dietary components.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1007-1007
Author(s):  
Katelin Hudak ◽  
Sarah Gonzalez-Nahm ◽  
Tiange Liu ◽  
Sara Benjamin-Neelon

Abstract Objectives Food insecurity has been associated with poor diet-related health in women, but few prior studies focused on the postpartum period—a particularly important time for the health of women and children. We examined associations between food security and maternal diet quality in a racially diverse cohort of postpartum women. We further assessed whether participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or the Supplemental Nutrition Assistance Program (SNAP) modified this potential relation. Methods We examined 363 women in central North Carolina from the Nurture study (2013–2017). We computed maternal food security status using the 10-item USDA food security survey module at 3 months postpartum. We calculated Alternate Healthy Eating Index-2010 (AHEI) scores (range of 0 to 100) and component scores from food frequency questionnaires completed at 6 months postpartum. We conducted multiple linear regression examining associations between food security status (high, marginal, low, and very low) and AHEI, adjusting for age, race, education, marital status, number of children, breastfeeding, and total calories. We assessed WIC and SNAP as potential effect modifiers. Results Among women, 64.4% were Black and had a mean (standard deviation, SD) age of 28.2 (5.9) years. Nearly half (45.7%) had a high school diploma or less. Of women, 21.3% had low or very low food security. Mean (SD) AHEI score was 41.5 (11.3). We found no evidence of an interaction between food security and WIC or SNAP so we adjusted for both. In adjusted models, food security status at 3 months postpartum was not associated with AHEI (data not shown) at 6 months postpartum. However, low (ß: −0.64; 95% CI: −1.15, −0.13; P = 0.01) and very low (ß: −0.57; 95% CI: −1.02, −0.13; P = 0.01) food security were associated with a less healthy score for trans fat intake. Conclusions Food security status was not associated with overall diet quality in postpartum women. However, food insecure women showed higher consumption of trans fats. Future research should evaluate interventions to alleviate food insecurity in postpartum women, and assess whether these interventions lead to improved diet quality. Funding Sources National Institutes of Health.


2019 ◽  
Vol 77 (12) ◽  
pp. 903-921 ◽  
Author(s):  
Rebecca L Rivera ◽  
Melissa K Maulding ◽  
Heather A Eicher-Miller

AbstractThe Supplemental Nutrition Assistance Program–Education (SNAP-Ed) is the nutrition promotion component of SNAP, formerly known as food stamps. SNAP-Ed assists low-income populations in the United States improve dietary intake and reduce food insecurity through nutrition education. This narrative review summarizes current investigations of SNAP-Ed’s effectiveness at improving food security and dietary outcomes, and it can help inform future policy and implementation of the program. There was stronger evidence for SNAP-Ed as an effective means of improving food security (n = 4 reports) than for its effects on nutrition or dietary outcomes (n = 10 reports). Inconsistency in measurement tools and outcomes and a lack of strong study designs characterized the studies that sought to evaluate the effectiveness of SNAP-Ed at improving nutrition or dietary outcomes. Additional rigorous study designs in diverse population groups are needed to strengthen the evidence. In the face of reduced financial SNAP benefits, SNAP-Ed may play an important role in helping to eliminate food insecurity and improve dietary outcomes and, ultimately, the health of low-income Americans.


Author(s):  
Jun Zhang ◽  
Yanghao Wang ◽  
Steven T. Yen

The Supplemental Nutrition Assistance Program (SNAP) is designed to improve household diet and food security—a pressing problem confronting low-income families in the United States. Previous studies on the issue often ignored the methodological issue of endogenous program participation. We revisit this important issue by estimating a simultaneous equation system with ordinal household food insecurity. Data are drawn from the 2009–2011 Current Population Survey Food Security Supplement (CPS-FSS), restricted to SNAP-eligible households with children. Our results add to the stocks of empirical findings that SNAP participation ameliorates food insecurity among adults only, but increases the probabilities of low and very low food security among children. These contradictory results indicate that our selection approach with a single cross section is only partially successful, and that additional efforts are needed in further analyses of this complicated issue, perhaps with longitudinal data. Socio-demographic variables are found to affect food-secure households and food-insecure households differently, but affect SNAP nonparticipants and participants in the same direction. The state policy tools, such as broad-based categorical eligibility (BBCE) and simplified reporting, can encourage SNAP participation and thus ameliorate food insecurity. Our findings can inform policy deliberations.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Rebecca Rivera ◽  
Yumin Zhang ◽  
Qi Wang ◽  
Melissa Maulding ◽  
Regan Bailey ◽  
...  

Abstract Objectives The goal of the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is to assist low-income households to improve diet quality. The objective of this study was to evaluate the long-term effects of SNAP-Ed nutrition education lessons on diet quality and key nutrient and food group outcomes among Indiana SNAP-Ed-eligible adults. Methods The study design was a parallel-arm randomized controlled nutrition education intervention. The intervention consisted of the first 4 lessons of the Indiana adult SNAP-Ed curriculum delivered to participants during the 4 to 10 weeks after their baseline assessment. Participants (≥18 yrs) eligible for SNAP-Ed and interested in receiving nutrition education lessons (direct SNAP-Ed) were recruited from 31 Indiana counties (N = 261) and completed baseline assessments from August 2015 to May 2016. Follow-up assessments were conducted approximately 1-year after baseline from August 2016 to May 2017 (n = 103). Dietary intake was assessed using up to 2 24-hour dietary recalls at each assessment time point. The main outcome measures were mean usual nutrient (calcium; vitamins D, A, C, E; magnesium; folate; potassium; fiber; dairy; fruit; vegetable; whole grains) the proportion meeting Estimated Average Requirements, exceeding Adequate Intakes, or meeting daily recommended servings, and diet quality as measured by the Healthy Eating Index-2010. This study is registered at www.clinicaltrials.gov as NCT03436784. Significance was P ≤ 0.05. Analyses were completed using SAS 9.4. Results No effect of direct SNAP-Ed was found on diet quality, nutrient, or food group intake in the treatment compared to the control group between baseline and the 1-year follow-up assessment (P > 0.05). Conclusions Direct SNAP-Ed did not improve long-term diet quality, nutrient, or food group intake among Indiana SNAP-Ed eligible adults. Funding Sources Funding for this research was provided by Purdue University as part of AgSEED Crossroads funding to support Indiana's Agriculture and Rural Development, Purdue University Frederick N. Andrews Fellowship, Purdue University Center for Families Justice Family Nutrition Award, the Purdue University Nutrition Education Program, and a USDA NIFA Hatch Project.


2020 ◽  
Vol 21 (2) ◽  
pp. 62-70
Author(s):  
Victoria M. Pak ◽  
Erin Ferranti ◽  
Ingrid Duva ◽  
Melissa Owen ◽  
Sandra B. Dunbar

The Supplemental Nutrition Assistance Program (SNAP) provides access to healthy food for low-income individuals and households. Food security, however, does not necessarily achieve higher diet quality for beneficiaries. Diet quality is an important consideration for the development and management of chronic illness, a significant public health concern. In this study, we review incentives and disincentives implemented to improve the diet quality, the evidence on SNAP including benefits, challenges, and the politics of funding. New interventions and policies will be needed in order to improve the overall diet quality of SNAP households. SNAP should align with nutritional science to meet national public health goals. Nurses are trusted advocates for patients and the public and are uniquely positioned to aid in this effort. Informed by evidence, nurses willing to leverage their influence, can lead this needed change.


Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1212 ◽  
Author(s):  
Shinyoung Jun ◽  
Alexandra Cowan ◽  
Janet Tooze ◽  
Jaime Gahche ◽  
Johanna Dwyer ◽  
...  

This analysis characterizes use of dietary supplements (DS) and motivations for DS use among U.S. children (≤18 years) by family income level, food security status, and federal nutrition assistance program participation using the 2011–2014 National Health and Nutrition Examination Survey data. About one-third (32%) of children used DS, mostly multivitamin-minerals (MVM; 24%). DS and MVM use were associated with higher family income and higher household food security level. DS use was lowest among children in households participating in the Supplemental Nutrition Assistance Program (SNAP; 20%) and those participating in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC; 26%) compared to both income-eligible and income-ineligible nonparticipants. Most children who used DS took only one (83%) or two (12%) products; although children in low-income families took fewer products than those in higher income families. The most common motivations for DS and MVM use were to “improve (42% or 46%)” or “maintain (34 or 38%)” health, followed by “to supplement the diet (23 or 24%)” for DS or MVM, respectively. High-income children were more likely to use DS and MVM “to supplement the diet” than middle- or low-income children. Only 18% of child DS users took DS based on a health practitioner’s recommendation. In conclusion, DS use was lower among children who were in low-income or food-insecure families, or families participating in nutrition assistance programs.


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