• Cindy W Leung, Eric L Ding, Paul J Catalano, Eduardo Villamor, Eric B Rimm, and Walter C Willett.
• Department of Nutrition, Harvard School of Public Health, Boston, MA, USA. cindyleung@post.harvard.edu
• Am. J. Clin. Nutr. 2012 Nov 1; 96 (5): 977-88.

BackgroundThe Supplemental Nutrition Assistance Program (SNAP) aims to alleviate hunger among its beneficiaries by providing benefits to purchase nutritious foods.ObjectiveWe conducted a comprehensive dietary analysis of low-income adults and examined differences in dietary intake between SNAP participants and nonparticipants.DesignThe 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.ResultsFew 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.ConclusionAlthough the diets of all low-income adults need major improvement, SNAP participants in particular had lower-quality diets than did income-eligible nonparticipants.

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