Dietary Quality of Americans by Supplemental Nutrition Assistance Program Participation Status: A Systematic Review

Abstract

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, macronutrient, 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.

Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2009 flow diagram.

Figure 2

Differences in diet and nutrition among adults on the Supplemental Nutrition Assistance Program and low-income nonparticipants. Note: Numbers represent reference citations.

Figure 3

Differences in diet and nutrition among children on the Supplemental Nutrition Assistance Program and low-income nonparticipants. Note: Numbers represent reference citations. HEI, Healthy Eating Index; SOFAAS, solid fats, alcoholic beverages and added sugars.

Figure 4

Differences in diet and nutrition among adults and children on the Supplemental Nutrition Assistance Program and higher-income nonparticipants. Note: Numbers represent reference citations.