title: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Although the diets of all low-income adults need major improvement, SNAP participants in particular had lower-quality diets than did income-eligible nonparticipants.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA. cindyleung@post.harvard.edu
authors.forename: Cindy W
authors.initials: CW
authors.lastname: Leung
authors.forename: Eric L
authors.initials: EL
authors.lastname: Ding
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Catalano
authors.forename: Eduardo
authors.initials: E
authors.lastname: Villamor
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
mesh_terms: D000328:Adult; D000368:Aged; D004032:Diet / Q000191:economics*; D005247:Feeding Behavior; D005260:Female; D063105:Food Assistance; D005523:Food Supply / Q000191:economics*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011203:Poverty; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult