title: Relation between the Supplemental Nutritional Assistance Program cycle and dietary quality in low-income African Americans in Baltimore, Maryland.
abstract: BACKGROUND
  There has been limited research regarding the Supplemental Nutritional Assistance Program (SNAP) and recipients' dietary quality during the days and weeks after benefit disbursement.
  
  
  OBJECTIVE
  We examined the relation between participants' stages in the SNAP cycle and their macronutrient consumption, Healthy Eating Index (HEI) scores, and fruit and vegetable intake.
  
  
  METHODS
  In this cross-sectional study, we analyzed single 24-h dietary recalls collected from 244 African American SNAP participants recruited near 24 corner stores in Baltimore City. A multiple linear regression analysis and bootstrapping were used.
  
  
  RESULTS
  Among participants who received a SNAP benefit ≤15 d before being surveyed, energy intake adjusted for minimum energy requirements (-4.49%; 95% CI: -8.77%, -0.15%) and HEI dairy scores (-0.12; 95% CI: -0.22, -0.01) were lower for each 1-d increase in the time since SNAP distribution (TSSD). Among participants who received SNAP benefits >15 d before being surveyed, energy intake (1.35%; 95% CI: 0.01%, 2.73%), energy intake adjusted for minimum energy requirements (3.86%; 95% CI: 0.06%, 7.96%), total fat intake (1.96%; 95% CI: 0.29%, 3.8%), saturated fat intake (2.02%; 95% CI: 0.23%, 4.01%), and protein intake (2.09%; 95% CI: 0.70%, 3.62%) were higher per each 1-d increase in the TSSD.
  
  
  CONCLUSIONS
  These findings suggest that the relation between the TSSD and macronutrient intake might be U-shaped, with higher intake of calories, fat, and protein in individuals in the very early and late stages of their SNAP cycles. Foods high in these nutrients might be cheaper, more accessible, and have a longer shelf-life than healthier options, such as fruit, vegetables, and whole grains, for SNAP participants when their benefits run out. Additional efforts are needed to investigate the effect of the TSSD on dietary intake by using a longitudinal design and to improve the quality of dietary intake in African American SNAP participants.
authors.affiliation: Departments of International Health (AYK, JCJ-S, YSC, NB, AC, YM, and JG) and Health, Behavior, and Society (LF), Johns Hopkins School of Public Health, Baltimore, MD, and the Health Science Department, Federal University of Sao Paulo, São Paulo, Brazil (AT).
authors.forename: Anna Y
authors.initials: AY
authors.lastname: Kharmats
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Jones-Smith
authors.forename: Yun Sang
authors.initials: YS
authors.lastname: Cheah
authors.forename: Nadine
authors.initials: N
authors.lastname: Budd
authors.forename: Laura
authors.initials: L
authors.lastname: Flamm
authors.forename: Alison
authors.initials: A
authors.lastname: Cuccia
authors.forename: Yeeli
authors.initials: Y
authors.lastname: Mui
authors.forename: Angela
authors.initials: A
authors.lastname: Trude
authors.forename: Joel
authors.initials: J
authors.lastname: Gittelsohn
mesh_terms: D000328:Adult; D001741:Black or African American; D015142:Baltimore; D003430:Cross-Sectional Studies; D003611:Dairy Products; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002523:Edible Grain; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D063105:Food Assistance; D063427:Food Quality; D005523:Food Supply; D005638:Fruit; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D015999:Multivariate Analysis; D009751:Nutritional Requirements; D011203:Poverty; D011795:Surveys and Questionnaires; D014675:Vegetables
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins