Food insecurity and ultra-processed food consumption: the modifying role of participation in the Supplemental Nutrition Assistance Program (SNAP)

Abstract

Background Ultra-processed foods contribute to risks of obesity and cardiometabolic disease, and higher intakes have been observed in low-income populations in the US. Consumption of ultra-processed foods may be particularly higher among individuals experiencing food insecurity and participating in the Supplemental Nutrition Assistance Program (SNAP). Objective Using data from the 2007-2016 National Health and Nutrition Examination Surveys (NHANES), we examined the associations between food insecurity, SNAP participation and ultra-processed food consumption. Design The study population was comprised of 9,190 adults, ages 20-65 years, with incomes ≤300% of the federal poverty level. Food insecurity was assessed using the Household Food Security Survey Module and SNAP participation over the past 12 months was self-reported. Dietary intake was measured from two 24-hour dietary recalls. Ultra-processed food consumption (% of total energy intake) was defined using the NOVA food classification system. Linear regression models were used to examine the associations between food insecurity, SNAP participation, and ultra-processed food consumption, adjusting for sociodemographic and health characteristics. Results More severe food insecurity was associated with higher intakes of ultra-processed foods (P-trend=0.003). The adjusted means of ultra-processed food intake ranged from 52.6% for adults with high food security to 55.7% for adults with very low food security. SNAP participation was also associated with higher intakes of ultra-processed foods (adjusted mean: 54.7%), compared to income-eligible participants (adjusted mean: 53.0%). Furthermore, the association between food insecurity and ultra-processed foods was modified by SNAP participation (P-interaction=0.02). Among income-eligible non-participants and income-ineligible non-participants, more severe food insecurity was associated with higher consumption of ultra-processed foods. Among SNAP participants, the association between food insecurity and consumption of ultra-processed foods was non-significant. Conclusion In a nationally representative sample of adults, food insecurity and SNAP participation were both associated with higher levels of ultra-processed food consumption.

Food insecurity and the role of food assistance programs in supporting diet quality during the COVID-19 pandemic in Massachusetts

“…Prior research has found that, compared to eligible non-participants, those enrolled in SNAP experience lower diet quality and may need to purchase foods that are inexpensive but are calorically dense and nutrient-poor in order to maximize their benefits ( 44 ). Notably, however, we found in this sample that SNAP participation was not associated with increased intake of SSBs, and other recent work suggests that food insecurity is not associated with increased intake of ultra-processed foods among SNAP participants ( 6 ). Policymakers should continue to consider strategies aimed to incentivize purchases of healthier foods using SNAP benefits, such as providing financial incentives for fruits and vegetables ( 45 ) or increasing the SNAP benefit size ( 46 , 47 ).…”

“…5 Overall disruption score is out of 14, with higher scores indicating greater disruption in overall diet. 6 P-values are computed from probability of direction (pd) values based on posterior samples. obscured differences observed when examining Healthy and Unhealthy sub-scores-participants experiencing FI had significantly lower scores for both types of sub-scores, suggesting they ate less of both healthy and unhealthy items.…”

“…Food insecurity (FI), or inconsistent access to enough food to maintain a healthy lifestyle ( 1 ), is associated with adverse physical, cognitive, and emotional health ( 2 – 4 ). In the 21st century, FI is often characterized by a state of having reduced access to healthy foods in particular, forcing a reliance on inexpensive but unhealthy or ultra-processed foods and beverages ( 5 , 6 ).…”

Diet and Food and Nutrition Insecurity and Cardiometabolic Disease

“…These findings suggest that several people with food insecurity Nonetheless, it is clear that food insecurity is linked to worse-quality diets. [107][108][109] For example, based on nationally representative data, individuals participating in the Supplemental Nutrition Assistance Program (SNAP; formerly the Food Stamp Program) have an average American Heart Association dietary score of 32 out of 80 (higher scores indicate better nutrition), individuals who are incomeeligible for SNAP but not participating have an average score of 37, and individuals with higher incomes have an average score of 40. 38 Many of the challenges that create low food access likewise lead to worse nutrition.…”

The combined consumption of fresh/minimally processed food and ultra-processed food on food insecurity: COVID Inconfidentes, a population-based survey

“…In Brazil, a study in the Amazon that sought to assess food consumption and food insecurity https://doi.org/10.1017/S136898002300054X Published online by Cambridge University Press Accepted manuscript noted that fresh/minimally processed foods, such as fruits and vegetables, were considered unaffordable 49 . Using data from the 2007-2016 National Health and Nutrition Examination Survey, Leung et al 50 found that severe food insecurity was associated with higher consumption of UPF in the United States of America. Therefore, it is likely that this scenario was already present prior to the COVID-19 pandemic and may have worsened.…”