Departments of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
Pediatrics. 2013 Mar;131(3):463-72. doi: 10.1542/peds.2012-0889. Epub 2013 Feb 25.
To determine if obesity and dietary quality in low-income children differed by participation in the Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp Program.
The study population included 5193 children aged 4 to 19 with household incomes ≤130% of the federal poverty level from the 1999-2008 NHANES. Diet was measured by using 24-hour recalls.
Among low-income US children, 28% resided in households currently receiving SNAP benefits. After adjusting for sociodemographic differences, SNAP participation was not associated with a higher rate of childhood obesity (odds ratio = 1.11, 95% confidence interval [CI]: 0.71-1.74). Both SNAP participants and low-income nonparticipants were below national recommendations for whole grains, fruits, vegetables, fish, and potassium, while exceeding recommended limits for processed meat, sugar-sweetened beverages, saturated fat, and sodium. Zero percent of low-income children met at least 7 of 10 dietary recommendations. After multivariate adjustment, compared with nonparticipants, SNAP participants consumed 43% more sugar-sweetened beverages (95% CI: 8%-89%), 47% more high-fat dairy (95% CI: 7%, 101%), and 44% more processed meats (95% CI: 9%-91%), but 19% fewer nuts, seeds, and legumes (95% CI: -35% to 0%). In part due to these differences, intakes of calcium, iron, and folate were significantly higher among SNAP participants. Significant differences by SNAP participation were not evident in total energy, macronutrients, Healthy Eating Index 2005 scores, or Alternate Healthy Eating Index scores.
The diets of low-income children are far from meeting national dietary recommendations. Policy changes should be considered to restructure SNAP to improve children's health.
确定低收入儿童的肥胖和饮食质量是否因参与补充营养援助计划（SNAP）而有所不同，该计划以前称为食品券计划。
研究人群包括来自 1999-2008 年全国健康与营养调查（NHANES）的 5193 名年龄在 4 至 19 岁、家庭收入≤联邦贫困线 130%的儿童。通过 24 小时回忆法来测量饮食。
在美国低收入儿童中，28%的儿童居住在目前正在领取 SNAP 福利的家庭中。在调整了社会人口统计学差异后，SNAP 的参与与儿童肥胖率的升高无关（比值比=1.11，95%置信区间[CI]：0.71-1.74）。SNAP 参与者和低收入非参与者均低于全谷物、水果、蔬菜、鱼类和钾的全国推荐量，而超过了加工肉类、含糖饮料、饱和脂肪和钠的建议限量。没有一个低收入儿童满足至少 10 项饮食建议中的 7 项。在进行多变量调整后，与非参与者相比，SNAP 参与者饮用了 43%更多的含糖饮料（95%CI：8%-89%）、47%更多的高脂肪乳制品（95%CI：7%，101%）和 44%更多的加工肉类（95%CI：9%-91%），但坚果、种子和豆类的摄入量减少了 19%（95%CI：-35%至 0%）。由于这些差异，SNAP 参与者的钙、铁和叶酸摄入量显著更高。在 SNAP 参与方面，总能量、宏量营养素、2005 年健康饮食指数和替代健康饮食指数得分没有明显差异。
低收入儿童的饮食远远不符合国家饮食建议。应考虑进行政策改革，以重组 SNAP 来改善儿童的健康。
