Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA.
Public Health Nutr. 2019 Nov;22(16):2989-2998. doi: 10.1017/S1368980019002209. Epub 2019 Aug 9.
The 2009 American Recovery and Reinvestment Act (ARRA) increased monthly Supplemental Nutrition Assistance Program (SNAP) benefits and expanded SNAP eligibility, yet limited evidence exists on the potential impact of ARRA on dietary intake among at-risk individuals. We aimed to examine pre-/post-ARRA differences in food insecurity (FI) and dietary intake by SNAP participation status.
Pre/post analysis.
Boston, MA, USA.
Data were from the longitudinal Boston Puerto Rican Health Study (2007-2015). The US Department of Agriculture ten-item adult module assessed FI. A validated FFQ assessed dietary intake. Diet quality was assessed using the Alternate Healthy Eating Index-2010 (AHEI-2010). Self-reported pre-/post-ARRA household SNAP participation responses were categorized as: sustained (n 249), new (n 95) or discontinued (n 58). We estimated differences in odds of FI and in mean nutrient intakes and AHEI-2010 scores post-ARRA.
Compared with pre-ARRA, OR (95 % CI) of FI post-ARRA were lower for all participants (0·69 (0·51, 0·94)), and within sustained (0·63 (0·43, 0·92)) but not within new (0·94 (0·49, 1·80)) or discontinued (0·63 (0·25, 1·56)) participants. Post-ARRA, total carbohydrate intake was higher, and alcohol intake was lower, for sustained and new participants, and dietary fibre was higher for sustained participants, compared with discontinued participants. Scores for AHEI-2010 and its components did not differ post-ARRA, except for lower alcohol intake for sustained v. discontinued participants.
Post-ARRA, FI decreased for sustained participants and some nutrient intakes were healthier for sustained and new participants. Continuing and expanding SNAP benefits and eligibility likely protects against FI and may improve dietary intake.
2009 年美国复苏与再投资法案(ARRA)增加了每月补充营养援助计划(SNAP)的福利,并扩大了 SNAP 的资格范围,但关于 ARRA 对处于风险中的个人饮食摄入的潜在影响的证据有限。我们旨在研究 SNAP 参与状况对食品不安全(FI)和饮食摄入的 ARRA 前后差异。
前后分析。
美国马萨诸塞州波士顿。
数据来自纵向波士顿波多黎各健康研究(2007-2015 年)。美国农业部十项成人模块评估了 FI。经过验证的 FFQ 评估了饮食摄入量。使用替代健康饮食指数-2010(AHEI-2010)评估饮食质量。自我报告的 ARRA 前后家庭 SNAP 参与情况的回复分为:持续(n 249)、新(n 95)或中断(n 58)。我们估计 ARRA 后 FI 的可能性差异以及平均营养素摄入量和 AHEI-2010 评分。
与 ARRA 前相比,所有参与者的 ARRA 后 FI 的比值比(95%置信区间)均较低(0.69(0.51,0.94)),在持续(0.63(0.43,0.92))但不在新(0.94(0.49,1.80))或中断(0.63(0.25,1.56))参与者中。与中断参与者相比,ARRA 后持续和新参与者的总碳水化合物摄入量较高,酒精摄入量较低,膳食纤维摄入量较高。AHEI-2010 及其成分的评分在 ARRA 后没有差异,除了持续参与者的酒精摄入量低于中断参与者。
ARRA 后,持续参与者的 FI 降低,一些营养素的摄入量对持续和新参与者更健康。继续和扩大 SNAP 的福利和资格范围可能有助于预防 FI,并可能改善饮食摄入。