Department of Psychological, Health and Learning Sciences, College of Education, The University of Houston, 3657 Cullen Blvd. Stephen Power Farish Hall, Houston, TX 77204, USA.
HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA.
Nutrients. 2021 Oct 12;13(10):3574. doi: 10.3390/nu13103574.
Nutrition assistance programs such as school meals and the Supplemental Nutrition Assistance Program (SNAP) are designed to provide a safety net for the dietary intake of children from low-income families. However, compared with eligible non-participants, the relationship of diet quality with school meals only and school meals + SNAP is not well understood. The objectives of the study include: (1) To explore whether and to what extent nutrition assistance program participation (school meals only and school meals + SNAP) is related to diet quality; and (2) to examine the differences of diet quality between participating in school meals only, school meals + SNAP, or non-participation among American children. Children aged 5 to 18 years old from income eligible households who participated in the 2013-2014 National Health and Nutrition Examination Survey (NHANES) were included in this cross-sectional study ( = 1425). Diet quality was measured using the Healthy Eating Index (HEI)-2015 and its 13 subcomponents. A Rao-Scott Chi-square test, propensity scores approach, and Analysis of Covariance were performed. Covariates included age, sex, race/ethnicity, weight status, and family monthly poverty index. SAS survey procedures were used to incorporate the appropriate sample design weights. Participation in school meals + SNAP was not associated with higher diet quality compared to eligible non-participants or school meals-only participants. Participation in school meals + SNAP improved the intake of total dairy, but not added sugars or total vegetables compared to school meals only. Overall, school meal + SNAP participation did not significantly improve the overall diet quality of children in low-income households relative to comparable non-participants.
营养援助计划，如学校膳食和补充营养援助计划（SNAP），旨在为低收入家庭儿童的饮食摄入提供保障。然而，与符合条件的非参与者相比，饮食质量与仅学校膳食和学校膳食+SNAP 的关系尚未得到充分了解。本研究的目的包括：（1）探讨营养援助计划参与（仅学校膳食和学校膳食+SNAP）是否以及在何种程度上与饮食质量相关；（2）检验仅参与学校膳食、同时参与学校膳食和 SNAP 以及不参与的美国儿童之间饮食质量的差异。本横断面研究纳入了来自符合收入条件家庭、年龄在 5 至 18 岁之间的儿童，他们参加了 2013-2014 年全国健康和营养调查（NHANES）（n=1425）。使用健康饮食指数（HEI）-2015 及其 13 个分量表来衡量饮食质量。采用 Rao-Scott 卡方检验、倾向评分法和协方差分析。协变量包括年龄、性别、种族/民族、体重状况和家庭月贫困指数。采用 SAS 调查程序纳入适当的样本设计权重。与符合条件的非参与者或仅学校膳食参与者相比，参与学校膳食+SNAP 与更高的饮食质量无关。与仅学校膳食相比，参与学校膳食+SNAP 可改善总乳制品、但不能改善添加糖或总蔬菜的摄入量。总体而言，与可比的非参与者相比，学校膳食+SNAP 的参与并没有显著提高低收入家庭儿童的整体饮食质量。
