Association of Grocery Expenditure Relative to Thrifty Food Plan Cost with Diet Quality of Women Participating in the Supplemental Nutrition Assistance Program

摘要

BackgroundThe Supplemental Nutrition Assistance Program (SNAP) is the largest food assistance program in the United States. Allotment of SNAP benefits is based on the Thrifty Food Plan (TFP), which is designed to achieve a nutritious diet at a minimal cost. Although low-income households do not meet the TFP cost for total groceries, the impact on diet quality is not known.ObjectiveThe objective of this research is to determine the relationship of TFP-adjusted total grocery and SNAP-related expenditures with diet quality of women participating in SNAP.DesignIn this observational study, participants were administered a demographics questionnaire, food frequency questionnaire, and United States adult food security module. Participants were also instructed to save grocery receipts for 1 month. Total and SNAP-related grocery expenditures and TFP cost for each household were determined. The Healthy Eating Index-2010 was used as a measure of diet quality.Participants/settingA total of 217 women from low-income housing and neighborhood centers in central Texas were enrolled from January through December 2015. Eligibility criteria included participation in SNAP; age 18 to 50 years; and Hispanic, non-Hispanic black, or non-Hispanic white race/ethnicity. Fifty-eight women were lost during follow-up. Data from 15 participants were excluded as a result of reporting of implausible caloric intakes or incomplete collection of receipts, thereby resulting in a final sample of?144.Main outcome measuresFood group and nutrient intake and diet quality were the main outcome measures of the study.Statistical analysisMultiple linear regression analyses determined the association of TFP-adjusted total grocery and SNAP benefit expenditure with food group intake and diet quality. Independent-samplesttest and one-way analysis of variance were used to determine differences in ratio of spending to TFP cost by demographic characteristics.ResultsThe mean ratio of total grocery expenditure to TFP cost was 0.74. Total and SNAP benefit expenditures relative to TFP cost were positively related to fruit and vegetable intake (P0.01) and diet quality (P0.05). Ratio of grocery spending to TFP costs did not differ based on food security status.ConclusionsThe results of this study indicate inadequate grocery spending among SNAP households relative to recommended TFP cost, which in turn was associated with poorer diet quality in women.