Associations of Food Stamp Participation With Dietary Quality and Obesity in Children

As pediatric and public health researchers we are concerned about the press surrounding the March 2013 Pediatrics publication 'Associations of the Food Stamp Program with Dietary Quality and Obesity in Children' by Leung et al.1 The article makes important contributions to understanding the impact of SNAP (formerly food stamps, now the Supplemental Nutrition Assistance Program), however, press reports, including one summary in AAP's SmartBrief, characterized the findings inaccurately with the headline "Food Stamps Don't Help Improve Nutrition for Children".2 In fact, Leung et al. found in a national sample of 5000+ low-income children age 4-19 that SNAP receipt was associated with small but statistically significant odds of improved intakes of water and 3 key micronutrients - calcium, folate, and iron - all essential for children's bone, cognitive, and neurodevelopmental health, but are insufficient in the diets of many. The authors also found that SNAP participation was not associated with increased macronutrient intake, overweight or obesity.

Additionally, Leung et al. found that low-income American children, regardless of SNAP receipt, did not meet national dietary recommendations, findings consistent with the Institute of Medicine and National Research Council (2013), which concluded that SNAP benefit levels are insufficient in many places for consistent purchase of a healthful diet.3 While Leung et al. express concern that SNAP is used to purchase sugar-sweetened beverages (SSBs), their data do not show any incremental adverse effects on obesity in SNAP recipient vs. non-recipient children. Excess consumption of SSBs is of concern for all Americans, not just children in SNAP-recipient families.4,5

At a time when lawmakers have proposed cutting billions of dollars from SNAP, the AAP Smart Brief headline was not only inaccurate, but hazardous to the health of 27 million American children who participate in this program. Policymakers look to scientific work like the Leung article to guide their choices, but some do not dig deeper than the 'Study shows...' headline to form their positions. It is therefore critical that communications from the AAP avoid misrepresenting scientific articles.

1. Food stamps don't help improve nutrition for children. AAP Smart Brief. March 7, 2013.
2. Pittman G. Kids on food stamps don't eat any healthier: study. Reuters. March 7, 2013:
3. Caswell JA, Yaktine AL, eds. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, D.C.: National Academies Press, 2013.
4. Etherton L, Russo R, Hossain N. Apples to Twinkies 2012: Comparing Taxpayer Subsidies for Fresh Produce and Junk Food. U.S. PIRG Education Fund. July 2012.
5. McGinnis JM, Gootman JA, Kraak VI, eds. Food marketing to children and youth: threat or opportunity? Washington, D.C.: National Academies Press, 2006

Conflict of Interest:

None declared