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Community and Public Health Nutrition (Poster Session)

(P20-113-24) Receipt of SNAP Modifies the Relationship Between Food Security and Diet Quality Among US Adults: NHANES 2017–2020

Monday, July 1, 2024
12:45 PM – 1:45 PM CT
Location: Poster Board 602
Disclosure(s):
Anne M. Williams, PhD: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Food insecure populations tend to have lower diet quality. Our objective was to determine if the relationship between food security and diet quality among U.S. adults varies by Supplemental Nutrition Assistance Program (SNAP) participation.

Methods: Diet quality was defined by the Healthy Eating Index (HEI-2020), constructed using the first 24-hour dietary recall data from the National Health and Nutrition Examination Survey 2017–March 2020. Mean HEI-2020 scores were calculated for U.S. adults aged 20+ years with non-missing covariate data by food security category (n=6,697). Relationships between food security, SNAP receipt in the past 12 months, and HEI-2020 were evaluated using linear regression with interaction terms for food security and SNAP and controlling for age, sex, race/Hispanic origin, and household poverty status. Adjusted models were then stratified by SNAP participation after a significant interaction between food security and SNAP participation was detected. All analyses accounted for the complex survey design.

Results: Overall, mean (SE) HEI-2020 score was 49.6 (0.5), and the prevalence of full food security was 72.8% (95% CI: 70.3-75.2). Almost 17% (16.7%, 95% CI: 14.8-18.7) of adults received SNAP benefits in the last 12 months. Mean (SE) HEI scores ranged from 50.9 (0.4) among adults in food secure households to 46.5 (0.9), 47.1 (0.8), and 43.7 (0.7) among marginal, low, and very low food security households, respectively. Among adults that did not receive SNAP in the past 12 months, the HEI-2020 score was 8.2-points higher among adults with full food security compared to those experiencing very low food security (p < 0.001). However, there was no significant relationship between HEI-2020 and food security categories among adults that received SNAP in the past 12 months (p=0.29).

Conclusions: SNAP participation modified the relationship between food security and diet quality among US adults.

Funding Sources: None