Feature Feature

Going hungry in America

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g3548 (Published 30 May 2014) Cite this as: BMJ 2014;348:g3548
  1. Suzy Frisch
  1. suzyfrisch{at}yahoo.com

Nutrition programmes feed more people than ever in the United States but, asks Suzy Frisch, are they helping participants to eat healthily?

In the United States, 49 million Americans are food insecure, meaning that they lack access to enough food for an active, healthy life. That equates to about one in six people and includes nearly 16 million children. The government spends about $80bn (£47.5bn; €59bn) on its primary initiative, the Supplemental Nutrition Assistance Programme (SNAP), to make sure people have enough food.

The SNAP debate

Although enrolling in SNAP has been found to reduce food insecurity, some recent studies question whether it goes far enough in improving participants’ diets. Overweight and obesity rates are higher among women and children in households that utilize SNAP benefits than among other low income people who don’t receive SNAP, reports a study of national dietary survey data by the Food Policy Research Center at the University of Minnesota.1

Additionally, SNAP benefits do not substantially improve participants’ food security or dietary quality, according to a 2013 study in the Journal of Nutritional Education and Behavior. There was no meaningful improvement in the diets of Massachusetts SNAP participants during the three month study, yet there was a significant increase in their consumption of refined grains and no effect on their consumption of total calories or nutrients.2

“We looked at 107 people who were in the same socioeconomic status, some who were on SNAP and some who weren’t,” said Eric Rimm, study coauthor and an associate professor of epidemiology and nutrition at the Harvard School of Public Health. “We wanted to see if they were using SNAP to make good choices. We found it didn’t help them buy more fruits and vegetables, and it was giving them more access to sweets and baked goods. It …

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