Proposed SNAP Changes Featured in JAMA: Reducing Hunger and Obesity Among Low-Income Children

Members of the SNAP to Health Project Team recently published a viewpoint article in the Journal of American Medical Association (JAMA) about reducing childhood hunger and obesity by restructuring the Supplemental Nutrition Assistance Program (SNAP). Authors David Ludwig, MD, PhD, Susan Blumenthal, MD, MPA (Project Director), and Walter Willett, MD, DrPH note that adequate nutrition is essential during childhood; it impacts physical development, cognitive performance, and psychological well-being. But adequate nutrition means more than just sufficient food quantity (caloric intake); ensuring food quality is also important. Historically, food insecurity among children has been a concern in the United States, but the picture of food insecurity has changed in recent years. Among populations living in poverty, many more children are obese than underweight. As the article explains, “typically the challenge for low-income families in today’s modern food environment is not obtaining enough food but rather having dependable access to high-quality food.” Food insecurity is still very prevalent in the United States, affecting 1 in 6 Americans, but its characteristics have changed.

SNAP is a 75 million dollar program that aims to address food insecurity and improve nutrition. With as many as 1 in 4 children enrolled in the program SNAP is a vital safety net for many families. However, recent data suggest that even among other low-income adults, SNAP beneficiaries have “lower dietary quality than non-participants.” Moreover, obesity is affecting poor youth disproportionally. How can this be? The authors discuss two potential problems: “cyclical variation in food availability” with SNAP benefits and consumption of high calorie, low-quality products. SNAP benefits are dispersed monthly which can lead to overconsumption at the beginning of the month when benefits are received and deprivation towards the end of the month when benefits are running low. Studies in animals show that this pattern of eating can lead to “increased body weight and fatness.” Additionally, SNAP currently does little to focus on food quality. Recent research suggests children eating nutrient dense, low-calorie snacks eat less and feel fuller longer than when snacking on high calorie foods of poor nutritional quality. The authors hypothesize that the lack of focus on food quality in SNAP may “simultaneously exacerbate hunger and promote obesity.”

The consequences of this perilous paradox of food insecurity and obesity in children are well documented including developmental delays, learning difficulties, impaired acquisition of social skills, behavioral and emotional problems, and obesity related diseases. So what can be done? The SNAP to Health Project Team has recommended aligning SNAP policies with the Dietary Guidelines for Americans in the same way other federal nutrition programs like WIC have been redesigned. SNAP should encourage the consumption of healthy and nutritious foods and discourage the consumption of high calorie foods with poor nutritional quality. As currently configured, SNAP only focuses on food quantity, which may be contributing to malnutrition and obesity despite its goal to help participants lead healthy lives. However, SNAP is in a position to help solve these problems. By making important improvements to the program that promote quality nutrition, SNAP can “provide a major opportunity to reduce the burden of diet-related disease among low-income children and families” by promoting a healthier future for them.

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