Supplemental Nutrition Assistance Program (SNAP): does receiving assistance impact food choices?

The Supplemental Nutrition Assistance Program (SNAP) is the largest federal program that provides assistance for the purchase of foods to low-income households in the United States. SNAP plays a valuable role in alleviating hunger and food insecurity in poor households; however, one consideration that remains relatively unexplored is the influence of this program on food choices. Food choices are guided by several factors in low-income individuals, including the cost of food, household size, nutrition knowledge, availability of fresh foods in the neighborhood, transportation, and cultural factors. Also, the complex relationship between SNAP participation and food choices is further confounded by the factors of demographics, food insecurity, poverty, and self-selection. There is a lack of quantitative investigations that directly evaluate food choices in SNAP recipients. As a result, this review will focus on summarizing finding from studies that assessed food purchasing patterns, diet quality, and weight gain in SNAP participants. These outcomes may serve as proxy measures to evaluate the food choices made by SNAP participants. In addition, this review discusses many behavioral economic strategies such as reducing the cost of healthy foods, providing monetary benefits for purchase of healthy foods, increasing the SNAP benefits, incentivizing small food retailers to offer more food choices in low-income neighborhoods, increasing grocery stores and supermarkets in poor neighborhood, and strengthening the SNAP-Ed program; some of which have been previously adopted to promote the selection of healthy foods in SNAP participants. SNAP has the potential to impact food choices in the society, as such longitudinal studies are needed to evaluate the effectiveness of any reforms in SNAP benefits or restrictions, which may seem logical but not impact food choices in reality. Keywords: Supplemental Nutrition Assistance Program, food choices, grocery purchase, diet, diet quality, obesity