Monthly subsidy increased purchase of fresh fruits and vegetables in Supplemental Nutrition Assistance Program beneficiaries

1. Participants enrolled in the Supplemental Nutrition Assistance Program receiving monthly subsidies for food purchases had increased purchases of fresh fruit and vegetables.

2. Participants did not increase purchase of less healthy foods.

Evidence Rating Level: 2 (Good)

Fresh fruit and vegetables are an essential part of a nutritious diet but are not accessible to everyone. SuperSNAP serves as a nutritional support program that provides an additional $40 per month for the purchase of fresh fruits and vegetables to beneficiaries of the Supplemental Nutrition Assistance Program (SNAP), a program aimed to mitigate general food insecurity in the US. However, the efficacy of SuperSNAP in altering food purchasing patterns has not been tested.

This retrospective cohort study compared purchase history of 436 SuperSNAP participants with 33,246 SNAP beneficiaries who shopped at the same stores but were not participating in SuperSNAP. The study also compared purchases in participants before and after the start of SuperSNAP program. Transaction records were extracted from approximately 500 supermarkets in North Carolina from October 2019 to April 2020. The primary outcome was monthly spending on fruits, vegetables, legumes, and nuts. Secondary outcomes examined spending on less healthy food categories as a potential negative impact of increasing purchasing capacity.

The study found that SuperSNAP participants had increased monthly purchases of fruits, vegetables, nuts and legumes (difference of $31.84) but minimal increase in spending on less healthy foods (difference of $1.60). Monthly spending on sweetened beverages also decreased. However, this study was limited in that the participants in SuperSNAP were identified in primary care clinics as patients likely to benefit from increased fruit and vegetable intake due to existing diabetes or obesity. Therefore, differences in health motivation and behavior could have confounded the effect of monetary subsidy on changes in purchasing behavior. Nonetheless, this study was significant in suggesting subsidized programs such as SuperSNAP could increase the purchasing of healthy foods.

Click to read the study in JAMA Network Open

Image: PD

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