The Supplemental Nutrition Assistance Program (SNAP) provides food assistance to more than 40 million impoverished Americans, including children. Health disparities, including diet quality, are well documented within the SNAP population. For example, previous research has indicated that SNAP participants are more likely to consume sugar-sweetened beverages (SSB) on a daily basis compared to non-SNAP participants. SSB consumption is associated with an increased risk for obesity, type 2 diabetes, heart disease and dental caries in both children and adults. The goal of this research article was to examine trends in sugar-sweetened beverage (SSB) consumption by SNAP participation status between 2003-2014 among participants aged 2-9 years-old. Dietary data of 15,646 participants obtained from the National Health and Nutrition Examination Survey (NHANES) was categorized into four categories: SNAP participant, income eligible non-participant, lower income- ineligible participant, and higher income- ineligible nonparticipant. Results from weighted logistic regressions estimated daily SSB consumption and showed that there were significant declines across all SNAP participation categories between the years of 2003-2014 (p < .05). However, daily consumption of SSB was still higher among SNAP participants with 75% consuming one or more SSB/day compared to 67% of higher income, ineligible non-SNAP participants.

Study strengths: This is one of the first studies to describe trends in SSB consumption among children and adolescents by SNAP participation status. Data from this study is nationally representative and used a nutrition assessment method that has been assessed for validity.

Study limitations: The data from this study was gathered from 24-hour recall surveys, which requires participants to have an accurate memory for both foods consumed and portion sizes. Data on children’s intake is reported by parents/guardians. Additionally, it was not possible to analyze results for trends by gender, ethnicity and age because of small sample sizes within each SNAP participant category. Finally, this is a cross-sectional study, and it is not possible to make casual inferences about SNAP participation and consumption of SSB.

What this means for your practice: SSB consumption remains high among all children aged 2–19 years-old, regardless of SNAP participation; 67%-75% consume at least one SSB/day. Education about the need to decrease SSB consumption is still needed for all children. The Dietary Guidelines for Americans recommends that Americans over the age of two consume <10% of their calories from added sugars. Resources to encourage healthy drink choices for both parents and children can be found at www.rethinkyourdrinknevada.com .

Original citation: Koma, J. W., Vercammen, K. A., Jarlenski, M. P., Frelier, J. M., & Bleich, S. N. (2019). Sugary Drink Consumption Among Children by Supplemental Nutrition Assistance Program Status. American Journal of Preventive Medicine. In press.

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