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SNAP Participation and Diet-Sensitive Cardiometabolic Risk Factors in Adolescents.
Am J Prev Med. 2017 Feb; 52(2S2):S127-S137.AJ

Abstract

INTRODUCTION

Previous research suggests participation in the Supplemental Nutrition Assistance Program (SNAP) is associated with poorer adult cardiometabolic health; the extent to which these associations extend to adolescents is unknown. Differences in diet quality, obesity, and cardiometabolic risk factors were examined among SNAP participants, income-eligible nonparticipants, and higher-income adolescents.

METHODS

The study population comprised 4,450 adolescents ≤300% federal poverty level from the 2003-2010 National Health and Nutrition Examination Survey. Generalized linear models were used to examine associations between SNAP participation and the Alternate Healthy Eating Index-2010. Linear and logistic regression models were used to examine associations between SNAP participation, obesity, and risk factors comprising the metabolic syndrome. Data were analyzed in 2015.

RESULTS

All surveyed adolescents consumed inadequate amounts of vegetables, fruits, whole grains, and long-chain fatty acids, while exceeding limits for sugary beverages, processed meats, and sodium. Although there were few dietary differences, SNAP participants had 5% lower Alternate Healthy Eating Index-2010 scores versus income-eligible nonparticipants (95% CI=-9%, -1%). SNAP participants also had higher BMI-for-age Z scores (β=0.21, 95% CI=0.01, 0.41), waist circumference Z scores (β=0.21, 95% CI=0.03, 0.39), and waist-to-height ratios (β=0.02, 95% CI=0.00, 0.03) than higher-income nonparticipants. SNAP participation was not associated with most cardiometabolic risk factors; however, SNAP participants did have higher overall cardiometabolic risk Z scores than higher-income nonparticipants (β=0.75, 95% CI=0.02, 1.49) and income-eligible nonparticipants (β=0.55, 95% CI=0.03, 1.08).

CONCLUSIONS

Adolescent SNAP participants have higher levels of obesity, and some poorer markers of cardiometabolic health compared with their low-income and higher-income counterparts.

Authors+Show Affiliations

Center for Health and Community, University of California, San Francisco, California. Electronic address: cindyleung@post.harvard.edu.University of California, San Francisco Benioff Children's Hospital Oakland, Oakland, California.Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28109414

Citation

Leung, Cindy W., et al. "SNAP Participation and Diet-Sensitive Cardiometabolic Risk Factors in Adolescents." American Journal of Preventive Medicine, vol. 52, no. 2S2, 2017, pp. S127-S137.
Leung CW, Tester JM, Rimm EB, et al. SNAP Participation and Diet-Sensitive Cardiometabolic Risk Factors in Adolescents. Am J Prev Med. 2017;52(2S2):S127-S137.
Leung, C. W., Tester, J. M., Rimm, E. B., & Willett, W. C. (2017). SNAP Participation and Diet-Sensitive Cardiometabolic Risk Factors in Adolescents. American Journal of Preventive Medicine, 52(2S2), S127-S137. https://doi.org/10.1016/j.amepre.2016.06.011
Leung CW, et al. SNAP Participation and Diet-Sensitive Cardiometabolic Risk Factors in Adolescents. Am J Prev Med. 2017;52(2S2):S127-S137. PubMed PMID: 28109414.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - SNAP Participation and Diet-Sensitive Cardiometabolic Risk Factors in Adolescents. AU - Leung,Cindy W, AU - Tester,June M, AU - Rimm,Eric B, AU - Willett,Walter C, PY - 2016/04/01/received PY - 2016/06/13/revised PY - 2016/06/28/accepted PY - 2017/1/23/entrez PY - 2017/1/23/pubmed PY - 2018/1/6/medline SP - S127 EP - S137 JF - American journal of preventive medicine JO - Am J Prev Med VL - 52 IS - 2S2 N2 - INTRODUCTION: Previous research suggests participation in the Supplemental Nutrition Assistance Program (SNAP) is associated with poorer adult cardiometabolic health; the extent to which these associations extend to adolescents is unknown. Differences in diet quality, obesity, and cardiometabolic risk factors were examined among SNAP participants, income-eligible nonparticipants, and higher-income adolescents. METHODS: The study population comprised 4,450 adolescents ≤300% federal poverty level from the 2003-2010 National Health and Nutrition Examination Survey. Generalized linear models were used to examine associations between SNAP participation and the Alternate Healthy Eating Index-2010. Linear and logistic regression models were used to examine associations between SNAP participation, obesity, and risk factors comprising the metabolic syndrome. Data were analyzed in 2015. RESULTS: All surveyed adolescents consumed inadequate amounts of vegetables, fruits, whole grains, and long-chain fatty acids, while exceeding limits for sugary beverages, processed meats, and sodium. Although there were few dietary differences, SNAP participants had 5% lower Alternate Healthy Eating Index-2010 scores versus income-eligible nonparticipants (95% CI=-9%, -1%). SNAP participants also had higher BMI-for-age Z scores (β=0.21, 95% CI=0.01, 0.41), waist circumference Z scores (β=0.21, 95% CI=0.03, 0.39), and waist-to-height ratios (β=0.02, 95% CI=0.00, 0.03) than higher-income nonparticipants. SNAP participation was not associated with most cardiometabolic risk factors; however, SNAP participants did have higher overall cardiometabolic risk Z scores than higher-income nonparticipants (β=0.75, 95% CI=0.02, 1.49) and income-eligible nonparticipants (β=0.55, 95% CI=0.03, 1.08). CONCLUSIONS: Adolescent SNAP participants have higher levels of obesity, and some poorer markers of cardiometabolic health compared with their low-income and higher-income counterparts. SN - 1873-2607 UR - https://www.unboundmedicine.com/medline/citation/28109414/SNAP_Participation_and_Diet_Sensitive_Cardiometabolic_Risk_Factors_in_Adolescents_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(16)30234-3 DB - PRIME DP - Unbound Medicine ER -