Ending SNAP subsidies for sugar-sweetened beverages could reduce obesity and type 2 diabetes.

To reduce obesity and type 2 diabetes rates, lawmakers have proposed modifying Supplemental Nutrition Assistance Program (SNAP) benefits to encourage healthier food choices. We examined the impact of two proposed policies: a ban on using SNAP dollars to buy sugar-sweetened beverages; and a subsidy in which for every SNAP dollar spent on fruit and vegetables, thirty cents is credited back to participants' SNAP benefit cards. We used nationally representative data and models describing obesity, type 2 diabetes, and determinants of food consumption among a sample of over 19,000 SNAP participants. We found that a ban on SNAP purchases of sugar-sweetened beverages would be expected to significantly reduce obesity prevalence and type 2 diabetes incidence, particularly among adults ages 18-65 and some racial and ethnic minorities. The subsidy policy would not be expected to have a significant effect on obesity and type 2 diabetes, given available data. Such a subsidy could, however, more than double the proportion of SNAP participants who meet federal vegetable and fruit consumption guidelines.

[1]  B. Popkin,et al.  Averting Obesity and Type 2 Diabetes in India through Sugar-Sweetened Beverage Taxation: An Economic-Epidemiologic Modeling Study , 2014, PLoS medicine.

[2]  B. Swinburn,et al.  Dynamics of childhood growth and obesity: development and validation of a quantitative mathematical model. , 2013, The lancet. Diabetes & endocrinology.

[3]  Richard Taylor,et al.  Is there a dose-response relation of dietary glycemic load to risk of type 2 diabetes? Meta-analysis of prospective cohort studies. , 2013, The American journal of clinical nutrition.

[4]  W. Willett,et al.  Opportunities to reduce childhood hunger and obesity: restructuring the Supplemental Nutrition Assistance Program (the Food Stamp Program). , 2012, JAMA.

[5]  T. Blakely,et al.  Food Pricing Strategies, Population Diets, and Non-Communicable Disease: A Systematic Review of Simulation Studies , 2012, PLoS medicine.

[6]  E. Rimm,et al.  Dietary intake and dietary quality of low-income adults in the Supplemental Nutrition Assistance Program. , 2012, The American journal of clinical nutrition.

[7]  A. Drewnowski,et al.  Economic instruments for obesity prevention: results of a scoping review and modified delphi survey , 2011, The international journal of behavioral nutrition and physical activity.

[8]  K. Brownell,et al.  The Supplemental Nutrition Assistance Program, soda, and USDA policy: who benefits? , 2011, JAMA.

[9]  Carson C. Chow,et al.  Quantification of the effect of energy imbalance on bodyweight , 2011, The Lancet.

[10]  M. D. de Courten,et al.  The magnitude of association between overweight and obesity and the risk of diabetes: a meta-analysis of prospective cohort studies. , 2010, Diabetes research and clinical practice.

[11]  Ross A Hammond,et al.  The economic impact of obesity in the United States , 2010, Diabetes, metabolic syndrome and obesity : targets and therapy.

[12]  M. Jacobson,et al.  Using the Food Stamp Program and other methods to promote healthy diets for low-income consumers. , 2010, American Journal of Public Health.

[13]  K. Brownell,et al.  The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food. , 2010, American journal of public health.

[14]  M. Kushel,et al.  Food insecurity is associated with chronic disease among low-income NHANES participants. , 2010, The Journal of nutrition.

[15]  W. Willett,et al.  The public health and economic benefits of taxing sugar-sweetened beverages. , 2009, The New England journal of medicine.

[16]  F. Chaloupka,et al.  Food prices and obesity: evidence and policy implications for taxes and subsidies. , 2009, The Milbank quarterly.

[17]  Stephen S. Lim,et al.  Prevention of cardiovascular disease in high-risk individuals in low-income and middle-income countries: health effects and costs , 2007, The Lancet.

[18]  Dana Dabelea,et al.  Incidence of diabetes in youth in the United States. , 2007, JAMA.

[19]  K. Dodd,et al.  Most Americans eat much less than recommended amounts of fruits and vegetables. , 2006, Journal of the American Dietetic Association.

[20]  Joan M Conway,et al.  Accuracy of dietary recall using the USDA five-step multiple-pass method in men: an observational validation study. , 2004, Journal of the American Dietetic Association.

[21]  Simin Liu Intake of Refined Carbohydrates and Whole Grain Foods in Relation to Risk of Type 2 Diabetes Mellitus and Coronary Heart Disease , 2002, Journal of the American College of Nutrition.

[22]  P. Wilde,et al.  The Monthly Food Stamp Cycle: Shopping Frequency and Food Intake Decisions in an Endogenous Switching Regression Framework , 2000 .

[23]  J. Banks,et al.  Quadratic Engel Curves and Consumer Demand , 1997, Review of Economics and Statistics.

[24]  C. Olson,et al.  Relationship of hunger and food insecurity to food availability and consumption. , 1996, Journal of the American Dietetic Association.

[25]  W. Willett,et al.  Low-income Supplemental Nutrition Assistance Program participation is related to adiposity and metabolic risk factors. , 2012, The American journal of clinical nutrition.

[26]  M. Roizen Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A meta-analysis , 2012 .

[27]  M. Serdula,et al.  Fruit and vegetable intake among adolescents and adults in the United States: percentage meeting individualized recommendations. , 2009, Medscape journal of medicine.

[28]  R. Schreyer,et al.  THE DEPARTMENT OF AGRICULTURE. , 1901, Science.