Better Diet for Poor Americans Is Not a SNAP

Poor diet may underly a wide range of undesirable health problems, from obesity to diabetes and heart disease. The Supplemental Nutrition Assistance Program (SNAP) was designed to help very low-income Americans afford a better diet. Several years ago, scientists wondered how well this program was working to improve nutrition in poor families. They examined data from the National Health and Nutrition Examination Survey from 1999 to 2014, and discovered increasing dietary disparities between SNAP participants and the rest of the population.

Determining What People Are Eating:

The research included 38,696 participants who filled out either one or two detailed dietary questionnaires (JAMA Network Open, June 15, 2018). To determine diet quality, the researchers created a diet score based on recommendations of the American Heart Association. They calculated consumption of eight dietary components: fruits and vegetables; fish and shellfish; whole grains; nuts, seeds and legumes (all of which presumably counted positively); and sodium; sugar-sweetened beverages; processed meats; and saturated fat (which must have lowered the overall scores). They then estimated how many people were eating a poor diet, an intermediate diet or an ideal diet.

SNAP Diets Did Not Improve Noticeably:

Between 2003 and 2014, the mean diet score for Americans in general improved significantly, while the diets of people receiving SNAP assistance did not change. Higher-income individuals in particular started eating better during that time, although they still have a lot of room for improvement. The proportion following an ideal diet went from 1.4 percent to 2.6 percent, while the figures for intermediate diet scores increased from 59 percent to 69 percent.

In contrast, there were no significant changes in dietary scores for people with lower incomes, whether or not they participated in SNAP. In particular, people on SNAP drank more sugar-sweetened beverages and ate more added sugars and less fish, shellfish, nuts and seeds than those who were not participating in the program.

The authors concluded:

“our findings underscore the need for robust new strategies to improve diet quality and reduce dietary disparities in the United States.”

Would Incentives Improve SNAP Diets?

Increasingly, health experts are acknowledging that a high-produce diet is essential to good health. Figuring out how to operationalize that insight is tough, though.

A state-level incentive program in Rhode Island called EatWellBeWell offered SNAP recipients 50 cents of credit on their EBT cards for every dollar spent on fruits and vegetables (JAMA Network Open, Nov. 18, 2025). Two state-wide grocery chains (Stop & Shop, Walmart) participated. Data collected in Rhode Island were compared to those from Connecticut, where no incentives were available.

Investigators had hoped that this incentive would increase the consumption of fruits and vegetables among the low-income plan participants. It worked, but only for those who already were consuming more produce. Overall, consumption of produce increased from 2.05 to 2.2 cups in Rhode Island. In Connecticut, it was steady, going from 2.12 to 2.13 cups. In neither state was the change significant. Those who weren’t eating many vegetables or fruits at the start of the program didn’t increase their consumption very much.

The researchers reported:

“Our finding that participants with higher baseline fruit and vegetable intake but not those in the bottom half of the distribution experienced overall increases in fruit and vegetable intake suggests that individuals who are already motivated to eat healthfully are particularly responsive to financial incentives.”

Learn More:

If you would like to know more about the impact of diet, you may want to listen to some of our podcasts. We discuss the topic frequently. This podcast is a good place to start. It is Show 1161: What Is the Evidence for Food as Medicine?