Fruit and Vegetable Intake in SNAP Beneficiaries and Its Association with Perceived Health

Introduction Food scarcity is a common problem within the United States, prompting multiple efforts at the federal, state, and local levels working to alleviate food insecurity and the physical, mental, and social health disparities with which it is associated. One such program, Double Up Food Bucks (DUFB), incentivizes the purchase of local fruits and vegetables through matched dollars for Supplemental Food and Nutrition Assistance Program (SNAP) users. Few studies have examined the impact that this incentive program has on buying practices among this population, with even fewer focusing on the possible relationships that these buying practices have upon this population’s self-perceived health. Methods A secondary analysis was performed on data from an ongoing study conducted by Dr. Cheryl Gibson and her research team at the University of Kansas Medical Center in which SNAP users were surveyed to determine whether they had used DUFB in addition to generating a snapshot of their usual buying practices, fruit and vegetable intake, and self-identified level of health. This secondary analysis focused on perceived importance of fruit and vegetable intake for health in relation to self-reported intake, fruit and vegetable intake in relation to self-reported health, food security status in relation to fruit and vegetable intake, store type and transportation most commonly used to purchase fruits and vegetables, and the impact of perceived importance of locally sourced produce on store type utilization. Results DUFB participants did not differ significantly from non-DUFB respondents with respect to age (p=0.84) or race/ethnicity (p=0.058). While nearly all (i.e., 139 of 142) DUFB respondents indicated that fruits and vegetables are important for health, fruit intake ranged from 0-8 daily servings and 0.5-20 daily servings of vegetables. Only self-reported “poor” health showed a statistically significant correlation with diminished fruit intake (p=0.023). There was insufficient evidence to conclude that a relationship existed between reported health and whether or not respondent’s reported intakes met the 2015-2020 Dietary Guidelines for Americans recommendations for fruit (p=0.620) and vegetables (p=0.804). Intake in relation to level of food security showed no statistically significant correlation. The majority of DUFB users shopped at supermarkets (n=127) and the majority of DUFB users drove themselves to the store (n=61 for all users; n=38 for insecure) with no statistically significant relationship between store type utilized and method of travel used to access it (p=0.214). Self-perceived importance of purchasing locally sourced produce did not have statistically significant impact on store type utilized (p=0.904). Conclusion Reported importance of fruit and vegetable intake did not appear to influence self-reported intake levels in the DUFB population sample. With the exception of “poor” health and diminished fruit intake, self-reported intake does not have an impact on self-reported health even when factoring in food security status, dietary guideline recommendations and survey location. Food security status did not impact fruit and vegetable intake in this sample. Self-reported intake among the DUFB group was higher than the national average for fruit intake, comparable to the national average for vegetable intake, and appears higher than intake for both in comparison to SNAP eligible non-DUFB populations in Kansas and Missouri, suggesting that DUFB participants are eating more fruits and vegetables than their non-DUFB counterparts. Stores utilized for produce purchases were independent of travel method and ranked importance of purchasing locally sourced fruits and vegetables, indicating that these factors do not impact the motivations for choosing store types in this sample