Supplemental Nutritional Assistance Program Participation and Relationship With Obesity and Metabolic Syndrome: NHANES Adults, 2013–2018

OBJECTIVES: The Supplemental Nutrition Assistance Program (SNAP) is the largest food insecurity safety net program in America. Previous research suggests that participation in SNAP is associated with obesity and poor metabolic health. In recent years, there have been extensive federal nutrition education efforts to promote healthier food choices and increase access to healthier foods among SNAP participants. The purpose of this study was to assess the association between SNAP participation, obesity, and metabolic syndrome using recent data from the National Health and Nutrition Examination Surveys (NHANES). METHODS: A cross-sectional analysis was performed using data from the 2013–2018 NHANES. The study population included 4165 adults aged 18 to 65 with household incomes ≤130% of the federal poverty level. The association between SNAP participation and body mass index (BMI) was modeled using multinomial logistic regression while the association between SNAP participation and risk factors for metabolic syndrome was modeled using Poisson regression. RESULTS: Out of the 4165 individuals who met the inclusion/exclusion criteria, SNAP participation status was available for 2766. Among these, 80.4% received household SNAP benefits. After adjusting for sociodemographic differences, there was no statistically significant association between SNAP participation and obesity (prevalence ratio (PR): 1.15, 95% CI: 0.428, 3.1, p = 0.779), elevated waist circumference (PR: 1.01, 95% CI: 0.989, 1.04, p = 0.296), elevated blood pressure (PR: 0.999, 95% CI: 0.96, 1.04, p = 0.943), elevated fasting glucose (PR: 0.963, 95% CI: 0.909, 1.021, p = 0.229), elevated triglycerides (PR: 1.029, 95% CI: 0.965, 1.098, p = 0.39), or reduced HDL (PR: 1.017, 95% CI: 0.99, 1.046, p = 0.235). SNAP participation was not associated with metabolic syndrome (PR: 1.002, 95% CI: 0.978, 1.026, p = 0.887). CONCLUSIONS: SNAP participation is not associated with an increased risk of obesity or risk factors for metabolic syndrome among low-income adults. FUNDING SOURCES: None.