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Background: The diet quality among adults receiving nutrition education lessons through Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is currently unknown.Objectives: The objectives of this study were to characterize the diet quality of Indiana SNAP-Ed-eligible women; estimate their mean usual intake of fruits, vegetables, dairy, and whole grains compared to Dietary Guidelines for Americans (DGA) recommendations; and determine if these dietary outcomes differed by food security status.Methods: SNAP-Ed paraprofessionals recruited participants from August 2015 to May 2016 for this secondary analysis of cross-sectional data collected as the baseline assessment for a randomized controlled trial. Participants were SNAP-Ed-eligible women aged ≥18 y interested in nutrition education lessons. Dietary outcomes were assessed by one or two 24-h dietary recalls. The Healthy Eating Index (HEI)-2010 was used to characterize diet quality. Mean usual intake of food groups was estimated using the National Cancer Institute Method. Food security status was classified using the US Household Food Security Survey Module. Data were analyzed in October 2019.Results: Mean ± SEM HEI-2010 total score was 42 ± 0.9 for the study sample. Mean ± SE usual intake of servings of fruits (0.61 ± 0.08 cups [144.32 ± 18.93 mL]), vegetables [1.4 ± 0.10 cups (331.2 ± 23.66 mL)], dairy [1.5 ± 0.11 cups (354.88 ± 26.02 mL)], and whole grains [0.48 ± 0.06 ounces (13.61 ± 1.70 g)] did not differ by food security subgroup. Mean HEI-2010 total score was significantly higher by 4.8 ± 2.0 points for the food-secure than for the food-insecure subgroup (P = 0.01). Mean HEI-2010 component scores were 1.1 ± 0.5 points higher for whole grain (P = 0.01) and 1.0 ± 0.5 points higher for dairy (P = 0.05) in the food-secure than in the food-insecure subgroup. The proportions of the study sample not meeting the DGA recommendations for food group intake were ≥85% for both food-secure and -insecure subgroups.Conclusions: Indiana SNAP-Ed-eligible women reported poor diet quality, highlighting their need for nutrition interventions aiming to improve food security and diet as per DGA recommendations in low-income populations. [ABSTRACT FROM AUTHOR]

Food-insecure households access food pantries to receive supplemental food, yet limited examination of the relationships of food pantry use or household food insecurity with diet quality and health has been documented among food pantry users. This study investigated the associations among food pantry use, household food security, body mass index, self-reported chronic disease and related conditions, and diet quality among food pantry users. Food pantry users in central Indiana were recruited for this cross-sectional study and surveyed for sociodemographic characteristics, food pantry use frequency, household food security, diet quality, and chronic disease and related conditions. Measurements of height and weight were obtained. Data from 270 participants, aged 21 to 80 years, were collected from June 2014 to December 2015. Healthy Eating Index-2010 (HEI-2010) total score, component scores, and body mass index were analyzed across food pantry use and household food security groups using multiple linear regression. Odds of reporting chronic disease and related conditions were compared across food pantry use and household food security groups using logistic regression. Visiting food pantries more than once a month was associated with higher HEI-2010 total score (P =0.03) and Total Protein Foods score (P =0.05) than visiting less often. HEI-2010 scores were not significantly different across household food security groups. Body mass index was not different across food pantry use groups or household food security groups. Household food insecurity was associated with higher odds of reporting heart disease (age- and sex-adjusted odds ratio=2.65; 95% CI, 1.05-6.69) compared with household food security. Food pantry use frequency differentiates diet quality, and household food security status differentiates chronic disease and related conditions among low-resource food pantry user subpopulations. [ABSTRACT FROM AUTHOR]

The goal of US Department of Agriculture Supplemental Nutrition Assistance Program–Education (SNAP-Ed) is to improve the likelihood that those eligible for SNAP will make healthy choices aligned with the Dietary Guidelines for Americans, 2020-2025. The objective of the study was to evaluate the long-term effects of a direct SNAP-Ed intervention in which participants actively engage in learning with educator instruction about dietary quality and usual intake of key nutrient and food groups among Indiana SNAP-Ed–eligible women participants as an example sample in the context of no similar existing evaluation. The study design was a parallel-arm, randomized controlled, nutrition education intervention, with follow-up at 1 year. Participants (18 years and older; n = 97 women) eligible for SNAP-Ed and interested in receiving nutrition education lessons were recruited from 31 Indiana counties from August 2015 to May 2016 and randomized to an intervention (n = 53) or control (n = 44) group. The intervention comprised core lessons of Indiana SNAP-Ed delivered between 4 and 10 weeks after baseline assessment. Each participant completed a baseline and 1-year follow-up assessment. Dietary intake was assessed using repeated 24-hour dietary recalls (up to 2). Mean usual nutrient, food group intake, diet quality (ie, Healthy Eating Index-2010 scores), and proportion of intervention and control groups meeting Dietary Guidelines for Americans, 2020-2025 recommendations and Dietary Reference Intake indicators of requirement or adequacy, were determined using the National Cancer Institute method and the simple Healthy Eating Index-2010 scoring algorithm method. Dietary changes between intervention and control groups were examined over time using mixed linear models. Bonferroni-corrected significance levels were applied to the results of the mixed linear models for comparisons of usual intake of nutrients and foods. No differences in diet quality, intake of food group components, food group intake, or nutrients were observed at 1-year follow-up, except that vitamin D intake was higher among those who received SNAP-Ed compared with the control group. A direct SNAP-Ed intervention did not improve diet quality, food group intake, or key nutrient intake, except for vitamin D, among Indiana SNAP-Ed–eligible women up to 1 year after the nutrition education. [ABSTRACT FROM AUTHOR]

The purpose of this project was to determine whether consistent food assistance program participation or changes in participation over time mediated or moderated the effect of federal nutrition education through the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) on food security and determine the associations of SNAP-Ed program delivery characteristics with change in food security. This secondary analysis used data from a randomized controlled trial from September 2013 through April 2015. SNAP-Ed-eligible participants ( n = 328; ≥18 years) in households with children were recruited from 39 counties in Indiana, USA. The dependent variable was one year change in household food security score measured using the United States Household Food Security Survey Module. Assessment of mediation used Barron-Kenny analysis and moderation used interactions of food assistance program use and changes over time with treatment group in general linear regression modeling. Program delivery characteristics were investigated using mixed linear regression modeling. Results showed that neither consistent participation nor changes in food assistance program participation over time mediated nor moderated the effect of SNAP-Ed on food security and neither were SNAP-Ed program delivery characteristics associated with change in food security over the one year study period. SNAP-Ed directly improved food security among SNAP-Ed-eligible Indiana households with children regardless of food assistance program participation and changes over time or varying program delivery characteristics.