Food, Health, and Nutrient Supplements: Beliefs Among Food Stamp-Eligible Women and Implications for Food Stamps Policy

Year: 2000

Research Center: Department of Nutrition at the University of California, Davis

Investigator: Pelletier, David, Vivica Kraak, and Jamie Dollahite

Institution: Cornell University

Project Contact:
David Pelletier, Ph.D.
Associate Professor of Nutrition Policy
Division of Nutritional Sciences
378 MVR Hall
Cornell University
Ithaca, NY 14853
Phone: 607-255-1086
Fax: 607-255-0178


Several U.S. professional organizations that develop research-based dietary recommendations for the public support the position that most nutrients can and should be obtained by eating a balanced diet. In contrast to these recommendations, supplement use by the public is a growing trend. Recent legislation has considered allowing the purchase of nutrient supplements with food stamps, but little is known about nutrient supplement use among low-income Americans. This qualitative study investigated the attitudes and beliefs of an ethnically and regionally diverse sample of food stamp-eligible women concerning the relationship between food, health, nutrient supplementation, and associated lifestyle factors. The research team conducted semistructured interviews with 72 women from New York City, Fort Smith, Arkansas, and San Francisco, San Jose, and Oakland, California. They interviewed approximately equal numbers of African-American, Asian, Hispanic, and White women in each site.

The authors report that the majority of women in their study held general philosophies about nutrient supplementation that were influenced by a variety of factors. These factors included their views about the nutritional adequacy of food by itself, the feasibility of achieving a healthful diet, personal health status or special needs, perceived benefits of supplements, personal experience (positive or negative) with taking supplements in the past, and their concept of what constitutes a supplement. The women’s philosophies appeared malleable and/or negotiable, depending upon the degree of self-reflection, the clarification of existing information, the addition of new information, and changes in health status or income.

Many of the women interviewed view supplements as something that could replace or substitute for a healthful diet, but the sample was divided over the desirability of using supplements in this way. Most women acknowledged the difficulties of maintaining a healthful diet for themselves and their families, in part for reasons beyond their control, and they view supplements as a practical way to compensate. A smaller group expressed concern that not all dietary needs can be met in this way and that some people may not make wise decisions if the policy is changed. However, the majority feel this decision should be left to food stamp recipients themselves.

While the interviews revealed a strong preference on the part of food stamp-eligible women for changing the policy on supplement purchase, the authors point to some countervailing considerations. Specifically, they argue that the health benefits of a policy change may be quite limited because dietary deficiencies are rare in this population; that the potential exists for an unintended decline in the quality of food intake; and that there are imperfections and asymmetries in the information available on supplements and healthy eating.

The authors conclude that their findings suggest adopting a broad set of criteria in considering supplement- related policies for the Food Stamp Program, including anticipated impacts on food access, health promotion, and personal autonomy. They also recommend using a broader set of strategies to improve the nutritional health of the food stamp-eligible population.