Project:
Do Poverty, Food Stamps, Food Label Use, and Nutrition Knowledge Affect Dietary Quality among Adults? Results from the 1994-96 CSFII/DHKS
Year: 2000
Research Center: Department of Nutrition at the University of California, Davis
Investigator: Pérez-Escamilla, Rafael, and Lauren Haldeman
Institution: University of Connecticut
Project Contact:
Rafael Pérez-Escamilla, Ph.D.,
and Lauren Haldeman, MS
Department of Nutritional Sciences (U-17)
University of Connecticut, Storrs CT 06269
Phone: 860-486-5073
Fax: 860-486-3674
rperez@canr.uconn.edu
Summary:
The Food Stamp Program has enormous potential for
assisting with improved dietary behaviors in low-income
households. The program places very few
restrictions on the types of foods that people can buy.
With the exception of alcohol and hot meals, food
stamp recipients are allowed to purchase any of the
thousands of products available to them in the many
supermarkets and food outlets that accept food stamps.
The main objective of this study is to examine: (a) the
relationship of dietary quality to food label use and
nutrition knowledge among low-income groups, and
(b) whether food stamp receipt or income level modifies
this relationship.
The authors analyze recent data from the 1994-96 Diet
and Health Knowledge Survey (DHKS) and the
Continuing Survey of Food Intake by Individuals
(CSFII). They focus on 20- to 60-year-old respondents
(N=2950) and the subsample of these respondents with
incomes below 130 percent of the poverty line
(N=767) who were household meal preparers, meal
planners, or food shoppers. They used multivariate
logistic regression to estimate their model of dietary
quality (measured as a Healthy Eating Index (HEI)
below vs. above the median). Their main independent
variables were socioeconomic and demographic characteristics,
food stamp receipt, food label use, nutrition
knowledge, and several interactive terms.
The authors found that dietary quality increased with the
levels of income and education, and that it was also
higher among White subjects and those whose interviews
were conducted in Spanish. After adjusting for
these factors, food label use and nutrition knowledge
were independently and positively associated with
dietary quality. The key finding from the interactive
models was that the influence of income on dietary
quality is mediated by food label use. Specifically,
wealthier individuals (or population segments) who do
not use food labels are as likely as low-income individuals
not using the labels to have suboptimal dietary
quality. In other words, dietary quality appears to be
determined simply not by income, but also by the use of
nutrition information tools such as food labels. The
authors also found that, among food label users, income
does make a difference in dietary quality and that food
label use partially compensates for the influence of
lower income on dietary quality. Their analyses of adults
below 130 percent of the poverty line indicate that
among nonusers of food labels, a significantly higher
proportion of food stamp recipients than nonrecipients
have an HEI score above the median. Similarly, among
those not receiving food stamps, a significantly higher
proportion of those using food labels have HEI scores
above the median. The authors argue that nutrition information
tools such as food labels are likely to be essential
to making healthy food choices in the United States.
They conclude that their results support a priority role
for nutrition education as a component of food assistance
programs like the Food Stamp Program.