Relationships Between Participation in Food Assistance Programs and Skeletal Health in Adult Women and Men

Year: 1999

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

Investigator: Wang, May-Choo, and Lori Beth Dixon

Institution: San Jose State University

Project Contact:
May-Choo Wang, Dr. P.H., R.D.
Department of Nutrition and Food Science
One Washington Square
San Jose State University
San Jose, CA 95192-0058
408-924-3106, fax 408-924-3114


The relationship between osteoporosis and socioeconomic status has never been explored even though income and education-related lifestyle factors, such as diet and activity, are known to affect bone status. The primary objectives of this study are to determine if an association exists, and if bone density is higher among the poor who participate in food assistance programs.

The authors used the National Health and Nutrition Examination Survey (NHANES) III, 1988-94 for their analysis. They limited their sample to nonpregnant premenopausal women aged 20 years and older; postmenopausal women; and men age 50 and older. Their outcome variables were bone mineral density (BMD, g/cm2) for the femoral neck and total body. They used multiple linear regression to assess relationships between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Food Stamp Program, and bone density. They also included age, nutrient intakes, physical activity, oral contraceptive use, pregnancy history, income, education, and cultural factors indicated by language spoken at home and place of birth in the regression models.

The authors found that education was a positive predictor of BMD in all three groups—premenopausal women, postmenopausal women, and men—but only among whites. Participation in WIC was not related to BMD. Participation in the Food Stamp Program was associated with lower BMD in low-income Mexican American men and African American postmenopausal women. In premenopausal women, neither participation in the Food Stamp Program nor in WIC was associated with BMD. As in the Frongillo and Lee study, these results are likely to derive from the participants’ reasons for entering the programs, rather than from program impacts. Further research is needed to address the potential impacts of length of participation in food assistance programs on BMD.