Changes in the Supplemental Nutrition Assistance Program (SNAP) after the start of the COVID-19 pandemic included emergency benefit allotments and operation waivers. Using five expenditure-based measures of the nutritional quality of food purchases, we tested whether changes in SNAP during the first year of the pandemic were associated with better nutritional quality of food purchases by participating households with children relative to income-eligible nonparticipating households. Most nutritional quality measures declined from 2019 (pre-pandemic) to 2020 (pandemic) with larger decreases for SNAP households. SNAP participation was associated with small negative differences for nutritional quality of food purchases from stores.

Preference heterogeneity in food demand has important health and equity implications for targeted and broad-based taxes and subsidies intended to enhance diet quality and reduce obesity. We study the role of obesity in the purchases of food at home and food away from home using data from the nationally representative National Household Food Acquisition and Purchase Survey. We develop a method for incorporating the complex survey design and retail scanner data into the estimation of a 21-good Exact Affine Stone Index demand system with endogenous prices and truncated purchases. We find significant preference heterogeneity associated with the obesity status of household members. Counterfactual simulations find that (1) a sweetened beverage tax is effective in increasing the healthfulness of purchases by lower income obese consumers; (2) the nutritional benefits of a fruit and vegetable subsidy are concentrated on nonobese consumers with little improvement in obese consumers' Healthy Eating Index and an increase in their total calories purchased; and (3) a fiscally neutral healthy food subsidy fully funded by an unhealthy food tax benefits nonobese consumers both financially and nutritionally more than it does obese consumers. These findings show that lowering healthy food prices without raising the cost of unhealthy foods is unlikely to reduce obesity. Policymakers in favor of a systems approach of simultaneously taxing unhealthy foods and subsidizing healthy foods should be mindful of the distributional effects of this policy on obese consumers and the lower income population.

We analyze whether local and state mandates to post calorie information on restaurant menus change the effect of consuming food prepared away from home (FAFH) on total caloric intake. Information on area demographics and the local food environment were used to construct a comparison group. For identification, we use differences in two days of dietary intake and timing variations in policy implementation. We find the effect of FAFH meals on total daily intake is reduced by 21 calories among adults and by 34 calories among young children for each year the mandate is in place.(JELI12, I18, H75)

ERS researchers scored the nutritional quality of a week’s worth of food purchases and acquisitions by low-income food-secure and food-insecure households. For every 1,000 calories of food at home acquired, food-secure households acquired more total fruit, whole fruit, total protein, and seafood and plant proteins compared with food-insecure households.

Shoppers that use cash as a form of payment are more likely to evaluate the necessity of an item they purchase than shoppers that pay with other forms of payment, such as credit cards. In this paper, we hypothesize that the use of cash may nudge shoppers to buy more healthful food items. We empirically evaluate whether the payment method affects the nutritional quality of food purchases. We also test whether the effect of payment type differs between food-at-home and food-away-from-home events. Specifically, we test whether shoppers purchase a higher share of nutritious food items when they pay with cash compared to when they use credit and debit cards. We use the National Household Food Acquisition and Purchase Survey (FoodAPS) data that tracks individual's food purchases over one week. Using the Guiding Stars Program (GSP) algorithm to measure the nutritional quality of food items, we calculate the share of healthy items purchased at each event. We find that shoppers using cash purchase a higher share of healthy items than when they use credit or debit cards, and this nudging effect is primarily driven by food-away-from-home purchases.

The Supplemental Nutrition Assistance Program (SNAP) provides millions of low-income Americans food benefits and other forms of nutrition assistance. Evidence indicates that SNAP reduces food insecurity. However, there is a concern that the food benefit may increase the demand for less healthy foods more than healthier foods, thereby reducing the overall nutritional quality of the participant's food basket. This paper aims to examine the association of SNAP participation with the nutritional quality of food-at-home purchases of low-income households and to investigate the potential heterogeneity among consumers with different levels of nutrition attitude. This analysis used food purchase data from the USDA National Household Food Acquisition and Purchase Survey (FoodAPS). Our study sample included 2,218 low-income households, of which 1,184 are SNAP participants, and 1,034 are income-eligible nonparticipants. Multivariate regressions were performed to explore the SNAP-nutritional quality association. A household's nutrition attitude was measured using its response to a question on whether the household searched for nutrition information online in the last 2 months. Households that affirmed they had an online nutrition search were treated as nutrition-oriented households (21.2% of the low-income sample), and households that did not were considered less nutrition-oriented households (78.8%). For robustness, we also created an alternative nutrition attitude measure based on reported use of the nutrition facts label. We found that among less nutrition-oriented households, SNAP participants had a statistically significant 0.097 points (p = 0.018) lower Guiding Stars rating than low-income nonparticipants. However, there was no significant SNAP-nutritional quality association among nutrition-oriented households. In conclusion, SNAP participation was associated with lower nutritional quality of food purchases among less nutrition-oriented households, but not among nutrition-oriented households. The results suggest that the intended nutritional benefits of restrictions on purchases of healthy foods may not reach the subgroup of nutrition-oriented SNAP participants.

Abstract We pair IRI household purchase records with Nielsen TDLinx data on the retail food environment to investigate the associations between retail market structure and Americans’ adherence to the Dietary Guidelines. We focus specifically on fruit and vegetable consumption, as proxied by purchases. Controlling for various household characteristics, we find that increased market concentration is associated with lower produce consumption and weaker adherence to recommendations. We also find a number of small but significant associations with respect to the presence of nontraditional retail formats.

This research was not supported by any funding.

We use household scanner data, paired with rich demographics and merged with self-reported measures of obesity and body mass index (BMI), to investigate the potential effects of fruit and vegetable purchasing behavior on adult obesity and body weight. We find that increasing household fruit and vegetable expenditure shares by one percentage point decreases the multiyear incidence of adult obesity by approximately 9 percent and average adult BMI by 1.4 percent, controlling for a host of potential confounding factors and measures of lifestyle choices. The results are robust to specification choice, although estimated impacts differ by gender. Our findings help quantify the potential impacts of government efforts aimed at increasing fruit and vegetable intake.

Improvements in the healthfulness of packaged foods and beverages through reformulation could help reduce the prevalence of obesity among children and adolescents through improved diet quality. This study assessed changes in calories and four nutrients (saturated fat, total sugars, sodium, and dietary fiber) from 2012 through 2014 for packaged products frequently consumed by children and adolescents, simulated effects of potential improvements in 12 frequently consumed product categories based on actual purchasing patterns, and compared differences in prices of healthier versus less healthy products. Analysis of trends showed limited evidence that healthfulness of foods improved over the years examined. Simulation results showed minimal changes for calories and sodium, but daily intake of saturated fat could decrease by 4%, sugar consumption could decrease by 5%, and dietary fiber consumption could increase by 11% if products were reformulated to meet an existing healthfulness standard. Using a higher standard, caloric intake could decline by 4%, saturated fat by 6%, sugar by 9%, and sodium by 4%, and dietary fiber could increase by 14%. Healthier versions of most products ranged from an average of 3 to 12 cents more per serving, but not all healthier versions were more costly. Overall, reformulation is a potential avenue for improving diet quality in households with children and adolescents, but price could be a barrier to purchasing healthier products for some households.

OBJECTIVE:To inform policy proposals to allow online grocery shopping with Supplemental Nutrition Assistance Program (SNAP) benefits by examining relevant behaviors, knowledge, and attitudes of SNAP recipients.METHODS:This qualitative study used a purposive recruitment strategy to conduct 4 1-hour focus groups in Las Cruces, NM. Participants were SNAP recipients who do the grocery shopping for their families. Focus groups were video and audio recorded, transcribed, and coded.RESULTS:Few participants had shopped for groceries online, and participants were generally uninterested in grocery shopping online. Identified barriers were cost, quality control for perishable foods in particular, and distrust of the overall process. Participants expressed interest in suggested services aimed at increasing the benefits of shopping online.CONCLUSIONS AND IMPLICATIONS:SNAP recipients in this study have not adopted online grocery shopping for various reasons. Additional research could inform policy by investigating which participants would benefit from using SNAP benefits online and strategies for facilitating use.

Market concentration is associated with food prices, but little is known about the other potential economic consequences of market structure in food retailing. We create a novel dataset by merging IRI household-level purchase records with Nielsen TDLinx data on store location and USDA Food Environment Atlas data to study the food market structure and produce purchases. Treating zip codes as markets, we find that increased market concentration is associated with decreased produce expenditures. This impact is larger in rural markets than in urban areas. In addition, the presence of most nontraditional store formats such as convenience stores and dollar stores is associated with decreased produce purchases. However, the opposite is true for club stores and natural/gourmet supermarkets. The estimated effects of market entry are small, supporting the literature on supermarket intervention studies. [EconLit citations: L1, D1, D4, R2].

This overview paper provides a background for a series of papers on exploring ways to encourage healthier food purchases among low income consumers. The papers presented in this special issue make the case that behavioral economics is a promising approach to promotion of healthy food choices. They provide some examples of successful application of behavioral economics-based “nudges” at the time and place of food selection, whether in retail grocers or food banks. Future research may build on these examples to develop a broader array of strategies that could be used to improve food selection and, ultimately, diet and health of consumers.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program benefits nutritionally vulnerable populations by providing them with vouchers to buy healthful foods. In the retail sphere, the WIC program faces 2 challenges to maximizing its effectiveness: ensuring a positive retail experience that leads to full redemption of benefit vouchers and controlling food costs paid by the program. Unfavorable retail experiences may result in reductions in WIC benefit redemption, switching to other stores (even if expensive), or program dropout. We find that these WIC customer experiences depend on retailer size, store crowding, employee- customer interactions, and retailers' WIC program management. WIC vendor managers can set normative retailer benchmarks of what is expected for WIC customer experiences resulting in WIC participant retention, thereby nudging underperforming retailers to improve and rewarding already excellent performing retailers.

Policy and environmental changes to support and encourage individual-level nutrition and physical activity behavior are underway in many parts of the U.S. and around the world at national, state, and local levels. Yet, to the authors' knowledge, no summary of the cost-benefit or cost-effectiveness studies of obesity-related policy/environmental interventions exists.The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines were followed to identify, screen, and describe the protocols used in this systematic review. In 2014, a unique search was conducted of titles and abstracts in MEDLINE, EconLit, SCOPUS, and Web of Science databases that were published from January 2002 through January 2014 in English-language, peer-reviewed journals. The search terms described obesity, physical activity, and diet in combination with economic evaluation.In 2014 and 2015, the results were analyzed. A total of 27 studies met the inclusion criteria, of which 26 described separate interventions. Of the 27 included studies, eight focused on the community and built environment, seven assessed nutrition-related changes, nine reported on the school environment, and three evaluated social marketing and media interventions. The vast majority of included studies reported beneficial economic outcomes of the interventions.Given the large and growing literature on the health and behavioral outcomes of policy and environmental interventions, the relatively low number of located cost-benefit and cost-effectiveness economic assessments appears to indicate a prime opportunity for the research community to address.

Context: Policy and environmental changes to support and encourage individual-level nutrition and physical activity behavior are underway in many parts of the U.S. and around the world at national, state, and local levels. Yet, to the authors' knowledge, no summary of the cost-benefit or cost-effectiveness studies of obesity-related policy/environmental interventions exists.Evidence acquisition: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) statement guidelines were followed to identify, screen, and describe the protocols used in this systematic review. In 2014, a unique search was conducted of titles and abstracts in MEDLINE, EconLit, SCOPUS, and Web of Science databases that were published from January 2002 through January 2014 in English-language, peer-reviewed journals. The search terms described obesity, physical activity, and diet in combination with economic evaluation.Evidence synthesis: In 2014 and 2015, the results were analyzed. A total of 27 studies met the inclusion criteria, of which 26 described separate interventions. Of the 27 included studies, eight focused on the community and built environment, seven assessed nutrition-related changes, nine reported on the school environment, and three evaluated social marketing and media interventions. The vast majority of included studies reported beneficial economic outcomes of the interventions.Conclusions: Given the large and growing literature on the health and behavioral outcomes of policy and environmental interventions, the relatively low number of located cost-beneft and cost-effectiveness economic assessments appears to indicate a prime opportunity for the research community to address. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine

Objective: Using a taste-test competition in an elementary school lunchroom, researchers sought to increase consumption of select vegetables. Methods: Overall, 1030 students in a large urban school district participated in the study. The percentage of students who consumed the target vegetable was measured and compared between the experimental and control schools using a logistic regression framework. Results: There was a significant increase for all 3 vegetables in schools that conducted the taste-test competition. An odds ratio demonstrated that after the second follow-up, students were 2 to 7.2 times more likely to consume the vegetables. Conclusion: Using a taste-test competition may be a feasible and sustainable approach to engage students in their food selection.

In a 1943 speech, Winston Churchill declared “Healthy citizens are the greatest asset any country can have,” echoing a sentiment expressed by other observers of history and society. A key component to healthy citizens is a varied and nutritious diet. Where people shop for food can influence what they purchase and what they eat. If healthy foods are hard to find in a store, people may gravitate to less healthy options. If someone’s main grocery store option is a small convenience store where processed foods with fats and sugars PRINT PDF EMAIL