SNAP reform could protect 44 million Americans from heart disease

When it comes to Supplemental Nutrition Assistance Program (SNAP) reform, the White House is right about one thing: There are serious nutritional deficiencies in the program that must be addressed.

Food-related diseases, like heart disease and diabetes, kill a lot of Americans. But they affect lower income Americans at disproportionately high rates and SNAP participants at even higher rates.

{mosads}In fact, one study found that the program’s 44 million participants have an increased risk of death from heart disease and diabetes, even when compared to those at similar income levels who are SNAP-eligible but do not participate in the program.

Something needs to change. But providing boxes of foods that limit choice and offer no fresh fruits and vegetables isn’t the best solution.

We have to make it easier, not harder, for people to access fruits and vegetables. Recent Centers for Disease Control and Prevention (CDC) research shows that just 7 percent of people living below or close to the poverty level get the recommended 2 to 3 cups of vegetables per day.

The CDC report says that “because fruit and vegetable consumption affects multiple health outcomes, including cardiovascular disease, type 2 diabetes, some cancers, and obesity … continued efforts are needed to identify and address barriers to fruit and vegetable consumption.”

The root of these health problems lies with the U.S. Department of Agriculture, which oversees SNAP.

The agency’s own Dietary Guidelines for Americans recommend an eating pattern low in added sugars, saturated fats, and sodium, yet the USDA reimburses SNAP retailers for not only bacon, beef jerky, and soda, but for processed cheese, potato chips, and candy.

It’s often easiest to get the least healthful foods, so it’s no wonder that studies show that more SNAP dollars go toward junk food, like processed meats and convenience foods, than the vegetables, legumes, fruits, and grains that the Dietary Guidelines actually recommend.

Without any requirement to offer healthful foods, many SNAP retailers have no reason to stock their shelves with fresh fruits and vegetables — which spoil more easily than processed, shelf-stable foods — leading to food deserts that further limit low-income Americans’ access to the foods that can keep them healthy.

It doesn’t help that junk food producers — who receive huge revenue through SNAP — spend millions of dollars lobbying the federal government every year, fighting against efforts to make the program more healthful.  

So a program that’s meant to lift its participants out of poverty is impoverishing their health, causing them financial burden: The average medical expenditure for people with diagnosed diabetes is about $13,700 per year, while heart disease costs an individual $18,953 a year.

Could organizing SNAP to be more like the Women, Infants and Children (WIC) program — another USDA program — ensure that participants get more healthy foods? The idea makes sense.

WIC is based on the use of designated foods packages that include foods deemed to provide good nutrition.

After WIC implemented a rule to add more fruits, vegetables, and whole grains, a survey conducted in California showed that in just six months, consumption of whole grains increased by 17.3 percent among participants, and fruit and vegetable consumption increased by 7.2 percent.

My colleagues and I recommend a similar plan for SNAP in “A Proposal for Improvements in the Supplemental Nutrition Assistance Program” in the American Journal of Preventive Medicine.

SNAP would pay participating grocers who supply basic healthful foods, referred to as healthy staples — grains, vegetables, beans, fruits, and basic multiple vitamins.

Our research shows that a SNAP participant who chooses foods from healthy staples would get around twice the fiber, calcium, iron, and other essential nutrients as participants following a typical American diet.

A healthy staples participant would also boost his or her heart health by consuming 65 percent less fat and 85 percent less saturated fat, and the excess of 250 milligrams of cholesterol consumed daily would be reduced to essentially zero.

As a nation, we spend more than $300 billion a year treating cardiovascular disease — a condition that is mostly preventable through diet and lifestyle.

As Congress debates SNAP in advance of the 2018 Farm Bill negotiations, I hope they’ll consider the healthy staples plan, which could help millions of Americans better fight heart disease, despite their economic status.

Susan Levin, M.S., R.D., is director of nutrition education for the nonprofit Physicians Committee for Responsible Medicine.