BACKGROUND The Supplemental Nutrition Assistance Program (SNAP) is the largest food assistance program in the United States. Allotment of SNAP benefits is based on the Thrifty Food Plan (TFP), which is designed to achieve a nutritious diet at a minimal cost. Although low-income households do not meet the TFP cost for total groceries, the impact on diet quality is not known. OBJECTIVE The objective of this research is to determine the relationship of TFP-adjusted total grocery and SNAP-related expenditures with diet quality of women participating in SNAP. DESIGN In this observational study, participants were administered a demographics questionnaire, food frequency questionnaire, and United States adult food security module. Participants were also instructed to save grocery receipts for 1 month. Total and SNAP-related grocery expenditures and TFP cost for each household were determined. The Healthy Eating Index-2010 was used as a measure of diet quality. PARTICIPANTS/SETTING A total of 217 women from low-income housing and neighborhood centers in central Texas were enrolled from January through December 2015. Eligibility criteria included participation in SNAP; age 18 to 50 years; and Hispanic, non-Hispanic black, or non-Hispanic white race/ethnicity. Fifty-eight women were lost during follow-up. Data from 15 participants were excluded as a result of reporting of implausible caloric intakes or incomplete collection of receipts, thereby resulting in a final sample of 144. MAIN OUTCOME MEASURES Food group and nutrient intake and diet quality were the main outcome measures of the study. STATISTICAL ANALYSIS Multiple linear regression analyses determined the association of TFP-adjusted total grocery and SNAP benefit expenditure with food group intake and diet quality. Independent-samples t test and one-way analysis of variance were used to determine differences in ratio of spending to TFP cost by demographic characteristics. RESULTS The mean ratio of total grocery expenditure to TFP cost was 0.74. Total and SNAP benefit expenditures relative to TFP cost were positively related to fruit and vegetable intake (P<0.01) and diet quality (P<0.05). Ratio of grocery spending to TFP costs did not differ based on food security status. CONCLUSIONS The results of this study indicate inadequate grocery spending among SNAP households relative to recommended TFP cost, which in turn was associated with poorer diet quality in women.

中文翻译：

---

与节俭食品计划成本相关的杂货支出与参与补充营养援助计划的女性饮食质量的关联

背景 补充营养援助计划 (SNAP) 是美国最大的食品援助计划。SNAP 福利的分配基于节俭食品计划 (TFP)，该计划旨在以最低成本实现营养饮食。尽管低收入家庭无法满足总杂货的 TFP 成本，但对饮食质量的影响尚不清楚。目的 本研究的目的是确定 TFP 调整后的总杂货和 SNAP 相关支出与参与 SNAP 的女性饮食质量之间的关系。设计 在这项观察性研究中，参与者接受了人口统计问卷、食物频率问卷和美国成人食品安全模块。参与者还被指示将杂货收据保存 1 个月。确定了每个家庭的总和与 SNAP 相关的杂货支出和 TFP 成本。2010 年健康饮食指数被用作衡量饮食质量的指标。参与者/环境 从 2015 年 1 月到 12 月，共有来自德克萨斯州中部低收入住房和社区中心的 217 名女性参加。18 至 50 岁；西班牙裔、非西班牙裔黑人或非西班牙裔白人种族/族裔。58 名妇女在随访期间丢失。来自 15 名参与者的数据由于报告的热量摄入不合理或收据收集不完整而被排除在外，因此最终样本为 144。 主要结果测量 食物组和营养素摄入量和饮食质量是研究的主要结果测量。统计分析 多元线性回归分析确定了 TFP 调整后的总杂货和 SNAP 福利支出与食物组摄入量和饮食质量之间的关联。使用独立样本 t 检验和单因素方差分析来确定人口特征支出与 TFP 成本比率的差异。结果 总杂货支出与 TFP 成本的平均比率为 0.74。相对于 TFP 成本的总支出和 SNAP 收益支出与水果和蔬菜摄入量 (P<0.01) 和饮食质量 (P<0.05) 呈正相关。杂货支出与 TFP 成本的比率没有因粮食安全状况而异。结论 本研究的结果表明，相对于推荐的 TFP 成本，SNAP 家庭的杂货支出不足，这反过来又与女性较差的饮食质量有关。