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Supplemental Nutrition Assistance Program (SNAP)

A Personal Story on Health and Nutrition Education

      My Personal Story

      Let me share the perspective, not of a physician or public health expert, but of a Supplemental Nutrition Assistance Program (SNAP) recipient who has faced serious nutrition-related health problems. My diet as a food and wine writer was not conducive for good health. My father had died as a result of complications stemming from Type 2 diabetes. My mother, who also had Type 2 diabetes, died of metastatic breast cancer and my aunt died of pancreatic cancer. When I was diagnosed with Type 2 diabetes and a host of other health issues, my doctor sent me to a diabetes education course. I walked away from that class learning that my daily carbohydrate limit was 45 grams and that I should try to get some exercise. My diabetes did not improve, and my health continued to decline.
      When I went to my endocrinologist for a checkup, I casually brought up a vegan diet. I had heard about it, and wanted to know if it could help my diabetes. I fully expected him to say not to bother with it. He didn’t say that. My doctor said that he thought it would be good for me and gave me recommendations for vitamin B12 and vitamin D supplements because I spend a tremendous amount of time indoors writing, and told me that he had sent my refills for Januvia and metformin electronically to my pharmacy.
      Within 3 days of adopting my new diet, I saw startling results. My blood glucose readings had dropped 70 points. On Day 4, it dropped another 20 points, and on Day 5 an additional 10 points. In less than a week, my blood glucose readings dropped 100 points, and my doctor quickly reduced one of my medications (metformin) and discontinued the other (Januvia), after having been on these medications for more than a decade. I was shocked at how much better I felt and surprised that my medications were reduced so quickly. To be honest, I didn’t think it would work. I was just eating fruits, vegetables, beans, and grains. How could they be so powerful? I had been on formalized, medically supervised diets before. On those diets, I would see a little progress but nothing worth real note. Along with the dramatic drop in my blood glucose levels, weight loss was also a positive result of my diet change, and I was happy to have lost 15 pounds within the first 3 weeks. Within 3 months of changing my diet, I was off all medications. High blood pressure, high cholesterol, high triglycerides, and morbid obesity were a thing of the past.
      Although I was pleased that my new diet had breathed new life into me, and I felt I had been paroled from a life sentence of debilitating diseases, it unfortunately had devastating consequences for my livelihood. As a food and wine writer, I quickly found myself in conflict between what my job required me to do—write about the newest restaurant serving the biggest steak (in Texas)—and living a life that is now improved because I no longer consume the biggest steak. How could I continue to write about and advocate consuming something that I knew was harmful? My readership was confused and angry that my writing now was a reflection of my healthy lifestyle.
      Maybe I did not need to be so strict with my diet. I decided to try an experiment. I slowly added back in milk, cheese, eggs, and meat to see what would happen. I wasn’t consuming large amounts, just a few meals per week with these items. I found that diabetes returned. I returned to the whole-foods, plant-based diet and soon the diabetes was again eradicated. There was no need to experiment further, I knew the cause, and now, I understood what was, for me, the solution.
      Knowing what I now knew about food, nutrition, and journalism, it became impossible to apply my trade. I could no longer maintain a job promoting unhealthful foods.
      In dealing with this dilemma, a number of personal challenges arose. Financially, I suffered and found myself in need of assistance. Eventually, I enrolled in SNAP. Although I was not happy about becoming a SNAP recipient, it did open my eyes to how the program works and how its provisions might affect my health and that of others using SNAP.

      Snap and Nutrition

      As changes in the program are discussed, I would like to offer my assessment. My overall personal thoughts are that I have already paid for Type 2 diabetes for myself as well as a laundry list of other health issues, and I do not care to do so for someone else. I would want those on SNAP to receive the most scientifically based, up-to-date information on nutrition possible so that they could reap health benefits for themselves and their family members. There are many people who suffer from debilitating diseases and lack fundamental knowledge about good nutrition.
      Since its inception in the 1930s,

      The History of SNAP. www.snaptohealth.org/snap/the-history-of-snap/. Accessed April 27, 2016.

      the food stamp program (now known as SNAP) has helped millions of Americans stay alive. However, as industry has rapidly progressed, the SNAP program has not kept up with the changes in the commercial food environment. Food products that were not in existence when the program started are now accepted into SNAP. An unlimited amount of junk food can be purchased with SNAP benefits. Allowing purchases of junk food is counter to the program’s purpose. As a SNAP recipient, I believe there are specific areas of improvement that should be addressed within the program.

      Recommendations for Improving SNAP

      1. If the Program Is Designed to Help People, Why Not Help Them by Making Sure They Get the Proper Nutrition They Need?
      It is my opinion that sugar-sweetened beverages (soda, highly processed beverages); animal-based products (meat, milk, eggs, butter, yogurt); candy; chips; and other junk foods should be eliminated from the program or at least greatly reduced. These foods have been linked to a host of health problems in well-conducted studies. The current dietary guidelines point to limiting the consumption of food items that increase risk for cardiovascular disease, high blood pressure, and Type 2 diabetes, and SNAP should be in sync with these guidelines.
      I believe the current program focuses too much on the supplemental part and not enough on the nutrition part.
      2. Educate All SNAP Recipients About Good Nutrition
      Why would anyone give someone up to $194 a month and say, “OK, feed yourself the best way you can with these funds, see you next month?” That would be irresponsible. There are already federal and state guidelines that all SNAP recipients must follow to receive funds. All able-bodied adult recipients must be employed or actively seeking full-time employment. Recipients are required to take classes (resume writing, various computer skills courses, among others) to assist them in fulfilling the employment requirement. A mandatory nutrition education course or courses would be a more appropriate requirement and would be a benefit, not a burden. In fact, it would be a blessing because it would empower the recipients with information on how to shop efficiently with the funds they receive as well as how to purchase foods with the highest nutrient content for improving their health. According to the Centers for Disease Control and Prevention’s report for 2014,

      Centers for Disease Control and Prevention (CDC). National Diabetes Statistics Report, 2014. www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf. Accessed April 27, 2016.

      more than 29.1 million (9.3%) people in the U.S. have diabetes, of whom 8.1 million (27.8%) are undiagnosed. The 2012 costs for diabetes were estimated to be $245 billion ($176 million in direct medical costs and $69 billion in indirect costs such as disability, loss of work, and premature death). Many of those people are on SNAP, and education should be part of it. They need nutrition education to improve their health and potentially save their lives.
      3. Raise the Benefit Limit per Month for Adults
      By raising the limit per adult, an adult will be able to purchase better-quality food such as organic produce and take advantage of special buys of produce and other healthful foods that can be frozen or stored for a “rainy day.” The price of food fluctuates, and there are months when recipients are without food to last until the next funding date. Though some food banks help, most do not make up the difference and usually do not provide fresh produce. My experience has been that many food pantries are dumping grounds for expired food products and non-nutritious foods that companies have overproduced and are looking for a tax write-off.
      4. Reduce the SNAP Amount for Children
      Currently, SNAP benefits are the same for children as for adults, but a 7-year-old child is not going to consume the same amount of food as a 30-year-old adult. For example, the benefit amount could be reduced to $100.00 per month for children aged <10 years, $150.00 per month for children aged 10–13 years, and $200.00 per month for children aged 14–18 years. More research would have to be done to ascertain what would be the best financial assistance benefit for different age groups receiving SNAP benefits.
      5. Institute a Healthy Education Initiative
      We need to think beyond SNAP. Whether or not someone is on SNAP, all citizens should be educated on nutrition and its role in their lives. Appropriately conducted, this kind of education will not only protect their health, it will promote a better understanding of the challenges many people, including SNAP recipients, face.
      A healthier SNAP is vital to the well-being of the country. By focusing on better nutrition, the benefits will be incalculable—healthier citizens, more-productive workers, and cohesive families through better food and food education.

      Acknowledgments

      Publication of this article was supported by Physicians Committee for Responsible Medicine. The findings and conclusions in this article are those of the author and do not necessarily represent the official position of the Physicians Committee for Responsible Medicine.
      The author received $500.00 as honoraria from the Physicians Committee for Responsible Medicine to participate in a roundtable discussion on the topic and was a recipient of the Supplemental Nutrition Assistance Program (SNAP) in Dallas, Texas, from March 2014 to April 2016, receiving approximately $194.00 a month via a State of Texas Lone Star EBT card for food assistance only. No other financial disclosures were reported by the author of this paper.

      References

      1. The History of SNAP. www.snaptohealth.org/snap/the-history-of-snap/. Accessed April 27, 2016.

      2. Centers for Disease Control and Prevention (CDC). National Diabetes Statistics Report, 2014. www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf. Accessed April 27, 2016.