Introduction
The Supplemental Nutrition Assistance Program; Free/Reduced Priced Lunch Program;
and Special Supplemental Nutrition Program for Women, Infants, and Children reduce
food insecurity for millions of Americans with lower incomes. However, critics have
questioned whether they increase obesity. This study examined whether program participation
was associated with BMI z-score from kindergarten to fifth grade.
Methods
Data from 4,457 primary-grade students whose household incomes were equal to or below
200% of the federal poverty level from kindergarten to fifth grade as part of the
Early Childhood Longitudinal Study, Kindergarten Class of 2010‒2011 were analyzed.
Marginal structural models with inverse probability of treatment/censoring weights
were used to estimate associations between Supplemental Nutrition Assistance Program/Free
and Reduced Priced Lunch participation over time and fifth-grade BMI z-score, accounting for lost-to-follow-up and time-varying confounders. Weighted generalized
estimating equations were used to examine associations between Special Supplemental
Nutrition Program for Women, Infants, and Children participation and BMI z-score trends. All analyses incorporated sampling weights. The Early Childhood Longitudinal
Study, Kindergarten Class of 2010‒2011 data were collected from 2010-2016; analyses
were conducted in 2021 and 2022.
Results
At baseline, 2,419 (54.3%) respondents participated in the Supplemental Nutrition
Assistance Program, 3,993 (89.6%) participated in Free/Reduced Priced Lunch, and 3,755
(84.2%) reported past participation in the Special Supplemental Nutrition Program
for Women, Infants, and Children. No associations were found between any program and
fifth-grade BMI z-score or between Special Supplemental Nutrition Program for Women, Infants, and Children
participation and BMI z-score trend.
Conclusions
Previous findings of relationships between program participation and BMI may have
been because of weaker study designs and uncontrolled confounding. Participation in
the Supplemental Nutrition Assistance Program; Free/Reduced Priced Lunch; and Special
Supplemental Nutrition Program for Women, Infants, and Children was not associated
with increased risk of childhood obesity in this recently conducted longitudinal study.
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Article Info
Publication History
Published online: April 07, 2022
Identification
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