Are your patients receiving food stamps - why you want to know

Purpose: Participation in federal Supplemental Nutrition Assistant Programs (SNAP) has been associated with an increased BMI and waist circumference among its participants. This study examined the potential for CalFresh recipients (California's SNAP program) to consume a daily caloric intake beyond 3,000 and to consider if nutritional education should be routinely provided to patients participating in SNAP programs. Methodology: Qualified foodstuffs were priced at three national chain stores over a 2 week period in California and the maximum number of calories for the $322 average CalFresh household supplement was calculated. An analysis of the CalFresh interview process was conducted to determine what current requirements and methods are utilized to provide nutritional educational to recipients. Results: A total of approximately 268,000 calories per month can be purchased with the average $322 CalFresh supplement. With an average of 2.4 people in households receiving CalFresh benefits, this correlates to greater than 111,000 calories monthly per person. CalFresh requires that participants receive one initial interview session at which time participants are supposed to receive nutritional education but most educational material is given in the form of pamphlets and online resources. Only 0.1% of participants complete this process with a face-to-face interview, reducing the opportunity to provide nutritional education materials and resources to CalFresh recipients. Conclusion: It is known that the intake of >3,000 calories per day results in obesity. CalFresh recipients can consume over 3,700 calories a day, 33% above the recommended daily calorie intake for most adults. While studies have shown that SNAP program participants have improved overall diet quality, their overall HEI (Healthy Eating Index) score remains below that of non-participants. Participation in SNAP programs appears to have unintended consequences as a contributor to obesity among participants. A lack of proper nutrition information or an inadequate educational session for new and current participants in the CalFresh SNAP program is evident and a more effective educational component is recommended. Behavioral studies have found a nearly threefold increase in patients' attempts to manage their weight after a recommendation from their clinician. Thus, healthcare professionals have an opportunity and obligation to implement preventive care measures and provide patients with nutritional education. Clinicians should routinely inquire if patients are participating in a SNAP program and utilize the opportunity to provide nutritional counseling to their patients. These steps may help decrease the incidence of obesity in SNAP participants.