Hudak KM, Racine EF The Supplemental Nutrition Assistance Program and Child Weight Status: A Review. Am J Prev Med. 2019 Jun;56(6):882-893. doi: 10.1016/j.amepre.2019.01.006. Epub 2019 Apr 17. (Systematic review)

CONTEXT: The Supplemental Nutrition Assistance Program (SNAP) is a food assistance program that helps Americans afford a healthy diet. However, its influence on children's weight status is unclear. This review examined the evidence of the relationship between SNAP participation and child weight.

EVIDENCE ACQUISITION: The following databases were searched: PubMed, EconLit, Web of Science, and the U.S. Department of Agriculture Economic Research Service. The last search was performed in October 2018. This systematic review gives a narrative synthesis of included studies.

EVIDENCE SYNTHESIS: Twenty-three studies that examined the weight outcomes of children aged 2-18 years and SNAP participation were included. Eleven studies found no significant relationship between SNAP and child weight outcomes. Nine found that SNAP participation was associated with increased weight outcomes in certain subpopulations, and four found that SNAP was linked to a predicted decrease in weight outcomes in some subpopulations. However, many of these studies did not address a key methodologic challenge: self-selection. Of those that did, five found that SNAP participation was associated with an increased risk of being overweight and elevated weight in certain subpopulations.

CONCLUSIONS: SNAP participation may help boys maintain a healthy body weight but can be a contributing factor in being overweight or obese in girls who are long-term participants, or who are already overweight. Food security and participation in multiple food assistance programs may be important modifiers. These findings are relevant to policymakers who are considering reducing SNAP funding or restructuring the program. Further research that utilizes strong designs is needed.

Discipline Area Score
Physician 5 / 7
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Physician rater

I believe this to be very useful information. If a nutritional assistance program is to be implemented, it is vital that it "first does no harm". Contributing to the overweight/obesity epidemic will not adhere to that principle.
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