Sugar-Sweetened Beverage Consumption in Children: The Interplay of Household SNAP and WIC Participation

Abstract

Although sugar-sweetened beverage (SSB) consumption is associated with Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, no national studies have examined the interplay between these programs. This study compares children's sugar-sweetened beverage consumption across households enrolled in one, both, or neither program. A total of 4 waves (2009-2010 to 2015-2016) of the National Health and Nutrition Examination Survey were combined to obtain a sample of 4,772 children aged 0-19 years living in households eligible for both SNAP and WIC (households with income ≤130% of the Federal Poverty Level). Children were grouped as living in 4 household types: SNAP only; WIC only; SNAP + WIC; and neither program. Beverages with any added sugars were classified as SSBs. Two-part regression models examined the adjusted association between SSB consumption and program participation. Analyses were conducted in 2020. Compared with the SNAP‒only group, children in all other household types had lower odds of SSB consumption (AOR=0.44, p=0.002 for WIC only; AOR=0.69, p=0.020 for SNAP+WIC; AOR=0.61, p=0.025 for neither program). The lower probability of SSB consumption for children from WIC‒participating households was mostly driven by children aged 0-5 years, with the differences weakening for children aged 6-12 years and completely disappearing for those aged 12-19 years. No significant differences were observed for the amount of added sugar consumed by SSB consumers. Household WIC participation-whether jointly with SNAP or alone-may confer protection against SSB consumption. Unlike SNAP, WIC, by design, provides participating households with more information and opportunities to access and consume healthier diets. Understanding how SNAP and WIC interact can help policymakers improve the design and nutritional benefit of the U.S. food safety net.