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Unhealthy beverage consumption highest among economically-vulnerable households that rely on multiple food assistance programs

Philadelphia | July 10, 2023

Research published in the Journal of Nutrition Education and Behavior compared beverage consumption in low-income households that utilize food assistance programs

A long-standing and contentiously debated question is the extent to which US federal food assistance programs contribute to or deter healthy beverage intake. Findings of a new studyopens in new tab/window in the Journal of Nutrition Education and Behavioropens in new tab/window, published by Elsevier, show that while beverage intake patterns rarely differed between mothers and young children who participated only in the Supplementation Nutrition Program for Women, Infants, and Children (WIC), only the Supplemental Nutrition Assistance Program (SNAP), or neither program, those whose households participated in both programs consumed high amounts of sugar-sweetened beverages (SSBs). Bottled water intake, which is common among communities with high distrust of tap water and can be an economic burden for low-income families, was also common among mothers participating in WIC and SNAP.

While both WIC and SNAP aim to improve families’ food security, the programs operate quite differently. WIC benefits allow the purchase of specific foods and beverages and are only available to pregnant and breast-feeding women and children through age 4. Meanwhile, SNAP benefits are available to income-qualifying households and can be used on nearly all food and non-alcoholic beverages sold at authorized retailers.

Lead author Katherine W. Bauer, PhD, associate professor in the Department of Nutritional Sciences at the University of Michigan School of Public Health, says, "Few studies have acknowledged that families with low income commonly participate in multiple food assistance programs. Parents are constantly navigating the different requirements of these programs and working to combine benefits in ways that most benefit their families. It is increasingly important to understand how programs work together to impact the health of adults and children."

Study data were obtained from an online survey of 493 mothers with young children who had given birth at the University of Michigan hospital in Ann Arbor, Michigan. These mothers were insured by Medicaid at the time of their child’s birth, indicating low household income. Mothers completed questions about their household’s current participation in WIC or SNAP, their past month's intake of SSBs, their child’s beverage intake, bottled water intake, and several sociodemographic characteristics.

A child drinking bottled water

Consumption of bottled water was highest among families participating in multiple food assistance programs (Credit: yamasan/

Study results showed mothers who did not participate in either WIC or SNAP drank SSBs 4.5 times/week compared to 8.7 times/week for mothers participating in both WIC and SNAP. Although regular soda intake was low among children aged 1 to 4, children from households participating in both WIC and SNAP consumed soda approximately 5 times more frequently than those from households not participating in either program. Mothers from households participating in both programs also drank bottled water more frequently. These differences were evident even after accounting for sociodemographic differences between low-income families that do or do not participate in WIC and/or SNAP.

Dr. Bauer explains, “Participating in multiple programs increases a household’s food-specific purchasing power. Parents may use their WIC benefits to buy healthy staple foods and save their SNAP benefits for the small luxuries they can now afford, such as SSBs or bottled water. By better understanding the dietary intake of families enrolled in multiple food assistance programs, we can think about strategies that work synergistically across programs to promote food security and improve diet quality, while maintaining personal choice for participants.”


Notes for editors

The article is "Federal Food Program Participation and Beverage Intake Among Families With Low Household Income," by Roya Firoozi, MS; Heidi M. Weeks, PhD; Elizabeth Ludwig-Borcyz, MPH; Michelle Clayson, MS; Matt Zawistowski, PhD; Belinda Needham, PhD; and Katherine W. Bauer, PhD ( in new tab/window). It appears in the Journal of Nutrition Education and Behavior, volume 55, issue 7 (July 2023), published by Elsevier.

The article is openly available at in new tab/window.

Full text of the article is also available to credentialed journalists upon request; contact Eileen Leahy at +1 732 238 3628 or [email protected]opens in new tab/window to obtain a copy. To schedule an interview with the author(s), please contact Katherine W. Bauer, PhD, at [email protected]opens in new tab/window.

An audio podcast featuring an interview with Katherine W. Bauer, PhD, and other information for journalists are available at in new tab/window. Excerpts from the podcast may be reproduced by the media with permission from Eileen Leahy.

About the Journal of Nutrition Education and Behavior (JNEB)

The Journal of Nutrition Education and Behavior (JNEB), the official journal of the Society for Nutrition Education and Behavior (SNEB), is a refereed, scientific periodical that serves as a resource for all professionals with an interest in nutrition education and dietary/physical activity behaviors. The purpose of JNEB is to document and disseminate original research, emerging issues, and practices relevant to nutrition education and behavior worldwide and to promote healthy, sustainable food choices. It supports the society's efforts to disseminate innovative nutrition education strategies, and communicate information on food, nutrition, and health issues to students, professionals, policy makers, targeted audiences, and the public.

The Journal of Nutrition Education and Behavior features articles that provide new insights and useful findings related to nutrition education research, practice, and policy. The content areas of JNEB reflect the diverse interests of health, nutrition, education, Cooperative Extension, and other professionals working in areas related to nutrition education and behavior. As the Society's official journal, JNEB also includes occasional policy statements, issue perspectives, and member communications. www.jneb.orgopens in new tab/window

About Elsevier

As a global leader in scientific information and analytics, Elsevier helps researchers and healthcare professionals advance science and improve health outcomes for the benefit of society. We do this by facilitating insights and critical decision-making with innovative solutions based on trusted, evidence-based content and advanced AI-enabled digital technologies.

We have supported the work of our research and healthcare communities for more than 140 years. Our 9,500 employees around the world, including 2,500 technologists, are dedicated to supporting researchers, librarians, academic leaders, funders, governments, R&D-intensive companies, doctors, nurses, future healthcare professionals and educators in their critical work. Our 2,900 scientific journals and iconic reference books include the foremost titles in their fields, including Cell Press, The Lancet and Gray’s Anatomy.

Together with the Elsevier Foundationopens in new tab/window, we work in partnership with the communities we serve to advance inclusion and diversity in science, research and healthcare in developing countries and around the world.

Elsevier is part of RELXopens in new tab/window, a global provider of information-based analytics and decision tools for professional and business customers. For more information on our work, digital solutions and content, visit



Eileen Leahy


+1 732 406 1313

E-mail Eileen Leahy