(P02-098-25) Food Insecurity and Nutrition Insecurity Predicts Diet Quality in a National Sample of SNAP Participants

Objectives: To understand the difference in food insecurity versus nutrition insecurity in predicting diet quality among SNAP participants using the rapid Prime Diet Quality Score screener (rPDQS).

Methods: A nationally-representative, online survey was conducted through the NORC AmeriSpeak panel in June 2024 for adults >18 years with incomes < 250% of the federal poverty level and who participated in SNAP for at least three months in 2023 (N=1463). Food insecurity was measured with the US Department of Agriculture 6 item Food Security Survey and nutrition insecurity was measured with the Center for Nutrition and Health Impact 4 item Nutrition Security measure. Diet quality was measured with the rPDQS, a 13-item validated screener that includes foods relevant for chronic disease. Weighted multinomial regression models were ran with the exposures, food insecurity and nutrition insecurity, separately and jointly to examine their relationship with diet quality.

Results: In the weighted sample, 24% were food and nutrition secure (FS/NS), 1.4% were food secure and nutrition insecure (FS/NI), 28% were food insecure and nutrition secure (FI/NS), and 47% were both food and nutrition insecure (FI/NI). Compared to those with FS/NS and FI/NS, those with FI/NI had significantly higher intake of processed meat, fast food and white bread and significantly lower intake of vegetables and fruits. Soda consumption was significantly higher for those with FI/NI compared with FS/NS. In single exposure adjusted models, rPDQS scores were 0.98 points lower for individuals with food insecurity compared to food security (95% CI: -1.7, -0.24) and 0.77 points lower for individuals with nutrition insecurity compared with nutrition security (95% CI: -1.5, -0.08). In the joint exposure model, FI/NI was associated with a 1.2-point lower rPDQS score (95% CI: -2.0, -0.38) compared to FS/NS individuals. There were no significant differences in overall rPDQS score for those with FS/NI and FI/NS.

Conclusions: While both food and nutrition insecurity are independently associated with lower diet quality, they jointly had a greater effect. Further research is needed to understand the independent and additional impacts of nutrition insecurity contributes to food insecurity in predicting diet quality.

Funding Sources: R01NR021098 from the National Institute of Nursing Research (PI: Leung).