Household Supplemental Nutrition Assistance Program Participation is Associated With Higher Fruit and Vegetable Consumption

ObjectiveExamine whether differences were present by Supplemental Nutrition Assistance Program (SNAP) participation in dietary patterns, achievement of dietary recommendations, and food security for children (aged 7–18 years) receiving free/reduced-price school meals.MethodsCross-sectional study. Caregiver–child dyads at a pediatric clinic completed validated surveys. Food security, dietary patterns, and achievement of dietary recommendations were compared between child SNAP participants/nonparticipants.ResultsAmong 205 caregivers, 128 (62.4%) reported SNAP participation. Percentages of child SNAP participants/nonparticipants meeting recommendations were largely nonsignificantly different and overwhelmingly low. Supplemental Nutrition Assistance Program participants reported higher mean daily servings of vegetables (P = 0.01) and fruits (P = 0.01) than nonparticipants. Caregiver-reported household food security was not significantly different between SNAP participants and nonparticipants (P = 0.44).Conclusions and ImplicationsIn this study, child-reported fruit/vegetable intakes were significantly higher among SNAP participants than nonparticipants, suggesting child SNAP participants may experience small but noteworthy benefits related to fruit/vegetable consumption. Additional supports are needed to achieve dietary recommendations.     

State Implementation of SNAP Waivers and Flexibilities During the COVID-19 Pandemic: Perspectives From State Agency Leaders

ObjectiveTo describe state agencies’ implementation of the Supplemental Nutrition Assistance Program (SNAP) during the first year of the coronavirus disease of 2019 (COVID-19) pandemic, barriers and facilitators to SNAP implementation, and recommendations to improve SNAP implementation.DesignQualitative methodology guided by Bullock's determinants of policy implementation framework using 7 semistructured, virtual focus groups in April 2021.SettingTwenty-six states representing all 7 US Department of Agriculture Food and Nutrition Service regions.ParticipantsFour focus groups with state-level SNAP administrators and 3 focus groups with state-level SNAP supportive services (Supplemental Nutrition Assistance Program-Education, Employment & Training, and Outreach) supervisors (n = 62).Phenomenon of InterestSupplemental Nutrition Assistance Program implementation during the COVID-19 pandemic.AnalysisThematic analysis using a phronetic iterative approach.ResultsSix primary themes emerged: the policy response, technology needs, collaboration, participant communication, funding realities, and equity. Implementation challenges included the design of waivers in the early pandemic response, inadequate federal guidance and funding, outdated technology, and prepandemic regulations limiting state authority. Modernized technology systems, availability of virtual programming, partnerships, and enhanced benefits facilitated SNAP implementation.Conclusions and ImplicationsSupplemental Nutrition Assistance Program administrators adapted their programs to deliver services virtually during the COVID-19 pandemic. These experiences highlighted the importance of certain policy determinants, such as modernized technology and streamlined application processes, to improve outcomes for SNAP participants and staff.     

Few Changes in Food Security and Dietary Intake From Short-term Participation in the Supplemental Nutrition Assistance Program Among Low-income Massachusetts Adults

ObjectiveTo examine whether short-term participation in the Supplemental Nutrition Assistance Program (SNAP) affects food security and dietary quality among low-income adults recruited from a Massachusetts-wide emergency food hotline.MethodsA 3-month, longitudinal study was conducted among 107 adults recruited at the time of SNAP application assistance. Outcomes included household food security (10-item US Department of Agriculture Food Security Survey Module), dietary intake (eg, grains, fruit) and diet quality (modified Alternate Healthy Eating Index). Data were analyzed using paired t tests and multivariable linear regression.ResultsSupplemental Nutrition Assistance Program participation was not associated with improved household food security over 3 months (P = .25). Compared with non-participants, SNAP participants increased refined grain intake by 1.1 serving/d (P = .02), from baseline to follow-up. No associations were observed with other foods, nutrients, or dietary quality.Conclusion and ImplicationsPolicies that simultaneously improve household food security and dietary quality should be implemented to support the health of low-income Americans participating in this crucial program.     

Differences in Food-at-Home Spending for SNAP and Non-SNAP Households Given Geographic Price Variation

BackgroundAs the largest nutrition safety net program in the United States, the Supplemental Nutrition Assistance Program (SNAP) enhances food security by providing low-income households with benefits for food-at-home (FAH) spending. A large literature finds a positive effect of SNAP on FAH spending, but it is unclear whether this relationship varies with area-level prices. SNAP benefits do not explicitly account for price variation across the contiguous United States.ObjectiveOur objectives were to examine the SNAP/non-SNAP difference in FAH spending for households with varying levels of cash income and propensity for SNAP participation and to determine whether this difference varied with area-level prices.Design/participantsCross-sectional data on 2,524 SNAP and non-SNAP households with cash income at or below 185% of the Federal Poverty Level were obtained from the National Household Food Acquisition and Purchase Survey.Main outcome measuresThe outcome was FAH spending relative to the maximum SNAP benefit corresponding to household size.Statistical analyses performedHouseholds were grouped into quintiles based on estimated propensity of SNAP participation. Regression models included interactions between a SNAP participation indicator, a continuous price index for all goods and services, and propensity score quintile indicators.ResultsAccording to some models, the SNAP/non-SNAP spending difference was positive, on average. Among households that tended to have lower cash income and higher propensity of SNAP participation, FAH spending relative to the maximum benefit was 29 to 30 percentage points higher for SNAP households compared to low-income non-SNAP households (P≤0.05). The spending difference was similar across areas with different price levels.ConclusionsSNAP households spent more on FAH compared to low-income non-SNAP households. This association did not vary with area-level prices. Beyond food spending outcomes, future research could extend this work to understand SNAP’s role in promoting food security and other outcomes, given geographic price variation.     

Supplemental nutrition assistance program participation and sugar-sweetened beverage consumption,overall and by source

IntroductionThis paper examined patterns in adults' sugar-sweetened beverage (SSB) consumption and caloric intake by Supplemental Nutrition Assistance Program (SNAP) participation status and by source of purchases in the United States (US).MethodCross-sectional analysis of consumption of SSBs by source of purchases using 24-hour dietary recall data obtained from the US National Health and Nutrition Examination Survey 2003–2010 (N = 17,891). Bivariate analysis and multivariable regressions were used to examine the association between SNAP participation and SSB calories consumed overall and by source.ResultsSSBs account for approximately 12% of total daily caloric intake (258 kcal) among SNAP participants, higher than that of SNAP-eligible nonparticipants (9% total daily intake, 205 kcal) and SNAP-ineligible nonparticipants (6% total daily intake, 153 kcal). Among income-eligible adults, participating in SNAP is associated with 28.9 additional SSB calories, of which most were obtained from a store. From 2003–04 to 2009–10, SSB prevalence and caloric intake were flat among SNAP participants while it declined among both SNAP-eligible and SNAP-ineligible nonparticipants; this pattern held for all sources of SSBs except for those purchased from fast-food restaurants, which were not statistically reduced among nonparticipants.ConclusionSNAP participants consumed more SSB calories compared to SNAP-eligible nonparticipants; and their SSB prevalence and caloric intake trend was flat over the 2003–04 to 2009–10 period. SNAP-Education interventions that focus on improving access to healthy food in poor neighborhoods may benefit SNAP participants.     

Participation in the Supplemental Nutrition Assistance Program and Dietary Behaviors: Role of Community Food Environment

BackgroundThe United States Department of Agriculture’s Supplemental Nutrition Assistance Program (SNAP) is the country’s largest nutrition assistance program for low-income populations. Although SNAP has been shown to reduce food insecurity, research findings on the diet quality of program participants are inconsistent.ObjectiveThis study evaluated whether the community food environment is a potential moderator of the association between SNAP participation and eating behaviors.DesignThis cross-sectional study used participant data from a telephone survey of 2,211 households in four cities in New Jersey. Data were collected from two cross-sectional panels from 2009 to 2010 and 2014. Food outlet data were purchased from commercial sources and classified as supermarkets, small grocery stores, convenience stores, or limited service restaurants.Participants/settingAnalysis is limited to 983 respondents (588 SNAP participants) with household incomes below 130% of the federal poverty level.Main outcome measuresEating behaviors were assessed as frequency of consumption of fruit, vegetables, salad, and sugar-sweetened beverages.Statistical analyses performedInteraction and stratified analyses using gamma regression determined the differences in the association between SNAP participation and eating behaviors by the presence or absence of food outlets adjusted for covariates.ResultsSNAP participation was associated with a higher frequency of consuming sugar-sweetened beverages (P<0.05) when respondents lived within ¼ to ½ mile of a small grocery store, supermarket, and limited service restaurant. SNAP participants who did not live close to a convenience store reported a lower frequency of sugar-sweetened beverage consumption (P=0.01), and those living more than ½ mile away from a supermarket reported a lower frequency of fruit consumption (P=0.03).ConclusionsThe findings from this study suggest that the community food environment may play a role in moderating the association between SNAP participation and eating behaviors. Although SNAP participation is associated with some unhealthy behaviors, this association may only hold true when respondents live in certain food environments.     

Federal Food Program Participation and Beverage Intake Among Families With Low Household Income

ObjectiveExamine beverage intake among families with low income by household participation in federal food assistance programs.DesignCross-sectional study conducted in fall/winter 2020 via an online survey.ParticipantsMothers of young children insured by Medicaid at the time of the child's birth (N = 493).Variables MeasuredMothers reported household federal food assistance program participation, later categorized as Supplementation Nutrition Program for Women, Infants, and Children (WIC) only, Supplemental Nutrition Assistance Program-Education (SNAP) only, both WIC and SNAP, and neither. Mothers reported beverage intake for themselves and their children aged 1–4 years.AnalysisNegative binomial and ordinal logistic regression.ResultsAfter accounting for sociodemographic differences between groups, mothers from households participating in WIC and SNAP consumed sugar-sweetened beverages (incidence rate ratio, 1.63; 95% confidence interval [CI], 1.14–2.30; P = 0.007) and bottled water (odds ratio, 1.76; 95% CI, 1.05–2.96; P = 0.03) more frequently than mothers from households in neither program. Children from households participating in WIC and SNAP also consumed soda (incidence rate ratio, 6.07; 95% CI, 1.80–20.45; P = 0.004) more frequently than children in either program. Few differences in intake were observed for mothers or children participating in only WIC or SNAP vs both programs or neither program.Conclusion and ImplicationsHouseholds participating in both WIC and SNAP may benefit from additional policy and programmatic interventions to limit sugar-sweetened beverage intake and reduce spending on bottled water.     

Support for Policies to Improve the Nutritional Impact of the Supplemental Nutrition Assistance Program in California

The Supplemental Nutrition Assistance Program (SNAP) provides a vital buffer against hunger and poverty for 47.6 million Americans. Using 2013 California Dietary Practices Survey data, we assessed support for policies to strengthen the nutritional influence of SNAP. Among SNAP participants, support ranged from 74% to 93% for providing monetary incentives for fruits and vegetables, restricting purchases of sugary beverages, and providing more total benefits. Nonparticipants expressed similar levels of support. These approaches may alleviate the burden of diet-related disease in low-income populations.The Supplemental Nutrition Assistance Program (SNAP) aims to alleviate food insecurity and improve the health of low-income children and families.1 With a budget of $80 billion, SNAP currently serves 47.6 million Americans, including more than 20 million children.1,2Despite recent efforts to promote nutritious food options in SNAP,3,4 there are no established nutritional guidelines for SNAP-eligible foods.5 Obesity and diet-related disease disproportionately affect low-income individuals6–8; thus, public health advocates and researchers have urgently sought to identify policies that could bolster the nutritional influence of SNAP.9–12 So far, monetary incentives show promise: an evaluation of the US Department of Agriculture–funded Healthy Incentives Pilot showed that providing a $0.30 per SNAP dollar incentive for fruits and vegetables resulted in a 25% increase in their consumption levels.13The objective of this study was to identify strategies that would be perceived as most acceptable to improving the nutritional intake of SNAP participants, using a statewide sample of California adults, including an oversample of SNAP participants.     

Online Grocery Shopping Knowledge,Attitudes, and Behaviors Among SNAP Participants

ObjectiveTo inform policy proposals to allow online grocery shopping with Supplemental Nutrition Assistance Program (SNAP) benefits by examining relevant behaviors, knowledge, and attitudes of SNAP recipients.MethodsThis qualitative study used a purposive recruitment strategy to conduct 4 1-hour focus groups in Las Cruces, NM. Participants were SNAP recipients who do the grocery shopping for their families. Focus groups were video and audio recorded, transcribed, and coded.ResultsFew participants had shopped for groceries online, and participants were generally uninterested in grocery shopping online. Identified barriers were cost, quality control for perishable foods in particular, and distrust of the overall process. Participants expressed interest in suggested services aimed at increasing the benefits of shopping online.Conclusions and ImplicationsSNAP recipients in this study have not adopted online grocery shopping for various reasons. Additional research could inform policy by investigating which participants would benefit from using SNAP benefits online and strategies for facilitating use.     

Can the introduction of a full-service supermarket in a food desert improve residents' economic status and health?

PurposeTo estimate the impacts of a new supermarket in a low-income desert, on residents' economic status and health.MethodsWe surveyed a randomly selected cohort in two low-income Pittsburgh neighborhoods before and about 1 year following the opening of a supermarket. We used difference-in-difference approach to test changes across the two neighborhoods in residents' food security, United States Department of Agriculture Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women Infant and Children participation, employment, income, and self-reported health/chronic disease diagnoses.ResultsWe observed declines in food insecurity (−11.8%, P < .01), Supplemental Nutrition Assistance Program participation (−12.2%, P < .01), and fewer new diagnoses of high cholesterol (−9.6%, P = .01) and arthritis (−7.4%, P = .02) in the neighborhood with the new supermarket relative to residents of the comparison neighborhood. We also found suggestive evidence that residents' incomes increased more ($1550, P = .09) and prevalence of diabetes increased less in the neighborhood with the supermarket than in the comparison neighborhood (−3.6%, P = .10).ConclusionsLocating a new supermarket in a low-income neighborhood may improve residents' economic well-being and health. Policymakers should consider broad impacts of neighborhood investment that could translate into improved health for residents of underserved neighborhoods.     

Impact of Food Insecurity Nutrition Incentives on Household Fruit and Vegetable Expenditures

ObjectiveEvaluate the impact of the Food Insecurity Nutrition Incentive (FINI) grant program on self-reported fruit and vegetable (FV) expenditures.DesignPre-post quasi-experimental study design.SettingFarmers markets and grocery stores in states with FINI projects.ParticipantsA total of 2,471 Supplemental Nutrition Assistance Program (SNAP) households in 4 intervention groups who lived near a FINI retailer (farmers market or grocery store) and 4 matched comparison groups who did not live near a FINI retailer.Main Outcome MeasuresAwareness and use of point-of-sale incentives and changes in self-reported monthly household FV expenditures.AnalysisOrdinary least squares intent-to-treat regression model using lagged dependent variable model framework.ResultsAwareness of FINI was higher among households who were near a FINI retailer and had shopped there before FINI than those who lived near a FINI retailer but had not shopped there before FINI; the number of information sources from which SNAP participants heard about FINI was positively associated with incentive receipt (P < 0.05). Among those who received incentives, the average amount of incentives received at the last shopping trip ranged from $15 to $23. The FINI program had a positive impact on the average monthly FV expenditures for those in the farmers market shopper, grocery store shopper, and grocery store general intervention groups—increases ranged from $9 to $15 (P < 0.05).Conclusions and ImplicationsPoint-of-sale incentives were associated with an increase in FV expenditures among SNAP households. Further research is needed to examine (1) effective messaging strategies to increase incentive awareness and (2) the long-term impact of incentives on FV expenditures.     

Fruit and Vegetable Purchasing Patterns and Supplemental Nutrition Assistance Program Participation: Findings From a Nationally Representative Survey

BackgroundPrevious studies suggest that Supplemental Nutrition Assistance Program (SNAP) participants purchase less produce than nonparticipants. Whether this is due to buying smaller amounts or to being less likely to buy any produce is unclear. Purchase patterns may also differ over the monthly distribution cycle.ObjectiveTo examine differences in the likelihood and amounts of fruits and vegetables purchased between SNAP household compared with nonparticipant households and to determine differences in produce purchases among SNAP households at different time points in the monthly distribution cycle.DesignCross-sectional.Participants/settingData from 4708 households in the National Household Food Acquisition and Purchase Survey (April 2012 to January 2013). Participants recorded all foods acquired over 7 days.Main outcome measuresFruits and vegetables acquired over a 7-day period.Statistical analyses performedWeighted logistic and linear regression models adjusting for household and primary respondent characteristics were used to compare odds of purchasing fruits and vegetables and amounts purchased across 3 categories: SNAP participants, SNAP-eligible nonparticipants, and ineligible nonparticipants. SNAP participants were further subdivided according to weeks since last receiving benefits.ResultsIn adjusted analyses, SNAP participants and nonparticipants were similarly likely to purchase fruits and vegetables. However, SNAP households within a week of receiving benefits were more likely than SNAP households later in the benefit cycle to buy fruit overall, especially frozen or canned fruit, and vegetables overall, including fresh, frozen or canned, starchy, and nonstarchy vegetables (fruit odds ratio [OR] 1.68, 95% confidence interval [CI] 1.12, 2.53; vegetable OR 1.63, 95% CI 1.04, 2.55 vs households in middle of cycle). In contrast, those in the last week of the benefit cycle were less likely to purchase fruit, especially fresh fruit, and vegetables, especially fresh and nonstarchy vegetables (fruit OR 0.58, 95% CI 0.35, 0.94; vegetable OR 0.58, 95% CI 0.42, 0.79 vs. households in middle of cycle), and when they bought vegetables, they bought significantly less.ConclusionConsidering all SNAP households together at different points in their distribution cycle masks substantial declines in purchasing fruits and vegetables over the monthly cycle.     

Connecting Families at Risk for Food Insecurity With Nutrition Assistance Through a Clinical-Community Direct Referral Model

ObjectiveTo assess the feasibility of a clinical-community direct referral model to enroll eligible households in the Supplemental Nutrition Assistance Program (SNAP).MethodsPediatric clinics screening for food insecurity (n = 27) invited families experiencing food insecurity to participate in a direct referral to a local organization that assists with SNAP applications. A food stamp specialist telephoned participants to determine SNAP eligibility, assist with the application, and/or provide other supports. Referrals, eligibility determination, enrollment, and estimated benefits were tracked.ResultsA total of 486 families were referred to the community partner; 72% (n = 351) were successfully contacted by a food stamp specialist, with 17% (n = 83) applying for SNAP benefits. Another 16% (n = 79) were already enrolled in SNAP but received an additional service.Conclusions and ImplicationsThis referral model was feasible and increased the number of families who received nutrition assistance. This approach could be adapted for other health-related social needs.     

Implementation of Wireless Terminals at Farmers’ Markets: Impact on SNAP Redemption and Overall Sales

Although farmers’ markets offer healthy foods for purchase, many lack the equipment necessary to process convenient, card-based transactions. We assessed the impact of providing wireless terminals to 5 markets on overall sales and redemption of Supplemental Nutrition Assistance Program (SNAP) benefits. Sales increased significantly at 4 of the 5 markets after implementation of the terminals, and overall sales increased above and beyond SNAP redemption alone. Implementation of wireless terminals may be important for improving the financial stability and accessibility of farmers’ markets.With the increased popularity of the “buy local” movement, demand is growing for venues selling locally grown foods, such as farmers’ markets.1–4 These venues offer the potential to expand access to fresh, healthy foods for a variety of consumers, in particular low-income consumers.5,6 Farmers’ markets, for example, can become certified to accept benefits from food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP).7,8 However, barriers exist that limit the full use of such benefits.For instance, many farmers’ markets operate in temporary locations that lack electricity, making card-based transactions requiring plug-in terminals difficult to process.9,10 This can limit both the convenience of card-based purchasing for all consumers and accessibility of markets to SNAP participants. With the conversion of SNAP benefits from paper coupons to electronic benefit transfer (EBT) cards, SNAP redemption at markets dropped from $6.4 million in 1994 to $3.8 million in 1998.11 SNAP redemption has since increased, with more than $7.5 million in benefits redeemed in 2010.12 Despite this increase, only 0.01% of all SNAP benefits were redeemed at farmers’ markets that year.12In this pilot study, we investigated the impact of wireless terminal use on overall and EBT sales at farmers’ markets. We hypothesized that implementation of wireless terminals would increase SNAP redemption and overall sales at these markets.     

The Supplemental Nutrition Assistance Program,Food Insecurity,Dietary Quality,and Obesity Among US Adults

Objectives. We examined whether Supplemental Nutrition Assistance Program (SNAP) participation changes associations between food insecurity, dietary quality, and weight among US adults.Methods. We analyzed adult dietary intake data (n = 8333) from the 2003 to 2010 National Health and Nutrition Examination Survey. Bivariate and multivariable methods assessed associations of SNAP participation and 4 levels of food security with diet and weight. Measures of dietary quality were the Healthy Eating Index 2010, total caloric intake, empty calories, and solid fat; weight measures were body mass index (BMI), overweight, and obesity.Results. SNAP participants with marginal food security had lower BMI (1.83 kg/m²; P < .01) and lower probability of obesity (9 percentage points; P < .05). SNAP participants with marginal (3.46 points; P < .01), low (1.98 points; P < .05), and very low (3.84 points; P < .01) food security had better diets, as illustrated by the Healthy Eating Index. Associations between SNAP participation and improved diet and weight were stronger among Whites than Blacks and Hispanics.Conclusions. Our research highlights the role of SNAP in helping individuals who are at risk for food insecurity to obtain a healthier diet and better weight status.Food insecurity, broadly defined as having limited access to adequate food,1 is associated with increased stress levels and reduced overall well-being.2 In addition, food insecurity has been shown to diminish dietary quality and affect nutritional intake and has been associated with chronic morbidity (e.g., type 2 diabetes, hypertension) and weight gain.1,3–5 In 2012, approximately 14.5% of US households (17.6 million households) experienced food insecurity, of whom 5.7% (7.0 million households) experienced very low food security (i.e., reduction in food intake).6 The Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps, is the largest government assistance program in the United States and seeks to alleviate food insecurity in US households.7 SNAP has the potential to mitigate the adverse effects of food insecurity on health outcomes not only through attenuating food insecurity but also by enhancing the dietary quality of its participants.8,9Although cross-sectional studies have found no significant differences in food insecurity levels between SNAP participants and nonparticipants,10,11 in a longitudinal study, Nord observed a 28% reduction in the odds for very low food security among households that remained on SNAP throughout the year relative to those who left before the last 30 days of the year.12 In addition, studies by Leung and Villamor13 and Webb et al.14 found that independent of food insecurity, SNAP participation is associated with the increased likelihood of obesity, and other studies have observed lower dietary quality specifically among SNAP participants.15,16 Kreider et al. used partial identification bounding methods to take into account the endogenous selection and misreporting of SNAP enrollment and found that SNAP reduced the prevalence of food insecurity, poor general health, and obesity among children.17Thus, the interrelationships among SNAP participation, food insecurity, dietary quality, and weight status warrant further investigation to inform SNAP programming, policy, and outreach to ultimately improve the health and well-being of SNAP participants. We explored these relationships in data from the National Health and Nutrition Examination Survey (NHANES) over multiple years. We aimed to determine mitigating effects SNAP participation might have on the association of food insecurity with dietary quality and obesity among a nationally representative sample of US adults.     

Dietary Intake Changes in Response to a Sugar-Sweetened Beverage Reduction Trial for Various Supplemental Nutrition Assistance Program (SNAP) Eligibility Groups

Objective

To examine dietary intake differences resulting from a sugar-sweetened beverage reduction intervention by 3 Supplemental Nutrition Assistance Program (SNAP) participation groups: SNAP participants (n?=?56), income-eligible nonparticipants (n?=?30), and income-ineligible nonparticipants (n?=?60).

Development of the New York State Nutrition Surveillance Program.

New York State established a Nutrition Surveillance Program (NSP) in 1984. Precedents for the program included the Pediatric Nutrition Surveillance System of the Public Health Service''s Centers for Disease Control and Prevention and periodic food and nutrition surveys conducted by the National Center for Health Statistics and the Human Nutrition Information Service, Department of Agriculture. The first phase of NSP was connected to a new program, the Supplemental Nutrition Assistance Program (SNAP), which established support for more than 1,000 emergency food programs across the State. SNAP also expanded the home delivered meal program for the frail elderly and the Special Supplemental Food Program for Women, Infants, and Children. NSP provided information on the extent of unmet nutrition needs that was used to establish funding requests and provided data describing the characteristics of SNAP participants that were used in developing new SNAP program components. The second phase of NSP began in 1988. It identified populations that were thought to be at nutrition risk and compiled information about the extent of unmet need, the characteristics of the population, and the status of current nutrition programs to meet the needs. As a result of this review, NSP added a nutrition component to the Dental Survey of School Children; conducted a dietary survey; developed an inventory of information sources in all State agencies; and established an annual work plan using department of health objectives. The third phase of NSP is the policy and planning phase, monitoring the Year 2000 Objectives and the Five-Year Plan of the New York State Food and Nutrition Policy Council.