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Health Disparities

HD: Food Security (2011)

Citation:

 Rose D. Food stamps, the Thrifty Food Plan, and meal preparation: The importance of the time dimension for US nutrition policy. J Nutr Educ Behav. 2007 Jul-Aug; 39(4): 226-232.

PubMed ID: 17606249
 
Study Design:
Narrative Review
Class:
R - Click here for explanation of classification scheme.
Quality Rating:
Negative NEGATIVE: See Quality Criteria Checklist below.
Research Purpose:
  • To integrate new empirical evidence in an exploration of why time should be a critical aspect of of nutrition policy.
  • To examine the time it takes for meal preparation for other activities related to food preparation in populations that are recipients of the "Thrifty Food Plan."
Inclusion Criteria:

Not applicable; this was a narrative review and research parameters regarding the review were not listed.

Exclusion Criteria:

Not applicable; this was a narrative review and research parameters regarding the review were not listed.

Description of Study Protocol:

Not applicable.

Data Collection Summary:

 

Not applicable; narrative review. 

 

Description of Actual Data Sample:

Not applicable; narrative review.

Summary of Results:

 Findings

Thrifty Food Plan (TFP):

  • History:
    • This plan forms part of the USDA's set of food plans that includes the low-cost, moderate cost and liberal plans
    • To stay current, the TFP has been revised three times since its first major revision in 1975. It was updated in 1983, 1999 and 2006 to stay current with food consumption habits, dietary recommendations and food prices.
    • The TFP is a set of market baskets of food, each designed for a specific age and gender group; there are 15 baskets in all. Each basket lists quantities that can be purchased from 29 different food groups.
    • The cost of TFP is calculated monthly and provides the basis for inflation adjustments to the monthly allotment, or food stamps benefits, received by the household
    • In creation of the 2006 TFP, the Center for Nutrition Policy and Promotion (CNPP) began using consumption data from the 2001 to 2002 NHANES data. For each gender group, the following criteria had to be met: Meeting all nutrient and food component recommendations in latest Dietary Reference Intakes and the Dietary Guidelines for Americans and met food recommendation from MyPyramid Food Intake Pattern, cost no more than the food stamp allotment and was as close to possible as actual diets.
    • The TFP is largely based on raw food items that require significant preparation time
    • The authors concluded that cooking times for two weeks averaged 16.1 hours per week.  2.3 hours per day were necessary to prepare and cook the recipes. This time average did not include time for clean-up, shopping or non-recipe dishes (such as scrambled eggs, etc.).
  • Contradiction of government policy:
    • The cook-from-scratch approach does not take into consideration the time constraints of the meal preparers
    • Authors note that the origins of the TPF date back to an era when the labor force participation of women was much lower than today
    • Since the early 1990s, government policy has sought to increase employment rates of low-income women
    • Government policies encourage low-income women to go out and work in the labor market, but also provides programs that assume women have the time to prepare meals from scratch
  • The "home production" of meals:
    • The home production of meals focuses on output and input; the input consisting of food ingredients and kitchen labor and meal preparation and the output the meal itself
    • Theorists suggest that those with higher earning capacity would spend less labor time on meals in that they would purchase more convenient, but expensive items to prepare
    • The hypothesis that meal preparers whose time is valued higher in the labor market would increase the time spent in paid work and substitute prepared meals or food away from home for more labor-intensive home production of meals
    • The production of meals involves trade-offs in the case of time spent in food preparation and the cost of food ingredients
  • Empirical evidence on meal preparation time:
    • Data was analyzed from nationally representative time-use surveys conducted over the last several decades in the United States. All results were based on 24-hour time diaries, which were considered the gold standard.
    • Women respondents aged 18 to 65 who were not employed in the labor market were analyzed first. Students, retired women and the disabled were excluded. Research revealed that over the past few decades time spend in meal preparation decreased significantly. In non-working women, the time spent in meal preparation decreased from 10.9 hours in 1960 to 7. 9 hours in the 1990s and for women who were working, 5.6 hours per week in meal preparation in the 1960s to 4.5 hours per week in the 1990s.
    • The time that women spend in meal preparation is significantly lower, and the women using the TFP spend less time in meal preparation than the model accounts for
  • Implications for policy:
    • The authors suggest that the government can keep food stamp benefits low by assuming that households will spend more time in meal preparation
    • On average, households spent 29% more than the cost of the TFP that was adjusted for their household size
    • This is more of a concern for single-parent households who might be more time constrained  than households where there are other adults to assist
    • Research reviewed reveals that participants of these programs are already time constrained and constrained by the economic trends affecting the lower-income population and that the nations' food safety net may not be adequate
    • In addition to being constrained regarding food choices, this population may also be more likely to make trade-offs such as putting off routine health care visits and necessary medications, which may result in more emergency visits or hospitalizations
  • New directions for research:
    • There are three potential key areas for future research: 
      • Whether time and income constraints of low-income households affect aspects of food security such as decreased quantities of food, uneven access to food and decreased diet quality
      • The time spent in meal preparation, specifically regarding healthful, culturally appropriate meals
      • Food assistance policy analysis to provide additional assistance to those that are time constrained
  • Implications for nutrition education interventions:
    • Nutrition educators could focus efforts on time constraint in regards to meal preparation
    • Educate on time-saving techniques for food preparation, but also shopping and preparation time
    • Access to inexpensive, healthy food is a problem in many low-income neighborhoods, which increases the time spent shopping for foods.
Author Conclusion:

Based on the review of the research, the authors believe that policy should be reviewed in addition to more effort being applied to nutrition education. If the food ration is based on time assumptions that are not appropriate for the intended population, then the amount should be re-examined regarding the time it takes to prepare foods and to the increased costs of foods. Additional concern and attention should be given to single parents who have less time than their partnered counterparts. Focus should also be on enhancing nutrition education efforts to account for practices that may assist participants of the TFP regarding saving money and time while shopping and preparing meals.

Funding Source:
Government: Food Assistance and Nutrition Reserach Program of the USDA's Economic Research Service
Reviewer Comments:
Quality Criteria Checklist: Review Articles
Relevance Questions
  1. Will the answer if true, have a direct bearing on the health of patients? ???
  2. Is the outcome or topic something that patients/clients/population groups would care about? Yes
  3. Is the problem addressed in the review one that is relevant to dietetics practice? Yes
  4. Will the information, if true, require a change in practice? Yes
 
Validity Questions
  1. Was the question for the review clearly focused and appropriate? ???
  2. Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? No
  3. Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? No
  4. Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? No
  5. Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? No
  6. Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? No
  7. Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? No
  8. Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? No
  9. Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? No
  10. Was bias due to the review's funding or sponsorship unlikely? No