Food, health, and nutrient supplements: beliefs among food stamp-eligible women and implications for food stamp policy

Family Economics and Nutrition Review, Spring, 2002 by Vivica Kraak, David L. Pelletier, Jamie Dollahite

* fast-paced and stressful lifestyles

* ease and convenience of eating "junk" food

* lack of attention paid to the diet until chronic diseases develop

* lack of knowledge about what to select and prepare to meet needs

* lack of precision in serving sizes to eat according to the Food Guide Pyramid

* personal preferences that influence food choices that may not be nutritious

* time and money required to make wise decisions (especially challenging for low-income working mothers)

* the perception that healthful foods are too expensive to afford on a limited income

Theme 2: Less than one-quarter of respondents said it is not possible for a person to obtain all necessary nutrients exclusively from food because certain health conditions might require people to take nutrient supplements. Also, respondents had concerns about how food is produced and processed with special reference to nutrient losses, use of pesticides, and food additives and/or preservatives that were believed to change the nutrient value of food.

Illustrations of the participants' attitudes and beliefs about the adequacy of food-based nutrients and the role of nutrient supplements appear in the box on page 25.

Perceptions Concerning the Role of a Supplement

When participants were asked, "What comes to mind when you hear the word supplement?" the responses followed three themes. About one-half of the participants described a supplement as a substitute or a replacement for food. About one-quarter of the participants described it as something taken in addition to the nutrients one could obtain from food, and another quarter expressed uncertainty about the purpose or role of a supplement.

Perceptions of Health Status

The participants were asked a series of questions about what constitutes good health, their perceived health status, and any healthful or unhealthful activities they engaged in. They were asked, "Do you consider yourself to be healthy?" (table 1). In general, the women described health status along a continuum of well-being, with roughly equal numbers expressing these three views: (1)they did not feel healthy, (2) they were somewhat healthy but could make changes to improve their health, and (3) they were healthy.

The primary difference between the non-food stamp recipients and the current or former food stamp recipients is that the latter group reported more health problems, regardless of supplement use. Some women said they were not healthy because of chronic diseases such as diabetes, hypertension, obesity, asthma, and arthritis. Some also indicated that they had epilepsy, anemia, gastrointestinal problems, mental health conditions related to depression, and histories of substance abuse and domestic violence.

Reasons for Using Nutrient Supplements

Participants were asked whether they consumed anything besides food, for any reasons. Questioning was done to probe for the range of possibilities of supplement use. They were then asked whether they took any vitamin or mineral pills, and if they answered "yes," they were asked what they took (either generic or brand names were offered), the dosage, and how often they took the vitamin or mineral supplement. They were also asked the reason(s) for taking supplements, the means by which they obtained them, the estimated cost of the supplements, how they were paying for them (e.g., out-of-pocket cash or insurance reimbursement), and any other information about dietary supplements (e.g., herbs) that they and/or other household members were taking. The responses were categorized into eight emergent themes that related to