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Associations between Select State Policies and the Nutritional Quality of Household Packaged Food Purchases in the U.S. from 2008-2017


Lacko, Allison M.; Guilkey, David K.; Popkin, Barry M.; & Ng, Shu Wen (Online ahead of print). Associations between Select State Policies and the Nutritional Quality of Household Packaged Food Purchases in the U.S. from 2008-2017. Journal of the Academy of Nutrition and Dietetics.


BACKGROUND: Policy interventions are important public health tools because they can reach large numbers of people. State context has been associated with health outcomes, yet few studies have examined the extent to which state-level policies are associated with dietary quality.
OBJECTIVES: The objective of this study was to evaluate whether state policies are associated with the nutritional quality of household packaged food purchases (PFPs).
DESIGN: This observational study used data from Nielsen Homescan, an open-cohort household panel where participants track purchases, and a combination of state-level food and social safety net policy variables from 2008-2017.
PARTICIPANTS/SETTING: This study included 615,634 household-year observations in the U.S. from 2008-2017. Household-year observations were excluded if a household did not make a minimum number of purchases and if they had incorrect geographic information. The final analytic sample was 611,719 household-years.
MAIN OUTCOME MEASURES: Study outcomes included a set of nutritional measures of public health interest, including nutrients of concern (sugar, saturated fat, sodium) and calories from specific food groups (fruits, non-starchy vegetables, processed meats, mixed dishes, sugar-sweetened beverages and desserts and snacks).
STATISTICAL ANALYSIS: This study used multilevel generalized linear models with state fixed effects on three samples: all households, only households with low income, and only households with low educational attainment.
RESULTS: Few significant associations were found between Healthy Food Retail policies and the nutritional quality of purchases, and mixed associations were found between social safety net policies and lower or higher quality PFPs.
CONCLUSIONS: Little evidence was found that state policy context in 2008-2017 was associated with the quality of PFPs. However, variation in state policies is increasing over time, warranting future research into the relationship between these policies, the quality of PFPs, and the rest of the diet.


Reference Type

Journal Article

Year Published

Online ahead of print

Journal Title

Journal of the Academy of Nutrition and Dietetics


Lacko, Allison M.
Guilkey, David K.
Popkin, Barry M.
Ng, Shu Wen

Article Type


Data Set/Study

Nielsen Homescan Consumer Panels


United States of America




Popkin - 0000-0001-9495-9324
Ng - 0000-0003-0582-110X
Lacko - 0000-0001-7475-126X