Simulated Nutritional and Health Impacts of Restricting Ultra-Processed Food Purchases in the SNAP Program: A NHANES-Based Policy Modeling Study

Background Ultra-processed foods (UPFs), which now account for over half of caloric intake in the U.S., are consistently linked to increased cardiometabolic risk. Participants in the Supplemental Nutrition Assistance Program (SNAP) consume disproportionately high levels of UPFs, contributing to dietary disparities. Despite this, few policy simulations have quantified the potential health benefits of restricting UPF purchases within SNAP. Objective To estimate the nutritional and cardiometabolic health impacts of restricting UPF purchases in SNAP using nationally representative dietary data and a Monte Carlo policy modeling framework. Methods We conducted a cross-sectional simulation study using NHANES 2007–2020 data from adults aged 20–65. Foods were classified by NOVA criteria, and three scenarios were modeled: isocaloric replacement of 25%, 50%, and 100% of UPFs with minimally processed alternatives. Nutrient shifts (sodium, added sugar, fiber) were estimated for SNAP participants and nonparticipants. Health impacts were simulated by applying meta-analytic effect sizes linking these nutrients to systolic blood pressure (SBP), type 2 diabetes (T2D), and cardiovascular disease (CVD) risk. Results Full UPF replacement (100%) among SNAP participants led to reductions of 257 mg/day sodium, 30.7 g/day added sugar, and a gain of 1.13 g/day fiber. These shifts translated to a 0.64 mmHg SBP reduction, 0.25% relative reduction in T2D risk, and 1.01% relative reduction in CVD risk. Nonparticipants experienced slightly greater improvements. Conclusions Restricting UPF purchases in SNAP could yield meaningful population-level improvements in cardiometabolic health. Though individual risk reductions are modest, large-scale implementation may produce substantial public health benefits and help narrow dietary inequities.