Healthy Food Environment Recommendations: Complete List

How Eating Well Becomes the Easy Choice

“Toxic.”  It’s a word often used to describe the food environment in the United States and, increasingly, in many parts of the world. Because even though the food itself is usually safe to consume, the world in which most consumers live makes choosing healthy food very hard and choosing unhealthy food very easy. It’s truly a toxic environment that eats away at healthy lifestyles and promotes obesity.

Tools and Resources (tools_and_resrouces.jpg)

Related Articles (related-articles.jpg)

What makes up the food environment is vast and varied, ranging from broad federal issues—like agricultural and communication policy—to very local issues—like worksite policies and permits for farmers’ markets. To effectively combat obesity, this broad web of influence that developed over many years must begin to be disentangled, and there are numerous opportunities to do so.

Some avenues to effect change: Agriculture policy can focus on increased planting and buying of fresh fruits and vegetables. Revenue policy can focus on increasing taxes on unhealthy foods and subsidizing the cost of healthy choices. Zoning regulations can help bring supermarkets to low-income neighborhoods and limit fast-food restaurants in areas where there are already too many. And communication policy can restrict advertising to youth about unhealthy foods, or curb stealth marketing to youth through junk food product placements on prime-time television.

The food environment often lurks silently in the background—going largely unnoticed—but it plays a major role in the food choices people make, even for the most independent-minded consumer. Whether it’s small victories on the local level or large shifts on the national level, any positive changes to the food environment can begin to shift momentum: We move away from a world that so easily promotes unhealthy eating, and toward a world where healthy eating is the default choice.

This section of the website summarizes broad recommendations for improving the food environment, based on a review of expert guidance from the Centers for Disease Control and Prevention, the Institute of Medicine, the World Health Organization, and other major governmental, professional, and public health advocacy organizations. Some of the recommendations are aimed at national level change, while others can be implemented at the local level. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list on each page, as well as the links to useful toolkits and other resources. Keep in mind that these recommendations are based primarily on a review of U.S. expert guidance, unless otherwise indicated; in other countries, different policy approaches may be needed to achieve improvements in the food environment.

Healthy Food and Beverage Access

Healthy Food Access (healthy_food_access.jpg)

It’s one of the first steps toward bettering the food environment: making healthy foods and drinks more convenient and affordable. What’s equally important: limiting access to high-calorie, low-nutrient foods (also known as “junk food”) and sugary drinks. Since public buildings and facilities serve people of all ages and backgrounds, setting nutrition standards for food offered in public places or purchased with tax dollars can have an especially broad impact.

Here is a summary of recommendations for making healthy foods and drinks more convenient, available, and affordable in places that serve the public. It’s based on a review of expert guidance from the Centers for Disease Control and Prevention, the Institute of Medicine, the American Academy of Pediatrics, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources. Other sections of The Obesity Prevention Source give specific recommendations for familieschildcare centersschoolsworksites, andhealthcare facilities on how to create healthy food environments.

Tools for Healthy Food and Beverage Access (tools_for_healthy_food_and_beverage_access.jpg)

Establish strong nutrition standards and healthy food policies for foods served at public facilities and government buildings, as well as foods purchased with government funds (1,2,3)
Make healthy foods more available—and affordable—in public facilities and government buildings, and restrict the availability of less-healthy foods (4)
Ensure that smaller portion-size food options are available in public facilities and government buildings(4,5)
Limit or discourage access to sugar-sweetened beverages, especially in schools and childcare centers, worksites, government buildings, and public facilities(4,6,7,8,9,10)

  • Prohibit sugar-sweetened beverages in childcare centers and preschools (8,10,11)
  • Eliminate sugar-sweetened beverage sales as part of school meals or in competition with school meals, and revise school wellness policies to eliminate sales on school grounds (5,6,9)
  • Prohibit low-nutrition beverage sales in other settings where children congregate, such as zoos, children’s museums, boys’ and girls’ clubs, and athletic venues (3)
  • Lower the cost of healthier beverages, compared to sugar-sweetened beverages (6)
  • Set up healthy beverage policies that require offering more healthy beverages than sugar-sweetened beverages (6)
 Increase public access to water (1,5,12,13)

  • Ensure access to free water in all government buildings (1)
  • Ensure access to free water in places and settings where children congregate, such as schools, childcare centers, parks, playgrounds, and restaurants (5,6,10,14,15)
  • Ensure that healthcare institutions provide clean, safe drinking water for patients, staff, and visitors (5)
Quick links to healthy food and beverage access and food environment recommendations for the following settings:

Healthy Food and Beverage Access—Source List

1. Institute of Medicine. Local government actions to prevent childhood obesityOpens in New Window. Washington, D.C.: National Academy of Sciences Press; 2009.

2. U.S. Conference of Mayors. Mayors’ Guide to Fighting Childhood ObesityOpens in New Window. Washington, D.C.: U.S. Conference of Mayors; 2009.

3. Center for Science in the Public Interest. Reducing Junk Food Marketing to Children: State and Local Policy Options for Advocates and Policy MakersOpens in New Window. Washington, D.C.: Center for Science in the Public Interest; 2010.

4. Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. MMWR RecommOpens in New Window Rep. 2009;58:1-26.

5. American Academy of Pediatrics. Prevention and Treatment of Child Overweight and Obesity: Policy Opportunities Tool. Accessed February 8, 2012.Opens in New Window

6. Centers for Disease Control and Prevention. The CDC Guide to Strategies for Reducing the Consumption of Sugar-Sweetened BeveragesOpens in New Window. 2010. Accessed February 7, 2012.

7. Institute of Medicine. Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier YouthOpens in New Window. Washington, D.C: National Academies Press; 2007.

8. Institute of Medicine. Early Childhood Obesity Prevention PoliciesOpens in New Window. Washington, D.C.: National Academies Press; 2011.

9. American Academy of Pediatrics. Policy statement: Soft drinks in schools (reaffirmed in 2009).PediatricsOpens in New Window. 2004;113:152-4.

10. Friedman R. Strategies to Prevent Overweight and ObesityOpens in New Window. New Haven: Yale Rudd Center for Food Policy and Obesity; 2010.

11. American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. Preventing Childhood Obesity in Early Care and Education: Selected Standards from Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education ProgramsOpens in New Window; 2010.

12. Frieden TR, Dietz W, Collins J. Reducing childhood obesity through policy change: acting now to prevent obesity. Health Aff (Millwood)Opens in New Window. 2010;29:357-63.

13. National Association of County and City Health Officials. Statement of Policy: Comprehensive Obesity PreventionOpens in New Window; 2010.

14. Lee V, Mikkelsen L, Srikantharajah J, Cohen L. Promising Strategies for Creating Healthy Eating and Active Living EnvironmentsOpens in New Window. Oakland: Prevention Institute; 2008.

15. National Policy and Legal Analysis Network to Prevent Childhood Obesity. Model Wellness Policy Language for Water Access in SchoolsOpens in New Window. 2010.

Improving Food in the Neighborhood

fruit basket (fruit_basket.jpg)

Communities can use many strategies to make it easier for people to buy fresh, nutritious food close to home, school, and work. They can change zoning and give incentives to lure supermarkets and farmers’ markets to “food deserts,” or encourage corner stores to stock fruits and vegetables. They can even create “healthy food zones” near schools to ban the fast-food restaurants that so often tempt students to skip school meals.

It remains to be seen how effective many of these strategies will be at encouraging healthy food choices, and in turn, reducing obesity rates. It’s true that in the U.S., for example, millions of people do not live within easy access of a supermarket, and that living in a food desert is associated in some studies with a higher risk of obesity. But some studies have not found a relationship between supermarket access and obesity, and there’s no guarantee that building supermarkets will improve people’s diets: While supermarkets do offer vegetables, fruits, and other healthful foods and drinks, they also sell sugary sodas, salty chips, and other junk food—and making it easier for people to buy these unhealthy foods certainly won’t turn around the obesity epidemic. That’s why supermarkets and food marketers need to be partners in obesity prevention, and come up with innovative ways to make healthy foods more appealing—and more affordable. Other strategies to encourage consumption of healthy foods, such as taxing sugar-sweetened beverages and limiting food marketing to children, may have a greater impact on food choices.

Here is a summary of recommendations for improving the retail food environment in neighborhoods and communities, based on a review of expert guidance from the Centers for Disease Control and Prevention, the Institute of Medicine, the Robert Wood Johnson Foundation, the National Policy and Legal Analysis Network to Prevent Childhood Obesity, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.

On this page: Supermarket AccessFast Food and Food RetailingFarmers’ Markets and Community Gardens

Supermarket Access

Provide economic or other incentives to support development of supermarkets in food deserts(1,2,3,4,5,6,7,8,9,10,11,12,13)
Use zoning regulations to help supermarkets locate in underserved communities (3,4,7,12,13,14)
Ensure that public transportation routes and schedules maximize access to supermarkets (4,9,14,15)

Fast-Food Limits and Healthy Food Retailing

Limit the number of fast-food restaurants in a neighborhood through zoning restrictions(4,9,12,13,15,16)
Create buffer zones restricting fast food around schools and recreation areas, using zoning laws(4,9,13,16,17,18,19)
Encourage small store owners to offer fresh produce and healthier foods through financial or other incentives(2,4,5,6,7,9,10,15)
Encourage restaurants to reformulate menu items to provide healthier options (6,7,12,20)
Improve the mobile food vendor environment(7,10,12,16,18)

  • Limit mobile vending of unhealthy foods through legislation or health department regulations (12)
  • Limit mobile vending access to schools and recreation areas frequented by children (4,9,16,18)
  • Provide permits/incentives to healthy mobile vending carts (7,10,21)

Farmers’ Markets and Community Gardens

Tools for Promoting Farmers' Markets & Gardens (tools-for-promoting-farmers-markets-gardens.jpg)

Related Topics (related-topics.jpg)

Read the complete list of healthy food environment recommendations.

Increase access to farmers’ markets in low-income communities (2,4,5,6,7,9,10,13,15)

  • Use zoning/land use policies to create new space for farmers’ markets (4,7,10,12,13,15,16)
  • Provide government subsidies or create public/private partnerships to develop new farmers’ markets (6,7,12,15)
  • Provide financial support for marketing of and transportation to farmers’ markets (4,7,10,15)
Encourage farmers’ markets to accept electronic benefits from food assistance programs (Special Supplemental Nutrition Program for Women, Infants, and Children Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP))(2,4,5,6,7,9,10,12,15)
Increase farm-to-school and farm-to-institution programs (2,7,13,15)

  • Develop government procurement processes that support local farmers (7,15)
Promote community gardens through zoning policy and grants or other financial support (4,6,7,9,10,15)

Improving Food in the Neighborhood—Source List

1. Blue Cross and Blue Shield Association. Federal Policy Recommendations for Combating Childhood ObesityOpens in New Window. Chicago: Blue Cross and Blue Shield Association; 2010.

2. Centers for Disease Control and Prevention. The CDC Guide to Fruit & Vegetable Strategies to Increase Access, Availability, and ConsumptionOpens in New Window. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2010.

3. Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. MMWR Recomm RepOpens in New Window. 2009;58:1-26.

4. Institute of Medicine. Local government actions to prevent childhood obesityOpens in New Window. Washington, D.C.: National Academies Press; 2009.

5. Mulheron J, Vonasek K. Shaping a Healthier Generation: Successful state strategies to prevent childhood obesityOpens in New Window. Washington, D.C.: National Governors’ Association; 2009.

6. Lee V, Mikkelsen L, Srikantharajah J, Cohen L. Promising Strategies for Creating Healthy Eating and Active Living EnvironmentsOpens in New Window. Oakland: Prevention Institute; 2008.

7. Leadership for Health Communities. Action Strategies Toolkit: A Guide for local and state leaders working to create healthy communities and prevent childhood obesityOpens in New Window. Washington, D.C.: Robert Wood Johnson Foundation; 2009.

8. Friedman R. Strategies to Prevent Overweight and ObesityOpens in New Window. New Haven: Yale Rudd Center for Food Policy and Obesity; 2010.

9. U.S. Conference of Mayors. Mayors’ Guide to Fighting Childhood ObesityOpens in New Window. Washington, D.C.: U.S. Conference of Mayors; 2009.

10. White House Task Force on Childhood Obesity. Solving the Problem of Childhood Obesity within a Generation: White House Task Force on Childhood Obesity Report to the PresidentOpens in New Window: White House Task Force on Childhood Obesity; 2010.

11. National Association of County and City Health Officials. Statement of Policy: Comprehensive Obesity PreventionOpens in New Window; 2010.

12. American Academy of Pediatrics. Prevention and Treatment of Child Overweight and Obesity: Policy Opportunities ToolOpens in New Window. 2010. Accessed October 4, 2010.

13. Levi J, Segal, LM, St. Laurent, R, Kohn, D. F as in Fat 2011: How Obesity Threatens America’s FutureOpens in New Window. Washington, D.C.: Trust for America’s Health/Robert Wood Johnson Foundation; 2011.

14. National Policy and Legal Analysis Network to Prevent Childhood Obesity. Model Local Obesity Prevention ResolutionOpens in New Window. 2010.

15. Leadership for Health Communities. Improving Access to Healthy Foods: A guide for policy-makersOpens in New Window. Washington, D.C.: Robert Wood Johnson Foundation; 2007.

16. Frieden TR, Dietz W, Collins J. Reducing childhood obesity through policy change: acting now to prevent obesity. Health Aff (Millwood)Opens in New Window. 2010;29:357-63.

17. Center for Science in the Public Interest. Reducing Junk Food Marketing to Children: State and Local Policy Options for Advocates and Policy MakersOpens in New Window. Washington, D.C.: Center for Science in the Public Interest; 2010.

18. National Policy and Legal Analysis Network to Prevent Childhood Obesity. Model Healthy Food Zone OrdinanceOpens in New Window. 2009. Accessed February 6, 2012.

19. Leadership for Health Communities RWJF. Improving Access to Healthy Foods: A guide for policy-makersOpens in New Window. Washington, D.C.: Robert Wood Johnson Foundation; 2007.

20. National Policy and Legal Analysis Network to Prevent Childhood Obesity. Putting Health on the Menu: A Toolkit for Creating Healthy Restaurant ProgramsOpens in New Window. 2012. Accessed February 6, 2012.

21. National Policy and Legal Analysis Network to Prevent Childhood Obesity. Model Ordinance: Produce CartsOpens in New Window. 2010. Accessed February 6, 2012.

Food Marketing and Labeling

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The billions of dollars that the food industry spends on junk-food marketing each year influence what children eat—and what they pester their parents to buy. That’s why curbing junk-food marketing to children is an urgently needed strategy for obesity prevention. Also important is giving consumers more information about what’s really in their food, by standardizing nutrition labels and adding calorie information to restaurant menus. Changes in food marketing and labeling can make it easier for everyone to make better food choices, and may also nudge food producers to create healthier offerings. In the U.S., for example, after the Food and Drug Administration required manufacturers to start listing heart-harmful trans fats on the Nutrition Facts label in 2006, food makers and restaurants switched to using more healthful sources of fat. Since then, trans fat levels in the U.S. food supply have dropped, as have blood levels of trans fat. (Read more about trans fatsOpens in New Windowon The Nutrition Source website.)

Here is a summary of food marketing and labeling recommendations for obesity prevention,  based on a review of expert guidance from the Centers for Disease Control and Prevention, the World Health Organization, the Institute of Medicine, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.

On this page: Food Marketing to Children | Restaurant Marketing | Nutrition LabelingPublic Health Marketing

Food Marketing to Children

Tools for Improving Food Marketing and labeling (tools_for_improving_food_marketing_and_labeling.jpg)

Limit marketing of unhealthy foods and drinks to children on television and other electronic media(1,2,3,4,5,6,7,8,9,10,11)

  • Require food marketed to children to meet nutritional standards (1,2,3,4,5,6,7,8,9,10,11)
  • Limit the amount of time per hour of children’s programming that can include food marketing (1)
  • Encourage the food and restaurant industry to shift marketing efforts toward more healthful foods and beverages for children (12)
  • If voluntary efforts to improve the nutritional quality of foods marketed to children on television are not successful, enact federal legislation (12)
Restrict food product placement in television shows/movies, and restrict other forms of marketing to children, such as marketing agreements between entertainment brands and food brands (2,11,13)
Restrict food marketing in settings where children gather, such as parks and near schools(2,9,11,14,15,16,17,18)
Monitor compliance with and enforcement of child food marketing regulations at the national level (5,9,12,16)

Restaurant Marketing and Menu Labeling

Require restaurants to post calorie information on menus and menu boards (1,3,4,7,8,10,13,15,17,19,20,21)
Give restaurants incentives to offer healthier items, such as by creating promotional campaigns that highlight or recognize healthy restaurants or by offering other marketing support (1,15,17,20,21)
Set nutrition requirements for meals that include toys, giveaways, or other incentives aimed at children(10,11,13)

Nutrition Labeling

Standardize front-of-package health labeling(5,8,10,11,22,23)
Require more prominent calorie-per-serving labeling on food packaging (23)
Require additional information on food labeling, such as recommended daily limit on added sugar consumption or caffeine consumption (23)

Public Health Marketing

Social Marketing Resource (social-marketing.jpg)

Centers for Disease Control and Prevention: Gateway to Health Communication and Social Marketing PracticeOpens in New Window

Develop public service media and social marketing campaigns to promote healthy eating and drinking(1,3,4,12,17)
Develop counter-marketing campaigns, such as campaigns that highlight the negative health impact of sugar-sweetened beverages and other unhealthful foods(1,4,24)

Food Marketing and Labeling—Source List

1. American Academy of Pediatrics. Prevention and Treatment of Child Overweight and Obesity: Policy Opportunities ToolOpens in New Window. American Academy of Pediatrics, 2010. Accessed October 4, 2010.

2. American Heart Association. Policy Position Statement on Food Advertising and Marketing Practices to ChildrenOpens in New Window. Dallas: American Heart Association; 2008.

3. American Medical Association. Childhood Obesity: American Medical Association (AMA) policy and guidelinesOpens in New Window. Chicago: American Medical Association.

4. Frieden TR, Dietz W, Collins J. Reducing childhood obesity through policy change: acting now to prevent obesityOpens in New WindowHealth Aff (Millwood). 2010;29:357-63.

5. Hill D, Swinburn B, Johnson G, Harper T. Comprehensive Review of Food Labelling Law and Policy: Second submission from the Obesity Policy CoalitionOpens in New Window. Carlton, Victoria, Australia: Obesity Policy Coalition; 2010.

6. Obesity Policy Coalition. Obesity Prevention: Priorities for ActionOpens in New Window. Carlton, Victoria, Australia: Obesity Policy Coalition; 2007.

7. Lee V, Mikkelsen L, Srikantharajah J, Cohen L. Promising Strategies for Creating Healthy Eating and Active Living EnvironmentsOpens in New Window. Oakland: Prevention Institute; 2008.

8. Engelhard CL, Dorn S. Reducing Obesity: Policy strategies from the tobacco warsOpens in New Window. Washington, D.C.: Urban Institute; 2009.

9. World Health Organization. Set of recommendations on the marketing of foods and non-alcoholic beverages to children. In: Prevention and control of noncommunicable diseases: implementation of the global strategyOpens in New Window. Geneva: World Health Organization; November 2009.

10. White House Task Force on Childhood Obesity. Solving the Problem of Childhood Obesity within a Generation: White House Task Force on Childhood Obesity Report to the PresidentOpens in New Window: White House Task Force on Childhood Obesity; 2010.

11. Levi J, Segal LM, St. Laurent R, Kohn D. F as in Fat 2011: How Obesity Threatens America’s FutureOpens in New Window. Washington, D.C.: Trust for America’s Health/Robert Wood Johnson Foundation; 2011.

12. Institute of Medicine. Food Marketing to Children and Youth: Threat or Opportunity?Opens in New Window Washington, D.C.: National Academies Press; 2006.

13. Center for Science in the Public Interest. Reducing Junk Food Marketing to Children: State and Local Policy Options for Advocates and Policy MakersOpens in New Window. Washington, D.C.: Center for Science in the Public Interest; 2010.

14. Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. MMWR Recomm RepOpens in New Window. 2009;58:1-26.

15. Institute of Medicine. Local government actions to prevent childhood obesityOpens in New Window. Washington, D.C.: National Academy of Sciences Press; 2009.

16. Swinburn B, Baur L, Brownell K, et al. The Sydney Principles: guiding principles for achieving a substantial level of protection for children against the commercial promotion of food and beveragesOpens in New Window. London: International Obesity Taskforce; 2007.

17. Robert Wood Johnson Foundation. Action Strategies Toolkit: A Guide for local and state leaders working to create healthy communities and prevent childhood obesityOpens in New Window. Washington, D.C.: Robert Wood Johnson Foundation; 2009.

18. Friedman R. Strategies to Prevent Overweight and ObesityOpens in New Window. New Haven: Yale Rudd Center for Food Policy and Obesity; 2010.

19. American Heart Association. Policy Position Statement on Menu LabelingOpens in New Window. Dallas: American Heart Association; 2008.

20. Centers for Disease Control and Prevention. The CDC Guide to Strategies for Reducing the Consumption of Energy Dense FoodsOpens in New Window. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2010.

21. U.S. Conference of Mayors. Mayors’ Guide to Fighting Childhood ObesityOpens in New Window. Washington, D.C.: U.S. Conference of Mayors; 2009.

22. American Heart Association. Policy Position Statement on Food Package and Retail Shelf Icon SystemsOpens in New Window. Dallas: American Heart Association; 2009.

23. Center for Science in the Public Interest. Food Labeling Chaos: The Case for ReformOpens in New Window. Washington, D.C.; 2010.

24. Centers for Disease Control and Prevention. The CDC Guide to Strategies for Reducing the Consumption of Sugar-Sweetened BeveragesOpens in New Window; 2010.

Food Pricing, Taxes, and Agricultural Policy

soda bottle (soda_bottle.jpg)

The cost of food, high or low, influences what people buy and eat. Taxing sugary drinks could lead people to cut back on how much they drink, and could raise billions of dollars for obesity prevention programs. Repositioning priorities on agricultural subsidies—away from commodities that get processed into cheap, high-calorie food, and toward the fruits and vegetables that are lacking in most people’s diets—could make healthy foods more affordable. It’s a complex topic, and economists, farmers, and public health experts debate whether farm policies are indeed feeding the obesity epidemic. But it’s clear that we need to look at broad policy changes to transform our obesogenic food supply into one that promotes good health and a healthy weight.

Here is a brief summary of food pricing and agricultural subsidy-related recommendations for obesity prevention,  based on a review of expert guidance from the Centers for Disease Control and Prevention, the Institute of Medicine, the National Governors’ Association, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.

Food Pricing and Taxes

Tools for Food Pricing and Tax Policy (tools-for-food-pricing-tax-policy.jpg)

Tax foods of minimal nutritional value (“junk food”), to decrease consumption (1,2,3,4,5,6,7,8,9,10)

  • Tax sugar-sweetened beverages (1,2,3,5,6,7,8,9,10)
  • Tax other high-calorie, low-nutrient foods (1,4,6,7)
Earmark tax revenues from sugar-sweetened beverage taxes or other taxes for obesity prevention efforts(2,3,5,6)
Lower the relative cost of healthy foods through subsidies or other measures (6,7,8,11,12,13)

Agricultural Policy

Increase federal funding to support fruit and vegetable production, such as through changing the U.S. Farm Bill(see footnote) (1,2,13,14,15,16,17)

  • Remove fruit and vegetable planting restrictions in commodity food program (14,15,16)
  • Provide additional training, loans, research, and marketing support to fruit and vegetable farmers (13,14,15,16)
  • Increase preservation efforts for farmland devoted to fruit and vegetable production (13,14)
  • Develop a fruit and vegetable subsidy program (2,17)
Increase local support of production, processing, and distribution of locally grown fruits and vegetables(12,14,16,17)
Increase government procurement of locally grown fruits and vegetables (13,14,16)

 

* In addition to covering agricultural subsidies, the U.S. Farm Bill budget covers food assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP, formerly called Food Stamps) and the National School Lunch Program. Read more obesity prevention recommendations:  Food Assistance Programs | School Meal Programs

Food Pricing and Taxes and Agricultural Policy—Source List

1. American Academy of Pediatrics. Prevention and Treatment of Child Overweight and Obesity: Policy Opportunities ToolOpens in New Window. American Academy of Pediatrics, 2010. Accessed October 4, 2010.

2. Frieden TR, Dietz W, Collins J. Reducing childhood obesity through policy change: acting now to prevent obesity. Health Aff (Millwood)Opens in New Window. 2010;29:357-63.

3. Center for Science in the Public Interest. Reducing Junk Food Marketing to Children: State and Local Policy Options for Advocates and Policy MakersOpens in New Window. Washington, D.C.: Center for Science in the Public Interest; 2010.

4. Obesity Policy Coalition. Obesity Prevention: Priorities for ActionOpens in New Window. Carlton, Victoria, Australia: Obesity Policy Coalition; 2007.

5. Friedman R. Strategies to Prevent Overweight and ObesityOpens in New Window. New Haven: Yale Rudd Center for Food Policy and Obesity; 2010.

6. Engelhard CL, Dorn S. Reducing Obesity: Policy strategies from the tobacco warsOpens in New Window. Washington, D.C.: Urban Institute; 2009.

7. Levi J, Segal LM, St. Laurent R, Kohn D. F as in Fat 2011: How Obesity Threatens America’s FutureOpens in New Window. Washington, D.C.: Trust for America’s Health/Robert Wood Johnson Foundation; 2011.

8. Institute of Medicine. Local government actions to prevent childhood obesityOpens in New Window. Washington, D.C.: National Academy of Sciences Press; 2009.

9. Mulheron J, Vonasek K. Shaping a Healthier Generation: Successful state strategies to prevent childhood obesityOpens in New Window. Washington, D.C.: National Governors’ Association; 2009.

10. Antos J, Bertko J, Chernew M, et al. Bending the Curve: Effective steps to address long-term health care spending growthOpens in New Window. Washington, D.C.: The Brookings Institution; 2009.

11. Centers for Disease Control and Prevention. The CDC Guide to Fruit & Vegetable Strategies to Increase Access, Availability, and ConsumptionOpens in New Window. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2010.

12. Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. MMWR Recomm RepOpens in New Window. 2009;58:1-26.

13. Leadership for Health Communities. Improving Access to Healthy Foods: A guide for policy-makersOpens in New Window. Washington, D.C.: Robert Wood Johnson Foundation; 2007.

14. Krueger JE, Krub KR, Hayes LA. Planting the Seeds for Public Health: How the Farm Bill can help farmers to produce and distribute healthy foodsOpens in New Window. Saint Paul: Farmers’ Legal Action Group; 2010 February 2010.

15. Wallinga D. Agricultural policy and childhood obesity: a food systems and public health commentary.Health Aff (Millwood)Opens in New Window. 2010;29:405-10.

16. Lee V, Mikkelsen L, Srikantharajah J, Cohen L. Promising Strategies for Creating Healthy Eating and Active Living EnvironmentsOpens in New Window. Oakland: Prevention Institute; 2008.

17. White House Task Force on Childhood Obesity. Solving the Problem of Childhood Obesity within a Generation: White House Task Force on Childhood Obesity Report to the PresidentOpens in New Window: White House Task Force on Childhood Obesity; 2010.

Food Assistance Programs

SNAP logo (snap_logo.gif)

Food insecurity—living in a household that does not have consistent access to enough food for a healthy, active life—and obesity are increasingly seen as related problems. Food assistance programs can reduce hunger.  And in the U.S., the Supplemental Nutrition Assistance Program (SNAP, which was formerly called Food Stamps) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) help tens of millions of families put food on the table. SNAP benefits can be used for most anything in a supermarket (except for tobacco, alcohol, prepared foods, and vitamins), while WIC benefits can only be used for specific, nutritious foods. But questions have been raised as to whether food assistance programs are doing enough to help people obtain the most healthful foods and drinks.

Some proposed changes to food assistance programs have been highly controversial. In 2011, for example, the United States Department of Agriculture turned down New York City’s request to pilot test a ban on using food stamps for sugary drinks. There’s more support for using targeted subsidies or incentives for buying healthful foods, such as fruits and vegetables, and encouraging more local stores and farmers’ markets to accept food assistance program vouchers. Clearly, pilot studies are needed to explore different ways to improve the quality of foods purchased with food stamps, such as using the same nutrition criteria for food stamps as is used for the WIC program.

Here is a brief summary of recommendations for ways that food assistance programs can help prevent obesity. It’s based on a review of expert guidance from the Institute of Medicine, the Robert Wood Johnson Foundation, Trust for America’s Health, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.

Increase enrollment in WIC and SNAP, using existing government programs (such as Medicaid and the Children’s Health Insurance Program) (1,2)
Change SNAP and WIC guidelines to give people incentives to make healthier food choices (1,3,4,5,6,7)

  • Provide discounts or rebates for buying fruits and vegetables (5,3,6,7)
Identify and test improvements that would align SNAP purchases with 2010 Dietary Guidelines for Americans(7)
Study the impact of changing SNAP guidelines to prohibit benefits from being used to buy sugar-sweetened beverages, (8) or making other changes to improve the quality of foods purchased with SNAP (7)
Remove restrictions on the use of SNAP Education funds for materials or social marketing campaigns that discourage the consumption of unhealthy foods, such as sugar-sweetened beverages (5)
Increase WIC vouchers for fruit and vegetables (6,9)
Encourage farmers’ markets and small store owners to accept SNAP and WIC electronic benefit cards(2,3,9,10,11)
Focus on children’s nutrition by testing healthy food guidelines for children who receive SNAP benefits (7)
Create stronger healthy food stocking standards for SNAP retailers similar to those required of stores that participate in WIC (7)
Require the FDA to collect data on SNAP purchases that can be used to analyze the program’s effect on nutrition and health (7)
Improve nutrition guidelines for Child and Adult Care Food Program and Summer Food Service Program(12,13)
Increase supply of healthy foods (including produce) in food banks and other emergency food programs (9,14)

Food Assistance Programs—Source List

1. Blue Cross and Blue Shield Association. Federal Policy Recommendations for Combating Childhood ObesityOpens in New Window. Chicago: Blue Cross and Blue Shield Association; 2010.

2. Institute of Medicine. Local government actions to prevent childhood obesityOpens in New Window. Washington, D.C.: National Academy of Sciences Press; 2009.

3. Leadership for Healthy Communities. Improving Access to Healthy Foods: A Guide for Policy-MakersOpens in New Window. Washington, D.C.: Robert Wood Johnson Foundation; 2007.

4. Levi J, Segal LM, St. Laurent R, Kohn D. F as in Fat 2011: How Obesity Threatens America’s FutureOpens in New Window. Washington, D.C.: Trust for America’s Health/Robert Wood Johnson Foundation; 2011.

5. Shenkin JD, Jacobson MF. Using the Food Stamp Program and other methods to promote healthy diets for low-income consumers. Am J Public HealthOpens in New Window. 2010; 100:1562-4.

6. Frieden TR, Dietz W, Collins J. Reducing childhood obesity through policy change: acting now to prevent obesity. Health Aff (Millwood)Opens in New Window. 2010; 29:357-63.

7. Center for the Study of the Presidency and Congress. SNAP to Health: A Fresh Approach to Improving Nutrition in the Supplemental Nutrition Assistance ProgramOpens in New Window. Washington, D.C. 2012.

8. Brownell KD, Ludwig DS. The Supplemental Nutrition Assistance Program, soda, and USDA policy: who benefits? JAMAOpens in New Window. 2011;306:1370-1.

9. American Academy of Pediatrics. Prevention and Treatment of Child Overweight and Obesity: Policy Opportunities ToolOpens in New Window. 2010. Accessed February 7, 2012.

10. Centers for Disease Control and Prevention. The CDC Guide to Fruit & Vegetable Strategies to Increase Access, Availability, and ConsumptionOpens in New Window. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2010.

11. Levi J, Vinter S, St. Laurent R, Segal LM. F as in Fat: How Obesity Policies are Failing in AmericaOpens in New Window. Washington, D.C.: Trust for America’s Health; 2008.

12. Cutter C, Lou D, Donze Black J, et al. Child Nutrition Programs: Federal Options and OpportunitiesOpens in New Window. Little Rock: Robert Wood Johnson Foundation Center to Prevent Childhood Obesity; 2009.

13. U.S. Conference of Mayors. Mayors’ Guide to Fighting Childhood ObesityOpens in New Window. Washington, D.C.: U.S. Conference of Mayors; 2009.

14. Levi J, Vinter S, Richardson L, St. Laurent R, Segal L. F as in Fat: How Obesity Policies are Failing in AmericaOpens in New Window. Washington, D.C.: Trust for America’s Health; 2009.

Terms of Use

The aim of the Harvard School of Public Health Obesity Prevention Source Web site is to provide timely information about obesity’s global causes, consequences, prevention, and control, for the public, health and public health practitioners, business and community leaders, and policymakers. The contents of this Web site are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Web site. The Web site’s obesity prevention policy recommendations are based primarily on a review of U.S. expert guidance, unless otherwise indicated; in other countries, different policy approaches may be needed to achieve improvements in food and physical activity environments, so that healthy choices are easy choices, for all.

Terms of Use

The aim of the Harvard School of Public Health Obesity Prevention Source Web site is to provide timely information about obesity’s global causes, consequences, prevention, and control, for the public, health and public health practitioners, business and community leaders, and policymakers. The contents of this Web site are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Web site. The Web site’s obesity prevention policy recommendations are based primarily on a review of U.S. expert guidance, unless otherwise indicated; in other countries, different policy approaches may be needed to achieve improvements in food and physical activity environments, so that healthy choices are easy choices, for all.