Skip to main content
SpringerLink
Log in

Why We Need Local, State, and National Policy-Based Approaches to Improve Children’s Nutrition in the United States

  • Chapter
  • First Online:
Pediatric Obesity

Part of the book series: Contemporary Endocrinology ((COE))

Abstract

Government agencies have the authority to improve public health through laws and policies. Childhood obesity is one of the most pressing health issues today, and government policies are a critical strategy to improve children’s nutrition and health. This chapter reviews evidence-based policies that can be implemented at local, state, and federal levels to improve children’s nutrition and weight. We discuss (a) why policy change may be more cost-effective and impactful than programs aimed at individuals; (b) how to strengthen federal child-feeding programs; and (c) which policies have potential to improve and change food industry practices.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Notes

  1. 1.

    Formerly, the Institute of Medicine

  2. 2.

    Updated CACFP meal patterns recommend serving only unflavored milk to all participants; however, if flavored milk is to be served to children 6 years and older, it should be limited to no more than 22g of sugar per 8 fl oz.

  3. 3.

    Dietary recommendations for children under age 2 will be included in the 2020 Dietary Guidelines for Americans.

  4. 4.

    The National School Breakfast Program began as a pilot program in 1966; it received permanent authorization as a nationwide program in 1975.

  5. 5.

    This NYC sodium warning label was permitted under the preemption law because it was marking a set of items that exceeded a limit, but not actually providing the number of mg of sodium in the item.

Abbreviations

AAP:

American Academy of Pediatrics

ACA:

The Patient Protection and Affordable Care Act

CACFP:

The Child and Adult Care Food Program

CFBAI:

The Children’s Food and Beverage Advertising Initiative

CHOICES:

The Childhood Obesity Intervention Cost-Effectiveness Study

CVV:

Cash-Value Vouchers

DGA:

Dietary Guidelines for Americans

F2S:

Farm to School

FDPIR:

The Food Distribution Program on Indian Reservations

FFVP:

Fresh Fruit and Vegetable Program

FMNP:

The Farmer’s Market Nutrition Program

FMNV:

Foods of Minimal Nutritional Value

FNS:

USDA Food and Nutrition Services

FPL:

Federal Poverty Limit

FTC:

The Federal Trade Commission

FY:

Fiscal Year

HHFKA:

The Healthy, Hunger-Free Kids Act of 2010

HUSSC:

Healthier U.S. School Challenge

LSWP:

Local School Wellness Policies

NSLP:

The National School Lunch Program

NSBP:

The National School Breakfast Program

QRIS:

Quality Rating and Improvement Systems

SFSP:

Summer Food Service Program

SNAP:

The Supplemental Nutrition Assistance Program

SNDA-III:

The 3rd School Nutrition Dietary Assessment study

TANF:

Temporary Assistance for Needy Families

TEFAP:

The Emergency Food Assistance Program

USDA:

U.S. Department of Agriculture

WIC:

The Special Suplemental Nutrition Program for Women, Infants, and Children

References

  1. IOM. Local government actions to prevent childhood obesity. Washington, DC: Institute of Medicine, National Academies Press; 2009.

    Google Scholar 

  2. Jeffery RW, Drewnowski A, Epstein LH, Stunkard AJ, Wilson GT, Wing RR, et al. Long-term maintenance of weight loss: current status. Health Psychol. 2000;19(1 Suppl):5–16.

    Article  CAS  PubMed  Google Scholar 

  3. Brennan LK, Brownson RC, Orleans CT. Childhood obesity policy research and practice: evidence for policy and environmental strategies. Am J Prev Med. 2014;46(1):e1–e16.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Dietz WH, Solomon LS, Pronk N, Ziegenhorn SK, Standish M, Longjohn MM, et al. An integrated framework for the prevention and treatment of obesity and its related chronic diseases. Health Aff (Millwood). 2015;34(9):1456–63.

    Article  Google Scholar 

  5. Brownell KD, Kersh R, Ludwig DS, Post RC, Puhl RM, Schwartz MB, et al. Personal responsibility and obesity: a constructive approach to a controversial issue. Health Aff (Millwood). 2010;29(3):379–87.

    Article  Google Scholar 

  6. Johnson EJ, Goldstein D. Medicine. Do defaults save lives? Science. 2003;302(5649):1338–9.

    Article  CAS  PubMed  Google Scholar 

  7. Falbe J, Rojas N, Grummon AH, Madsen KA. Higher retail prices of sugar-sweetened beverages 3 months after implementation of an excise tax in Berkeley, California. Am J Public Health. 2015;105(11):2194–201.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Colchero MA, Popkin BM, Rivera JA, Ng SW. Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study. BMJ. 2016;352:h6704.

    Article  PubMed  PubMed Central  Google Scholar 

  9. About WIC. 2016.; http://www.fns.usda.gov/wic/about-wic-wic-glance. Accessed 6 Sept 2016.

  10. Fox MK, Hamilton, W, Biing-Hwan L. Effects of food assistance and nutrition programs on nutrition and health: executive summary of the literature review. 2004; 19-3.

    Google Scholar 

  11. Cole N, Fox MK. Diet quality of American young children by WIC participation status: data from the National Health and Nutrition Examination Survey, 1999–2004. WIC-08-NH.

    Google Scholar 

  12. Ogden CL, Carroll MD, Lawman HG, Fryar CD, Kruszon-Moran D, Kit BK, et al. Trends in obesity prevalence among children and adolescents in the United States, 1988–1994 through 2013–2014. JAMA. 2016;315(21):2292–9.

    Article  CAS  PubMed  Google Scholar 

  13. Institute of Medicine. WIC Food Packages: Time for a Change. Washington, DC: National Academy of Sciences, 2005.; http://www.fns.usda.gov/sites/default/files/Time4AChange%28mainrpt%29.pdf.

  14. Food and Nutrition Service, Special Supplemental Nutrition Program for Women, Infants and Children (WIC): Revisions in the WIC Food Packages, 2014; Final Rule, 7 C.F.R 246.

    Google Scholar 

  15. Andreyeva T, Luedicke J. Federal food package revisions effects on purchases of whole-grain products. Am J Prev Med. 2013;45(4):422–9.

    Article  PubMed  Google Scholar 

  16. Andreyeva T, Luedicke J, Henderson KE, Schwartz MB. The positive effects of the revised milk and cheese allowances in the special supplemental nutrition program for women, infants, and children. J Acad Nutr Diet. 2014;114(4):622–30.

    Article  PubMed  Google Scholar 

  17. Andreyeva T, Luedicke J, Middleton AE, Long MW, Schwartz MB. Positive influence of the revised Special Supplemental Nutrition Program for Women, Infants, and Children food packages on access to healthy foods. J Acad Nutr Diet. 2012;112(6):850–8.

    Article  PubMed  Google Scholar 

  18. Zenk SN, Odoms-Young A, Powell LM, Campbell RT, Block D, Chavez N, et al. Fruit and vegetable availability and selection: federal food package revisions, 2009. Am J Prev Med. 2012;43(4):423–8.

    Article  PubMed  Google Scholar 

  19. WIC Farmer’s Market Nutrition Program. 2016. http://www.fns.usda.gov/sites/default/files/fmnp/WICFMNPFactSheet.pdf. Accessed 6 Sept 2016.

  20. FMNP and SFMNP Activity Map–June 2015. 2016. http://www.fns.usda.gov/sites/default/files/wic/S-FMNP-CVV_Map.pdf.

  21. Review of WIC Food Packages. 2017.; http://www.nationalacademies.org/hmd/Activities/Nutrition/ReviewWICFoodPackages.aspx. Accessed 29 Jan 2017.

  22. Murphy SP, Yaktine AL, Suitor CW, Moats S. Child and adult care food program: aligning dietary guidance for all. Committee to review child and adult care food program meal requirements. Food and Nutrition Board, Institute of Medicine of the National Academies, 2011. http://www.nap.edu/catalog.php.

  23. Child and Adult Care Food Program. 2016. http://www.fns.usda.gov/cacfp/child-and-adult-care-food-program. Accessed 11 Sept 2016.

  24. Food and Nutrition Service, Child and Adult Care Food Program: Meal Pattern Revisions Related to the Healthy, Hunger-Free Kids Act of 2010, 2016; Final Rule, 7 C.F.R. 210, 215, 220, 226.

    Google Scholar 

  25. U.S. Department of Agriculture. Scientific Report of the 2015 Dietary Guidelines Advisory Committee Report, 2015. https://health.gov/dietaryguidelines/2015-scientific-report/pdfs/scientific-report-of-the-2015-dietary-guidelines-advisory-committee.pdf.

  26. DeBoer MD, Scharf RJ, Demmer RT. Sugar-sweetened beverages and weight gain in 2- to 5-year-old children. Pediatrics. 2013;132(3):413–20.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Keller A, Bucher Della Torre S. Sugar-sweetened beverages and obesity among children and adolescents: a review of systematic literature reviews. Child Obes. 2015;11(4):338–46.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Taveras EM, Perkins M, Woo Baidal JA. Issue brief: The impact of the first 1,000 days on childhood obesity. 2016; 1089.

    Google Scholar 

  29. Kaphingst KM, Story M. Child care as an untapped setting for obesity prevention: state child care licensing regulations related to nutrition, physical activity, and media use for preschool-aged children in the United States. Prev Chronic Dis. 2009;6(1):A11.

    PubMed  Google Scholar 

  30. Shuell J. State quality rating and improvement systems. Strategies to support achievement of healthy eating and physical activity practices in early care and education settings. 2016; CAS020.

    Google Scholar 

  31. Health Impact Assessment: National Nutrition Standards for Snack and a la Carte Foods and Beverages Sold in Schools. The Pew Charitable Trusts. June 2012. http://www.pewtrusts.org/~/media/assets/2012/06/26/rev_hia_-full-final-web090712.pdf.

  32. Johnston LD, O’Malley PM, Terry-McElrath YM, Colabianchi N. School policies and practices to improve health and prevent obesity: national secondary school survey results: school years 2006–07 through 2010–11. Volume 3. 2013; 2016:1–42.

    Google Scholar 

  33. Fox MK, Condon E. School nutrition dietary assessment study-IV. Alexandria, VA: Food and Nutrition Service, USDA; 2012. http://www.fns.usda.gov/sites/default/files/SNDA-IV_Findings_0.pdf

    Google Scholar 

  34. School Meals, Healthy Hunger-Free Kids Act. 2016.; http://www.fns.usda.gov/school-meals/healthy-hunger-free-kids-act. Accessed 11 Sept 2016.

  35. National School Lunch Program: Participation and Lunches Served. 2016.; http://www.fns.usda.gov/sites/default/files/pd/slsummar.pdf. Accessed 11 Sept 2016.

  36. National School Breakfast Program: Participation and Meals Served. 2016.; http://www.fns.usda.gov/sites/default/files/pd/sbsummar.pdf. Accessed 11 Sept 2016.

  37. Gordon AR, Crepinsek MK, Briefel RR, Clark MA, Fox MK. The third School Nutrition Dietary Assessment Study: summary and implications. J Am Diet Assoc. 2009;109(2 Suppl):S129–35.

    Article  PubMed  Google Scholar 

  38. U.S. Department of Agriculture, Nutrition Standards in the National School Lunch and School Breakfast Programs, 2012; Final Rule, 7 C.F.R. 210, 220.

    Google Scholar 

  39. Johnson DB, Podrabsky M, Rocha A, Otten JJ. Effect of the healthy hunger-free kids act on the nutritional quality of meals selected by students and school lunch participation rates. JAMA Pediatr. 2016;170(1):e153918.

    Article  PubMed  Google Scholar 

  40. Schwartz MB, Henderson KE, Read M, Danna N, Ickovics JR. New school meal regulations increase fruit consumption and do not increase total plate waste. Child Obes. 2015;11(3):242–7.

    Article  PubMed  PubMed Central  Google Scholar 

  41. School Meal Certification Data. USDA. http://www.fns.usda.gov/school-meals/school-meal-certification-data. Accessed 23 Sept 2016.

  42. U.S. Department of Agriculture, National School Lunch Program and School Breakfast Program: Nutrition Standards for All Foods Sold in School as Required by the Healthy, Hunger-Free Kids Act of 2010; Interim Final Rule, 7 C.F.R. 210, 220.

    Google Scholar 

  43. Chriqui JF, Pickel M, Story M. Influence of school competitive food and beverage policies on obesity, consumption, and availability: a systematic review. JAMA Pediatr. 2014;168(3):279–86.

    Article  PubMed  Google Scholar 

  44. Taber DR, Chriqui JF, Chaloupka FJ. Differences in nutrient intake associated with state laws regarding fat, sugar, and caloric content of competitive foods. Arch Pediatr Adolesc Med. 2012;166(5):452–8.

    Article  PubMed  Google Scholar 

  45. Alaimo K, Oleksyk SC, Drzal NB, Golzynski DL, Lucarelli JF, Wen Y, et al. Effects of changes in lunch-time competitive foods, nutrition practices, and nutrition policies on low-income middle-school children’s diets. Child Obes. 2013;9(6):509–23.

    Google Scholar 

  46. Harris JL, Hyary M, Schwartz MB. Effects of offering look-alike products as smart snacks in schools. Child Obes. 2016;12(6):432–9.

    Article  PubMed  Google Scholar 

  47. Welker E, Lott M, Story M. The school food environment and obesity prevention: progress over the last decade. Curr Obes Rep. 2016;5(2):145–55.

    Article  PubMed  Google Scholar 

  48. Food Research and Action Center. Hunger doesn’t take a vacation: summer nutrition status report, 2016.; http://frac.org/pdf/2016_summer_nutrition_report.pdf.

  49. Trust for America’s Health. F as in Fat: How Obesity Policies are Failing in America, 2009 http://stateofobesity.org/files/fasinfat2009.pdf.

  50. Schwartz MB, Henderson KE, Falbe J, Novak SA, Wharton CM, Long MW, et al. Strength and comprehensiveness of district school wellness policies predict policy implementation at the school level. J Sch Health. 2012;82(6):262–7.

    Article  PubMed  Google Scholar 

  51. Nanney MS, MacLehose R, Kubik MY, Davey CS, Coombes B, Nelson TF. Recommended school policies are associated with student sugary drink and fruit and vegetable intake. Prev Med. 2014;62:179–81.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Lucarelli JF, Alaimo K, Belansky ES, Mang E, Miles R, Kelleher DK, et al. Little association between wellness policies and school-reported nutrition practices. Health Promot Pract. 2015;16(2):193–201.

    Article  PubMed  Google Scholar 

  53. Local School Wellness Policy Implementation Under the Healthy, Hunger-Free Kids Act of 2010: Summary of the Final Rule. 2016; FNS-627.

    Google Scholar 

  54. Nanney MS, Davey CS, Kubik MY. Rural disparities in the distribution of policies that support healthy eating in US secondary schools. J Acad Nutr Diet. 2013;113(8):1062–8.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Kehm R, Davey CS, Nanney MS. The role of family and community involvement in the development and implementation of school nutrition and physical activity policy. J Sch Health. 2015;85(2):90–9.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Nestle M. Food politics. Berkeley: University of California Press; 2003.

    Google Scholar 

  57. Farley TA, Caffarelli A, Bassett MT, Silver L, Frieden TR. New York City’s fight over calorie labeling. Health Aff (Millwood). 2009;28(6):w1098–109.

    Google Scholar 

  58. Center for Science in the Public Interest. State and Menu Labeling Policies. 2014; https://cspinet.org/new/pdf/ml_map.pdf. Accessed 24 Sept 2016.

  59. Menu Labeling Requirements. 2016.; http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm217762.htm. Accessed 24 Sept 2016.

  60. Jalonick MC. FDA punts calorie labels on menus for another year-again. U.S. News and World Report, March 28, 2016.; http://www.usnews.com/news/politics/articles/2016-03-28/looking-for-calorie-labels-on-menus-not-until-2017.

  61. Larson N, Story M. Menu labeling: does providing nutrition information at the point of purchase affect consumer behavior? [Internet]. 2009:1–11.

    Google Scholar 

  62. Dumanovsky T, Huang CY, Bassett MT, Silver LD. Consumer awareness of fast-food calorie information in New York City after implementation of a menu labeling regulation. Am J Public Health. 2010;100(12):2520–5.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Antman EM, Appel LJ, Balentine D, Johnson RK, Steffen LM, Miller EA, et al. Stakeholder discussion to reduce population-wide sodium intake and decrease sodium in the food supply. Circulation. 2014;129(25):e660–79.

    Article  PubMed  Google Scholar 

  64. NYC Health Sodium Initiative. 2016.; https://www1.nyc.gov/site/doh/health/health-topics/national-salt-reduction-initiative.page. Accessed 13 Sept 2016.

  65. Freifeld K. New York City can enforce rule on salt warnings in restaurants: court. Reuters, May 26, 2016.; http://www.reuters.com/article/us-health-new-york-salt-idUSKCN0YH2CF.

  66. Kraak VI, Story M. The use of brand Mascots and media characters: opportunities for responsible food marketing to children, 2016; 1082. Durham, NC: Health Eating Research. http://healthyeatingresearch.org/wp-content/uploads/2016/03/her_mascot_3-22_FINAL-1.pdf.

  67. Healthy Eating Research. Recommendations for responsible food marketing to children, 2015; 1084. http://healthyeatingresearch.org/wp-content/uploads/2015/01/HER_Food-Marketing-Recomm_1-2015.pdf.

  68. Harris JL, Pomeranz JL, Lobstein T, Brownell KD. A crisis in the marketplace: how food marketing contributes to childhood obesity and what can be done. Annu Rev Public Health. 2009;30:211–25.

    Article  PubMed  Google Scholar 

  69. Kelly B, Vandevijvere S, Freeman B, Jenkin G. New media but same old tricks: food marketing to children in the digital age. Curr Obes Rep. 2015;4(1):37–45.

    Article  PubMed  Google Scholar 

  70. Elsey JW, Harris JL. Trends in food and beverage television brand appearances viewed by children and adolescents from 2009 to 2014 in the USA. Public Health Nutr. 2016;19(11):1928–33.

    Article  PubMed  Google Scholar 

  71. Molnar A, Boninger F, Wilkinson G, Fogarty J. At sea in a marketing-saturated world: the eleventh annual report on schoolhouse commercialism trends: 2007–2008. 2008.

    Google Scholar 

  72. Infant and Toddler Marketing. University of Connecticut Rudd Center for Food Policy and Obesity. 2016. In Press.

    Google Scholar 

  73. CHOICES Project. 2015.; http://choicesproject.org/about/. Accessed 13 Sept 2016.

Download references

Author information

Authors and Affiliations

  1. Duke Global Health Institute, Duke University, Durham, NC, USA

    Megan Lott MPH, RD

  2. Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA

    Marlene Schwartz PhD

  3. Department of Community and Family Medicine and Global Health, Duke Global Health Institute, Duke University, Durham, NC, USA

    Mary Story PhD, RD

  4. Sanford School of Public Policy, Duke University, Durham, NC, USA

    Kelly D. Brownell PhD

Authors
  1. Megan Lott MPH, RD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marlene Schwartz PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mary Story PhD, RD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kelly D. Brownell PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Megan Lott MPH, RD .

Editor information

Editors and Affiliations

  1. Duke University School of Medicine , Durham, North Carolina, USA

    Michael S. Freemark

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Lott, M., Schwartz, M., Story, M., Brownell, K.D. (2018). Why We Need Local, State, and National Policy-Based Approaches to Improve Children’s Nutrition in the United States. In: Freemark, M. (eds) Pediatric Obesity. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-68192-4_42

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-68192-4_42

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-68191-7

  • Online ISBN: 978-3-319-68192-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation