Table 1.

Description of policies and programs addressing nutrition security relevant to the review of the importance of nutrition security to CVD prevention efforts in the USA

Policy/program	Description
Federal, state, and local programs and policies
Child and Adult Care Food Program	State-administered program providing reimbursements for nutritious meals and snacks to enrolled child care centers, afterschool care programs, day care homes, and adult day care centers serving eligible children and adults (fns.usda.gov/cacfp).
Dietary Guidelines for Americans	Jointly published by the USDA and HHS every 5 years, the guidelines outline “the components of a healthy and nutritionally adequate diet to help promote health and prevent chronic disease” and are required to be based on the most current scientific and medical knowledge (dietaryguidelines.gov).
Families First Coronavirus Response Act	Legislation adopted in 2020 that augmented SNAP by suspending work requirements, allowing distribution of maximum benefits, and initiating the pandemic electronic benefits transfer program (congress.gov/116/plaws/publ127/PLAW-116publ127.htm).
Fruit and vegetable subsidies	Lower the cost of produce by providing the consumer with a voucher, coupon, or debit card to pay for produce.
Healthy, Hunger-Free Kids Act of 2010	Legislation in 2010 that required USDA school meals to include whole-grain-rich foods, more fruits and legumes, and a broader mix of vegetables (fns.usda.gov/cn/healthy-hunger-free-kids-act).
National Salt and Sugar Reduction Initiative	Established voluntary targets for sugar and salt reduction through a partnership of organizations and health authorities (nyc.gov/site/doh/health/health-topics/national-salt-sugar-reduction-initiative.page).
NSLP	Operated in public and nonprofit private schools and residential child care institutions, NSLP provides nutritionally balanced, low-cost or free lunches to children who qualify individually based on household income or who attend schools that qualify under the Community Eligibility Provision (fns.usda.gov/nslp, frac.org/community-eligibility).
Reformulation	Changing the nutrient profile of foods by targeting products high in the target nutrient (e.g., trans-fat, sodium) and setting product-specific reformulation goals [66].
SBP	Administered by the USDA and state education agencies, local school food authorities are reimbursed for providing nonprofit breakfast programs in schools and residential childcare institutions for free or at reduced price to eligible children (fns.usda.gov/sbp/school-breakfast-program).
WIC	Determined by Congress annually federal grants are provided to states which determine the type of benefit provided. This may include supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and children up to age 5 who have a qualifying dietary or medical condition putting them at nutritional risk (fns.usda.gov/wic).
Sugar-sweetened beverage taxation	Taxes on beverages (e.g., soda, juice, sweetened tea or coffee drinks, sports drinks, and energy drinks) may be applied directly to the consumer or to the distributor/wholesaler and passed on to the consumer.
SNAP	The largest federal food assistance program, SNAP provides monthly nutrition benefits to eligible low-income individuals and families via an electronic benefits card that can be used to purchase food at authorized retailers (fns.usda.gov/snap).
SNAP-Ed	Through federal grant funding, implementing agencies (e.g., state departments, universities) contract with state agencies to implement evidence-based programs that help participants lead healthy, active lives. (snaped.fns.usda.gov/)
Thrifty food plan	Updated annually and used to adjust the maximum monthly SNAP benefit that can be allotted, The thrifty food plan identifies the cost of groceries needed to provide a healthy, budget-conscious diet for a family of four (fns.usda.gov/snap/thriftyfoodplan).
Community-based programs
Food environment	Various aspects of the food system that interact with the physical and social environment (e.g., farms, retail locations, availability, marketing, store hours) [83].
Charitable food system	Food banks, food pantries, meal programs, and other community organizations that distribute food to those experiencing food insecurity at no cost [77].
Community garden	Spaces where community members can grow plants, fruits, and vegetables. Typically, a membership or plot fee apply (communitygarden.org/).
Community kitchen	Kitchen spaces owned by schools, churches, businesses, or other organizations that are opened for shared use for community-initiated cooking programs in which members can learn cooking skills and prepare meals (legalfoodhub.org/wp-content/uploads/2018/07/Community-Kitchens-Massachusetts-July-2018.pdf).
Community supported agriculture	Enables consumers to purchase a share of the goods, typically produce, produced from a farm, by becoming “members” [91].
Healthcare interventions
Food prescription programs	Typically vouchers for free or discounted healthy food are provided to patients through their health care provider for use at participating locations like retail stores or farmers’ markets [101•].
Medically tailored meals	Referred through their health care provider or health plan, patients with chronic illnesses (e.g., diabetes) typically receive meals delivered to patients’ homes that are designed by nutrition professionals to meet their dietary needs (fimcoalition.org/our-model).
Section 1115 demonstration waivers	Allow Centers for Medicare and Medicaid Services to waive certain provisions of the Medicaid Statute and provide federal funds to pay for services and services to populations that would not otherwise be covered. For example, some states have used these to fund produce prescriptions (medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations/index.html).
Teaching kitchens	Typically located in hospitals or community organizations, classes are offered for participants to learn how to prepare healthy meals, and funding is usually sourced from the government, sponsorships, philanthropy, or patient insurance or payment (teachingkitchens.org).

HHS, Health and Human Services; NSLP, National School Lunch Program; SBP, School Breakfast Program; SNAP, Supplemental Nutrition Assistance Program; SNAP-Ed, Supplemental Nutrition Assistance Program-Education; USDA, United States Department of Agriculture; WIC, The Special Supplemental Nutrition Program for Women, Infants, and Children