Table 2.
Dietary Policies Recently Adopted by US Local, Tribal, State and Federal Governments, and Proposed by the Federal Government a, for Improving Cardiometabolic Health.
| Diet Domains and Policies | Policy Case | Typeb | Level of Governmentc | Timed |
|---|---|---|---|---|
| Food Prices | ||||
| SSB taxe | Berkeley, California tax [117] | Law | Local | 2014 – |
| Philadelphia, Pennsylvania tax [106] | Law | Local | 2016 – | |
| San Francisco, California tax [118] | Law | Local | 2016 – | |
| Albany, California tax [119] | Law | Local | 2016 – | |
| Oakland, California tax [120] | Law | Local | 2016 – | |
| Boulder, Colorado tax [121] | Law | Local | 2016 – | |
| Cook County, Illinois tax [122] | Law | Local | 2016 – | |
| Seattle, Washington SSB tax [123] | Law | Local | 2017 – | |
| Navajo Nation Healthy Dine Act of 2014 [124] | Law | Tribal | 2014 – | |
| Federal bill H.R. 5279 Sweet Act [40] | Bill | Federal | 2013 | |
| Federal bill H.R. 1687 Sweet Act [41] | Bill | Federal | 2015 | |
| “Junk” food taxf | Navajo Nation Healthy Dine Act of 2014 [124] | Law | Tribal | 2014 – |
| Texas Tax Code 151.314 [125] | Law | State | 2013 – | |
| Maine law 36 MRS. 1811; 36 MRS. 1752 [126] | Law | State | 2016 – | |
| Healthy food subsidy | Navajo Nation Sales Tax (eliminating tax on fresh fruits, fresh vegetables, water, nuts, seeds and nut butters) [127] | Law | Tribal | 2014 – |
| Food Reformulation | ||||
| Trans-fat restrictiong | FDA Final Determination Regarding Partially Hydrogenated Oils [50] | Law | Federal | 2015 – |
| Sodium reformulation | New York City, NY, National Sodium Reduction Program Initiative [128] | Program | Local | 2009 – |
| FDA’s voluntary sodium reduction guidelines [22] | Guidelines | Federal | 2016 | |
| Food Marketing | ||||
| Healthy food MMCh | San Diego, CA “5-2-1-0” Campaign [129] | Program | Local | 2011 – |
| Los Angeles, CA “Choose Less Weigh Less” campaign [130] | Program | Local | 2011 – 2012 | |
| San Francisco, CA “Eat Fresh” campaign (SNAP Ed) [131] | Program | Local | 2013 – | |
| New York City, NY “Take me with you” Campaign [132] | Program | Local | 2014 – | |
| San Antonio, TX “Viva Health” Campaign [133] | Program | Local | 2017 – | |
| Arizona “Simple Goodness” campaign (SNAP Ed) [134] | Program | State | n/a | |
| California “Eat Fresh” campaign (SNAP Ed) [131] | Program | State | n/a | |
| Iowa low fat milk campaign (SNAP Ed) [135] | Program | State | n/a | |
| Maine “Healthy Weight Awareness” campaign (SNAP Ed) [136] | Program | State | 2002 – 2012 | |
| Wyoming “Cent$ible Nutrition Program” (SNAP Ed) [137] | Program | State | 2003 – | |
| Iowa “Pick a Better Snack” campaign (SNAP Ed) [138] | Program | State | 2011 | |
| Oregon “Food Hero” campaign (SNAP Ed) [139] | Program | State | 2011 | |
| Michigan “They Learn from Watching You” campaign (SNAP Ed) [140] | Program | State | 2012 | |
| Oklahoma “The Whole Milk Truth” campaign (SNAP Ed) [141] | Program | State | 2012 – 2014 | |
| South Dakota “Pick it! Try it! Like it!” campaign (SNAP Ed) [142] | Program | State | 2014 | |
| Rhode Island mass transit social marketing campaign (SNAP Ed) [143] | Program | State | 2016 | |
| Fruit and Veggies More Matters (formerly 5 a Day) [53] | Program | Federal | 2007 – | |
| Let’s Move! [54] | Program | Federal | 2010 – 2016 | |
| Unhealthy food MMCh | New York City, NY “Pouring on the Pounds” campaign [144] | Program | Local | 2009 |
| San Francisco, CA “Pouring on the Pounds” campaign [145] | Program | Local | 2010 | |
| Los Angeles, CA Choose Health LA Sugar Pack campaign [146] | Program | Local | 2011 – 2012 | |
| Philadelphia, PA “Food Fit Philly” campaign [147] | Program | Local | 2013 – | |
| New York City, NY “Drinking yourself sick” campaign [148] | Program | Local | 2013 – 2014 | |
| New York City, NY campaign highlighting the health risks of children consuming SSBs [149] | Program | Local | 2015 | |
| Baltimore, MD “Rethink Your Drink” campaign [150] | Program | Local | 2016 | |
| Nevada “Rethink Your Drink” campaign (SNAP Ed) [151] | Program | State | 2011 | |
| Marketing restriction | San Francisco, CA Health Food Incentives Ordinance [58] | Law | Local | 2011 – |
| Santa Clara, CA Ordinance No 300–820 Toys and other incentives with restaurant food [59] | Law | Local | 2010 – | |
| Maine ban of brand-specific advertising of certain unhealthy food and beverages on school grounds [55] | Law | State | 2007 – | |
| California A.B. 841: pupil nutrition: food and beverages: advertising: corporate incentive programs (Section 49431.9 in the Education Code) [57] | Law | State | 2017 – | |
| Local school wellness policy implementation under the Healthy, Hunger-Free Kids Act of 2010 [56] | Law | Federal | 2016 | |
| Interagency Working Group Principles [60] | Guidelines | Federal | 2012 | |
| Federal Bill H.R. 4310 - Deny tax deductions for food advertising and marketing directed at children [152] | Bill | Federal | 2010 | |
| Federal Bill H.R. 6599 - Stop subsidizing childhood obesity act [153] | Bill | Federal | 2012 | |
| Federal Bill S.B. 2342 - Stop subsidizing childhood obesity act [154] | Bill | Federal | 2013 | |
| Federal Bill. H.R. 2831 – Regarding tax subsidies and advertising to children [155] | Bill | Federal | 2013 | |
| Federal Bill S.B. 39 – HELP America Act [156] | Bill | Federal | 2013 | |
| Federal Bill H.R. 5232 – Stop subsidizing childhood obesity act [157] | Bill | Federal | 2016 | |
| Federal bill S.B. 2936 – Stop subsidizing childhood obesity act [158] | Bill | Federal | 2016 | |
| Food Labeling | Federal Bill H.R. 3147 Food Labeling Modernization Act of 2013 [159] | Bill | Federal | 2013 |
| FOP labeling | Federal Bill S.B. 1653 Food Labeling Modernization Act of 2013 [160] | Bill | Federal | 2013 |
| Federal Bill H.R. 4061 Food Labeling Modernization Act of 2015 [161] | Bill | Federal | 2015 | |
| Federal Bill S.B. 2301 Food Labeling Modernization Act of 2015 [162] | Bill | Federal | 2015 | |
| Nutrition Facts Panel | Nutrition Facts Panel (mandated by the Nutrition Labeling and Education Act of 1990) [19] | Law | Federal | 1990i |
| Menu labelingj | Nutrition Labeling of Standard Menu Items (section 4205 of the Patient Protection and Affordable Care Act of 2010) [18] | Law | National | 2010 – |
| Health warning label | New York City, NY sodium warning rule (Article 81 of the New York City Health Code) [163] | Law | Local | 2015 – |
| San Francisco, CA Ordinance Sugar-sweetened beverage warning for advertisements (No. 100–15 Health Code) [164] | Law | Local | 2015k | |
| Improvements to Government Food Assistance Programs | ||||
| SNAP/WIC subsidyl | New York City, NY Health Bucks program [165] | Program | Local | 2005 – |
| Boston, MA Bounty Bucks program [166] | Program | Local | 2008 – 2016 | |
| Philadelphia, PA Philly Food Bucks program [167] | Program | Local | 2010 – | |
| Yolo, CA Bonus Bucks program [168] | Program | Local | 2015 – | |
| Aurora, IL Bonus Value Tokens program [169] | Program | Local | 2015 – | |
| Guilford, NC Double Bucks program [170] | Program | Local | 2015 – | |
| Madison & Dane County, WI SNAP subsidy program [171] | Program | Local | 2016 – | |
| Massachusetts Healthy Incentive Program [172] | Program | State | 2015 – | |
| Washington Veggie RX program [173] | Program | State | 2015 – | |
| Vermont produce prescription project [174] | Program | State | 2016 – | |
| WIC Farmers’ Market Nutrition Program [68] | Program | Federal | 1992 – | |
| Senior Farmers’ Market Nutrition Program [67] | Program | Federal | 2007 – | |
| WIC Cash Value Voucher [175] | Program | Federal | 2007 – | |
| Healthy Incentives Pilot [69] | Program | Federal | 2011 – 2012 | |
| Federal bill H.R. 3072 – Local Food for Healthy Families Act of 2013 [176] | Bill | Federal | 2013 | |
| Federal bill H.R. 4904 - Vegetables Are Really Important Eating Tool for You (VARIETY) Act of 2014 [177] | Bill | Federal | 2014 | |
| Food Insecurity Nutrition Incentive (FINI) Grant Program [21] | Program | Federal | 2015 – | |
| Federal bill H.R. 5423 - SNAP Healthy Incentives Act of 2016 [178] | Bill | Federal | 2016 | |
| SNAP restriction | Senate Amendment 1152 to S. 954 (amendment to the farm bill to allow for demonstration projects [179] | Bill | Federal | 2011 |
| Senate Amendment 2235 to S. 3240 (amendment to the farm bill to allow for pilot projects) [ 180] | Bill | Federal | 2012 | |
| Federal bill H.R. 3073 - Healthy Food Choices Act of 2013 [181] | Bill | Federal | 2013 | |
| Federal bill H.R. 4881 - Healthy Food Choices Act of 2016 [182] | Bill | Federal | 2016 |
See recent policies proposed by local and state governments to improve cardiometabolic health in Resource 2 and Resource 3.
The type of policy case indicates its legislative status: laws are enacted; bills and guidelines are proposed. Programs are implemented.
Refers to the level of US government that initiated the policy/program, including local, state and federal, and not necessarily the geographic area the policy/program targets. For instance, the National Sodium Reduction Initiative was led by a local government (NYC), but was designed as a program and collaborated with other state and local agencies to encourage reformulation nationwide.
For laws, time indicates the year the law was enacted; for bills, the year the bill was proposed; for programs, the year the program was implemented; and for government-led voluntary guidelines, the year they were proposed. Dash (–) indicates that a law or program is ongoing.
In addition to these new SSB taxes, 34 US states and the District of Columbia also tax SSBs as part of their general sales tax and 7 states have excise tax on SSBs for revenue purposes (the majority of which were enacted before 2010) [38].
In addition to these laws, 12 states have broad taxes on food (which would additionally include “junk” food). We did not include these laws given these taxes do not specifically target unhealthy food [39].
We did not search for local and state trans-fat laws as the FDA’s ban on partially hydrogenated oil rendered any prior local and state trans-fat policies irrelevant.
Supplement Nutrition Assistance Program Education (SNAP Ed) is the nutrition promotion and obesity prevention component of SNAP.
The Nutrition Facts Panel was mandated by law in 1990; important revisions were issued in 2003 (trans-fat labeling) [47] and 2016 (disclosure of added sugar content, Daily Value update, serving size change, new format design, among other changes).
We did not search for state menu labeling bills as the federal menu labeling law preempts state and local menu labeling laws (that apply to the same restaurants and are not identical to federal law).
The warning label ordinance was passed in 2015, but was recently blocked by the 9th Circuit Court of Appeals from implementation [66].
Food Insecurity Nutrition Incentive (FINI) Grant Program has awarded grants to numerous nonprofits and state/local governments to implement SNAP subsidy programs. In this table, we only included programs where the grant was awarded to state/local governments.