Introduction
The choices we make every day about food and physical activity have a direct impact on our health, both in the short and long term, and are closely linked to our weight. Eating well and being active can lower the chances of getting heart disease, high blood pressure, diabetes, osteoporosis, some cancers, and being overweight or obese. These conditions affect people's lives and increase healthcare costs, which puts a strain on governments and businesses. Childhood is a critical time to build a strong base for healthy eating habits that last a lifetime. Preventing childhood obesity is key to having a healthier, more productive society.
The Current Food Environment
Several factors have changed the way we eat, including food and agriculture policies, population growth, and changes in our economy, society, and lifestyles. Food is now easily found in many places throughout the day. However, much of our food supply is made up of energy-dense foods that are high in refined grains, fats, and sugars but low in essential nutrients. These foods are often sold in large portions at low prices.
Americans are also eating out more often and consuming more calories away from home. Families are eating fewer meals together, and school environments now offer and promote high-calorie, low-nutrition foods. Food marketing aimed at children has greatly increased through digital media. Additionally, lower-income urban areas have seen an exodus of grocery stores and an influx of fast-food restaurants, creating disparities in access to healthier foods.
Defining Healthy Eating and Healthy Foods
Healthy eating means consuming the types and amounts of foods, nutrients, and calories recommended in the Dietary Guidelines for Americans. Healthy foods include fruits and vegetables with minimal added sugar, fat, or salt; fat-free or low-fat dairy products; whole grains; and lean meats. These foods are rich in health-promoting nutrients like fiber, vitamins, and minerals.
Calorie-dense, nutrient-poor foods, on the other hand, contribute few vitamins and minerals but are high in fat, sugar, and calories. These foods, such as sugary drinks, candy, and chips, can lead to excess calorie intake and weight gain, and they may replace more nutritious options.
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Creating a Supportive Environment
While individual food choices are important, the local food environment greatly influences what people eat. As Surgeon General David Satcher stated, people can only change their behavior if they have access to affordable, healthy food choices and opportunities for physical activity. Policies and practices that change the environment can help people make better food choices. A healthy eating environment ensures that families can access affordable healthy foods like fruits and vegetables, that healthy options are available in restaurants and public buildings, that lower-income community members are aware of and participate in federal nutrition programs, that women feel supported in breastfeeding, and that there are plenty of water fountains in public places.
Addressing Disparities in Access
In some neighborhoods, making the healthy choice is more difficult. Lower-income and minority communities often have higher rates of diet-related diseases, including obesity, due to inequalities in access to affordable, healthy food. These areas are less likely to have supermarkets and grocery stores that carry healthy foods compared to wealthier, predominantly white neighborhoods. Stores in lower-income areas are often smaller, with fewer healthy options like fruits, vegetables, low-fat dairy, and whole grains. Public transportation to supermarkets may also be lacking. Studies suggest that people who have better access to supermarkets and limited access to convenience stores tend to have healthier diets and lower rates of obesity. The abundance of fast-food restaurants serving high-calorie, high-fat meals at low prices exacerbates the problem in lower-income areas.
The Role of Local Governments
Local governments have a significant impact on people's health and well-being and can make positive changes to food environments. They can provide strategic leadership by improving access to healthy foods in lower-income areas, using zoning laws to shape local food environments, requiring menu labeling in restaurants, offering healthier foods at government facilities, developing infrastructure for obesity prevention policies, and communicating the importance of healthy eating. Local governments should create opportunities to change the community food environment and make the healthy choice the easy choice.
Local governments can increase access to healthy foods and decrease access to unhealthy foods. Strategies that reduce access to unhealthy foods may be more effective in reducing obesity than simply increasing access to healthy foods. For example, restricting sugar-sweetened beverages in after-school programs may have a greater impact on reducing calorie consumption and weight gain than opening a farmers' market once a week. Initiatives that strengthen community ties can also facilitate advocacy for policies that have a greater impact on healthy eating.
Strategies for Local Governments
The following strategies and action steps are recommended for local governments to promote healthy eating:
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1. Improve Access to and Consumption of Healthy, Safe, and Affordable Foods
- Increase the number of supermarkets and grocery stores in underserved areas: People need access to healthy foods to consume a healthy diet. Research shows that people who have better access to supermarkets and grocery stores tend to have healthier diets and lower rates of obesity. Residents of lower-income, minority, and rural neighborhoods are most likely to have poor access to supermarkets.
- Support farmers' markets and community gardens: Farmers' markets and community gardens provide access to fresh, locally grown produce.
- Promote the acceptance of SNAP benefits at farmers' markets: This makes healthy food more accessible to low-income individuals.
- Improve the availability of healthy foods in convenience stores: Convenience stores can play a role in providing access to healthy foods, especially in areas where supermarkets are limited.
- Encourage restaurants to offer healthier options: This can include offering smaller portion sizes, using healthier ingredients, and providing nutrition information.
2. Reduce Access to and Consumption of Calorie-Dense, Nutrient-Poor Foods
- Limit the availability of sugar-sweetened beverages in schools and community centers: Sugar-sweetened beverages contribute to excess calorie intake and weight gain.
- Regulate the placement of fast-food restaurants near schools: The availability of fast-food restaurants near schools can influence children's eating habits.
- Implement taxes on sugar-sweetened beverages: Taxes on sugar-sweetened beverages can discourage consumption and generate revenue for health programs.
- Restrict the marketing of unhealthy foods to children: Food marketing aimed at children can influence their food preferences and eating habits.
3. Raise Awareness About the Importance of Healthy Eating to Prevent Childhood Obesity
- Launch public awareness campaigns: These campaigns can educate people about the importance of healthy eating and provide tips for making healthy choices.
- Provide nutrition education in schools and community centers: Nutrition education can help people develop the knowledge and skills they need to make healthy food choices.
- Promote breastfeeding: Breastfeeding provides numerous health benefits for both mothers and infants.
- Encourage families to eat meals together: Eating meals together can promote healthier eating habits and strengthen family bonds.
State-Level Actions to Support Local Efforts
While local governments can implement many strategies to promote healthy eating, state governments also have a crucial role to play. State governments can:
- Tailor SNAP implementation: States can adapt SNAP to meet the unique needs of their populations.
- Empower localities: States can empower local governments to regulate food production, consumption, and distribution.
- Encourage food donation: States can enact regulations that encourage the safe donation of unused food.
- Provide incentives: States can provide loans or grants for supermarkets to establish businesses in underserved areas.
- Establish nutrition standards: States can establish minimum nutrition standards for food purchased or served on state property.
- Prioritize local food procurement: States can require state agencies to set local food procurement goals.
Food Policy Councils
Food policy councils (FPCs) are frequently used to facilitate change in food systems at the local, state, and regional levels. FPCs bring together representatives from various sectors to work across the food system to express their values, initiate collective action, coordinate programs, and identify and implement food policy priorities. Municipalities with FPCs have significantly higher odds of having policies supporting access to food retail stores, farmers markets, transportation supports, and objectives in community planning documents.
Menu Labeling
Requiring restaurants to include calorie counts on menus, along with the physical activity equivalents required to burn off a meal, is another effective option. Presenting calorie information in the form of a physical activity equivalent has been shown to reduce calorie consumption and lead to healthier choices. Another recommendation is that restaurants change their menu default options, such as replacing default fries and soda in a kid-friendly meal with apple slices and low-fat milk.
Healthy Food Purchasing Policies
Healthy Food Purchasing policies promote the health and well-being of people by expanding access to healthy choices on public property. These policies ensure that the food offered in public spaces is healthy by setting nutrition criteria for products served and sold in these locations. They can also advance health equity by prioritizing settings that primarily serve communities at higher risk of diet-related disease. Local governments can also leverage their food purchasing power to shift the food supply to be healthier, more sustainable, and more equitable.
Addressing Food Insecurity and Urban Affordability
City leaders can address food insecurity and urban affordability through creative solutions that recognize the link between food and civic participation. Community dining halls can provide affordable meals for urban residents while also building community and healthy nutrition practices. Food is not just something to be distributed â it also builds local connection, employment, solidarity, and community responsibility.
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