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An Exploration of U.S. Nutritional Diet Policies: History
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Subjects: Political Science
Contributor: Ana Daniela Gonzalez-Alvarez , Asma Tahir Awan , Manoj Sharma

Background: Current food systems contribute significantly to poor public health and environmental degradation. With increasing rates of chronic disease and undernutrition globally and in the United States of America (U.S.), transforming food systems toward sustainability is a critical public health priority. Objectives: This narrative review aimed to summarize U.S. policies from the past decade relevant to sustainable food systems, focusing on four domains—availability, accessibility, affordability, and desirability—proposed by the 22nd Annual Harvard Nutrition Obesity Symposium. Methods: Systematic searches were conducted using MEDLINE (PubMed), Scopus, U.S. Congress websites, and Google searches. Studies and policies published between 2013 and 2023 that addressed at least one of the four domains were included. Policies were reviewed according to their alignment with the policy lifecycle framework, encompassing formulation through implementation. Results: A review of the final 632 articles explained that, despite growing interest in sustainable food systems, there is a lack of comprehensive U.S. policies that address the four domains in an integrated manner. Most initiatives were limited in scope, often school-based, and not explicitly sustainability-focused. Food availability and accessibility policies exist but remain fragmented, while affordability and desirability domains are severely underrepresented. Few laws or bills have been enacted or evaluated for population-level or environmental outcomes. Conclusions: Transforming U.S. food systems requires more robust evidence-based policy development and evaluation. There is an urgent need for integrated multisectoral policy frameworks to ensure health, equity, and sustainability across all food system domains.

  • sustainable food systems
  • food availability
  • food accessibility
  • food affordability
  • food desirability
  • policies
  • nutrition
  • healthy foods
Food systems impact diet, nutrition, and population health outcomes [1]. Around the world, more than two billion people are micronutrient-deficient, 151 million children are stunted, 51 million children are wasted, and over 820 million people worldwide continue to be undernourished [2]. At the same time, in the last 30 years, many countries have undergone the nutrition transition [3]. This means that, as the countries have become more urbanized and industrialized, their traditional eating patterns have changed to diets high in sugars, fats, sodium, and ultra-processed meats, accompanied by decreased physical activity [3]. This transition has led to approximately two billion adults becoming overweight or obese, and the prevalence of non-communicable diseases such as diabetes, cardiovascular diseases, and cancer has more than doubled in the last 30 years [2]. Chronic diseases account for more than 70% of the deaths worldwide [4]. According to the Centers for Disease Control and Prevention (CDC), 41.9% of American adults are overweight or obese [5]. Moreover, 60% of adults have one or more chronic diseases, which are the leading causes of death and disability in the United States [6]. In addition to the human health emergency, traditional food production practices, characterized by intensive farming methods and reliance on fossil fuels, have imposed significant strains on natural resources, including land, water, and biodiversity [7][8]. Moreover, these practices contribute substantially to more than 30% of greenhouse gas emissions, exacerbating climate change and threatening the stability of ecosystems worldwide [7][8].
Most researchers agree that the current food systems must be drastically changed to ensure food security and nutrition for the world’s growing population [2][9], which is expected to reach over 10 billion people by the year 2050 [10]. Food systems are defined as all elements and activities that intervene in the production, processing, distribution, preparation, and consumption of food [2]. Thus, the interconnectedness of food systems with the health of the planet and people’s health necessitates a paradigm shift towards more sustainable approaches to food production, distribution, and consumption. However, another element that needs to be considered is the price of healthy diets. The cost of obtaining a nutrient-rich diet exceeds the available income of three billion people worldwide [3]. Healthier diets are more expensive because they are more arduous to cultivate, store, and transport [3]. The high prices of healthier diets are associated with food insecurity and an increase in the burden of non-communicable diseases [3]. In 2022, more than 12% of households in the United States were food insecure, making it more challenging to have access to healthy food [11]. Additionally, the economic burden, physical access, and availability of fresh produce affect the capability of healthy eating [3].
Sustainable Healthy Diets are defined as dietary patterns that promote all dimensions of people’s health and well-being [12]. Food systems need to be changed to provide everyone with a sufficient, nutritious, desirable, and safe diet. They also need to reach the right levels of availability, accessibility, and affordability [2][3][7]. Simultaneously, these diets ought to come from resilient and sustainable food systems that support just and equal livelihoods and have a positive impact on the environment [2][3][7]. Promoting sustainable and healthy eating habits is a significant task for policymakers [7][9]. Sustainable nutrition policies serve as a crucial framework to address these multifaceted challenges, offering pathways to safeguard both the planet and human health for present and future generations. Sustainable nutrition policies advocate holistic approaches that prioritize environmental stewardship, promote regenerative agricultural practices, reduce food waste, and preserve biodiversity [13]. By embracing sustainable agriculture and resource-efficient food production systems, these policies aim to mitigate environmental degradation and build resilience to the impacts of climate change [14]. By fostering food environments that encourage the consumption of plant-based foods, whole grains, fruits, and vegetables, these policies have the potential to improve public health outcomes while simultaneously reducing the environmental footprint of food production and consumption [2][3]. This narrative review aimed to provide a comprehensive overview and summarize the existing United States evidence on policy initiatives related to sustainable diets and nutrition. This objective encompasses at least one aspect of the four domains of transformation necessary across food systems proposed by the 22nd Annual Harvard Nutrition Obesity Symposium.

This entry is adapted from the peer-reviewed paper 10.3390/encyclopedia5030114

References

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  2. Willett, W.; Rockström, J.; Loken, B.; Springmann, M.; Lang, T.; Vermeulen, S.; Garnett, T.; Tilman, D.; DeClerck, F.; Wood, A.; et al. Food in the Anthropocene: The EAT–Lancet Commission on healthy diets from sustainable food systems. Lancet 2019, 393, 447–492.
  3. Fanzo, J.; Rudie, C.; Sigman, I.; Grinspoon, S.; Benton, T.G.; Brown, M.E.; Covic, N.; Fitch, K.; Golden, C.D.; Grace, D.; et al. Sustainable food systems and nutrition in the 21st century: A report from the 22nd annual Harvard Nutrition Obesity Symposium. Am. J. Clin. Nutr. 2022, 115, 18–33.
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  8. Fras, Z.; Jakše, B.; Kreft, S.; Malek, Ž.; Kamin, T.; Tavčar, N.; Mis, N.F. The Activities of the Slovenian Strategic Council for Nutrition 2023/24 to Improve the Health of the Slovenian Population and the Sustainability of Food: A Narrative Review. Nutrients 2023, 15, 4390.
  9. Swinburn, B.A.; Kraak, V.I.; Allender, S.; Atkins, V.J.; Baker, P.I.; Bogard, J.R.; Brinsdenh, H.; Calvilloi, A.; Schutter, O.D.; Devarajan, R.; et al. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. Lancet Br. Ed. 2019, 393, 791–846.
  10. Food and Agriculture Organization of the United Nations (FAO). The Future of Food and Agriculture—Trends and Challenges. Available online: https://openknowledge.fao.org/server/api/core/bitstreams/2e90c833-8e84-46f2-a675-ea2d7afa4e24/content (accessed on 23 July 2025).
  11. US Department of Agriculture (USDA). Key Statistics & Graphics. Available online: https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/key-statistics-graphics/ (accessed on 13 February 2024).
  12. Food and Agriculture Organization of the United Nations (FAO). Sustainable Healthy Diets: Guiding principles. Available online: https://www.fao.org/documents/card/en/c/ca6640en (accessed on 14 February 2024).
  13. Grosso, G.; Mateo, A.; Rangelov, N.; Buzeti, T.; Birt, C. Nutrition in the context of the Sustainable Development Goals. Eur. J. Public Health 2020, 30, i19–i23.
  14. Mozaffarian, D.; Angell, S.Y.; Lang, T.; Rivera, J.A. Role of government policy in nutrition—Barriers to and opportunities for healthier eating. BMJ Online 2018, 361, k2426.
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