Key points
- Healthy eating patterns help people live longer, strengthen their immune systems, and have fewer chronic diseases.
- To increase access to healthy food and beverages, states and communities can promote food service and nutrition guidelines.
- These guidelines can be used where food is sold, served, or distributed.
Background
Healthy eating patterns help people live longer, strengthen their immune systems, and have fewer chronic diseases. However, many people have limited access to affordable, convenient places that offer healthier foods. This may include people living in lower-income urban neighborhoods, rural areas, and tribal communities, as well some racial and ethnic groups. In 2021, nearly 34 million U.S. residents lived in food insecure households.
Healthy eating emphasizes fruits, vegetables, whole grains, low-fat or fat-free dairy, and lean protein. Healthy eating also limits added sugar, saturated fat, and sodium.
However, in 2019, only about 1 in 10 US adults met recommendations for fruit and vegetable intake. Among adolescents, 7% met the recommendation for fruits, while only 2% met the recommendation for vegetables.
In addition, federal guidelines recommend that Americans 2 years and older keep their intake of added sugars to less than 10% of their total daily calories. That means that in a 2,000-calorie diet, no more than 200 calories—about 12 teaspoons—should come from added sugars. Yet in 2017–2018, the average intake of added sugars was 17 teaspoons for children and adults.
When healthy items are not readily available, people may settle for unhealthy foods. States and communities can increase access to healthy foods in a variety of ways. Applying food service or nutrition guidelines can improve healthy food choices where foods and beverages are sold, served, and distributed.
The Food Service Guidelines for Federal Facilities (federal food service guidelines) can be used in worksites and community settings. The Healthy Eating Research Nutrition Guidelines for the Charitable Food System (HER guidelines) can be used in food banks and pantries.
Potential state activities
Tip
On this page:
* Indicates short-term activities that may be accomplished in 1 to 2 years.
+ Indicates activities that may take up to 5 years, depending on the organization's capacity, previous work in this area, and size of the project.
Support the development, adoption, and application of state-wide policies that apply federal food service guidelines or HER guidelines in statewide food service or food distribution operations and procurement mechanisms. +
- New and existing partners from state sectors and organizations may convene to help plan, write, and incorporate these policies into statewide systems.
- Sectors may include state hospital associations, state park services, state university partners, aging services, correctional institutions, or state food bank associations.
- Organizations may include food policy councils, anti-hunger coalitions, or equity task forces.
Include all four domains of the federal food service guidelines in statewide policies and implementation of food service guidelines:
- Food and nutrition
- Facility efficiency, environmental support, and community development
- Food safety
- Behavioral design
Potential state and local activities
With partners, complete a food security, health equity, or community needs assessment in relation to food and nutrition to prioritize populations, settings, and programs.*
Develop or revise (if needed) food service or charitable food distribution policies and contracts in community institutions. Such settings include hospitals, state government worksites, colleges and universities, food banks and pantries, or parks and recreation centers. The policies should align with the federal food service guidelines or the HER guidelines (Healthy Eating Research).
Assess the cultural food preferences of your priority population. Incorporate findings into food service and charitable food distribution guidelines, policies, and practices.*
Develop or refine emergency management plans, such as preparedness, relief/response, and recovery. Work with state or local officials to ensure equitable access to foods and beverages that meet food service guidelines. Make sure to address training needs in your plans.+
Monitor and evaluate food service guidelines and charitable food policies and programs to track progress, determine future needs, and improve program sustainability. As needed, provide training or technical assistance to others making baseline assessments or monitoring progress.+
Create or expand a culturally appropriate communication campaign to priority communities or populations to promote healthier food and beverages. Topics may include increasing the consumption of fruits, vegetables, and whole grains and reducing added sugars.*
Potential local activities
Support development, adoption, and application of municipal- and facility-level food service guidelines policies and procurement practices. Encourage the development of organizational policies and contracts in other institutional settings, including charitable food settings.+
Work on food procurement, food distribution, and other food systems efforts where food service guidelines are not feasible.+
Form a food service guidelines team to plan and apply food service guidelines at the municipal or organizational level. Include representatives from various functional areas (such as leaders, food service vendors, or nutrition experts) and cultures. Also include customers or clients who have experienced limited access to affordable, healthy foods.*
Provide technical assistance to organizations or external institutions to help them their guidelines with the federal food service guidelines or the HER guidelines.*
Train food service staff to use healthy food service practices. These include appropriate portion sizes, healthier entrée recipes, healthier cooking methods, promotion of healthier items, and tracking of sales and procurement of healthier items.*
Train staff and volunteers at food banks, food pantries, faith-based organizations, or other food distribution networks to ensure best practices are followed. This includes implementing nutrition standards for foods purchased or accepted through donations. Use inventory tracking and ordering systems and evaluate the quality and cultural desirability of foods.*
Working together
Philadelphia Hospitals Offer Healthier Options with Good Food, Healthy Hospitals
Good Food Healthy Hospitals invited hospitals to adopt standards in at least one of five hospital food environments: purchased food and beverages, cafeteria meals, patient meals, catering, and vending machines. After 1 year in action, two hospitals saw an increase in sales in healthy items.
2019 Food Service Guidelines Local Action Institute
Provides examples of success from Multnomah County, Oregon; Erie County, New York; and the University of Pittsburgh when healthier food service and procurement practices were applied in various settings.
Resources
Food Service Guidelines for Federal Facilities
Voluntary best business practices to increase healthy and safe food options for employees and visitors in worksite and community settings. Use the guidelines to make cafeterias and other food service venues healthier, safer, more sustainable, and easier to select healthier foods and beverages.
Food Service Guidelines Implementation Toolkit
In-depth guidance on using building blocks to implement food service guidelines. Useful features of this key resource include:
- Sample language for policies and contracts
- Guidance for considering cultural food preferences
- Food Service Guidelines Calculator for Packaged Snacks and Beverages
Healthy Eating Research Nutrition Guidelines for the Charitable Food System
Provides specific, evidence-based nutritional guidance tailored for the charitable food system.
Supporting Wellness at Pantries (SWAP) Resources
Tips for applying the SWAP ranking system for food banks and pantries.
Healthier Food Donation Guidelines for Retailers and Distributors
How to donate nutritious foods and beverages to food banks, food pantries, and other charitable food networks. Provides practical tips on identifying and tracking items for donation.
What is the Evidence for State and Local Laws Addressing Sodium Reduction among the US Adult Population?
Assesses the strength and quality of six policy interventions to reduce sodium consumption among adults.
Behavioral Design Tools
Contains an evidence review, sample diagrams, and electronic checklists of behavioral design strategies to facilitate healthier food purchases. Use the checklists below to record if suggested strategies are already in use, planned for implementation, or may be considered in the future.
Infant and Young Child Feeding in Emergencies Toolkit
Helps emergency preparedness and response personnel, families, and the public ensure that children are fed safely when disaster strikes.
Cultural Food Preferences in Food Service
Considerations when seeking to offer cultural foods in food service. Covers topics such as how to decide which foods to offer, how to communicate with vendors, and how to use policies and contracts to ensure these foods are available.
Johns Hopkins Center for a Livable Future's Food Policy Networks
A comprehensive online directory of US food policy councils.
Resources for fruit and vegetable voucher incentives and produce prescriptions.
Cross-cutting areas
Communication tips to support program efforts.
Evaluation framework for making evaluations useful, feasible, ethical, accurate, and culturally responsive.
Health equity tools to help remove barriers to health.
Definitions
Behavioral design uses cognitive, emotional, behavioral, and informational strategies to create food environments that support healthier choices. It modifies the way foods and beverages are prepared, placed, presented, promoted, and/or priced. In addition, behavioral design optimizes building and facility design, construction, and management to improve the overall experience.
Facility efficiency, environmental support, and community development are food service facility and management practices that:
- Maximize cost-effectiveness (such as purchasing in bulk and using energy-efficient equipment).
- Reduce harmful effects on the environment (such as using waste diversion practices and purchasing compostable or biobased products).
- Aid the local economy (such as sourcing locally produced foods and supporting the local work force).
Nutrition guidelines for charitable food systems are used in settings such as food banks and food pantries to ensure that people with food insecurity have nutritious food offerings. The HER guidelines are recommended for these types of settings. For charitable meal distribution programs, food service guidelines can be adapted to meet consumer needs.
Food and nutrition security refers to "having reliable access to enough high-quality food to avoid hunger and stay healthy."
Food service guidelines are specific standards for healthier food and beverages and food service operations used in venues such as cafeterias, cafés, grills, snack bars, concession stands, micro markets, and vending machines. The venues can be in worksites, such as hospitals, colleges and universities, private workplaces, and state, local, or tribal government facilities. Venues can also be in community settings, such as parks, recreational centers, and stadiums.
Food service guidelines do not apply to food served to children in childcare or school settings that are governed by federal laws and regulations, including the National School Lunch Program, the School Breakfast Program, the Child and Adult Care Food Program, and the Summer Food Service Program.
Food Service Guidelines for Federal Facilities was developed to improve food service at federal facilities but can be used as a model in public and private settings in a state or community. It is one of the most comprehensive sets of food service guidelines available. It contains standards for food and nutrition; facility efficiency, environmental support, and community development; food safety; and behavioral design. The food and nutrition standards align with the 2020-2025 Dietary Guidelines for Americans.
Healthy food procurement is purchasing foods and beverages that align with food service guidelines/nutrition standards. Procurement may be through statewide or acquisition mechanisms, such as bulk food contracts, which maximize the collective purchasing power of state, local, tribal, and community-based institutions.
Additional priority strategies
Breastfeeding Continuity of Care
Increasing Physical Activity Through Community Design
Early Care and Education (ECE) Policies and Activities