Purpose of review In 2020, obesity prevalence among US children reached 19.7%, impacting about 14.7 million children and adolescents. Food insecurity among children is also a public health concern but has largely decreased or remained stable over the past decade, reaching 6.2% of US households with children in 2021. Given food insecurity and obesity's interconnected nature and their negative consequences on children's health, it is of interest to assess the Supplemental Nutrition Assistance Program's (SNAP's) impact on childhood food security, dietary quality, disease risk, and health outcomes. Recent findings Evidence suggests that SNAP participants, including children, struggle to meet key dietary guidelines and perform poorly on key health indicators when compared with income-eligible and higher income nonparticipants. Children participating in SNAP were more likely to have elevated disease risk and consume more sugar-sweetened beverages (SSBs), more high-fat dairy, and more processed meats than income-eligible nonparticipants. However, research suggests that federal food assistance programs with more stringent nutrition standards – the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the National School Lunch Program (NSLP) and School Breakfast Program (SBP) – improve dietary quality, increase birth weight and gestation periods, and reduce childhood obesity, infant mortality and healthcare costs. Summary After reviewing the evidence on SNAP's impacts on food insecurity, dietary quality, and health as well as research on the health impacts of other more successful federal food assistance programs, we provide three policy recommendations to strengthen SNAP's effectiveness as a health intervention for children and families.

Objectives. To assess stakeholder perceptions of the impact and feasibility of 21 national, state, and local nutrition policies for cancer prevention across 5 domains in the United States.Methods. We conducted an online survey from October through December 2018. Participants were invited to take the survey via direct e-mail contact or an organizational e-newsletter.Results. Federal or state Medicare/Medicaid coverage of nutrition counseling and federal or state subsidies on fruits, vegetables, and whole grains for participants in the Supplemental Nutrition Assistance Program were the policies rated as having the highest perceived impact and feasibility. Overall, the 170 respondents rated policy impact higher than policy feasibility. Polices at the federal or state level had a higher perceived impact, whereas local policies had higher perceived feasibility.Conclusions. Our findings might guide future research and advocacy that can ultimately motivate and target policy actions to reduce cancer burdens and disparities in the United States.

BACKGROUND:The US faces remarkable food and nutrition challenges. A new federal effort to strengthen and coordinate nutrition research could rapidly generate the evidence base needed to address these multiple national challenges. However, the relevant characteristics of such an effort have been uncertain.OBJECTIVES:Our aim was to provide an objective, informative summary of 1) the mounting diet-related health burdens facing our nation and corresponding economic, health equity, national security, and sustainability implications; 2) the current federal nutrition research landscape and existing mechanisms for its coordination; 3) the opportunities for and potential impact of new fundamental, clinical, public health, food and agricultural, and translational scientific discoveries; and 4) the various options for further strengthening and coordinating federal nutrition research, including corresponding advantages, disadvantages, and potential executive and legislative considerations.METHODS:We reviewed government and other published documents on federal nutrition research; held various discussions with expert groups, advocacy organizations, and scientific societies; and held in-person or phone meetings with >50 federal staff in executive and legislative roles, as well as with a variety of other stakeholders in academic, industry, and nongovernment organizations.RESULTS:Stark national nutrition challenges were identified. More Americans are sick than are healthy, largely from rising diet-related illnesses. These conditions create tremendous strains on productivity, health care costs, health disparities, government budgets, US economic competitiveness, and military readiness. The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system. More than 10 federal departments and agencies currently invest in critical nutrition research, yet with relatively flat investments over several decades. Coordination also remains suboptimal, documented by multiple governmental reports over 50 years. Greater harmonization and expansion of federal investment in nutrition science, not a silo-ing or rearrangement of existing investments, has tremendous potential to generate new discoveries to improve and sustain the health of all Americans. Two identified key strategies to achieve this were as follows: 1) a new authority for robust cross-governmental coordination of nutrition research and other nutrition-related policy and 2) strengthened authority, investment, and coordination for nutrition research within the NIH. These strategies were found to be complementary, together catalyzing important new science, partnerships, coordination, and returns on investment. Additional complementary actions to accelerate federal nutrition research were identified at the USDA.CONCLUSIONS:The need and opportunities for strengthened federal nutrition research are clear, with specific identified options to help create the new leadership, strategic planning, coordination, and investment the nation requires to address the multiple nutrition-related challenges and grasp the opportunities before us.

This study aimed to assess expert stakeholder perceptions on the impact and feasibility of 21 national, state, and local nutrition policies for cancer prevention in the US. We distributed a survey to members of professional groups in the field of nutrition, cancer prevention, and public policy through direct email contact, organizational email/e-newsletter, and listservs. The survey asked participants to rank the health impact and political feasibility of 21 nutrition policies across 5 domains: (a) taxes/subsidies, (b) labeling, (c) nutrition standards, (d) nutrition education, and (e) nutrition promotion in healthcare, based on a Likert scale (1 = least; 5 = most impactful or feasible). We compared the impact and feasibility scores for each policy and by levels of implementation (federal, state, or local). A total of 170 respondents provided complete responses, representing civil service employees (n = 92, 54.1%), employees of advocacy groups (n = 31, 18.2%), researchers (n = 19, 11.2%), healthcare professionals (n = 18, 10.6%), and others (n = 10, 5.9%). For perceived impact, policies with the highest impact scores were Medicare/Medicaid coverage of nutrition counseling for people with chronic conditions at the federal and state levels (mean ± SE: 4.25 ± 0.10); and policy with the lowest impact score was local tax on processed meat (2.90 ± 0.13). For perceived feasibility, policy with the highest feasibility score was federal subsidies on fruits, vegetables, and whole grains in Medicare/Medicaid (4.13 ± 0.09); and policy with the lowest feasibility score was federal tax on processed meat (1.86 ± 0.10). When the impact and feasibility were evaluated jointly, Medicare/Medicaid subsidies for fruits, vegetables, and whole grains and coverage of nutrition counseling received the highest scores, whereas taxes on processed meats or junk food received the lowest scores. Based on expert stakeholder perceptions, specific federal, state, and local government nutrition policies for cancer prevention have varying health impact and potential feasibility. Providing food subsidies and nutrition counseling in Medicare/Medicaid were considered the most jointly impactful and feasible, whereas taxing processed meat or junk food were least impactful and feasible. This study was supported by NIH/NIMHD.