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Objectives. To map US state Supplemental Nutrition Assistance Program (SNAP) bans for individuals with felony drug convictions between 2004 and 2021. Methods. Using standard legal-mapping methodology, we categorized states as maintaining the lifetime ban imposed by federal law, modifying the lifetime ban, or fully opting out of the lifetime ban in each year. Among states with modified bans in 2021, we coded types of modifications. Results. As of 2021, 26 states and the District of Columbia fully opted out of the lifetime ban, 23 states modified bans, and 1 state maintained a lifetime ban. Among states with modified bans in 2021, 13 states required compliance with parole and probation, 12 states required drug treatment, 7 states required drug testing, and 9 states limited eligibility to certain populations. Conclusions. Most states effectively de-implemented the federal lifetime ban on SNAP for people with felony drug convictions by fully opting out or modifying bans over time. However, some states still had stringent modified ban provisions. Public Health Implications. These findings underscore the need to study the effects of this patchwork of drug conviction-related ban policies on substance use and nutrition-related outcomes. ( Am J Public Health . 2025;115(2):170-177. https://doi.org/10.2105/AJPH.2024.307873).

Background: The Community Eligibility Provision (CEP) allows high-poverty schools participating in US Department of Agriculture meal programs to offer universal free school meals. Emerging evidence suggests benefits of CEP for student meal participation, behavior, and academic performance. Although CEP became available nationwide in 2014, in school year 2019-2020, one third of eligible schools were not participating., Objective: This study evaluates which school, district, and state factors are associated with CEP participation., Design: Cross-sectional study comparing CEP-participating with eligible nonparticipating schools to assess the relationship between CEP participation and school, district, and state factors., Participants: US public schools eligible for CEP in school year 2017-2018 (n = 42,813)., Main Outcome Measures: CEP participation., Statistical Analyses Performed: Penalized regression variable selection methods to determine which factors contribute information to the model. Generalized logistic regression to predict odds of CEP participation unadjusted and adjusted for each factor in the full sample and in stratified analyses by whether a state was part of the CEP phase-in period (early vs late implementing states)., Results: In the full sample, adjusted odds of CEP participation were greater in states where CEP had been available longer (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.34, 1.67). In late implementing states, adjusted odds of CEP participation were higher in schools with more students directly certified for free meals (OR in schools with 80%-89% vs 30%-39% directly certified: 19.32; 95% CI, 12.98, 28.76), Title I schools (OR, 1.85; 95% CI, 1.55, 2.21), and urban schools (OR suburban vs urban, 0.46; 95% CI, 0.36, 0.59). Differences by school level, enrollment, district size, student race/ethnicity, and geographic region also existed., Conclusions: Findings may help advocates, state agencies, and policymakers understand potential barriers to adoption and guide research exploring effective strategies to promote uptake. Future research should use qualitative and longitudinal designs to explore barriers to adoption, including cost and state and local policies., (Copyright © 2022 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Research conducted before coronavirus disease-2019 illustrated high rates of food insecurity among college students. The pandemic has likely increased student food insecurity because of factors like unemployment and closure of campus resources, and many students cannot access federal food assistance because of long-standing student restrictions. This perspective reviews federal legislation on college food insecurity introduced in the 116th legislative session (2019-2020) immediately before coronavirus disease-2019 in the US, as well as pandemic-related stimulus bills and their implications for future policies and practice. Food insecurity promises to become more pressing as colleges try to reopen and the country grapples with economic recovery., (Copyright © 2020 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Importance: The Healthy, Hunger-Free Kids Act of 2010, implemented nationwide in 2012, was intended to improve the nutritional quality of meals served in the National School Lunch Program (NSLP)., Objective: To assess whether there was an association between the Healthy, Hunger-Free Kids Act of 2010 and dietary quality of lunch for students participating in the NSLP, stratified by income., Design, Setting, Participants: Serial cross-sectional study design, using National Health and Nutrition Examination Survey (NHANES) data from 2007-2008, 2009-2010, 2013-2014, and 2015-2016, of students who were surveyed in the NHANES and were attending schools participating in the NSLP. Individuals who were aged 5 to 18 years, in kindergarten through 12th grade, enrolled in a school that served school lunch, and had a reliable weekday dietary recall were included., Exposures: The Healthy, Hunger-Free Kids Act of 2010 (prepolicy period: 2007-2010; postpolicy period: 2013-2016), with participation in the NSLP estimated based on an algorithm., Main Outcomes and Measures: The primary outcome was dietary quality of intake for lunch, measured by the Healthy Eating Index-2010 (HEI-2010) score (range, 0-100; 0 indicates a diet with no adherence to the 2010 Dietary Guidelines for Americans and 100 indicates a diet with complete adherence to the guidelines)., Results: Among 6389 students included in the surveys (mean age, 11.7 [95% CI, 11.6-11.9] years; 3145 [50%] female students; 1880 [56%] were non-Hispanic white), 32% were low-income, 12% were low-middle-income, and 56% were middle-high-income students. A total of 2472 (39%) were participants in the NSLP. Among low-income students, the adjusted mean prepolicy HEI-2010 score was 42.7 and the postpolicy score was 54.6 among NSLP participants and the adjusted mean prepolicy score was 34.8 and postpolicy score was 34.1 among NSLP nonparticipants (difference in differences, 12.6 [95% CI, 8.9-16.3]). Among low-middle-income students, the adjusted mean prepolicy HEI-2010 score was 40.4 and postpolicy score was 54.8 among NSLP participants and the adjusted mean prepolicy score was 34.2 and postpolicy score was 36.1 among NSLP nonparticipants (difference in differences, 12.4 [95% CI, 4.9-19.9]). Among middle-high-income students, the adjusted mean HEI-2010 prepolicy score was 42.7 and postpolicy score 55.5 for NSLP participants and the adjusted mean prepolicy score was 38.9 and prepolicy score was 43.6 for NSLP nonparticipants (difference in differences, 8.1 [95% CI, 4.2-12.0])., Conclusions and Relevance: In a serial cross-sectional study of students, the Healthy, Hunger-Free Kids Act of 2010 was associated with better changes in dietary quality for lunch among presumed low-income, low-middle-income, and middle-high-income participants in the NSLP compared with nonparticipants.

Background: Many lower-income communities in the United States lack a full-line grocery store. There is evidence that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) increases the availability of healthy foods in stores. One national discount variety store chain (DVS) that is often located in low-income neighborhoods became an authorized WIC vendor in 8 pilot stores., Objectives: The objective of this study was to evaluate how implementing WIC in DVS pilot stores affected sales of healthy, WIC-eligible foods., Methods: We used DVS sales data and difference-in-differences regression to evaluate how WIC authorization affected sales of WIC-eligible foods in 8 DVS pilot stores, compared with 8 matched comparison stores., Results: DVS added 18 new WIC-approved foods to become an authorized vendor. Results indicate that becoming a WIC vendor significantly increased sales of healthy, WIC-eligible foods that DVS carried before authorization. WIC implementation in DVS led to a 31-unit increase in sales of the original WIC foods per week on average (P < 0.01). Lower socioeconomic status, assessed using a summary measure, is associated with increased sales of WIC foods. Yet sales of non-WIC eligible foods (e.g., salty snack foods, candy bars, soda, and processed meats) were not affected by WIC authorization., Conclusions: Encouraging DVS stores to become WIC-authorized vendors has the potential to modestly increase DVS sales and the availability of healthy foods in low-income neighborhoods. If WIC authorization is financially viable for small-format variety stores, encouraging similar small-format variety stores to become WIC-authorized has the potential to improve food access., (Copyright © The Author(s) on behalf of the American Society for Nutrition 2020.)

The Supplemental Nutrition Assistance Program (SNAP) provides funding to low-income households to purchase food at participating stores. The goals of the program include reducing hunger, improving nutrition, and strengthening the US food system. These are interrelated, as food access and choice depend on availability.SNAP generates data that could be useful for program evaluation and evidence-based policymaking to reach public health goals. However, the US Department of Agriculture (USDA) does not collect or disclose all SNAP-related data. In particular, the USDA does not systematically collect food expenditure data, and although it does collect transaction (sales) and redemption data (the amount retailers are reimbursed through SNAP), it does not release these data at the store level.In 2018, Congress quietly changed the law to prohibit the USDA from disclosing store-level transaction and redemption data, and in 2019, the US Supreme Court blocked disclosure of these data. These federal proceedings can inform the outcome of additional efforts to disclose SNAP-related data, as well as future research and policy evaluation to support improved public health outcomes for SNAP beneficiaries.

This commentary introduces a special section of AJPH on the Supplemental Nutrition Assistance Program (SNAP), the US government's largest antihunger program and third-largest antipoverty program. SNAP demonstrably lifts adults, children, and families out of poverty, thereby constituting a vital component of this nation's public health safety net.Despite its well-documented benefits, SNAP is under political and budgetary siege, mainly from congressional representatives and lobbying groups opposed to a federal role in welfare. In part, SNAP is protected from total annihilation by its unusual authorizing legislation-the Farm Bill.This commentary provides a brief overview of the political history of SNAP and its Farm Bill location as background to the deeper analyses provided in this series of articles.

Background: Emergency foods distributed during a federal disaster relief response must follow the federal Dietary Guidelines for Americans according to the 1990 National Nutrition Monitoring Related Research Act. Nutrition information about emergency foods for household distribution is scarce., Methods: According to structured observation protocols, foods received daily at a federal distribution center in Puerto Rico after Hurricane María (November 10-25, 2017) were grouped into Dietary Guidelines for Americans ChooseMyPlate food groups. Data about their sodium, saturated fat, added sugar, and fiber content per serving were captured. Registered dietitians designed meal plans with the foods distributed., Results: Of 107 unique food items, 41% were snacks and sweets; and 13%, 4%, 13%, and 7% were fruits, vegetables, proteins, and grains, respectively. Fifty-eight percent of all foods were low in fiber (≤1 g); 46% included high amounts of sodium, saturated fats, or added sugars (≥20% daily value). The registered dietitians were able to design meal plans that complied with the Dietary Guidelines for Americans food group recommendations, but they exceeded upper daily limits for sodium, saturated fat, or added sugars., Conclusions: In view of projected increases in natural disasters and diet-related chronic diseases, DGA compliance must be improved so that federal emergency foods can support the health of survivors., (Copyright © 2019 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objectives. To assess the effects of work requirements for able-bodied adults without dependents in the Supplemental Nutrition Assistance Program (SNAP). Methods. We used changes in waivers of work requirements to assess the impact of requiring work on the number of SNAP participants and benefit levels in 2410 US counties from 2013 to 2017 using 2-way fixed effects models. Results. Adoption of work requirements was followed by reductions of 3.0% in total SNAP participation, 4.5% in SNAP households, and 3.8% in SNAP benefit dollars, after controlling for the unemployment, poverty, and Medicaid expansions. Because able-bodied adults without dependents comprise 8% to 9% of all SNAP participants, our findings indicate that work requirements caused more than one third of able-bodied adults without dependents to lose benefits. Conclusions. Expansions of work requirements caused about 600 000 participants to lose SNAP benefits from 2013 to 2017 and caused a reduction of about $2.5 billion in federal SNAP benefits in 2017. The losses occurred rapidly, beginning a few months after work requirements were imposed. Public Health Implications. SNAP work requirements rapidly reduce caseloads and benefits, reducing food and health access. Effects on participation could be similar for work requirements in Medicaid or other programs.

This paper examines whether a chilling effect of restrictive state laws aimed at immigrants creates a barrier to enrollment in the food stamp program (now called the Supplemental Nutrition Assistance Program or SNAP) for U.S. citizen children in low-income immigrant families. This analysis looks at 20 states in the continental United States from 2000 to 2008 that were either at or above the U.S. average for percentage of foreign-born population, or states that ranked in the top 10 percent in terms of change in foreign-born population for that time period. To examine this issue, a multivariate, regression-based difference-in-differences (DD) analysis was applied. The "treatment" group is immigrant families with a U.S. citizen child that is 130% of the federal poverty level or below in states with restrictive immigrant related legislation and the "control" group is native families meeting the same federal poverty level guidelines as well as low-income immigrant families in states without the restrictive legislation. The research findings show that there does not appear to be a chilling effect associated with restrictive state laws on participation in the food stamp program. Food insecurity is an immediate need that may override the impediments to enrollment due to immigration status, causing families to apply despite a negative climate toward immigrants. For policy makers and immigrant advocates it is important to know where chilling effects might not occur in order to work with politicians and federal agencies on crafting sound evidence-based policy. Independent of any chilling effect, the model shows that immigrant families are less likely to enroll in food stamp benefits, consistent with other literature. In addition, independent of the effects of restrictive immigration legislation, both non-citizen and naturalized mothers were less likely to be in a family with food stamp benefits compared to similar native-born mothers. This indicates that all states have a gap in food stamp program enrollment that merits further attention and research., Competing Interests: The author has declared that no competing interests exist.

Until recently, lawfully present noncitizens participating in the US Department of Agriculture Supplemental Nutrition Assistance Program (formerly Food Stamps) faced no immigration consequences. However, in September, 2018, the Trump Administration proposed a more expansive public charge rule in the Federal Register that would deny lawfully present noncitizens a path to citizenship if they had participated in certain federal safety net programs, including Supplemental Nutrition Assistance Program. This perspective discusses the proposed rule's implications, particularly for those with professional interests in promoting effective nutrition education and healthy behavior through research, policy, and practice among individuals who will potentially be affected., (Copyright © 2019 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

The 2018 Farm Bill was finalized in mid-December of 2018 after months of discussion and debate between policymakers. The Farm Bill has many implications for low-income and food-insecure populations in the United States. One program within the Farm Bill that helps bridge the nutrition gap for low-income Supplemental Nutrition Assistance Program participants is the Food Insecurity Nutrition Incentive Grant Program (FINI). This commentary explores the best practices and promising findings of FINI projects to inform future policy discussions and implementation of FINI. In addition, we discuss knowledge gaps and opportunities within the context of the extant literature. Stakeholders and FINI grantees reported positive impacts of FINI grants, describing outcomes across farmers, grocery store owners, local economies, and Supplemental Nutrition Assistance Program participants (eg, increased fruit and vegetable consumption). The 2018 Farm Bill was largely in alignment with the Academy's recommendations, and preserved the integrity of the Supplemental Nutrition Assistance Program as well as increased funding for FINI., (Copyright © 2019 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Deep cuts have been proposed to federally funded nutrition assistance programs, including the Supplemental Nutrition Assistance Program (SNAP); the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and federally subsidized school breakfast and lunch programs. Yet, these programs help parents afford healthy meals for their families, pregnant and postpartum mothers access supplemental foods and health services for themselves and their infants and young children, and children obtain the nutrition necessary for optimal school performance. Participation in these programs is linked with reductions in perinatal morbidity and mortality, improved childhood growth trajectories, enhanced school performance, and reductions in food insecurity and poverty. Given these compelling health and economic benefits, the Society of Behavioral Medicine urges Congress to protect and increase funding for federally funded nutrition assistance programs, specifically SNAP, WIC, and school breakfast and lunch programs. Per the recent (2017) recommendations of the School Nutrition Association, Congress should also resist any attempts to "block-grant" subsidized school breakfast and lunch programs, which could reduce access to these programs. It is further recommended that Congress improve the scope of implementation- and outcomes-based assessments of these programs. Finally, we recommend efforts to increase awareness of and participation in SNAP, WIC, and federally funded school meal programs for eligible individuals, children, and families.

Purpose of Review: Suboptimal diet is a leading cause of cardiometabolic disease and economic burdens. Evidence-based dietary policies within 5 domains-food prices, reformulation, marketing, labeling, and government food assistance programs-appear promising at improving cardiometabolic health. Yet, the extent of new dietary policy adoption in the US and key elements crucial to define in designing such policies are not well established. We created an inventory of recent US dietary policy cases aiming to improve cardiometabolic health and assessed the extent of their proposal and adoption at federal, state, local, and tribal levels; and categorized and characterized the key elements in their policy design., Recent Findings: Recent federal dietary policies adopted to improve cardiometabolic health include reformulation (trans-fat elimination), marketing (mass-media campaigns to increase fruits and vegetables), labeling (Nutrition Facts Panel updates, menu calorie labeling), and food assistance programs (financial incentives for fruits and vegetables in the Supplemental Nutrition Assistance Program (SNAP) and Women, Infant and Children (WIC) program). Federal voluntary guidelines have been proposed for sodium reformulation and food marketing to children. Recent state proposals included sugar-sweetened beverage (SSB) taxes, marketing restrictions, and SNAP restrictions, but few were enacted. Local efforts varied significantly, with certain localities consistently leading in the proposal or adoption of relevant policies. Across all jurisdictions, most commonly selected dietary targets included fruits and vegetables, SSBs, trans-fat, added sugar, sodium, and calories; other healthy (e.g., nuts) or unhealthy (e.g., processed meats) factors were largely not addressed. Key policy elements to define in designing these policies included those common across domains (e.g., level of government, target population, dietary target, dietary definition, implementation mechanism), and domain-specific (e.g., media channels for food marketing domain) or policy-specific (e.g., earmarking for taxes) elements. Characteristics of certain elements were similarly defined (e.g., fruit and vegetable definition, warning language used in SSB warning labels), while others varied across cases within a policy (e.g., tax base for SSB taxes). Several key elements were not always sufficiently characterized in government documents, and dietary target selections and definitions did not consistently align with the evidence-base. These findings highlight recent action on dietary policies to improve cardiometabolic health in the US; and key elements necessary to design such policies.

This final rule establishes requirements for State agencies, local educational agencies, and schools operating the Community Eligibility Provision, a reimbursement option that allows the service of school meals to all children at no-cost in high poverty schools without collecting household applications. By eliminating the household application process and streamlining meal counting and claiming procedures through the Community Eligibility Provision, local educational agencies may substantially reduce administrative burden related to operating the National School Lunch and School Breakfast Programs. This rule codifies many requirements that were implemented through policy guidance following enactment of the Healthy, Hunger-Free Kids Act of 2010, as well as provisions of the proposed rule. These requirements will result in consistent, national implementation of the Community Eligibility Provision.

This rule adopts the interim rule implementing the Supplemental Nutrition Assistance Program (SNAP) nutrition education and obesity prevention grant program with changes as provided in this rule. This rule also amends SNAP regulations to implement section 28 of the Food and Nutrition Act (FNA) of 2008, as added by section 241 of the Healthy, Hunger-Free Kids Act (HHFKA) of 2010, to award grants to States for provision of nutrition education and obesity prevention programs. These programs provide services for eligible individuals that promote healthy food choices consistent with the current Dietary Guidelines for Americans (DGAs). The rule provides State agencies with requirements for implementing section 28, including the grant award process and describes the process for allocating the Federal grant funding for each State's approved SNAP-Ed plan authorized under the FNA to carry out nutrition education and obesity prevention services each fiscal year. This final rule also implements section 4028 of the Agricultural Act of 2014 (Farm Bill of 2014), which authorizes physical activity promotion in addition to promotion of healthy food choices as part of this nutrition education and obesity prevention program.

The United States has a long history of food assistance for humanitarian need. The Food for Peace Act of 1954 established the United States' permanent food assistance program which has fed over 3 billion people in 150 countries worldwide through thousands of partner organizations. In 60 years, the program has evolved and will continue to do so. Recently, the program has gone from a focus on quantity of food shipped to quality food assistance from improved products, programs, and processes to effectively meet the needs of different vulnerable groups. The current debate focuses on the appropriateness of using fortified blended foods to prevent and treat malnutrition during the first 1000 days of life. Dairy ingredients have been at the center of this debate; they were included initially in fortified blended, removed in the 1980s, and now reincorporated into fortified therapeutic and supplemental foods. Improved quality food baskets and effective nutrition programming to prevent and treat malnutrition were developed through multisectoral collaboration between government and nongovernment organizations. The US Agency for International Development has focused on improving nutrition through development programs often tied to health, education, and agriculture. The years since 2008 have been a particularly intense period for improvement. The Food Aid Quality Review was established to update current food aid programming products, program implementation, cost-effectiveness, and interagency processes. Trials are underway to harmonize the areas of multisectoral nutrition programming and gather more evidence on the effects of dairy ingredients in food aid products., (© The Author(s) 2016.)

US state and local governments are debating sugar-sweetened beverage excise taxes to support public health. A related issue is whether such taxes would apply to beverage purchases made by Supplemental Nutrition Assistance Program (SNAP) participants. Federal law proscribes states from collecting excise taxes on SNAP purchases, but the law is confined to taxes at the point of sale. I provide legal analysis and recommendations for policymakers to enact taxes that are not subject to the SNAP tax exemption to potentially deter consumption by all consumers.

Under the current version of the Supplemental Nutrition Assistance Program (SNAP), participants can purchase virtually any food or beverage (collectively, food). Research indicates that SNAP recipients may have worse dietary quality than income-eligible nonparticipants. Policymakers have urged the U.S. Department of Agriculture (USDA) to pilot SNAP purchasing restrictions intended to support a healthier diet, and state legislators have proposed similar bills. The USDA rejected these invitations, stating that it would be administratively and logistically difficult to differentiate among products, amid other concerns. However, the USDA's Dietary Guidelines for Americans and the Supplemental Nutrition Program for Women, Infants, and Children (WIC) do just that. Further, state governments define and differentiate among foods and beverages for tax purposes. This paper reviews several factors intended to inform future policy decisions: the science indicating that SNAP recipients have poorer diet quality than income-eligible nonparticipants; the public's support for revising the SNAP program; federal, state, and city legislators' formal proposals to amend SNAP based on nutrition criteria and the USDA's public position in opposition to these proposals; state bills to amend eligible foods purchasable with SNAP benefits; state retail food tax laws; and the retail administration and program requirements for both WIC and SNAP. The paper finds that the government has a clear ability to align SNAP benefits with nutrition science and operationalize this into law., (Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: During 2008, we conducted a statewide survey on beverages served to preschool-aged children in California child care that identified a need for beverage policy. During 2011, the US Department of Agriculture began requiring that sites participating in the Child and Adult Care Food Program (CACFP) make drinking water available throughout the day and serve only low-fat or nonfat milk to children aged 2 years and older. During 2012, the California Healthy Beverages in Childcare law additionally required that all child-care sites eliminate all beverages with added sweetener and limit 100% juice to once daily., Design: To assess potential policy effects, we repeated the statewide survey in 2012. During 2008 and 2012, a cross-sectional sample of ∼1,400 licensed child-care sites was randomly selected after stratifying by category (ie, Head Start, state preschool, other CACFP center, non-CACFP center, CACFP home, and non-CACFP home)., Results: Responses were obtained from 429 sites in 2008 and 435 in 2012. After adjustment for child-care category, significant improvements in 2012 compared with 2008 were found; more sites served water with meals/snacks (47% vs 28%; P=0.008) and made water available indoors for children to self-serve (77% vs 69%; P=0.001), and fewer sites served whole milk usually (9% vs 22%; P=0.006) and 100% juice more than once daily (20% vs 27%; P=0.038). During 2012, 60% of sites were aware of beverage policies and 23% were judged fully compliant with the California law., Conclusions: A positive effect occurred on beverages served after enactment of state and federal policies. Efforts should continue to promote beverage policies and support their implementation., (Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Food insecurity is a pressing issue in the United States where one in six people suffer from hunger. The older adult population faces unique challenges to receiving adequate nutrition. The federal government currently employs four food and nutrition programs that target the senior population in an effort to address their specific needs. These are the Congregate Meals and Home Delivered Meals Programs (provided through the Older Americans Act), and the Senior Farmers' Market Nutrition Program and Child and Adult Care Food Program (provided by the United States Department of Agriculture). As the older adult population continues to grow, it will be important to evaluate and improve these programs and the social policies related to them. This manuscript describes each policy in depth, considers economic and political elements that have shaped each policy, describes the level of program success, and offers suggestions for future research and program development.

To reduce obesity and type 2 diabetes rates, lawmakers have proposed modifying Supplemental Nutrition Assistance Program (SNAP) benefits to encourage healthier food choices. We examined the impact of two proposed policies: a ban on using SNAP dollars to buy sugar-sweetened beverages; and a subsidy in which for every SNAP dollar spent on fruit and vegetables, thirty cents is credited back to participants' SNAP benefit cards. We used nationally representative data and models describing obesity, type 2 diabetes, and determinants of food consumption among a sample of over 19,000 SNAP participants. We found that a ban on SNAP purchases of sugar-sweetened beverages would be expected to significantly reduce obesity prevalence and type 2 diabetes incidence, particularly among adults ages 18-65 and some racial and ethnic minorities. The subsidy policy would not be expected to have a significant effect on obesity and type 2 diabetes, given available data. Such a subsidy could, however, more than double the proportion of SNAP participants who meet federal vegetable and fruit consumption guidelines., (Project HOPE—The People-to-People Health Foundation, Inc.)

Obesity and overweight prevalence soared to unprecedented levels in the United States, with 1 in 3 adults and 1 in 6 children currently categorized as obese. Although many approaches have been taken to encourage individual behavior change, policies increasingly attempt to modify environments to have a more positive influence on individuals' food and drink choices. Several policy proposals target sugar-sweetened beverages (SSBs), consumption of which has become the largest contributor to Americans' caloric intake. Yet proposals have been criticized for unduly inhibiting choice, being overly paternalistic, and stigmatizing low-income populations. We explored the ethical acceptability of 3 approaches to reduce SSB consumption: restricting sale of SSBs in public schools, levying significant taxes on SSBs, and prohibiting the use of Supplemental Nutrition and Assistance Program (formerly food stamps) benefits for SSB purchases.

Many anti-obesity policies face a variety of ethical objections. We consider one kind of anti-obesity policy - modifications to food assistance programs meant to improve participants' diet - and one kind of criticism of these policies, that they are inequitable. We take as our example the recent, unsuccessful effort by New York State to exclude sweetened beverages from the items eligible for purchase in New York City with Supplemental Nutrition Support Program (SNAP) assistance (i.e., food stamps). We distinguish two equity-based ethical objections that were made to the sweetened beverage exclusion, and analyze these objections in terms of the theoretical notions of distributive equality and social equality. First, the sweetened beverage exclusion is unfair or violates distributive equality because it restricts the consumer choice of SNAP participants relative to non-participants. Second, it is disrespectful or violates social equality to prohibit SNAP participants from purchasing sweetened beverages with food stamps. We conclude that neither equity-based ethical objection is decisive, and that the proposed exclusion of sugar-sweetened beverages is not a violation of either distributive or social equality., (© 2013 American Society of Law, Medicine & Ethics, Inc.)

Agricultural policies are often criticized for promoting the overconsumption of unhealthy foods, thereby contributing to rising obesity rates. This article explores the accuracy of claims that existing agricultural policies contribute to obesity and describes the conflict between traditional nutrition and agricultural policy goals. The article concludes by asserting that the challenges facing farmers must be considered in the redesign of agriculture policy to support obesity prevention goals of governments. If the needs of farmers are overlooked, efforts to improve the nutritional profile of the average American diet will be undermined.