Abstract
Unhealthy diets contribute to one in every five deaths in the United States, yet federal policy action to improve dietary quality has been limited. We argue that researchers and advocates should engage in state and local food policymaking, which offers an important complementary avenue for creating healthier food environments and improving diet quality. We outline key questions researchers can address to inform local and state policymaking and provide practical tips on how they can engage with the policy process. Finally, we present a case study of researcher engagement with the New York City Sweet Truth Act policy process.
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References
Afshin, A. et al. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 393, 1958–1972 (2019).
Willett, W. C. & Stampfer, M. J. Current evidence on healthy eating. Annu. Rev. Public Health. 34, 77–95 (2013).
Liu, J., Micha, R., Li, Y. & Mozaffarian, D. Trends in food sources and diet quality among US children and adults, 2003–2018. JAMA Netw. Open 4, e215262 (2021).
Liu, J. & Mozaffarian D. Trends in diet quality among U.S. adults from 1999 to 2020 by race, ethnicity, and socioeconomic disadvantage. Ann. Intern. Med. https://doi.org/10.7326/M24-0190 (2024).
Hawkes, C. et al. Smart food policies for obesity prevention. Lancet 385, 2410–2421 (2015).
Eyler, A. A. & Brownson R. C. in Prevention, Policy, and Public Health (eds Eyler, A. & Chriqui, J.) 3–39 (Oxford Univ. Press, 2016).
Frieden, T. R. A framework for public health action: the health impact pyramid. Am. J. Public Health 100, 590–595 (2010).
Swinburn, B. A. et al. The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission report. Lancet 393, 791–846 (2019).
Roberto, C. A. et al. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. Lancet 385, 2400–2409 (2015).
Global SSB Tax Database (World Bank, 2024); https://datacatalog.worldbank.org/search/dataset/0063310
Maps (Global Food Research Program, 2024); https://www.globalfoodresearchprogram.org/resources/maps/
Warburton, M. Congress is getting less productive. Reuters https://www.reuters.com/graphics/USA-CONGRESS/PRODUCTIVITY/egpbabmkwvq/ (2024).
Brownell, K. D. & Warner, K. E. The perils of ignoring history: big tobacco played dirty and millions died. How similar is big food? Milbank Q. 87, 259–294 (2009).
Wilson, D. & Roberts, J. Special Report: How Washington went soft on childhood obesity. Reuters https://www.reuters.com/article/world/special-report-how-washington-went-soft-on-childhood-obesity-idUSBRE83Q0EE/ (2012).
Lacy-Nichols, J. & Williams, O. “Part of the solution”: food corporation strategies for regulatory capture and legitimacy. Int. J. Health Policy Manag. 10, 845–856 (2021).
Mialon, M. et al. Conflicts of interest for members of the US 2020 dietary guidelines advisory committee. Public Health Nutr. 27, e69 (2024).
Nestle, M. Regulating the food industry: an aspirational agenda. Am. J. Public Health. 112, 853–858 (2022).
Pomeranz, J. L. & Silver, D. State legislative strategies to pass, enhance, and obscure preemption of local public health policy-making. Am. J. Prev. Med. 59, 333–342 (2020).
While the Federal Government Slows its Legislative Action, States Keep Pace with Over 100,000 Bills Introduced in 2023 (Quorum, 2024); https://drive.google.com/file/d/1sS6vWyIv3lOJDej9aNqZ2azNWLfq3_ZD/view
State Legislatures vs. Congress: Which is More Productive? (Quorum, 2024); https://www.quorum.us/data-driven-insights/state-legislatures-versus-congress-which-is-more-productive/
Jensen, A., Marble, W., Scheve, K. & Slaughter, M. J. City limits to partisan polarization in the American public. Polit. Sci. Res. Meth. 9, 223–241 (2021).
Brown, J. R. & Enos, R. D. The measurement of partisan sorting for 180 million voters. Nat. Hum. Behav. 5, 998–1008 (2021).
Copeland, J. Americans rate their federal, state and local governments less positively than a few years ago. Pew Research Center https://www.pewresearch.org/short-reads/2024/04/11/americans-rate-their-federal-state-and-local-governments-less-positively-than-a-few-years-ago/ (2042).
Amico, A., Wootan, M. G., Jacobson, M. F., Leung, C. & Willett, W. The demise of artificial trans fat: a history of a public health achievement. Milbank Q. 99, 746–770 (2021).
Block, J. P. The calorie-labeling saga: federal preemption and delayed implementation of public health law. N. Engl. J. Med. 379, 103–105 (2018).
Einstein, K. L. & Kogan, V. Pushing the city limits: policy responsiveness in municipal government. Urban Aff. Rev. 52, 3–32 (2016).
Caughey, D. & Warshaw, C. Policy preferences and policy change: dynamic responsiveness in the American states, 1936–2014. Am. Polit. Sci. Rev. 112, 249–266 (2018).
Grummon, A. H. & Hall, M. G. Sugary drink warnings: a meta-analysis of experimental studies. PLoS Med. 17, e1003120 (2020).
Hall, M. G. et al. How pictorial warnings change parents’ purchases of sugar-sweetened beverage for their children: mechanisms of impact. Int. J. Behav. Nutr. Phys. Act. 20, 76 (2023).
Code of Ordinances Ch. 203 (City of Minneapolis, 2024); https://library.municode.com/mn/minneapolis/codes/code_of_ordinances?nodeId=COOR_TIT10FOCO_CH203GRST
Brownell, K. D. & Roberto, C. A. Strategic science with policy impact. Lancet 385, 2445–2446 (2015).
Huang, Y. et al. Adoption and design of emerging dietary policies to improve cardiometabolic health in the US. Curr. Atheroscler. Rep. 20, 25 (2018).
Anderson, J., Brady, D., Bullock, C. III & Stewart, J. Jr Public Policy and Politics in America 2nd edn (Brooks/Cole, 1984).
Sabatier, P. A. (ed.) Theories of the Policy Process 3–20 (Westview Press, 2007).
CDC Policy Process (Centers for Disease Control and Prevention, 2024); https://www.cdc.gov/polaris/php/cdc-policy-process/index.html
The Sweet Truth (Center for Science in the Public Interest, 2024); https://www.cspinet.org/nyc-sweet-truth
Falbe, J. et al. Online RCT of icon added-sugar warning labels for restaurant menus. Am. J. Prev. Med. 65, 101–111 (2023).
Hall, M. G. & Grummon, A. Nutrient warnings on unhealthy foods. JAMA 324, 1609–1610 (2020).
Sigala, D. M. et al. Perceived effectiveness of added-sugar warning label designs for U.S. restaurant menus: an online randomized controlled trial. Prev. Med. 160, 107090 (2022).
New York City council votes on legislation to confront historic racial disparities in treatment of sickle cell disease, and require that chain restaurants post added sugar levels on menus. New York City Council https://council.nyc.gov/press/2023/11/02/2493/ (2023).
High Sugar Warnings on Food Service Establishment Menus (New York City Department of Health and Mental Hygiene, 2024); https://rules.cityofnewyork.us/rule/high-sugar-warnings-on-food-service-establishment-menus/
Rummo, P. & Grummon, A. R37 CA294883: A Large Scale Quasi-Experimental Evaluation of Added Sugar Warning Labels in Restaurants (National Institutes of Health, 2024); https://reporter.nih.gov/search/9STSNjUBLEepD9qAMUPvXw/project-details/10998314
California State Assembly Pupil Nutrition: Food and Beverages: Advertising: Corporate Incentive Programs (LegiScan, 2017); https://legiscan.com/CA/text/AB841/id/1607623
Executive Order No. 9 (The City of New York Office of the Mayor, 2022); http://www.nyc.gov/office-of-the-mayor/news/009-002/executive-order-9
Berkeley Municipal Code Ch. 9.82 (City of Berkeley, 2024); https://berkeley.municipal.codes/BMC/9.82
Administrative Code—Healthy Food Retailer Incentives Program (City and County of San Francisco, 2012); https://codelibrary.amlegal.com/codes/san_francisco/latest/sf_admin/0-0-0-26735
Senate Bill No. 348, Skinner. Pupil Meals (LegInfo, 2023); https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB348
New York City food standards. City of New York City https://www.nyc.gov/site/foodpolicy/governance-initiatives/nyc-food-standards.page (2024).
California State Assembly The California Food Safety Act AB418 (LegiScan, 2023); https://legiscan.com/CA/text/AB418/id/2839554
Code of Ordinances Article XII (City of Detroit, 2024); https://library.municode.com/mi/detroit/codes/code_of_ordinances?nodeId=COCH50_CH50ZO_ARTXIIUSRE_DIV2GEUSST_S50-12-127SPSP
Bill Status of SB1846 (Illinois General Assembly, 2021); https://www.ilga.gov/legislation/BillStatus.asp?DocNum=1846&GAID=16&DocTypeID=SB&SessionID=110&GA=102
Municipal Code Ordinance No. 125324 (City of Seattle, 2024); https://library.municode.com/wa/seattle/ordinances/municipal_code?nodeId=833338
Title 20-A: §6602: School Food Service Programs (Maine Legislature, 2023); https://www.mainelegislature.org/legis/statutes/20-a/title20-Asec6602.html
Double Up Food Bucks (Arizona Department of Economic Security, 2024); https://des.az.gov/double-food-bucks
Roberto, C. A. et al. The influence of front-of-package nutrition labeling on consumer behavior and product reformulation. Annu. Rev. Nutr. 41, 529–550 (2021).
Jones-Smith, J. C. et al. Sweetened beverage taxes: economic benefits and costs according to household income. Food Policy 110, 102277 (2022).
Pomeranz, J. L. Policy opportunities and legal considerations to reform SNAP-authorized food retail environments. J. Public Health Manag. Pract. 29, 614 (2023).
Chriqui, J. F., Sansone, C. N. & Powell, L. M. The sweetened beverage tax in Cook County, Illinois: lessons from a failed effort. Am. J. Public Health 110, 1009–1016 (2020).
Falbe, J., Marinello, S., Wolf, E. C., Solar, S. & Powell, L. M. Food environment after implementation of a healthy checkout policy. JAMA Netw. Open 7, e2421731 (2024).
Powell, L. M., Vandenbroeck, A., Leider, J., Pipito, A. A. & Moran, A. Evaluation of fast-food restaurant kids’ meal beverage offerings 1 year after a state-level healthy beverage default policy. AJPM Focus. 3, 100226 (2024).
Prasad, D. et al. Changes in consumer purchasing patterns at New York City chain restaurants following adoption of the sodium warning icon rule, 2015–2017. PLoS ONE 18, e0274044 (2023).
Laska, M. N. et al. Evaluation of the first U.S. staple foods ordinance: impact on nutritional quality of food store offerings, customer purchases and home food environments. Int. J. Behav. Nutr. Phys. Act. 16, 83 (2019).
Gibson, L. et al. No evidence of food or alcohol substitution in response to a sweetened beverage tax. Am. J. Prev. Med. 60, e49–e57 (2021).
Willett, W. et al. Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems. Lancet 393, 447–492 (2019).
Bleich, S. N. et al. The association of a sweetened beverage tax with changes in beverage prices and purchases at independent stores. Health Aff. 39, 1130–1139 (2020).
Cleveland, L. P. et al. Obesity prevention across the US: a review of state-level policies from 2009 to 2019. Obes. Sci. Pract. 9, 95–102 (2023).
Acknowledgements
We thank C. Chelius and A. Zeitlin for research assistance.
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A.H.G. and M.G.H. conceptualized the manuscript. A.H.G. drafted the paper with input from M.G.H. and J.W.K. M.G.H. and J.W.K. provided critical input on the draft.
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J.W.K. is employed by Healthy Food America, which has organizational policy positions and advocates for some of the policies included in this article. The other authors declare no competing interests.
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Grummon, A.H., Krieger, J.W. & Hall, M.G. How and why researchers and advocates should engage with state and local food policymaking. Nat Food 6, 232–238 (2025). https://doi.org/10.1038/s43016-025-01142-x
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DOI: https://doi.org/10.1038/s43016-025-01142-x


