Healthy Food Environments

People generally get most of their food from either food retail venues, where they buy foods to prepare and eat from home, or from food service venues, where they eat away from home. Grocery stores, corner stores, and farmers’ markets are examples of food retail venues. Restaurants (including quick serve), child care facilities, schools, hospital and worksite cafeterias are examples of food service venues.

Having healthy food available and affordable in food retail and food service settings allows people to make healthier food choices. When healthy foods are not available, people may settle for foods that are higher in calories and lower in nutritional value. Thus, creating and supporting healthy food environments is an important part of public health work.

There are many different strategies that can contribute to healthy food environments. These include 1) providing incentives for supermarkets or farmers’ markets to establish their businesses in underserved areas; 2) having nutrition information and caloric content on restaurant and fast food menus; and 3) applying nutrition standards in child care facilities, schools, hospitals, and worksites.

Read more about what you can do to help support people in making healthier food choices in your communities.

Child Care and Early Education Programs can:

Use best practices to increase consumption of healthy food and beverages and increase breastfeeding based on nutrition standards for the early care and education setting and as recommended by the Dietary Guidelines for Americans. Child care centers can also assess their food environments and develop action plans and policies that promote healthy eating. Helpful resources include the following:

• Caring for Our Children: National Health and Safety Performance Standards (CFOC), 3rd ed. [PDF- 4.71MB] This resource contains comprehensive, evidence-based national standards for this setting, including standards for obesity prevention addressing nutrition, infant feeding, physical activity, and screen time.
• Let’s Move! Child Care. A website for early care and education (ECE) providers offers practical tools and resources to help ECE providers achieve obesity prevention best practices in the following areas: 1) improving food choices, 2) providing healthy beverages, 3) increasing physical activity, 4) reducing screen time, and 5) supporting breastfeeding. A key resource is a “Checklist Quiz” that helps providers assess how well they are currently meeting best practices and gives information on how to develop an action plan for making improvements. The site features information on curriculum development, menu planning, and resources for parents. There is also a national recognition map of ECE providers who report meeting all of the best practices and a resource section for trainers also is available on the site.
• Go NAPSACC.This website provides information and resources from the Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC). Go NAP SACC is the next generation of NAP SACC. Updates include resources for children from birth to 5 years, plus a new focus on breastfeeding and infant feeding, screen time, and outdoor play. Go NAP SACC can also tailor tools and recommendations for different child care settings, including family child care homes. Downloadable Go NAP SACC self-assessments are available on this site.
• Model Child Care Health Policies (5^th edition). This resource, developed by the American Academy of Pediatrics, provides guidance on the adoption of policies related to best practices on the health and safety of young children in early care and after school settings. Section 4 provides example policies related specifically to nutrition, food handling, and feeding that child care centers can adopt for their own use.
• Farm to Preschool. This program involves implementation of one or more of three core elements: 1) purchasing of local and regional food products to serve at meals and snacks; 2) nutrition education, with activities related to local agriculture and food; and 3) school gardens. Farm to preschool programs are diverse and can take shape in a number of ways (e.g., gardens, cooking demonstrations and tastings, farmers’ markets, produce sold to families.), serving not only the 0-5 age group, but also teachers and child care providers, parents and family members, as well as communities. The overarching goals of farm to preschool programs are promoting healthy eating by purchasing local or regional healthy foods and educating participants on their origin, use, and nutritional value.
• Grow It, Try It, Like It! Nutrition Education Kit Featuring MyPlate. This is a garden-themed nutrition education kit that features fun activities in an imaginary garden. Each set of lessons contains hands-on activities, planting activities, nutrition education, and recipes to try at home.

Schools can follow nutrition standards to ensure that food and beverage options are healthy. They also can encourage students to eat foods that meets dietary recommendations for fruits, vegetables, whole grains, and nonfat or low-fat dairy products.

Other options also include the following:

• Encourage children to drink water in place of sugar-sweetened beverages and ensure access to free drinking water as an alternative to sugar-sweetened beverages before, during, and after school. See Water Access in Schools [PDF-1.8MB].
• Establish school salad bars to increase access to fruits and vegetables for children. See Let’s Move Salad Bars to Schools.
• Limit foods and drinks with added sugar, fat and sodium that can be purchased outside the school lunch program. See Competitive Foods in Schools.

Hospitals can assess their food and beverage offerings to ensure healthier choices are available for their patients, employees, and visitors.

Helpful resources include the following:

• A Toolkit for Creating Healthy Hospital Environments: Making Healthier Food, Beverage, and Physical Activity Choices. This toolkit provides guidance to hospital nutritionists, human resource and employee health staff, and others who wish to promote and support healthy food, beverage, and physical activity options in hospitals. It includes information about engaging stakeholders, assessing needs, and also contains assessment tools for food, beverage, and physical activity environments.
• The Healthy Hospital Practice to Practice (P2P) Series. These are case studies of hospitals that have improved their environments to better support the health of their employees and communities and the mission of their organizations. Providing healthier food and beverage options is covered in this series.

Worksites can promote health and wellness in the workplace.

One way to do this is to implement food service guidelines, such as those developed for federal government worksites below.

• The Food Service Guidelines for Federal Facilities [PDF-1.3MB]. This document includes guidelines to assist contractors in increasing healthy food and beverage choices and sustainable practices in federal worksites. The guidelines are designed to make healthier choices more available in cafeterias, concession stands, snack bars, and vending machines.
• The Smart Food Choices: How to Implement Food Service Guidelines in Public Facilities [PDF-1.81MB]. This is a guide with action steps to help implement food service guidelines in government work sites or other public facilities to increase the availability of healthier food and beverage options at food service venues, including cafeterias, concession stands, snack bars, and vending machines.
• The Tips For Offering Healthier Options and Physical Activity at Workplace Meetings and Events [PDF-586KB]. This publication includes tips and resources for increasing healthier food and beverage options at worksite meetings, parties, conferences, and events and for offering physical activity opportunities for employees throughout the work day.
• The Under Pressure: Strategies for Sodium Reduction in Worksites[PDF-1.36MB]. These guides include strategies for sodium reduction in a variety of settings for use when improving the food environment.

States and communities can

• Assist in the creation of new food retail outlets in underserved areas to increase access to healthier foods and beverages.
• Support the improvement of the quality, variety, and amount of healthier foods and beverages in existing stores.
• Help with the promotion and marketing of healthier foods and beverages to the consumer.

Helpful resources include the following:

• Healthier Food Retail: An Action Guide for Public Health Practitioners [PDF-7.72MB]. This document provides guidance for public health practitioners on how to develop, implement, and partner on initiatives and activities around food retail to improve access, availability, and affordability of healthier foods and beverages. With this guide, public health practitioners can begin or enhance their work in healthier food retail.
• The Healthier Food Retail: Beginning the Assessment Process in Your State or Community; [PDF-522KB]. This resource provides an overview of how to develop a state or community assessment in food retail settings and it gives “how-to” information for practitioners. These assessments can help identify disparities in peoples’ ability to access affordable, nutritious foods. The document takes practitioners through a step-by-step process for conducting assessments, including focusing, planning, implementing, and communicating assessment findings.

Restaurants can

• Implement menu labeling, adopt nutrition standards for children’s meals, and promote healthier meals and food items. See Food and Drug Administration (FDA) Labeling Requirements for Restaurants, Similar Retail Food Establishments and Vending Machines