U.S. Progress to Promote a Healthful Diet to American Children and Adolescents


In 2005, the Institute of Medicine (IOM) released a report assessing food and beverage marketing practices on the diets and health of American children1. The report concluded that the prevailing marketing practices did not support a healthful diet and offered recommendations to promote a healthful diet. The IOM report documented that most American youth have inadequate intakes of nutrient-dense foods, including fruits and vegetables (F&V).

Evaluating Progress of Public-Sector Stakeholders From December 2005 to January 2011, a comprehensive evidence review was undertaken to evaluate progress made by private and public-sector stakeholders toward the IOM food marketing report recommendations. This article focuses on school and government progress2 and summarizes the findings relevant to F&V availability, access and promotion to young people.

Government and School Progress

The IOM report recommended that government partner with the private sector to create a longterm, multi-faceted and financially sustainable social marketing program to promote a healthful diet. In 2007, the CDC partnered with the Fruit & Veggies More Matters social marketing campaign that reinvigorated the Five-a-Day brand. However, government made no progress to create an adequately funded “healthy eating” campaign that had a reliable and sustainable funding stream. Indeed, the National Fruit & Vegetable Alliance released a report card in 2010 that gave several D and F grades for food marketing activities, nutrition education spending, and the failure of children and adults to meet the government recommendations for F&V servings.

Government was also charged with using all public policy tools (including subsidies, taxes, legislation and regulation) to expand F&V availability and access. Promising progress was made through several efforts:

  • the 2008 Food, Conservation, and Energy Act provided one billion dollars in state grants to expand fresh produce to school-aged children through the Fresh Fruit and Vegetable Program,
  • the 2009 American Recovery and Reinvestment Act enabled the government to distribute millions of dollars in state and community grants in 2010 to increase fresh F&V availability,
  • the 2010 Healthy Food Financing Initiative proposed $400 million dollars in tax credits for food retailers to increase F&V availability,
  • the Healthy, Hunger-Free Kids Act of 2010 provides $4.5 billion to improve school meal nutrition standards in 2012.

Despite this progress, the evaluation found that legal ordinances were underutilized at state and local levels to expand healthy mobile markets and attract farmer’s markets to promote F&V consumption. It also found that government failed to use policy tools to fund initiatives promoting F&V according to diet-related health. A federal government spending analysis of F&V across the USDA, CDC and NIH found that only 2.8 percent of the combined budgets were used for F&V-related activities. To align spending in ways to address diet-related chronic diseases, USDA would need to double its spending for F&V from $3.4 billion to $7.0 billion dollars. NIH and CDC would require an additional $107.5 million and $44.7 million dollars, respectively, to address F&V research gaps.

Accelerating Government and School Progress to Promote F&V to Young People

There are many unrealized opportunities for schools and government to promote F&V. Several new alliances and partnerships are underway to work toward this goal.

At the start of the 2012 school year, U.S. school districts are implementing healthier school meal guidelines nationwide, including a requirement that school districts serve F&V to children daily in order to receive federal reimbursement for school meals. Other promising initiatives include the USDA’s Fresh Fruit and Vegetable Program, Chefs Move the Schools Program, Farm-to-Schools Grant Program, school gardens, and the Let’s Move! Salad Bars to Schools Program.

The government could raise public and private sector funding to develop and implement a sustained ‘healthy eating’ social marketing campaign; and to use policy tools to provide incentive for increased F&V intake, including federal subsidies to support farmers’ production of F&V. These initiatives are feasible through government funding, innovative partnerships, legislation and education. Evaluations are needed to socially normalize F&V availability, access and consumption to move millions of children and adolescents toward consuming the recommended servings of F&V every day.

  1. McGinnis JM, Gootman JA, Kraak VI, editors; Committee on Food Marketing and the Diets of Children and Youth; Institute of Medicine. Food Marketing to Children and Youth: Threat or Opportunity? Washington, DC: The National Academies Press, 2006.
  2. Kraak VI, Story M, Wartella EA, Ginter J. Industry progress to market a healthful diet to American children and adolescents. Am J Prev Med. 2011;41(3):322-33.
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