Prevalence of Nutrition Standards Use by Municipalities in Government-Owned or Operated Properties, United States, 2021

Background/Objectives: Adopting written nutrition standards for food sold or served by local governments is a strategy for increasing access to healthier options among employees and residents. Methods: We used data from a 2021 national survey of 1982 municipal governments serving populations of 1000 or more. Among municipalities that sell or serve food or beverages, we examined the prevalence and 95% confidence intervals (CI) of those with written nutrition standards. Logistic regression models were used to obtain odds ratios and 95% CIs of written nutrition standards by municipality characteristics. Finally, we examined the prevalence including nutrition standards in food purchasing agreements or food service contracts among municipalities that sell or serve food and have written nutrition standards. Results: Among U.S. municipalities in 2021, 32% reported selling and 21% reported serving food or beverages. Among U.S. municipalities that sell or serve food or beverages, the prevalence of municipalities with written nutrition standards was 19%, and of these, 78% reported including their written nutrition standards in city food purchasing agreements or food service contracts. In adjusted analyses, the region (West vs. Midwest adjusted odds ratio aOR: 2.9 95% CI: 1.7, 4.9) and presence of a food policy council remained significantly associated with having written nutrition standards (aOR: 1.7 1.1, 2.5). Conclusions: Although only 1 in 5 municipalities that sell or serve food or beverages have written nutrition standards, of those that do, almost 80% reported including the standards in contracts, highlighting an important implementation lever and a public health opportunity for communities to adopt standards that offer healthy food and beverage options in public spaces.