Assessment of the Presence, Content, and Gaps in Municipal Food Service Guidelines: An Analysis of Policies in the 20 Most Populous U.S. Cities, 2017-2023.

PurposeLocal food service guidelines (FSG) policies can affect the foods sold or served to support local businesses and human health. This study identified FSG policies enacted between 2017 and 2023 and used an FSG Classification Tool to quantify alignment of policy attributes.DesignQuantitative content analysis.SettingLocal jurisdictions.SampleTwenty most populous U.S. cities in 2022.MeasuresFrequency of FSG policies and percent alignment to coding tool.AnalysisUsing municipal legal code databases and city clerk websites, enacted FSG policies were identified. Content analysis determined policy attributes across 3 FSG domains: (1) nutrition standards; (2) behavioral design; (3) facility efficiency; and the construct of implementation supports.ResultsFrom 2017 to 2023, 7 policies across 6 cities met inclusion criteria. Alignment to the tool ranged from 6% to 71%, with 2 policies scoring higher than 51%. Nutrition domain scores ranged from 0% to 100%, with 3 policies scoring >70%. Behavioral design and facility efficiency domain attributes were less frequent. All policies included at least 1 implementation supports provision, with scores ranging from 14% to 61%.ConclusionFrom 2017 to 2023, 7 FSG policies were enacted by 6 of the 20 most populous cities in the U.S. These policies can serve as models for other jurisdictions. To maximize impact, FSG policies can include additional FSG standards to improve food environments.