For many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U.S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families. In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA's Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.

The prevalence of childhood obesity is so high in the United States that it may reduce the life expectancy of today's generation of children. While parents and other adult caregivers play a fundamental role in teaching children about healthy behaviors, even the most positive efforts can be undermined by local environments that are poorly suited to supporting healthy behaviors. For example, many communities lack ready sources of healthy food choices, such as supermarkets and grocery stores. Or they may not provide safe places for children to walk or play. In such communities, even the most motivated child or adolescent may find it difficult to act in healthy ways. Local governments-with jurisdiction over many aspects of land use, food marketing, community planning, transportation, health and nutrition programs, and other community issues-are ideally positioned to promote behaviors that will help children and adolescents reach and maintain healthy weights. Local Government Actions to Prevent Childhood Obesity presents a number of recommendations that touch on the vital role of government actions on all levels-federal, state, and local-in childhood obesity prevention. The book offers healthy eating and physical activity strategies for local governments to consider, making it an excellent resource for mayors, managers, commissioners, council members, county board members, and administrators.

Dietary Risk Assessment in the WIC Program reviews methods used to determine dietary risk based on failure to meet Dietary Guidelines for applicants to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Applicants to the WIC program must be at nutritional risk to be eligible for program benefits. Although "dietary risk" is only one of five nutrition risk categories, it is the category most commonly reported among WIC applicants. This book documents that nearly all low-income women in the childbearing years and children 2 years and over are at risk because their diets fail to meet the recommended numbers of servings of the food guide pyramid. The committee recommends that all women and children (ages 2-4 years) who meet the eligibility requirements based on income, categorical and residency status also be presumed to meet the requirement of nutrition risk. By presuming that all who meet the categorical and income eligibility requirements are at dietary risk, WIC retains its potential for preventing and correcting nutrition-related problems while avoiding serious misclassification errors that could lead to denial of services for eligible individuals.

In the United States, people living in low-income neighborhoods frequently do not have access to affordable healthy food venues, such as supermarkets. Instead, those living in "food deserts" must rely on convenience stores and small neighborhood stores that offer few, if any, healthy food choices, such as fruits and vegetables. The Institute of Medicine (IOM) and National Research Council (NRC) convened a two-day workshop on January 26-27, 2009, to provide input into a Congressionally-mandated food deserts study by the U.S. Department of Agriculture's Economic Research Service. The workshop, summarized in this volume, provided a forum in which to discuss the public health effects of food deserts.