The Move Toward National Menu Labeling

As the national consciousness regarding nutrition and physical activity continues to rise, the Food and Drug Administration (FDA) is actively preparing the framework to guide the nation’s chain restaurants toward caloric disclosure as mandated by the Patient Protection and Affordable Care Act.

“Diet-related chronic disease takes a heavy toll on American lives. The dangers of heart disease, stroke and diabetes are significant, and they are preventable,” noted FDA spokesperson Siobhan DeLancey, RVT, MPH. “Consumers are besieged by tough food choices in a variety of environments; approximately one-third of all meals are consumed outside of the home. FDA believes menu labeling is a tremendous opportunity to provide consumers with information about the nutritional value of the food they eat every day so they can make better food choices.”

It’s a move broadly supported by healthcare associations, public health officials, and the National Restaurant Association. Although some local and state restaurant and hospitality associations opposed local ordinances regarding menu labeling over the past few years, objection was largely tied to implementation and concerns over managing inconsistent rules from city to city.

“From an industry standpoint, we think having one national standard as opposed to a patchwork of state and local requirements is preferable,” said Dan Roehl, public affairs specialist for the National Restaurant Association. “And certainly,” he continued, “providing nutritional information to consumers allows them to make the best decisions for their own dietary needs.”

Roehl stressed that while his association was not in favor of the broader healthcare reform law, the group has been a vocal advocate for providing key nutritional information to consumers. In 2008, Sens. Tom Carper (D-Del.) and Lisa Murkowski (R-Alaska) first introduced the Labeling Education and Nutrition Act (LEAN) calling for chains with more than 20 locations to post calorie counts for menu items.

At the time, Carper said, “This bill is not going to magically solve our obesity problems, but I do believe we have a responsibility to give Americans … more and more of whom are eating outside the home these days … the tools they need to make healthy, educated choices.”

The National Restaurant Association came out in support of the LEAN Act in 2008 and again when it was reintroduced in 2009. However, the association opposed an earlier nutritional labeling bill — The MEAL Act (Menu Education and Labeling) introduced by Rep. Rosa DeLauro, (D-Conn.) and Sen. Tom Harking (D-Iowa). Ultimately what was included in the March 2010 healthcare reform law was a bipartisan compromise between LEAN and MEAL that did have the strong support of the National Restaurant Association.

Although packaged foods have been required to include nutrition information since the Nutrition Labeling Education Act was signed into law two decades ago on Nov. 8, 1990, this is the first time prepared foods have come under similar scrutiny. The new law has several mandates but also offers some protections and exemptions for establishments that are required to comply or that do so voluntarily. Key components include:

• Restaurants and similar food retail establishments (and vending machine operators) in a chain of 20 or more locations under the same name must provide nutritional information on standard menu items offered for sale at least 60 days per calendar year.
• Requirements do not apply to condiments, most alcoholic beverages, daily specials, custom orders and customary test marketing menu offerings (those on the menu less than 90 days).
• Menus, menu boards and drive thru boards must include the number of calories for standard menu items plus a short statement concerning recommended daily caloric intake. Additionally, there must be a referral statement regarding the availability of additional nutrition information. Upon request, impacted food establishments and vendors must provide written information about standard menu items including calories, calories from fat, total fat, saturated fat, cholesterol, sodium, carbohydrates, sugars, dietary fiber and protein.
• Impacted restaurants and food vendors are protected from unreasonable litigation over accuracy of nutrient content disclosure. Final regulations must consider “reasonable variation” in serving size and formulation of menu items. Nutrition information should be determined by “reasonable basis,” which is believed to include deriving information from nutrient databases, cookbooks, laboratory analyses and other reasonable means.
• The federal law preempts state and local ordinances, and non-chain restaurants (or chains in advance of the mandatory program) that voluntarily introduce menu labeling are provided the same legal protection as the mandatory program will offer upon national rollout.
• The FDA issued two guidance documents on the federal menu labeling program in late August. According to a timeline set forth in the healthcare reform law, a proposed rule is due from the FDA by March 2011.

“All indications we’ve heard from the FDA are that they plan to meet that deadline for the proposed rulemaking,” said Roehl. “It’s our anticipation that restaurants are going to have an interest in making comments so we want to ensure there is adequate time for comments.”

In fact, DeLancey with the FDA noted, “The agency is engaging state and local partners, along with the industry and consumer groups, to help develop the proposed rule.” Enforcement isn’t expected to go into effect until after a final rule is established and an adequate amount of time for compliance has been allotted.

Once the law is nationally implemented, it will be interesting to see what impact it has on eating habits. Roehl said he believes the questions to be studied and answered are two-fold:

1.      Did the information impact a buying decision onsite?

2.      Did that purchasing decision change the eating habits or experience for the whole day … and if so, for better or for worse?

“Menu labeling is still so new I don’t think there is a lot of good analysis of what that impact looks like,” Roehl said. Still, the latest information from the National Restaurant Association shows America’s restaurants are embracing healthier options and ‘putting nutrition at the center of the plate.’ The association’s “What’s Hot in 2010?” survey of professional chef members of the American Culinary Federation found nutrition to be a major focus, and nutritionally balanced dishes topped the trend list for children’s meals. Additionally, the association found menu items listed as “healthy” increased 65 percent between the second quarter of 2009 and the second quarter of 2010.

The bottom line for most stakeholders in the national conversation on menu labeling is that the new law provides more information to help inform choices. Whether or not consumers use that information remains to be seen.

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Heading: Helping Consumers Get a Handle on Dining Options

To truly help patients make dietary changes, they must first understand how to use nutrition facts and have easy access to useful information.

A nutrition facts primer is available through the U.S. Food and Drug Administration at www.fda.gov/Food/LabelingNutrition/ConsumerInformation.

The National Restaurant Association has a web-based tool to help diners find the best choices at favorite chain restaurants. Healthy Dining Finder (www.healthydiningfinder.com) allows searches by geographic location, name of restaurant and price range. The site also includes information on nutrition criteria, sodium savvy, tips for healthy dining and hyperlinks to other national resources.

Diabetes Daily: www.diabetesdaily.com/wiki/Restaurant_Nutrition_Guides and Wiki Weight Watcher: www.wikiweightwatcher.com also publish free restaurant nutrition guides online. Additionally, there are now multiple calorie-counting apps available for mobile devices.