A wide range of restaurants, cafes, entertainment venues, and even vending machines would have to post calorie counts on food and beverage choices under two proposed rules issued Nov. 25 by the Food and Drug Administration.
Both the restaurant menu rule and the vending machine rule are carrying out requirements by the Affordable Care Act that certain chain restaurants and similar establishments with 20 or more locations disclose certain nutrition information for standard menu items.
“We are responding to legislation, as well as a compelling public health need,” FDA Commissioner Margaret Hamburg said during an FDA press briefing. “Obesity is a huge problem, and we need to develop better strategies to address that,” she said, adding, “a huge contributor is caloric intake.”
Americans eat and drink about one-third of their calories away from home, Dr. Hamburg added. “Making calorie information available on chain restaurant menus and vending machines is an important step for public health that will help consumers make informed choices for themselves and their families.”
The establishments covered by the restaurant rule will be required to clearly and conspicuously display calorie information for standard items on menus and menu boards, next to the name or price; such displays must be in place by Dec. 1, 2015. Menus and menu boards also must note that “2,000 calories a day is used for general nutrition advice, but calorie needs vary.”
Among those covered by the rule: sit-down and fast-food restaurants, bakeries, and coffee shops; restaurant-type foods in certain grocery and convenience stores; take-out and delivery foods such as pizza; foods that you serve yourself from a salad or hot-food bar; foods at amusement parks and movie theaters; and alcoholic drinks when they appear on a menu. Drinks ordered from a bartender, and bottles of liquor at a bar or restaurant are not covered.
In vending machines, calories would be listed on the front of the product for sale or on a sign or sticker near the food or selection button. The rules apply only to operators who control more than 20 vending machines and operators have until Dec. 1, 2016, to comply.
Several physicians praised the intent, but doubted the efficacy of the proposed rules.
“Having the information available doesn’t guarantee attention is paid to it but for those who would otherwise seek the information, the rules make it easier to find, ” said Dr. Joseph Domachowske, professor of pediatrics and professor of microbiology and immunology at the State University of New York (SUNY) Upstate Medical University, Syracuse. But, he added, “I am skeptical that the posted information will have much influence of the dietary decisions of those confronted with it.”
Dr. Lillian Beard applauded the FDA rules, but said, “I do not think it will make a meaningful difference for the population who could most benefit.” Calorie counters will take to the information readily, but “for those who do not want to be bothered, it will become more stuff for their eyes to encounter as they order what they want anyway,” said Dr. Beard, a pediatrician at George Washington University, Washington, D.C.
The American Cancer Society Cancer Action Network said it supports the rules.
“Between one-fourth and one-third of all cancers are caused by poor nutrition, physical inactivity, and excess weight,” Chris Hansen, president of ASC CAN, said in a statement.
He said the group was especially pleased that the rules covered a wide variety of establishments that serve food, and that they applied to certain alcoholic beverages, “considering that alcohol is the fifth leading source of calories in American adult diets.”
The FDA has estimated that the potential benefits of the two rules will far outweigh the costs. The agency first proposed the calorie listing requirements more than 3 years ago, in April 2011 . It took that long to analyze and consider the more than 1,100 comments the FDA received, Dr. Hamburg said.
She said the FDA has no plans to use any information generated from the rules to gauge their impact on eating habits. But she predicted that the rules would create “a great deal of interest” at public health agencies, and from consumer groups and the academic community.
The two proposed rules are open for comment for 30 days after their publication in the Federal Register.
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