Legislation for Nutrition Labeling

on Restaurant Menus

Marie de la CruzPh.D. StudentWalden UniversityPUBH 8165-2Dr. Robert MarinoFall Term, 2011

After this presentation, you will: Recognize the burden of obesity on Americans. Understand the importance of menu

labeling. Describe the benefits of menu labeling. Be aware of current menu labeling

legislation throughout the U.S.

LEARNING OUTCOMES

WE NEED YOUR HELP! Nutritional and calorie labeling is provided on

a voluntary basis. Only 54% of the 300 largest chain restaurants

provide such information. Of the restaurants that make nutritional

information available to consumers, 86% only do so through the Internet (Wootan & Osborn 2006, as cited in Savage & Johnson, 2006).

Most small chain restaurants and smaller establishments provide little or no nutritional information (Wootan & Osborn 2006, as cited in Savage & Johnson, 2006).

Legislation is needed to make this information available on restaurant menus at the point of sale.

THIS IS WHY WE NEED YOU.

(Savage & Johnson, 2006)

WHY ADD NUTRITION & CALORIE INFORMATION ON MENUS?

(1) Reduce obesity epidemic(2) Americans support it

(3) Consumers have a right to information

(4) Customers make healthier choices

(5) Americans eat out more than ever before

(Center for Science in the Public Interest [CSPI], 2008)

MENU LABELING CAN REDUCE OBESITY

Consuming high caloric foods contribute to obesity epidemic.

Studies link eating out with obesity and higher caloric intakes: Davis and Carpenter (2009) French, Story, and Jeffery (2001) Timmerman (2006)

What is Obesity?

Weight greater than what is considered healthy for a specific height.

Ranges determined by Body Mass Index (BMI)

BMI: 25-29 OVERWEIGHT

BMI: >30 OBESE

(Centers for Disease Control and Prevention [CDC], 2011)

The U.S. Obesity Epidemic

1 out of 3 (33.8%) U.S. adults are obese.

34% of adults are overweight (and not obese)

17% (or 12.5 million) of children and adolescents aged 2—19 years are obese.

(CDC, 2011)

Obesity trends continue to increase. All 50 states have obesity prevalence ≥ 20%. 12 states (Alabama, Arkansas, Kentucky,

Louisiana, Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia) have a prevalence ≥ 30%

(CDC, 2011)

Data & Statistics for the State of Maryland

Obesity prevalence increased from 17.5% to 26.3% between 1997 and 2007 (50% increase).

62.7% of Maryland adults were overweight or obese in 2007.

By 2007, 22 out of 24 Maryland jurisdictions had an obesity prevalence ≥ 20% and 11 of 24 jurisdictions had obesity prevalence > 30%(Healthy Active Maryland, 2008)

Impact of Obesity Health:

Type 2 Diabetes Heart Disease Stroke Metabolic disorders Sexual dysfunction &

infertility Certain cancers

(Sloane, 2009)

Economic 2008: Medical costs

associated with obesity: $147 billion (CDC, 2011)

Medical costs $1,429 higher than those of normal weight (CDC, 2011).

Morbidity costs (CDC, 2011)

(CDC, 2011; Obesity in America, n.d.; Sloane, 2009)

AMERICANS SUPPORT MENU

LABELING

Center for Science in the Public Interest (CSPI) : 78% of Americans support menu labeling.

Yale University Rudd Center for Food Policy and Obesity: Up to 83% favor menu labeling.

Bleich and Pollack (2010): 68% favor posting calorie information on menus.

The Food and Drug Administration (FDA), Surgeon General, U.S. Dept. of Health and Human Services, National Cancer Institute (NCI), & the American Medical Assn (AMA) support menu labeling (CSPI, 2008).

(CSPI, 2008; Yale University Rudd Center, 2008; Bleich & Pollack, 2010)

CONSUMERS HAVE A RIGHT TO

INFORMATION

People need nutritional information to manage weight, diabetes, other conditions.

Burton, Creyer, Keys, and Huggins (2006): Levels of calories, fat, and saturated fat in restaurants were significantly underestimated by consumers.

Companies provide information on everything from cars to appliances.

Nutritional Labeling and Education Act (NLEA)

This should apply to restaurant menus

(Burton et al., 2006; CSPI, 2008)

CONSUMERS MAKE HEALTHIER CHOICES

Studies show that providing nutritional information help consumers make healthier choices: CSPI (2008) Dumanovsky, Huang, Bassett, and Silver (2010) Pulos and Leng (2010) Roberto, Larsen, Agnew,

Baik, and Brownell (2010) Burton, Creyer, Kees, and Huggins (2006)

“AMERICANS EAT OUT MORE THAN EVER BEFORE”

(CSPI, 2008, p. 1)

© Michelle Henry

Americans consume 1/3 of calories from restaurants.

1970: Americans spent 26% of food income on restaurant meals

Today, we spend 48% More than 130 million

Americans eat out Adds up to more than 70

billion meal and snack occasions in 2009.

(CSPI, 2008)

Counties & States with Menu Labeling New York City Westchester County,

New York San Francisco,

California Santa Clara County,

California San Mateo County,

California King County (Seattle),

Washington Multnomah County

(Portland), Oregon

Montgomery County, Maryland

Philadelphia, Pennsylvania

Other localities that have or are presently considering menu labeling legislation include: Boston Chicago Minneapolis Nassau County, New York

(CSPI, 2008, as cited in Public Health Law Center, 2009

New York, New York

January 2008: Regulations require calorie disclosure on menus, menu boards, and food tags by all chain restaurants with 15 or more locations nationwide.

Fines are issued to noncompliant restaurants. According to a September 2008 study: 86%

of respondents reported that they considered the law a positive measure and 75% of respondents reported that seeing calorie information on menus made an impact on their ordering decisions.

(Public Health Law Center, 2009)

State of California

The first state to enact menu labeling legislation in the fall of 2008.

Restaurants with 20 or more locations in the state

Must disclose the caloric content of standard menu items on menus, menu boards, and menu tags.

Two-year phase-in periods and an eight-month delayed implementation gives restaurants ample time to comply.

(Public Health Law Center, 2009)

King County, Washington

Example of the struggle between restaurant industries and legislators regarding menu labeling laws.

Menu labeling applies to chain restaurants with at least fifteen locations in the U.S.

Excludes grocery stores, convenience stores, and movie theaters.

Gave restaurants more flexibility in how they can label their menu items.

(Public Health Law Center, 2009)

Montgomery County, Maryland

Resolution 16-1194: Any eating and drinking establishment with at least 20 locations.

Grocery stores, convenience stores, and movie theaters exempt.

Three things must be posted: Calories must be clearly posted next to menu

item. A statement as to the current suggested daily

caloric intake (2,000 calories) determined by the U.S. Department of Health and Human Services.

A statement that additional nutrition information is available in writing upon request.

(Montgomery County MD Department of Health and Human Services., n.d.)

YOU CAN MAKE A DIFFERENCE

SUPPORT MENU LABELING

LEGISLATION

THANK YOUQuestions?

REFERENCES:

Bleich, S. N., & Pollack, K. M. (2010). The publics' understanding of daily caloric recommendations and their perceptions of calorie posting in chain restaurants. BMC Public Health. Retrieved from the Academic Search Premier database. (Accession No. 49161865)

Burton, S., Creyer, E. H., Kees, J., & Huggins, K. (2006). Attacking the obesity epidemic: The potential health benefits of providing nutrition information in restaurants. American Journal of Public Health, 96(9), 1669-1675. Retrieved from the Academic Search Premier database. (Accession No. 22304271)

Center for Science in the Public Interest [CSPI]. (2008). Nutrition labeling at fast-food and other chain restaurants. Retrieved from http://cspinet.org/new/pdf/fact_sheet_2008.pdf

Centers for Disease Control and Prevention [CDC]. (2011). Overweight and obesity. Retrieved from http://www.cdc.gov/obesity/index.html

Davis, B., & Carpenter, C. (2009). Proximity of fast-food restaurants to schools and adolescent obesity. American Journal of Public Health, 99(3), 505-510. doi:10.2105/AJPH.2008.137638

Dumanovsky, T., Huang, C. Y., Bassett, M. T., & Silver, L. D. (2010). Consumer awareness of fast-food calorie information in New York City after implementation of a menu labeling regulation. American Journal of Public Health, 100(12), 2520-2525. doi:0.2105/AJPH.2010.191908

REFERENCES (cont)

French, S., Story, M., & Jeffery, R. (2001). Environmental influences on eating and physical activity. Annual Review of Public Health, 22(1), 309. Retrieved from the Academic Search Premier database. (Accession No. 5366831)

Healthy Active Maryland. (2008). Burden of overweight and obesity in Maryland: Data update summary, 2008. Retrieved from http://www.healthyactivemaryland.org/2008_BURDEN_OF_ADULT_OVERWEIGHT_AND_OBESITY_IN_MARYLAND_Final1.pdf

Montgomery County MD Department of Health and Human Services. (n.d.). Nutrition labeling in eating and drinking establishments: Moving to a healthier Montgomery County. Retrieved from http://www.montgomerycountymd.gov/content/hhs/license/Administrative/WhatsNew/menulabelingfaq.pdf

Obesity in America. (n.d.). Obesity-related diseases. Retrieved from http://www.obesityinamerica.org/understandingObesity/diseases.cfm

Public Health Law Center. (2009, January). Menu labeling legislation: Options for requiring the disclosure of nutritional information in restaurants. Retrieved from http://publichealthlawcenter.org/sites/default/files/resources/phlc-policy-menu-labeling.pdf

Pulos, E., & Leng, K. (2010). Evaluation of a voluntary menu-labeling program in full-service restaurants. American Journal of Public Health, 100(6), 1035-1039. doi: 10.2105/AJPH.2009.174839

REFERENCES (cont)

Roberto, C. A., Larsen, P. D., Agnew, H., Baik, J., & Brownell, K. D. (2010). Evaluating the impact of menu labeling on food choices and intake. American Journal of Public Health, 100(2), 312-318. Retrieved from the Academic Search Premier database. (Accession No. 47521828)

Savage, L. C., & Johnson, R. K. (2006). Labeling in restaurants: will it make a difference?. Nutrition Bulletin, 31(4), 332-338. doi: 10.1111/j.1467-3010.2006.00591.x

Sloane, M. (2009). Obesity responsible for 100,000 cancer cases annually. Retrieved from http://articles.cnn.com/2009-11-05/health/obesity.cancer.link_1_cancer-cases-cancer-research-endometrial-cancers?_s=PM:HEALTH

Timmerman, G. M. (2006). Restaurant eating in nonpurge binge-eating women. Western Journal of Nursing Research, 28(7), 811-824. doi: 10.1177/0193945906289501

Yale University Rudd Center. (2008). Menu labeling in chain restaurants: Opportunities for public policy. Retrieved from http://www.yaleruddcenter.org/resources/upload/docs/what/reports/RuddMenuLabelingReport2008.pdf

FOR FURTHER INFORMATION:

Center for Science in the Public Interest [CSPI]. (2008). Nutrition labeling at fast-food and other chain restaurants. Retrieved from http://cspinet.org/new/pdf/fact_sheet_2008.pdf

Public Health Law Center. (2009, January). Menu labeling legislation: Options for requiring the disclosure of nutritional information in restaurants. Retrieved from http://publichealthlawcenter.org/sites/default/files/resources/phlc-policy-menu-labeling.pdf

Yale University Rudd Center. (2008). Menu labeling in chain restaurants: Opportunities for public policy. Retrieved from http://www.yaleruddcenter.org/resources/upload/docs/what/reports/RuddMenuLabelingReport2008.pdf