FDA Commissioner Scott Gottlieb, MD, has embraced the calorie counts at restaurants a year after his agency put them hold on the eve of his arrival. A Nutrition Facts label update is delayed but not scuttled, in contrast with the reversal of school lunch changes from the Obama administration.
Fifteen years after an advocacy group called for them, calorie counts become the rule today at chain restaurants across the United States, bringing a new tool to the war against diabetes and obesity. Visible support from FDA Commissioner Scott Gottlieb, MD, is part of the story, given where things stood a year ago.
Gottlieb was not sworn in as FDA Commissioner until May 11, 2017, but by then the Trump administration had already taken aim at nutrition legacy of the Obama administration, much of it enshrined in the Affordable Care Act (ACA). On May 4, 2017, FDA delayed an ACA provision that called on chain restaurants with at least 20 locations to post calorie counts, a day before it was to take effect—even though most of the industry had embraced the concept to avoid a patchwork of state and local laws, notably in New York City.
In August 2017, Gottlieb made it clear that the restaurant rules would go into effect, after the Center for Science in the Public Interest (CSPI) and other groups sued FDA over the delay. The groups reached an agreement to give the commissioner time to address some concerns from supermarkets and the pizza industry. The guidance taking effect today differs little from the original in spirit, but a statement Gottlieb released today says it will go far in reducing costs and burdens for businesses and offers flexibility on rules for self-service buffets, billboards, and toppings on pizza.
In an olive branch to the parts of the food industry that remain unhappy, Gottlieb vowed to spend the next year focusing on education instead of enforcement. “We plan to work collaboratively with covered establishments to help them meet the requirements so that more consumers will be able to access and use nutritional information that will now be at their fingertips or in front of them on a menu board,” he wrote. For the first year, “FDA will allow covered entities a reasonable opportunity to make adjustments to bring themselves into compliance.”
For CSPI, today is a milestone. The rule was first envisioned in the ACA, then finalized in 2014, then delayed in 2015. When Trump was elected, many feared all bets were off. An updated article released by the group last week noted that most Americans want restaurant calorie counts since up to a third of meals are eaten away from home. By 2017, the group said, chains like McDonald’s and Panera were already posting calorie counts, while holdouts like Domino’s and some supermarkets still hoped to stop food labeling.
In his statement, Gottlieb makes it clear that from his vantage point, science is on the side of giving consumers more information, especially if the country hopes to reduce rates of chronic disease. That’s why Congress gave FDA the power to enact food labeling rules, he said.
“We know that many Americans both want and use nutritional information on food package labels to make decisions about what to eat to help improve their health. But consumers can’t always access similar information at their favorite restaurant chains. Or there is little consistency in the information that they receive,” he wrote. According to a RAND Corporation study he cited, when Americans have information, they choose items with fewer calories. Over time, Gottlieb said, these individual choices will make a difference.
In the statement from CSPI, former New York City Mayor Michael Bloomberg credited the group with spearheading the menu labeling campaign, and said it works because it consumers want information about their health. “That’s why calorie counts have been so popular since we first introduced them in New York City,” he said. Other research on efforts to get children to drink less soda have shown that arming parents with information is much better received than other methods, such as taxes, and that receptiveness cuts across the parents’ personal views.
CSPI’s food labeling agenda is not complete. The group today issued a “call to action” in response to the notice in the Federal Register that FDA is giving companies additional time to comply with the updated Nutrition Facts label, another Obama-era initiative that more prominently displays calorie counts, segments out added sugar, and offers more realistic serving sizes. Again, many companies have accepted the inevitable and are updating labels ahead of the requirement. This delay, however, stands in contrast to the unraveling of the school lunch requirements at the Department of Agriculture, which were of particular interest to former First Lady Michele Obama.
In an era of health consciousness, elected leaders see advocacy on these issues as a plus. Representative Rosa DeLauro, D-Connecticut, said in the CSPI statement that serving as a sponsor on the national menu labeling law was one of the proudest moments so her time in Congress. “The changes going into effect … give Americans the tools they need to make healthy choices. With rates of obesity and diabetes at crisis levels across the country, consumers deserve to know how many calories are in the food they are buying. After eight years of delays, industry pushback, and lawsuits, this pro-consumer policy is long overdue.”