Julia Childs on Nouvelle Cuisine: "It's so beautifully arranged on the plate - you know someone's fingers have been all over it".

Is it a coincidence that STRESSED is DESSERTS spelled backwards?

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To implement the menu labeling provisions of the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), the Food and Drug Administration (FDA) has proposed requirements for providing certain nutrition information for standard menu items in certain chain restaurants and similar retail food establishments. The premise is that the public health impacts of overconsumption of calories and poor nutrition can be partly overcome by providing menu nutrition information at the time and place where consumers make food choices, such as restaurants. Perhaps you have seen the addition of calorie information to the menu in your favorite restaurant? This 2010 law was supported by both the National and California Restaurant Associations as it created a single Federal law for menu labeling that pre-empted the rash of municipal laws that were being passed and written hodge-podge by various states and cities throughout the US. 

On April 6, 2011 FDA published in the Federal Register their proposed enforcement rule for nutrition labeling of standard menu items. Of concern to institutional food service providers has been if this menu labeling law applies to hospitals and other licensed health care facilities such as SNF. How or where would our dining services be required to post not only calories, but the other eight nutrients that must be made available upon request? How would this information help LTC residents to make better food choices?   

Although this law was effective March 23, 2010, the food service industry has been waiting for the final enforcement guidelines to fully understand the impact of the law. In fact, even the National Restaurant association had taken a position that since the FDA Model Food Code applies to hospitals, therefore the FDA menu labeling laws would also apply to hospitals. These new proposed restaurant menu labeling enforcement rules are very clear that healthcare menus are NOT covered by this law in that they are not the primary business of the hospital; kitchen and dining services do not constitute more than half of the facility square footage; nor does the cafeteria constitute more than 50% of the revenue of hospitals. Further, the proposed rule also states that contractors providing food service in a hospital would not need to comply with the menu labeling in their hospital accounts just because they provide food services to other types of restaurant establishments in 20 or more locations that are covered.   

Since healthcare facilities are exempted, one undecided point is whether to allow states or municipalities to establish their own menu labeling laws for healthcare or other institutions since this FDA law does not apply. The FDA is also considering if the final rule should state that only the FDA can promulgate further regulations of menu nutrition labeling for any venue not all ready covered. The 46 page proposed rule can be read at www.regulations.gov by looking for document FDA-2011-F-0172-0001. The management team at Nutricopia is supporting the FDA position that only FDA be allowed to promulgate additional menu labeling laws so as to maintain a consistent Federal standard for menu labeling rather than allowing for a vacuum in the specific area of hospital menu labeling laws. Our healthcare profession is all ready highly regulated, specifically regulated for nutritional adequacy of menus, and the additional burden of menu labeling in hospitals and healthcare must be carefully researched and evaluated on the Federal level. Comment period ends June 6, 2011 and comments can be easily submitted at the above link.  

Feel free to provide your comments at the link www.regulations.gov for document FDA-2011-F-0172-0001 in support of FDA maintaining the "gatekeeper" status for further menu labeling laws. 

Judy Morgan, MBA, RD
Editor