cover foods sold in movie theaters, casinos, bowling alleys, stadiums, cafes in superstores, hotels, and airlines

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1 July 5, 2011 Division of Dockets Management (HFA-305) Food and Drug Administration 5630 Fishers Lane, Room 1061 Rockville, MD Docket No: FDA-2011-F-0172 and FDA-2011-F-0171 Food Labeling; Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Food Establishments and Food Labeling; Calorie Labeling of Articles in Vending Machines We, the undersigned, strongly support menu labeling at chain restaurants and calorie labeling for vending machines. With American adults and children consuming about one-third of their calories from restaurants and other similar retail food establishments, menu and vending labeling will provide important tools to allow people to make informed food choices. The Food and Drug Administration (FDA) has generally proposed sound and clear regulations on how to fulfill the requirements of the law. However, we respectfully urge the FDA to reconsider several of the proposed provisions. We vigorously urge the FDA to return to the definition of restaurants and similar retail food establishments in the draft menu labeling guidance that the FDA issued last summer, and cover foods sold in movie theaters, casinos, bowling alleys, stadiums, cafes in superstores, hotels, and airlines. Many of the foods sold in the venues that the FDA has proposed exempting are similar to foods that will be covered in restaurants. It would be unfair if those competing venues were exempted from menu labeling. Such an interpretation of the definition would significantly limit the ability of consumers to make informed choices by reducing the number of venues providing calorie labeling. We strongly oppose the exemption for alcoholic beverages from menu labeling. Labeling of alcohol drinks on menus and menu boards is important given the contribution of alcoholic beverages to Americans' calorie intake and the fact that the calorie content of alcoholic beverages can vary widely. We are pleased that the FDA plans to do research on how restaurants should label variable menu items and urge the FDA to provide additional guidance to help ensure that restaurants provide meaningful calorie labeling for menu items that come in multiple flavors, varieties, and combinations. We support the FDA's proposal that all primary writings from which customers make ordering decisions must provide calorie labeling, including menu boards, take-out menus, children's menus, dessert menus, and food display tags. We also agree that the law requires calories be posted directly on drive-through menu

2 boards. Separate stanchions can be hard to read, especially from a car, where customers have limited mobility and field of vision. We agree with the FDA that calories must be listed per standard menu, displayed or vended item as offered for sale, even if it provides multiple servings. It would be deceptive to label a bag of chips as 160 calories (per one-ounce serving) on a vending machine, only to have people discover that the whole bag of chips contained 240 calories once they purchased it. We strongly oppose the FDA's proposal to allow companies to post the calories for all vending machine items on a single sign next to a vending machine. Section 4205 of the Affordable Care Act requires that companies must "provide a sign in close proximity to each article of food or the selection button" providing the calories for each vended item (emphasis added). It is essential that the nutrition information to be easy to see, find, and use. We agree with the FDA's proposed definition of vending machines. However, we urge the FDA to require calorie labeling for all types of vending machines included in that definition. Bulk vending machines, which make up 20 percent of vending machines and often dispense nutrition-poor candy, should provide calorie disclosures. We strongly support FDA s proposal to implement menu labeling six months following publication of the final rule, and ask that vending labeling be implemented on the same time table. If six months is enough time for restaurants, it should be ample time for vending operators. We ask the FDA to provide more detailed guidance on serving sizes for calorie disclosures for foods on display in restaurants and on enforcement in the final regulations. It is essential that there be a clear and strong enforcement scheme in place to ensure compliance. We respectfully urge the FDA to address the above issues in the final rule and look forward to the publication of the final menu and vending labeling rules by the end of Respectfully, Adam Tsai, MD University of Colorado Denver Advocates for Better Children s Diets American Academy of Pediatrics American Association for Health Education American Cancer Society Cancer Action Network American College of Preventive Medicine American Diabetes Association American Heart Association

3 American Nurses Association American Public Health Association American Society of Bariatric Physicians Anita Courtney, MS, RD Chairperson, Tweens Nutrition and Fitness Coalition Arkansas 5 A Day Coalition Association of State & Territorial Public Health Nutrition Directors Association of State and Territorial Health Officials Be Active New York State Berkeley Media Studies Group California Association of Nutrition and Activity Programs (CAN-Act) California Center for Public Health Advocacy California Food Policy Advocates California WIC Association Campaign for a Commercial-Free Childhood Catalyst Center for Communication, Health & the Environment Center for Science in the Public Interest Consumer Federation of America Corporate Accountability International David Britt Retired CEO, Sesame Workshop Defeat Diabetes Foundation Directors of Health Promotion and Education Disciples Justice Action Network Eat Smart, Move More South Carolina FGE Food & Nutrition Team Healthy Living Rochester Indiana Rural Health Association Integrated Healthcare Policy Consortium Latino Coalition for a Healthy California Leadership for Healthy Communities Liz Kniss Santa Clara County (CA) Supervisor Louisiana Public Health Institute Maine Public Health Association Obesity Policy Committee Marin Institute Marion Nestle, PhD, MPH New York University Mark B. Horton, MD, MSPH State Health Officer/Director California Department of Public Health Mary Miller Springdale School District (Arkansas) Coordinated School Health

4 Mary Story, PhD, RD University of Minnesota MobileMD National Action Against Obesity National Association of Chronic Disease Directors National Association of County and City Health Officials (NACCHO) National Association of Local Boards of Health (NALBOH) National Association of Pediatric Nurse Practitioners National Congress of Black Women, Inc. National Consumers League National Parent Teacher Association (PTA) National Physicians Alliance National WIC Association National Women s Health Network New England Coalition for Health Promotion and Disease Prevention (NECON) New York State Healthy Eating and Physical Activity Alliance (NYSHEPA) North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Nutrition Policy & Legal Analysis Network to Prevent Childhood Obesity (NPLAN), a project of Public Health Law & Policy Ohio Public Health Association Oral Health America Oregon Public Health Institute Partnership for Prevention Physicians Committee for Responsible Medicine Preventive Cardiovascular Nurses Association Public Health Institute Public Health Seattle & King County Richard J Jackson, MD, MPH University of California, Los Angeles Robert Wood Johnson Foundation Center to Prevent Childhood Obesity Rudd Center for Food Policy and Obesity, Yale University Samuels & Associates Service Employees International Union Local 32BJ Shape Up America! Society for Nutrition Education Trust for America s Health

5 US Water Fitness Association Washington State Childhood Obesity Coalition Young People's Healthy Heart Program For more information, contact Margo G. Wootan, CSPI, at or