Local restaurants can provide nutritional health empowerment:

Through nutritional information on dine-in and take-out menus in local restaurants

Gladys Crews, MPH student Walden University

PUBH 6165-1 Instructor: Dr. Howard Rubin

November 4, 2012

Learning objectives

South Shore restaurants Purpose U.S. FDA regulation of nutritional information on menus Obesity in the U.S.

Definition of Obesity Causes and outcomes Statistics and evidence

Strategies for making an impact Conclusions References

Further suggested readings

Restaurants in South Shore

Over 100 restaurants in the area 2 vegetarian restaurants

There’s a need for healthy, dine-out, meal choices for the area

Grid of City of Chicago neighborhoods used with permission from the City of Chicago

Purpose of today’s discussion

Motivate restaurants to include nutritional information on menus Addressing obesity in dining out situations

Make an impact on obesity Nutritional empowerment

FDA regulation of nutritional information on menus (FDA, 2012)

March 23, 2012 Health care reform became a law The Patient Protection and Affordable Care Act Section

4205 requires the posting of calories of items on menus Regulated and enforced by the U.S. FDA

Required for restaurants with 20 or more locations

Not required for restaurants with less than 20 locations Owners can voluntarily register with the U.S. FDA

Source: FDA. (2012). New Menu and Vending Machines Labeling Requirements. Retrieved from http://www.fda.gov/Food/LabelingNutrition/ucm217762.htm

Continuation slide: FDA regulation of nutritional information on menus (IRAMB, 2012)

The Act costs the federal government over $238 million Benefits the lives and health of 0.6% of obese adults

Outweighs governmental monetary costs by saving consumers lives.

Source: Office of Information and Regulatory Affairs Office of Management and Budgets (IRAMB). (2012). View Rule: RIN: 0910-AG57. Retrieved from http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201110&RIN=0910-AG57

Obesity and overweight (CDC, 2012)

Clinical definitions of obesity Health outcomes from being obese

Heart disease, hypertension, diabetes, cancer, and other chronic diseases

Source: CDC. (2012). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/adult/defining.html

Clinical example of and obese adult (CDC, 2012)

Height Weight (lbs.) BMI ranges Classification

5' 9"

124 or less Below 18.5 Underweight125 to 168 18.5 to 24.9 Healthy weight169 to 202 25.0 to 29.9 Overweight203 or more 30 or higher Obese

Source: CDC. (2012). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/adult/defining.html

Causes of obesity (CDC, 2012)

Source: CDC. (2012). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/adult/defining.html

Caloric intake imbalances Eating too much high caloric and fatty meals

Burning less calories (lack of exercise)

Environments and socioeconomic status (SES) Restaurants in lower SES communities serve higher caloric and

fatty meals Eating buffet style meals increases caloric intake

Other risk factors and negative health behaviors

Prevalence of obesity in adults living in the U.S. (Ogden et al., 2006)

Source: Ogden, C., Carroll, M., Curtin, L., McDowell, M., Tabak, C., Flegal, K., (2006). Prevalence of Overweight and Obesity in the United States, 1999-2004. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=202627

Obesity, from the National Health and Nutrition Examination Survey (NHANES), was evaluated in White, Black, and Mexican adults (n= 4431) living in the U.S. Prevalence of obesity in men increased 3.6%

Women showed a 0.2% decrease

Prevalence of obesity and extreme obesity was higher in adult Blacks

Blacks and Mexicans are at risk for being obese and extremely obese

Prevalence of obesity in Illinois (CDC, 2012)

Source: CDC. (2012). Behavioral Risk Factor Surveillance System: Prevalence and Trends Data. Retrieved from http://apps.nccd.cdc.gov/brfss/

Midwest states are closely following Southern states in prevalence of obesity Highest prevalence of obesity (29.5%) in the Southern regions of

the U.S.

Obesity and race/ethnicity in IL High prevalence in Blacks and Whites

Obesity in IL compared to the U.S. IL is 0.7% behind the U.S. prevalence of obesity

How local restaurants could make an impact

Register with the U.S. FDA if not registered Display caloric information on menus

Add more healthy meal choices to menus Modify the preparation processes of some common meals

References

Bezerra, I., Curioni, C., and Sichieri, R. (2012). Association between eating out of home and body weight. Retrieved from

http://www.ncbi.nlm.nih.gov/pubmed/22300594

CDC. (2012). Behavioral Risk Factor Surveillance System: Prevalence and Trends Data. Retrieved from http

://apps.nccd.cdc.gov/brfss/

CDC. (2012). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/adult/defining.html

City-data. (2012). South Shore neighborhood in Chicago, Illinois (IL), 60619, 60637, 60649 detailed profile. Retrieved from

http://www.city-data.com/neighborhood/South-Shore-Chicago-IL.html

FDA. (2012). Calories Count and Keystone Report FDA Obesity Working Group Report and Related Information Keystone

Report Documents. Retrieved from http://www.fda.gov/Food/LabelingNutrition/ReportsResearch/ucm081114.htm#key

FDA. (2012). New Menu and Vending Machines Labeling Requirements. Retrieved from http://

www.fda.gov/Food/LabelingNutrition/ucm217762.htm

FOX Chicago News. (2012). The Talker: Soda vending machines to display calorie labels. Retrieved from http://

www.myfoxchicago.com/story/19768401/the-talker-calorie-labels-will-soon-be-on-vending-machines

Office of Information and Regulatory Affairs Office of Management and Budgets (IRAMB). (2012). View Rule: RIN: 0910-

AG57. Retrieved from http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201110&RIN=0910-AG57

Office of the Legislative Counsel. (2010). Title IV—Prevention of chronic disease and improving public health: Subtitle A-

Modernizing disease prevention and public health systems. Retrieved from http

://housedocs.house.gov/energycommerce/ppacacon.pdf

 Ogden, C., Carroll, M., Curtin, L., McDowell, M., Tabak, C., Flegal, K., (2006). Prevalence of Overweight and Obesity in the

United States, 1999-2004. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=202627

Wikipedia. (2012). South Shore, Chicago. Retrieved from http://en.wikipedia.org/wiki/South_Shore,_Chicago

 

Further reading recommendations For more information please read or access the following:

The Mayor’s comments about calorie labels on vending machines: http://www.myfoxchicago.com/story/19768401/the-talker-calorie-labels-will-soon-be-on-vending-machines#ixzz29pXI7qyr

Patient Protection and Affordable Care Act Health-Related Portions of the Healthcare and Education Reconciliation Act of 2010: http://housedocs.house.gov/energycommerce/ppacacon.pdf

DHHS/FDA Menu And Vending Machine Labeling Voluntary Registration form http://www.fda.gov/downloads/Food/LabelingNutrition/UCM219677.pdf

Need assistance with filling out voluntary registration form call: 240-402-2371

The FDA (2012) works closely with stakeholders, including the restaurant industry to implement this important new law and all stakeholders are encouraged to share their thoughts about the proposed rules.Submit your comments electronically to the docket at www.regulations.govChoose “Submit a Comment” from the top task bar Enter the following docket number in the “Keyword” space FDA-2011-F-0172 (menu) Then select “Search”

To submit your comments to the docket by mail, submit to:The Division of Dockets ManagementHFA-305Food and Drug Administration5630 Fishers Lane, Room 1061Rockville, MD 20852Be sure to include the appropriate docket number on each page of your written comments.

Source: FDA. (2012). New Menu and Vending Machines Labeling Requirements. Retrieved from http://www.fda.gov/Food/LabelingNutrition/ucm217762.htm