February 12th, 2024
Proposed Rule Title Menu Labeling: Supplemental Guidance for Industry
(Edition 2)
Docket No. FDA-2011-F-0172
We appreciate the opportunity to comment on the FDA’s draft guidance regarding: “Menu Labeling: Supplemental Guidance for Industry”.
The National Center for Health Research (NCHR) is a nonprofit think tank that conducts, analyzes, and scrutinizes research on a range of health issues, with a particular focus on which prevention strategies, treatments, and products are most effective for patients and consumers. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.
We appreciate the FDA’s proposal to help consumers make an informed decision about their food choices. Current menu labeling regulations require that “covered establishments” (i.e. chain restaurants) provide nutritional information for standard menu items to consumers on physical menus and “on internet” menus.[1] Unfortunately, in this guidance the FDA fails to specify that third party platforms (such as GrubHub or Ubereats) would be considered “on internet” menus and would therefore be subject to mandatory disclosure on these websites and apps. This failure is harmful to public health because a substantial percentage of American consumers use these third-party platforms to order food and the percentage will continue to rise over the coming years.[2]
Similarly, the FDA should use their power to require mandatory disclosure of added sugars on standard menu items on physical menus and internet menus of “covered establishments” as well as on third-party platforms. It is well established that the average American adult, teenager, and child consumes substantially more sugar than is recommended by the 2020-2025 Dietary Guidelines for Americans.[3] NCHR recognizes high sugar consumption as a major burden to public health, increasing the risk of diabetes and cardiovascular disease. However, to have a meaningful impact on sugar consumption, it is vital for the FDA to make disclosures of added sugar mandatory for standard menu items for chain restaurants as well as on third party platforms.
Consumers deserve easy access to this information regardless how they interact with restaurants to order and receive food. Lack of awareness of the nutritional content of food consumed is associated with poor health behaviors and subsequently increases the risk of developing chronic diseases. [4] [5] [6] Bridging this gap in awareness can mitigate these effects and help people lead healthier lives.
The current draft guidance relies entirely on the “covered establishments” voluntarily including information about added sugar. There is no incentive for restaurants and other food establishments to comply with the recommendations made in this draft guidance. For that reason, voluntary action is insufficient to improve the health of American adults and children and we strongly urge the FDA to use their authority to make these recommendations mandatory.
[1] 21 C.F.R. § 101.11(a).
[2] Online Food Delivery—Worldwide | Statista Market Forecast. (n.d.). Statista. Retrieved February 11, 2024, from https://www.statista.com/outlook/dmo/online-food-delivery/worldwide
[3] Dietary Guidelines for Americans, 2020-2025. (n.d.). Accessed January 16th. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf
[4] Wojcicki, J. M., & Heyman, M. B. (2012). Adolescent nutritional awareness and use of food labels: Results from the national nutrition health and examination survey. BMC Pediatrics, 12(1), 55. https://doi.org/10.1186/1471-2431-12-55
[5] Wu, Y., Wang, S., Shi, M., Wang, X., Liu, H., Guo, S., Tan, L., Yang, X., Wu, X., & Hao, L. (2022). Awareness of nutrition and health knowledge and its influencing factors among Wuhan residents. Frontiers in Public Health, 10, 987755. https://doi.org/10.3389/fpubh.2022.987755
[6] Alkerwi, A., Sauvageot, N., Malan, L., Shivappa, N., & Hébert, J. R. (2015). Association between Nutritional Awareness and Diet Quality: Evidence from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) Study. Nutrients, 7(4), 2823–2838. https://doi.org/10.3390/nu7042823