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Strategies to Reduce Sodium Intake in the United States
applicable to such claims on packaged foods, but notice-and-comment rulemaking could be used to expand or adjust these regulations to include restaurant/foodservice menu items as appropriate. It is important to note that such rulemaking would relate only to the voluntarily use of such claims by restaurant/foodservice operations, as they do now to packaged foods. The advantage of such provisions is that they could be considered specifically for the unique characteristics of restaurant/foodservice operations and would offer the opportunity for a consistent approach and format across this industry.
As noted earlier, while there are no specific provisions for Nutrition Facts panel type of information on menus, FDA has sought to enlist the assistance and support of restaurants in addressing national obesity concerns by urging them to provide point-of-sale nutrition information to consumers (HHS/FDA, 2004). Further, as signed into law in March 2010, the PatientProtection and Affordable Care Act33 contains provisions to address nutrition labeling of menu items. Restaurants with 20 or more outlets are required to post calories on menus, menu boards (including drive-thrus) and food display tags, with additional information (fat, saturated fat, carbohydrates, sodium, protein, and fiber) available in writing upon request. This requires national uniformity, ensuring consistency in information provided. States and localities would not be able to require additional nutrient information on menus.
STATE AND LOCAL MENU LABELING INITIATIVES
The recognition of the contribution that menu items from restaurant/foodservice operations make to the American diet, coupled with growing public health concerns about obesity and other chronic diseases, has increased the focus on point-of-purchase nutrition information within restaurant/foodservice operations. To a large extent, these initiatives are being driven by state and local public health authorities.
Before passage of the Patient Protection and Affordable Care Act, some states and localities considered or passed into law proposals to provide customers with sodium information at the point of purchase. Examples of these initiatives are summarized in Appendix J.
Patient Protection and Affordable Care Act, HR 3590, Title IV, Subtitle C, § 4205; 111th Congress, 2nd session, March 2010.