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Eating Well While Eating Out: How calories on the menu can

guide healthy choiceshttps://learn.extension.org/events/2145

This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, and the Office of Family Readiness Policy, U.S. Department of Defense under Award Numbers 2012-48755-20306 and 2014-48770-22587.

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MFLN Nutrition and Wellness

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• 15 years in corporate dietetics with experience in packaged foods, restaurant and retail

Meet Cheryl L. Dolven, MS, RD

“I am passionate about making menu labeling manageable for businesses and

meaningful for consumers.”

Eating Well While Eating Out: How calories on the menu can help guide healthy choices

Cheryl L. Dolven, MS, RD

ObjectivesAt the end of this presentation, participants will be able to:

1. Describe the basic tenants of FDA’s menu labeling legislation

2. List at least 3 new insights about eating away from home (and its impact on dietary intake and health outcomes)

3. Apply new ideas and resources (including calories on the menu) to help consumers make better choices when eating outside the home

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Our agenda

A look at eating away

from the home

A review of

the regulation

Ideas to put menu labeling to

work

A review of resources

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Section 1A look at eating away from home

Eating out: The new norm? • nine in 10 consumers say they enjoy going to restaurants

• half of consumers say restaurants are an essential part of their lifestyle

• seven in 10 consumers say their favorite restaurant foods provide flavors they can’t easily duplicate at home

• eight in 10 consumers say dining out with family and friends is a better use of their leisure time than cooking and cleaning up

http://www.restaurant.org/Downloads/PDFs/News-Research/research/Factbook2015_LetterSize-FINAL.pdf

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The majority of calories come from home

• 63-76% of dietary energy comes from grocery stores

• Total FAFH represents up to 32% of total daily calories

• No age group consumes more than 25% of their calories from restaurant foods

• “contrary to popular belief, restaurant-sourced pizza, burgers, chicken and French fries accounted for less energy than store sourced breads, grain-based desserts, pasta and soft drinks.”

Drewnowski A, Rehm CD. Energy intakes of US children and adults by food purchase location and by specific food source. Nutr J 2013;12:59

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A systematic literature

  General to Topic

Fast Food Specific

Menu Labeling

 Review

 Total

Children & Adolescents 20 18 7   45Consumer Behavior 3 9 38 3 53

Nutrients/Diet Quality 13 17 6 1 37Health Outcomes 9 17   4 30

Total 45 61 51 8 165

Summary of papers reviewed based on PubMed literature search through January of 2014; C.McGill

There are no consistent definitions for type of restaurant in the literature – which makes an examination of the findings difficult.

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A systematic literature review (cont.)

There are no experiment studies and only one randomized control trial.

TYPE OF STUDY  Experimental 0Randomized controlled trial 1Quasi-experimental 5Observational 0Cohort 15Case-control 0Cross-sectional 68Before & after study 3Case series 0Restaurant density 1Mathematical modeling 1

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Insights from the literatureDietary Intake: • In general, consumption of FAFH is associated with decreased diet quality and increased intakes of energy, total fat, saturated fat and sodium

Health outcomes:• Body weight or BMI is the most often reported health outcome

• Results are mixed• Type of restaurant appears to be an important factor

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Eating well while eating out is possible!• The only randomized control trial in the current literature demonstrated that eating out can be part of a healthy diet pattern -6 weekly 2-hour small group sessions-education, behavior change strategies and mindful eating meditations

• Participants in the intervention group: -lost significantly more weight -had lower average daily caloric and fat intake -had increased diet related self-efficacy-had fewer barriers to weight management when eating out

Timmerman & Brown, 2011

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Eating well while eating out is possible!

http://www.nutrition411.com/articles/eating-well-while-eating-out-toolkit-healthcare-professionals

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Section 1 Summary• Eating away from home is an intrinsic part of today’s lifestyle

• The majority of calories still come from “at home” consumption

• Restaurant meals tend to be higher in calories, fat and sodium

• Research and HEI modeling demonstrate FAFH can fit into a healthy lifestyle

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QUESTIONS

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Section 2A review of the regulation

How did the regulation come to be?

http://cspinet.org/new/pdf/ml_map.pdf

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How did the regulation come to be? (cont)

Jan 2011 Jan 2012 Jan 2013 Jan 2014 Jan 2015Jan 2010

March 2010Affordable Care Act signed into lawSection 4205 requires restaurant chains and similar retail food establishments to provide calorie information for standard menu items.

April 2011FDA releases draft guidanceAvailable for public comment

November 2014Final Regulation AnnouncedPublished in Federal Register

December 1, 2015Original Compliance Date

Jan 2016

December 1, 2016NEW Compliance Date

Dec 2017

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Why menu labeling?

“…people need nutritional information to manage their weight and reduce the risk of, or

manage, heart disease, diabetes, and high blood pressure, which are leading causes of death, disability, and high health care costs; it is difficult

for consumers to exercise personal responsibility and limit their intake of

calories at restaurants, given the limited availability of nutrition information at the

point of ordering in restaurants…”21

Who does this apply to?• FDA adopted a broad definition of covered establishments and developed a specific definition for restaurant type food

• FDA defined a “covered establishment” as a restaurant or similar food retail food establishment ….

• “Restaurant-type foods” was defined as a food that is usually eaten on the premises, while walking away, or soon after arriving at another location

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What is required?• Covered entities must comply with three basic requirements:

ON

ECalories must be disclosed for each standard menu item on the menu or menu board

TWOA statement must be posted on the menu concerning suggested daily caloric intake

THRE

EA statement must be posted on the menu advising that written nutrition information is available upon request

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How will calories appear?• How calories will appear on the menu will depend on how the meal is merchandised

Internet search 10.05.1524

Section 2 Summary• The intent of the menu labeling regulation is to inform consumers

• The regulation applies to chain restaurants and “similar retail food establishments” with 20 or more locations

• December 1, 2016 is the compliance date

• There are a myriad of rules to ensure calorie labeling is “clear & conspicuous”

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QUESTIONS

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Section 3Putting menu labeling to work

What do consumers think?• The majority of consumers have positive perceptions of menu labeling

• Most consumers say they will use the calorie information when posted“The more informed

we are, the better choices we can

make. I see this as very positive.”

“I usually try to choose healthier options. The

labeling will enable me to have a better idea of the

calorie count.”

“I think it’s a great regulation. When I go to the restaurant I am never sure what to buy on the menu

because I don’t have the information available.”

http://www.nutrition411.com/wp-content/uploads/2014/04/calorie%20confusion.pdf

Oct 20, 2015

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What will consumers do?Based on a review of the literature, approximately ½ of studies showed a positive impact and ½ showed no impact

1. Barriers to usage includes confusion and a general lack of understanding of calorie values

2. Nutrition information is most impactful when consumers are provided with the context of how calories and nutrients fit into their overall diet

http://www.nutrition411.com/wp-content/uploads/2014/04/calorie%20confusion.pdf

Education will be critical

to help consumers understand

and use the calorie on menus.29

Lessons learned from focus groups

Emphasize the YOU

Provide a RULE OF THUMB

Provide RESOURC

ES

Respect the

OCCASION

Keep messag

es POSITI

VE

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3 approaches to putting menu labeling to use

Go the distance

Generalize it

Break the tie

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3

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Section 3 Summary• Consumers generally have a positive perception of menu labeling

• Education will be critical to help consumers use menu labeling

• Keep messages positive and personal

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A review of resources

Resources for YouMore about the regulation:• FCP has a self-study module• http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm217762.htm

www.nutrition411.com > education materials >> menu labeling and eating out Calorie Confusion: a review of the literature Communicating Calories: consumer tested

messages about menu labeling Menu Makeover: a turnkey consumer handout Eating Well While Eating Out: A Toolkit for

Healthcare Professionals

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Example 1Coaching for “clusters”

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Example 2Overcoming obstacles

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Additional examplesConsumer tools

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In summary1. Eating away from home is an intrinsic part of

today’s lifestyle; we can help consumers make better choices while eating out

2. FDA’s menu labeling regulation will go into effect December 1, 2016; the intent is to inform consumers

3. Education will be critical to help consumers use menu labeling; keep messages positive and personal

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Thank you!www.cldnutrition.com

QUESTIONS

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Evaluation and CPEU Credit

• To receive CPEU credit please complete the evaluation found at: https://vte.co1.qualtrics.com/SE/?SID=SV_1AMT7G2hviDdqcd

• Available until October 20, 2016. The applicability of information presented today may change with new research or policies after this time.

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This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, and the Office of Family Readiness Policy, U.S. Department of Defense under Award Numbers 2012-48755-20306 and 2014-48770-22587.