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April 3, 2018

Trump's FDA is embracing Obama-era moves on calorie counts, sodium levels

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    FDA Commissioner Scott Gottlieb in a speech at the National Food Policy Conference on Thursday announced a multiyear plan under which FDA will advance proposals to reduce sodium levels in the U.S. food supply and require restaurants to include calorie counts on their menus.

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    Gottlieb's comments

    Gottlieb said FDA this summer plans to launch an initiative called the Nutrition Innovation Strategy. The comprehensive plan will include a series of nutrition initiatives intended to reduce obesity rates and the prevalence of chronic conditions.

    Several of the initiatives will build on FDA proposals under former President Barack Obama's administration—including a proposal aimed at reducing sodium levels in the U.S. food and supply. Gottlieb called the proposal the "single [most] effective public health action related to nutrition." Gottlieb said FDA in 2019 will release short-term targets for sodium reduction in the U.S. food supply and will continue to push for longer-term reductions to address health conditions, such as high blood pressure, which are tied to eating high amounts of salt.

    Gottlieb said FDA also will advance an Obama-era proposal that requires all chain restaurants and grocery stores to display calorie and nutrition information on their menus. FDA has delayed the requirements from taking effect multiple times, but Gottlieb said the agency soon will release final guidance on the requirements.

    In addition, Gottlieb said FDA will begin enforcing a previously delayed rule regarding nutrition facts labels by January 2020. Under the rule, food manufacturers are required to replace existing nutrition facts labels with new labels that align serving sizes with actual average portion sizes, increase the prominence of calorie counts, and specify the amount of added sugars in products. Gottlieb in his speech suggested FDA would not delay the rule any longer, noting that some food manufacturers  already have implemented the new labels. "Consumers are starting to have access to an updated label that's based on current science and provides more information to empower them to choose healthful diets," he said.

    Gottlieb said FDA is considering new proposals, as well. For example, he said FDA is contemplating whether to develop a voluntary, front-of-pack labeling system. In addition, he said FDA is examining how food manufacturers use health and science claims to market food. In particular, Gottlieb said FDA will evaluate how food manufacturers use the word "health" and will examine how to streamline the process the agency uses to review qualified health claims. Gottlieb said FDA also is considering how to make ingredient information more clear. 

    Further, Gottlieb said FDA might re-examine proposals on how the agency regulates the content of processed foods with an aim toward making it easier for food companies to develop healthier recipes. For instance, under current regulations, cheese used in processed foods must contain a specific amount of sodium, which makes it more difficult to reduce sodium levels, the Washington Post's "Wonkblog" reports.

    Gottlieb said FDA also is exploring how the agency could do more to encourage U.S. residents to eat from specific food groups instead of only encouraging U.S. residents to take in certain nutrients. "Traditionally, [FDA has] focused primarily on the nutrients contained in food in considering what is healthy. But people eat foods, not nutrients," Gottlieb said.


    Margo Wootan, VP for nutrition at the Center for Science in the Public Interest, has criticized FDA's past decisions to delay nutrition policies, but said she felt "encouraged" by Gottlieb's speech.  "This commissioner does seem to have an interest and understanding of the importance of nutrition," she said, but added that Gottlieb must follow through with turning his statements into policy.

    Marion Nestle, a professor who specializes in nutrition and food politics at New York University, commended Gottlieb for the tone of his speech, saying his focus on disease prevention through nutrition is "revolutionary." Nestle said, "Gottlieb's words reflect modern public health thinking and it's great that FDA is considering taking these actions," adding, "I'm interested to see what … FDA actually does."

    However, Lori Roman, president of the Salt Institute, said, "FDA's actions are some of the most intrusive actions ever taken on industry—essentially recommending recipe content for almost every food manufactured in the [United States]" (Dewey, "Wonkblog," Washington Post, 3/29; LaVito, CNBC, 3/29; Bottemiller Evich/Crampton, Politico, 3/29).

    Understand the wellness spectrum—and promote healthy habits at work

    understanding the employee wellness spectrum

    Programs aimed at promoting healthy habits among employees are likely to lead to improved employee engagement and productivity—but they're unlikely to reduce the total cost of care. To do that, you'll need to take a population health approach.

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