258481 Away-From-Home Meal Standards: Government roles in creating healthier food environments

Tuesday, October 30, 2012 : 5:19 PM - 5:34 PM

Rajiv Bhatia, MD, MPH , Occupational and Environmental Health, San Francisco Department of Public Health, San Francisco, CA
INTRODUCTION: Away-from-home foods are regulated with respect to the prevention of food-borne diseases and potential contaminants, but not for their contribution to dietary-related chronic diseases. Away-from-home foods have more calories, salt, sugar, and fat and provide fewer fruits and vegetables than recommended by national guidelines; thus, frequent consumption of away-from-home foods contributes to obesity, hypertension, diabetes, heart disease, and cancer. Regulation of away-from- home food environments is one complementary strategy to address overconsumption and poor nutrition.

METHODS: We provide a rationale for nutritional performance standards for away-from-home foods. We offer a set of model standards and alternative approaches to their application.

RESULTS: Business standards include 1) Provide at least one meal conforming to USDA Dietary Guidelines for Americans (DGA) 2) Offer foods in portion sizes that are consistent with the serving sizes recommended by DGA, 3) Label all foods that do and do not conform to the DGA recommended quantity and quality with appropriate cautionary symbols, 4) To preferentially place information about the healthiest options on menus and menuboards where customers would notice them first, and 5) Competitively price DGA-conforming meals. Voluntary incentive, recognition programs or statutory regulations are two alternative approaches for implementing standards

DISCUSSION: Each alternative approach to application of standards has discrete advantages and challenges. Implementing such standards, whether via incentives, recognition or via regulations, will require addressing a number of practical and ideological challenges. Politically, nutrition standards challenge the ideology that adults should be able to navigate dietary risks in away-from-home settings unaided.

Learning Areas:
Chronic disease management and prevention
Environmental health sciences
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
1. Describe the history of public health practice and how it has been effective in reducing morbidity and mortality through regulation; 2. Analyze whether similar approaches are relevant for obesity control; and 3. Describe current approaches to obesity control, and whether they are sufficient.

Keywords: Chronic Diseases, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am responsible for overseeing the regulation of food outlets in San Francisco
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.