CSPI International
Center for Science in the Public Interest

Broad-based Transatlantic Consumer Dialogue Proposes Tighter Controls of Antimicrobial Use on the Farm

CSPI Applauds Pepsi for Making World-Wide Commitment Not to Sell Sugary Soft Drinks in Schools


IACFO Comment to the Codex Committee on Nutrition and Foods for Special Dietary Uses on new Proposals  for ‘Processed Cereal Based Foods for Infants and Young Children in Developing Countries’
July 2009

Transatlantic Consumer Dialogue: International  Survey on Consumer Attitudes Supporting Nutrition Disclosure at Chain Restaurants

The Trans Atlantic Consumer Dialogue Food Working Group

Help Urge Chain Restaurants to provide nutrition disclosures at the point of sale for standardized menu items

Eating Out is a Major Contributor to the International Obesity Crisis

Americans are increasingly relying on restaurants to feed themselves and their families.  Almost half of the typical American’s food budget is spent on food consumed away from home and Americans consume about one-third of their calories from restaurants and other food-service establishments. i, ii, iii Foods that Americans eat from restaurants are generally higher in calories and saturated fat and lower in nutrients, such as calcium and fiber, than home-prepared foods. 

Europeans are also increasingly shifting their diets towards greater fast food consumption and larger portion sizes.  McDonald’s is now the largest food service provider in Europe with sales of €12.7 Billion in 2006;  sales growth for McDonald’s in Europe (11.2% in 2007), has been more than enough to offset declining sales in the US.

Out-of-home eating grew from 24.4% of eating occasions to 27% throughout Europe between the years 2002 and 2007.  In some European countries, rates are even higher; in the United Kingdom, 35.5% of eating occasions were out-of-home in 2007.    Britons spend an average of 25 minutes eating in cafes and restaurants every day for a cost of ₤11.41 each week.

Studies link eating out with obesity and higher caloric intakes.  American children eat almost twice as many calories when they eat a meal at a restaurant (770 calories) compared to at home (420 calories).  The average American eats out almost six times a week; enough to exceed calorie requirements over the course of an entire week.iv.

A leading study of European eating habits away from home, “Eating out of home and its correlates in 10 European countries…,” considered survey data from 36,894 individuals, and found that out-of-home eating “is associated with increased energy intake” and corresponds with the increasing prevalence of obesity in Europe. v   When eating out, Europeans tend to consume more sweets (23.7% of all out-of-home calories), cereals (16.8%), and dairies (11.2%), and fewer fruits (7.3%) and vegetables (1.6%)vi than when eating at home. Little difference in nutritional quality between fast food items in the US and Europe also suggest that these statistics correlate with higher caloric intake and a corresponding rise in obesity rates. 

Restaurants Should be Required to Disclose Calorie and Other Basic Nutrition Information for Standardized Foods

It is difficult to compare options and make informed decisions when eating out, as a result of the absence of nutrition information. For example, a large chocolate shake at McDonalds has 400 more calories than a whole meal of a hamburger, small fries, and a small Coke. A Burger King Tendercrisp Chicken Sandwich (780 calories) has about the same number of calories as a Burger King Whopper hamburger (700 calories).vii

Three-quarters of adults report using nutrition labeling information on packaged food, and using labels is associated with eating more healthful diets. viii, ix   Studies also show that the provision of nutrition information at restaurants helps people make lower calorie choices.  Nutrition disclosure also leads to reformulation of existing products and the introduction of new nutritionally improved products. For example, trans fat labeling in the U.S. on packaged food has lead many companies to reformulate their products and use healthier fats and oils. In a similar fashion, nutrition labeling on menus and menu boards is likely to spur nutritional improvements in restaurant foods.x
The U.S. National Academies’ Institute of Medicine recommends that restaurant chains “provide calorie content and other key nutrition information, as possible, on menus and packaging that is prominently visible at point of choice and use” (2006).xvi The Food and Drug Administration, Surgeon General, and U.S. Department of Health and Human Services also recommend that restaurants provide nutrition information.xvii
However, half of the largest chain restaurants in the U.S. do not provide any nutrition information about their foods.xviii Those that do provide information usually do so in hard to use formats.  Brochures and posters are often hard to find and provide nutrition data tables that are hard to read.  Nutrition information on company websites requires people to access computers. Information on tray liners or fast-food packages is not accessible to customers until after they order.

Recently, the state of California, and several American cities, including New York and Philadelphia, passed laws requiring calorie disclosure on menu boards.  One chain restaurant, Kentucky Fried Chicken, has agreed to provide calorie information on menu boards for all of its standardized items (sold at company owned franchises).

A Global Perspective

The case for nutrition disclosure for standardized restaurant foods can and should be made for the rest of the world as well as for the U.S.  As in the U.S., nutrition disclosure would assist consumers in making healthier eating choices, spur product reformulations, and help reduce the incidence of obesity and diet-related disease.  The UK Food Standards Agency has recently called on chain restaurants to display nutrition information at the point of purchase.  Other national public health agencies should do the same.

Legislative and Regulatory Approaches

Requirements for nutrition disclosures may vary from nation to nation, due to nutritional health priorities, cultural traditions, results of consumer research studies, and consumer expectations.  In general, such requirements should be based on the following principles:

  • Nutrition disclosures requirements for chain restaurants with 10 or more outlets should be mandatory for each standardized menu item.
  • Nutrition disclosures should made at the point of purchase, in a uniform location on menu boards or menus next to the name and price of each standard menu option, and should be easy to comprehend by consumers, including children.
  • Current practices by some companies of disclosing nutrient levels and GDA’s for particular items on the Internet, in brochures, and/or on posters, or trayliners  are difficult to comprehend, confusing, and do not sufficiently inform consumers at the point of sale.
  • National authorities should determine the most useful form of nutrition disclosure.  This may include use of universal symbols indicating calorie content and/or saturated fat, sodium and sugar levels.  Simple signposting should clearly indicate healthier and less healthy options consistent with national dietary guidelines based on public heath priorities. 



Transatlantic Consumer Dialog (TACD) Resolution on Nutrition Disclosure for Restaurant Foods, March 2007

Useful Tools:

Model Letter to Chain Restaurant Executives from Consumer Organizations

Model Letter to Government Agencies from Consumer Organizations

Menu Labeling Legislation:

California Regulation mandating the posting of calories on restaurant menus. September 30, 2008.

New York City Regulation mandating the posting of calories on restaurant menus, January 22, 2008.

Philadelphia Regulations mandating the posting of calories on menus and menu boards, February 14, 2008.

Published Studies:

Yale University Rudd Center for Food Policy and Obesity, Scientific Studies Related to Menu Labeling (2007)

“Menu labeling as a Potential Strategy for Combating the Obesity Epidemic,” County of Los Angeles, May 2008.

“The fattening truth about restaurant food,” British Medical Journal (Nov. 22, 2008).

“Obesity prevention in the Information Age: Caloric Information at the Point of Purchase,” The Journal of the American Medical Association, July 2008.

California Center for Public Health Advocacy: Potential Impact of Menu Labeling.
Materials include 1) Press release; 2) New York City study on Purchasing Behavior and Menu Labeling; 3)CCPHA Menu Labeling Fact Sheet; and 4) Center for Weight and Health-Potential Impact of Menu Labeling of fast Foods in California.

“Ignorance is Not Bliss When Eating Out,” A report by the UK Food Commission, December 2008.

Additional Resources:

Photos of New York City Menu Boards Displaying Calorie Information - Starbucks

i US Department of Labor.  Bureau of Labor.  « Consumer Expenditures in 2005 »  Accessed at <http://www.bls.gov/cex/csxann05.pdf> on March 3, 2008.

ii Lin B, Guthrie J, Frazao E. Away-From-Home Foods Increasingly Important to Quality of American Diet. Washington, DC: U.S. Department of Agriculture, Economic Research Service, 1999. Agriculture Information Bulletin No. 749.

iii Lin B, Guthrie J, Frazao E. « Nutrient Contribution of Food Away From Home. » America’s Eating Habits: Changes and Consequences. Washington, DC: U.S. Department of Agriculture, Economic Research Service, 1999b. Agriculture Information Bulletin No. 750, pp. 213-242.

iv Lin, et al.  Ibid.

v Horizons (Market Research), 2006. 

vi Datamonitor Report.  Quoted in « Habit of a lifetime. »  Bakery and snacks.com.  July 21, 2003.  Accessed at < http://www.bakeryandsnacks.com/news/ng.asp?id=13909-habit-of-a > on March 3, 2008.

vi Britons spending ever more time and money on out-of-home dining. » The Leisure Report.  February 2008.

viiiZoumas-Morse C, Rock CL, Sobo EJ, Neuhouser ML. « Children’s Patterns of Macronutrient Intake and Associations with Restaurant and Home Eating. »  Journal of the American Dietetic Association 2001, vol. 101, p. 923-925.

ixNational Restaurant Industry.  « 2008 Restaurant Industry Forecast. » Quoted in « Restaurant Industry to Continue to Be Major Driver in Nation's Economy Through Sales,... »  Reuters Online.  Accessed at < http://www.reuters.com/article/pressRelease/idUS138203+12-Dec-2007+PRN20071212> on March 3, 2008.

xP Orfanos et al.  « Eating out of home and its correlates in 10 European countries.  The European Prospective Investigation into Cancer and Nutrition (EPIC) Study. » Public Health Nutrition : 10(12), 1515-1525. 21 June 2007.  Accessed online.

xiP Ofanos et al.  Ibid.

xiiWootan, Margo.  Anyone’s Guess: The Need for Nutrition Labeling at Fast-Food and Other Chain Restaurants.  Washington,. DC: Center for Science in the Public Interest, November 2003.

xiiiU.S. Department of Health and Human Services (US DHHS). The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General, 2001.  U.S. Department of Health and Human Services (US DHHS), Centers for Disease Control and Prevention, National Center for Health Statistics. Healthy People 2000 Final Review. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2001b. DHHS Publication No. 01-0256.

xivKim SY, Nayga RM, Capps O. « The Effect of Food Label Use on Nutrient Intakes: An Endogenous Switching Regression Analysis. » Journal of Agricultural and Resource Economics 2000, vol. 25, pp. 215-231. Kreuter MW, Brennan LK, Scharff DP, Lukwago SN. « Do Nutrition Label Readers Eat Healthier Diets? Behavioral Correlates of Adults’ Use of Food Labels. » American Journal of Preventive Medicine 1997, vol. 13, pp. 277-283.  Neuhouser ML, Kristal AR, Patterson RE.
« Use of Food Nutrition Labels Is Associated with Lower Fat Intake. » Journal of the American Dietetic Association 1999, vol. 99, pp. 45-50, 53.

xvSilverglade, Bruce. « Food Labeling: Rules You Can Live By. » Legal Times, July 17, 1995, pp. 21-24.

xviCommittee on Food Marketing and the Diets of Children and Youth, J. Michael McGinnis, Jennifer Appleton Gootman, Vivica I. Kraak, Editors.  Food Marketing to Children and Youth: Threat or Opportunity?  Washington, DC: The National Academies Press, 2006, p. 382.

xviiU.S. Department of Health and Human Services (US DHHS). The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity.  Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General, 2001.

xviiiWootan, Margo, D.Sc., and Melissa Osborn.  « Availability of Nutrition Information from Chain Restaurants in the United States. » American Journal of Preventive Medicine.  Volume 30, Issue 3, March 2006, pp. 266-268.

Food Labeling^TOP

“Campaigners call for KFC and Pizza Hut to follow US lead in calorie labelling,” The UK Food Commission. October 2, 2008

“Our fast food giants under pressure to calorie label as they do in America,” Daily mail UK, October 3, 2008.

“Which Fast Food Meals are Healthiest? Anyone’s guess!” The UK Food Commission, February 11, 2008.

“Campaigners want fast food chains to show fat and calorie content on menus,” The UK Telegraph, August 11, 2008.

“Snacking delusions Destroyed by NYC calorie-Posting Law,” Advertising Age, July 7, 2008.

“Frustrated Consumers Look to Government,” QSR Magazine, September 4, 2008.

“Call for fast food info displays,” www.inthenews.co.uk, August 11, 2008.

CSPI letter to Coca-Cola on disclosing calories on fronts of beverage labels in Australia
(Acrobat 56k) —November 8, 2006

CSPI's letter to Kellogg's on discrepancies between U.S. and U.K. versions of cereals
(Acrobat 69k) —October 20, 2006

WHO Forum on Marketing of Food and Non-alcoholic Beverages to Children
        Children's WHO Forum (Acrobat 29k)
        Children's Advertising (Acrobat 31k)
        Silverglade Presentation (Acrobat 77k)
—May 2-3, 2006

Comments of the International Association of Consumer Food Organization (IAFCO) Concerning the Discussion Paper on Advertising Prepared by the Government of Canada
(Acrobat 48k) —May 1, 2006

Comments of the International Association of Consumer Food Organizations (IACFO) to the Codex Food Labelling Committee (CCFL)
(Acrobat 73k) —April 11, 2006

The World Health Organization's Global Strategy on Diet, Physical Activity, and Health: Turning Strategy Into Action
(Acrobat 240k)—December, 2005

World Health Organization Strategy on Diet, Physical Activity, and Health
May 22, 2004

Lost in Translation: Regulatory Cooperation by the United States and European Union Needed to Address the Transatlantic Epidemic of Obesity and Diet-Related Disease
(Acrobat 150k) —June 09, 2006

Comments on the EU/US Platform on Diet, Physical Activity and Health
(Acrobat 76k)—May 11, 2006

Joint US/EU Limits On Food Marketing Urged To Combat Obesity Crisis
May 5, 2004

Quantitative Ingredient Declaration (QUID) On Food Labelling - Promoting Consumer Health and Preventing Unfair Trade Practices
(Acrobat 2,210k)—May 10, 2005

Codex Committee on Food Labelling: Discussion Paper on Quantitative Ingredient Declaration
May 2000

Food Labeling for the 21st Century
A Global Agenda for Action
(Acrobat 488k)— May 1998

Using Food Labeling to Improve Diet and Health:
An Examination of the U.S. Nutrition Labeling and Education Act, by Bruce Silverglade, Director of Legal Affairs

Functional Foods^TOP

Silverglade Presentation (Acrobat 77k)

Consumer Groups Call for Greater Regulation of “Functional Foods”
— News Release

Functional Foods: Public Health Boon or 21st Century Quackery? An International Comparison
— Full Report

Food Safety Standards

Letter to US Trade Representative regarding SPS Conference in Geneva on cattle feedlot regulations, antibiotic cattle growth promoters, Salmonella in poultry, dioxin and reduction of fats in meat (Acrobat 53k)
March 8, 2004

Letter to The Honorable Charlene Barshefsky Re: Ongoing Negotiations Between the United States and Canada to Develop a Seafood Equivalency Agreement
— March 29, 2000

Consumer Group Asks FDA/USDA to Comply with Transatlantic Recommendations
— May 6, 1999

The WTO Agreement on Sanitary and Phytosanitary Measures - Weakening Food Safety Regulation to Facilitate Trade?
— January 25, 1999

Letter to U.S.D.A. on Harmonization of Food Additive Standards
— January 22, 1999


IACFO Comment to the Codex Committee on Nutrition and Foods for Special Dietary Uses on new Proposals for ‘Processed Cereal Based Foods for Infants and Young Children in Developing Countries’ —July 2009

Round-table discussion on the WHO global strategy on diet, physical activity, and health
(Acrobat 95k)
June 09, 2006

IACFO comments on the need for Codex to Set Standards for Food Advertising
— March 10, 2005

Broadcasting bad health: Why food marketing to children needs to be controlled (Acrobat 785k)
July, 2003

International Consumer Coalition Urges UN Committee to Call for Improved Food Labelling
— May 2, 2002

Consumers Association of Singapore Joins IACFO
— April 2001

The Food Commission — An IACFO Coalition Partner

Japan Offspring Fund — An IACFO Coalition Partner

What is IACFO?

Joint FAO/WHO Food Standards Programme

Consumer Groups Call for Greater Regulation of “Functional Foods” — IACFO News Release

Functional Foods: Public Health Boon or 21st Century Quackery? An International Comparison
— Executive Summary


IACFO Comments on Codex Electronic Working Group Draft Report on Risk Management Recommendations for Veterinary Drugs without ADI/MRL (Acrobat 94k)
April 2011

IACFO Comments on Proposed Draft Guidelines for Control of Campylobacter and Salmonella SPP. in Chicken Meat (Acrobat 64k)
November 2010

IACFO Comment on Proposed Draft Principles and Guidelines for National Food Control Systems (Acrobat 49K)
March 2010

IACFO comments to CODEX food labelling committee on proposed amendment on labelling of prepackaged foods: quantitative ingredient declarations (QUID) (Acrobat 174k)
October 20, 2006

IACFO's Comments on CODEX Plan for Implementation of the Global Strategy on Diet, Physical Activity, and Health (Acrobat 37k)
October 20, 2006

Proposed Draft Code of Ethics for International Trade in Food (Acrobat 60k)
June 09, 2006

The Implementation of the Global Strategy on Diet, Physical Activity and Health - Discussion Paper (Acrobat 67k)
March 30, 2006

WHO Recommendations for Revamping Codex Nutrition Standards Revealed (Acrobat 1,345k)
November 5, 2004

IACFO Proposed Draft Standard for Soy Sauce
September 27, 2004

IACFO proposed amendment to the general standard for the labelling of prepackaged foods (CL 2003/18-FL - Part B)
May 12, 2004

Comments re proposed international standards for percentage ingredient labelling
April 28, 2003

Comments re proposed international standards for organic foods.
April 28, 2003

Proposed Draft Guidelines on the Judgement of Equivalence of Sanitary Measures Associated with Food Inspection and Certification Systems (At Step 3)
September 29, 2000

Consumer, Labor, and Environmental Groups Tell Clinton Administration To Support Openness at Global Food Safety Meetings Despite Industry Opposition
— April 10, 2000

Consumer Groups Call for Stronger International Food Safety, Labeling Rules
— June 28, 1999

International Harmonization of Food Safety and Labeling Standards: Threats and Opportunities for the U.S. Food and Drug Administration and the U.S.D.A.
— June 1997

U.S. Position on Codex Draft Medium-Term Plan for 1998 to

—December 23, 1997

Request for comments on draft Codex guidelines for vitamin and mineral supplements. CL1997/12-NFSDU
—December 5, 1997

Comments on the Consideration of Codex Alimentarius Standards; Advance Notice of Proposed Rulemaking. Docket No. 97N-0218
— October 6, 1997

CSPI Comments on the U.S. Position on Codex "Proposed Draft Guidelines for the Development of Equivalence Agreements Regarding Food Import and Export Inspection Certification Systems (at Step 4)," Sixth Session, Melbourne, Australia, February 23-27, 1998.
—December 10, 1997

Comments on matters arising from the 22nd session of the Codex Alimentarius Commission as related to food additives and contaminants
— Oct. 23, 1997

Codex Committee on Food Labeling, U.S. Position on Agenda Items for May 25-28 Meeting
— October 9, 1997

World Trade Organization^TOP

The WTO Agreement on Sanitary and Phytosanitary Measures: Weakening Food Safety Regulations to Facilitate Trade?
— December, 2000

The Impact of the TBT and SPS Agreements on Food Labeling and Safety Regulations
— October, 2000

The WTO Agreement on Sanitary and Phytosanitary Measures - A Speech to the U.S. National Academy of Sciences National Research Council Conference on Incorporating Science, Economics, Sociology, and Politics in International Food Safety Standards.
— May 25, 2000

Preparations For the 1999 Ministerial Conference: Proposal for Reforms to the Agreement on the Application of Sanitary and Phytosanitary Measures

Testimony on United States Trade Policies and Agricultural Disease: Safety, Economic, and Global Considerations
— October 26, 1999

Reforming the World Trade Organization: Testimony Before the House Ways and Means Committee
— August 5, 1999

Food Safety Threatened by WTO Agreement - Letter to the U.S. Trade Representative
— May 27, 1999

Comments of Bruce Silverglade at the “Global Policy: Local Issues” Conference.

Should the SPS Agreement Be Amended? A Modest Proposal to Restore Public Support.  By Bruce Silverglade, at the 1998 Ceres Conference on Politicizing Science: What Price Public Policy?
April 4, 1998

CSPI's Comments on the Triennial Review of the SPS Agreement
— January 8, 1998

Impacts of Changes to Consumer Protection Rules in Accordance with the North American Free Trade Agreement (NAFTA), by Bruce Silverglade