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Regulatory Scoring

Agency:

FDA

Rule title:

Food Labeling; Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Food

RIN

0910–AG57 RIA Separate? Yes

Stage Publication Date

Proposed rule 4/6/2011

Rule summary:

To implement the menu labeling provisions of the Patient Protection and Affordable Care Act of 2010

(Affordable Care Act), the FDA is proposing requirements for providing certain nutrition information for

standard menu items in certain chain restaurants and similar retail food establishments. The Affordable Care

Act, in part, amended the Federal Food, Drug, and Cosmetic Act (FD&C Act), among other things, to require

restaurants and similar retail food establishments that are part of a chain with 20 or more locations doing

business under the same name and offering for sale substantially the same menu items to provide calorie and

other nutrition information for standard menu items, including food on display and self-service food.









Openness Score Comments

1. How easily were the RIA, the proposed rule, and any supplementary

materials found online? 5 1A

2. How verifiable are the data used in the analysis? 3 1B

3. How verifiable are the models and assumptions used in the analysis? 2 1C

4. Was the Regulatory Impact Analysis comprehensible to an informed

layperson? 4 1D



Total Openness (Sum of 1-4) 14



Analysis Score Comments

5. How well does the analysis identify the desired outcomes and demonstrate

that the regulation will achieve them? 3 2A



6. How well does the analysis identify and demonstrate the existence of a

market failure or other systemic problem the regulation is supposed to solve? 2 2B

7. How well does the analysis assess the effectiveness of alternative

approaches? 2 2C

8. How well does the analysis assess costs and benefits? 2 2D



Total Analysis (Sum of 5-8) 9



Use Score Comments

9. Does the proposed rule or the RIA present evidence that the agency used

the Regulatory Impact Analysis? 1 3A

10. Did the agency maximize net benefits or explain why it chose another

alternative? 2 3B

11. Does the proposed rule establish measures and goals that can be used

to track the regulation’s results in the future? 1 3C



12. Did the agency indicate what data it will use to assess the regulation’s

performance in the future and establish provisions for doing so? 1 3D



Total Use (Sum of 9-12) 5



Total Score 28

Openness

Criterion Score Com. No. Comment

The agency's website and

1. How easily were the RIA , regulation.gov both contain direct links

to the proposed rule and the RIA, both

the proposed rule, and any of which can be found through a

supplementary materials keyword search of the regulation's

found online? 5 1 title.

RIA displays few summary tables and

raw data is rarely shown or displayed.

General data sources are mostly listed

2. How verifiable are the data but not clearly sourced for specific

used in the analysis? 3 2 use.

Fairly clear, but despite FDA's

acknowledgement of little available

evidence on how the proposed rule

might affect consumption choices,

3. How verifiable are the there is little discussion of how

models and assumptions assumptions or alternatives were

used in the analysis? 2 3 chosen.

Analysis could be easily followed by

4. Was the analysis an interested layperson with few

comprehensible to an abbreviations and little jargon. Much of

informed layperson? 4 4 the analysis was clear.

Analysis

Score Com. No. Comment







5. How well does the

analysis identify the desired

outcomes and demonstrate

that the regulation will

achieve them? 3



Primary risk factors for overweight and obesity are

overconsumption of calories and physical inactivity.

Excess body weight has many health, social,

psychological, and economic consequences for

affected individuals. FDA uses Quality Adjusted

Life Years (QALYs) to measure loss of well-being

individual suffers due to obesity. But FDA notes

estimates used for annual lost QALYs of all obese

adults are not estimates of benefits of the proposed

Does the analysis clearly

requirements. Such estimates (and not examined

identify ultimate outcomes in RIA) would include lower medical costs and

that affect citizens’ quality of higher productivity brought on by lower obesity

life? 4 5A prevalence and of co-morbidities.



Instead of estimating the reductions in obesity or

medical costs and the increase in QALYs, FDA

conducted a breakeven analysis that determined

what proportion of the U.S. obese adult population

would need to attain a "minimal response" (100-

calorie per week reduction per individual) from the

proposed rule in order to yield a positive net

benefit. FDA estimates that at least 0.06 percent of

Does the analysis identify the adult obese population would need to reach at

how these outcomes are to least this benchmark in order for the rule to break

be measured? 3 5B even on the primary mean annualized cost.



Theory is that providing calorie and other nutrition

information in restaurants and similar retail food

Does the analysis provide a establishments would assist consumers in making

healthier dietary choices. It is believed proposed

coherent and testable theory

rule will help consumers limit excess calorie intake

showing how the regulation and understand how the foods purchased at these

will produce the desired establishments fit within their daily caloric and other

outcomes? 4 5C nutritional needs.

FDA is unaware of any comprehensive data

allowing accurate predictions of the effect of the

proposed requirements on consumer choice and

establishment menus. The primary empirical

evidence given by FDA is that restaurant food and

restaurant-type food form a significant and

increasing part of U.S. diets. These foods are often

relatively high in calories, fat and portion size, and

lower in fiber and other essential nutrients. The

proportion of total food expenditure spent on food

offered for sale by such establishments increased

from 34% during the 1970s up to approximately

50% through 2009. So empirical support is that

Does the analysis present proposed regulation will direct consumers to

credible empirical support for healthier food choices in an industry that has been

the theory? 2 5D providing more of their food choices.



FDA notes that any reduction in calorie intake from

proposed rule may be at least partially offset by

increases in calorie intake during other meals or

snacks as has been demonstrated in the contexts

of menu labeling and other attempts to modify food

choices. FDA admits there is available evidence of

substitution of one calorie source for another in the

context of menu labeling. This casts some degree

of uncertainty on the hypothesized benefits of the

proposed rule. To partially compensate, FDA

constructs a "plausible" individual effect of a 100-

Does the analysis

calorie per week reduction for individuals that is

adequately assess used to estimate a breakeven point that would

uncertainty about the meet a minimal response yielding a positive net

outcomes? 1 5E benefit.

6. How well does the

analysis identify and

demonstrate the existence of

a market failure or other

systemic problem the

regulation is supposed to

solve? 2



FDA acknowledges the market for restaurant-type

foods is highly competitive and this fact might

suggest many consumers would be willing to pay

for and discriminate based on availability of

nutrition information and thus the industry would

provide it. Indeed, they discuss evidence that many

retail food establishments do provide nutrition

information through brochures and/or the Internet.

However, mandating disclosure requirements is

believed to be justified due to an absence of

sufficient nutritional information produced by an

inadequate incentive for restaurants to produce it

on their own. Primary blame for the ensuing market

failure is placed on consumer demand because of

systematic biases in how consumers weigh current

or immediate benefits (from eating more, or higher

calorie, foods) against future or long-term costs

(higher probability of obesity and its co-

morbidities). These biases are argued to work

against an efficient provision of nutrition

Does the analysis identify a information for food. However, FDA ignores that

market failure or other failure of some individuals to process information

systemic problem? 3 6A rationally is not synomous with market failure.

FDA cites studies suggesting that one problem

arises because food decisions are made so often,

and the marginal effect of any one meal on future

obesity is small, and so cumulative costs of a large

number of relevant decisions may be neglected.

Studies suggest some consumers will not demand

calorie information, because the issue of calories

often lacks salience, or relevance, at the time of

purchase and consumption, even though they may

experience future regret. FDA also argues

establishments have costs of providing nutrition

information, including opportunity costs of limited

time and space, and that providing calorie

information may exert unintended effects on profits.

Thus costs and the uncertain reception of

displayed calorie information lead most

establishments to not display this information.

Does the analysis outline a Surprisingly, FDA does not distinguish between the

coherent and testable theory obese and non-obese in their discussion nor do

they delve deeper into why some establishments

that explains why the

apparently volunteer more nutrition information

problem (associated with the than others and whether it is likely that the market

outcome above) is systemic will provide more such information in the future on

rather than anecdotal? 2 6B its own.

FDA hypothesizes that providing more nutrition

information will likely promote more informed

choice and also likely raise consumer awareness

regarding the number of calories in foods thus

raising awareness of potential future costs of

additional calorie consumption. But FDA

acknowledges that it is unaware of any

comprehensive data allowing accurate predictions

of the effect of the proposed requirements on

Does the analysis present consumer choice and establishment menus. This

credible empirical support for acknowledgement suggests weak empirical

the theory? 1 6C support.



FDA does not present much evidence supporting

the hypothesis that consumers suffer from time-

preference bias or that proposed rule will reduce

caloric intake. FDA ignores whether proposed rules

will differentially affect behavior of obese and non-

obese customers. Moreover, the proposed rule

applies to chain retail food establishments (defined

as those part of chain with 20 or more locations

Does the analysis doing business under the same name and offering

for sale substantially the same menu items) but

adequately assess

does not discuss whether consumers at these

uncertainty about the establishments are subject to different (in nature or

existence or size of the extent) market failures than those the rule does not

problem? 1 6D regulate.

7. How well does the

analysis assess the

effectiveness of alternative

approaches? 2

Four options: (1) covers all establishments in

proposed rule with the exception that grocery and

convenience stores would not be subject to the

proposed requirements; (2) scope of proposed rule

broadened to include a wide variety of

establishments that serve restaurant or restaurant-

type food; (3) effective date starting three months

after publication of the final rule instead of six

Does the analysis enumerate months; and (4) effective date starting 12 months

other alternatives to address after publication of the final rule instead of six

the problem? 4 7A months.

Is the range of alternatives

considered narrow (e.g.,

some exemptions to a

regulation) or broad (e.g.,

performance-based

regulation vs. command and

control, market mechanisms,

nonbinding guidance,

Narrow range of alternative options and all based

information disclosure,

on government regulation. No mention of taxing

addressing any government high calorie food, bans, subsidies, information

failures that caused the campaigns, or other commonly considered

original problem)? 2 7B government interventions.

Does the analysis evaluate

how alternative approaches Only estimated annualized compliance costs for

would affect the amount of each option are presented. Compliance is

the outcome achieved? 1 7C assumed to be perfect.

Does the analysis Baseline is no new regulation and does not

adequately address the address what the state of the world would likely be

baseline? That is, what the in the absence of this regulation. There is little

discussion of how consumers and sellers would

state of the world is likely to

behave in the future and in the absence of the

be in the absence of federal proposed regulation, despite FDA acknowledging

intervention not just now but that firms appear to be increasingly providing

in the future? 1 7D nutritional information.

8. How well does the

analysis assess costs and

benefits? 2

Does the analysis identify

and quantify incremental High, low, and median estimates (with 3% and 7%

costs of all alternatives discount rates) of costs are provided for

considered? 4 8A alternatives.

Three costs are identified (1) collecting and

managing records of nutritional analysis for each

standard menu item; (2) revising or replacing

existing menus, menu boards, and other affected

displays; and (3) training employees to understand

nutrition information to help ensure compliance

with the proposed requirements. FDA states that,

although it is likely the proposed rule will cause

firms to reformulate food and menu items, these

Does the analysis identify all costs are not estimated. However, FDA does

expenditures likely to arise include costs associated with analyzing nutritional

as a result of the regulation? 3 8B content of new or reformulated items.

FDA acknowledges costs of proposed rule are

borne by both consumers and firms: prices rise to

reflect new costs, but generally not by enough to

Does the analysis identify

completely offset them. FDA does not estimate or

how the regulation would explore likely price hikes, or whether some foods

likely affect the prices of (and thus consumers) might rise (or fall) more than

goods and services? 1 8C others.

FDA hypothesizes price increases are likely to

Does the analysis examine cause consumption of affected foods to fall, further

reducing profits for some, or all, of these

costs that stem from

establishments. Consumers would need to pay

changes in human behavior more for this food, requiring some reduction in

as consumers and producers valued consumption. These effects are not

respond to the regulation? 1 8D estimated or explored.





High, mean, and low estimates of costs of

proposed rule are provided using 3% or 7%

discount rates. Little discussion of the uncertainty

surrounding theory or previous empirical analysis

finds its way to analysis of the rule. FDA

acknowledges some establishments may respond

to increased consumer interest on caloric content

by reformulating existing menu items or by

introducing new, lower calorie items. Such costs

are not included by FDA, but they request

If costs are uncertain, does

comment and data on whether the proposed

the analysis present a range requirements will accelerate the rate of new item

of estimates and/or perform introduction and how the cost of these items may

a sensitivity analysis? 2 8E be affected by the proposed requirements.

FDA conducted a breakeven analysis to determine

proportion of obese adult population needed to

attain minimal response in order for proposed rule

to yield a positive net benefit. However, FDA

admits it does not directly estimate benefits and

Does the analysis identify thus does not clearly measure net benefits, nor

the alternative that does it present analysis of net benefits for the four

maximizes net benefits? 3 8F options.

FDA presents a breakeven analysis that is

suggestive of cost-effectiveness analysis. Perfect

compliance is implicitly assumed. Costs are

estimated for alternatives, but costs are very

Does the analysis identify insensitive to different alternatives (and minor in

the cost-effectiveness of comparison to costs of obesity) and so breakevens

each alternative considered? 3 8G are essentially the same.

Various costs are estimated but there is little

discussion of who bears burdens, whether these

burdens are higher on different parties (obese vs.

Does the analysis identify all

non-obese, large vs. small establishments, children

parties who would bear costs vs. adults, by location, by type of food served, etc.)

and assess the incidence of Enforcement costs by government are not

costs? 1 8H discussed.

Benefits are assessed for the adult obese

population, but not for obese children even though

Does the analysis identify all

FDA states that about 31% of those aged 2-19 are

parties who would receive overweight or obese. No benefits are assessed for

benefits and assess the the overweight, but not obese adult population with

incidence of benefits? 1 8I BMI of 25-29.9.

Use

Criterion Score Com. No. Comment

FDA provides a breakeven cost point, but options

are highly correlated to the rule FDA proposes.

RIA does not attempt to tailor rule to information

9. Does the proposed rule or

provided or developed. FDA asks for comments

the RIA present evidence about the data and the methods used for

that the agency used the estimating the regulatory impact of the proposed

analysis? 1 9 rule.

FDA does not directly assess benefits. FDA

estimates the percent of the adult obese

10. Did the agency maximize population that would need to reduce caloric

net benefits or explain why it intake by at least 100-calories per week for a

chose another alternative? 2 10 breakeven point on annualized costs.



FDA does not directly assess benefits of its

proposed rule due to many acknowledged

complications. Estimates the percent (0.06%) of

the adult obese population that would need to

reduce caloric intake by at least 100-calories per

11. Does the proposed rule week for a breakeven point on annualized costs.

However, obesity is also caused by factors that

establish measures and

lie outside the domain of this proposed regulation

goals that can be used to and, therefore, it is not clear how the independent

track the regulation's results impact of this regulation on obesity can be clearly

in the future? 1 11 estimated in the future.

12. Did the agency indicate

what data it will use to

FDA made no commitment to goals or measures.

assess the regulation's

FDA does not directly assess this issue, though

performance in the future RIA indicates access to relevant data that could

and establish provisions for be used to assess regulation's future

doing so? 1 12 performance.

Rule Title RIN Agency Pub Date RIA separate? Total (G+H+J) Openness

0910–AG57 FDA 4/6/2011 Yes 28 14

Food Labeling; Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Food Establishments

Analysis Quality (G+H) Use 1 2 3 45

9 23 5 5 3 2 4 3

5A 5B 5C 5D 5E 6 6A 6B 6C

4 3 4 2 1 2 3 2 1

6D 7 7A 7B 7C 7D 8 8A 8B

1 2 4 2 1 1 2 4 3

8C 8D 8E 8F 8G 8H 8I 9 10

1 1 2 3 3 1 1 1 2

11 12

1 1



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