Obesity medicine specialists, health providers, insurers and employers urged to make obesity treatment a right of all Americans

October 13, 2023

Media contact: National Consumers League – Nancy Glick, nancyg@nclnet.org, 202-823-8442 NCOA –Simona Combi, Simona.combi@ncoa.org, 571-527-3982

Washington, D.C. – With growing evidence that U.S. adults with obesity feel stigmatized and ignored by their health care providers, the National Consumers League (NCL) and National Council on Aging (NCOA) today urged health professionals, insurers and employers to join a national movement to define quality obesity care as a right for every American.

Taking the case directly to health professionals on the front lines in delivering obesity care, NCL and NCOA used The Obesity Society’s annual meeting in Dallas October 14-17 to announce plans to provide Americans with an Obesity Bill of Rights.  Today, over 100 million adults are living with obesity[1] (42 percent of the public), yet only 10 percent get help from medical professionals.[2] An Obesity Bill of Rights has the potential to transform obesity care by empowering Americans to demand the respect of their health providers and to be screened, diagnosed, and effectively treated for their obesity based on medical treatment guidelines.

“For too long, adults with obesity have encountered a healthcare system that works against them. They are stigmatized, discriminated against, not treated with respect by their health providers, and confront significant obstacles in receiving the care they deserve. ” said Sally Greenberg, Chief Executive Officer of the National Consumers League. “This must change; we need an overhaul of the health system, and we believe an Obesity Bill of Rights can drive this transformation.”

Because this change will only happen if there is agreement on a set of basic rights that ensure adults with obesity receive respectful, timely, and effective obesity care, NCL and NCOA unveiled www.Right2ObesityCare.org, a new online engagement platform, so the nation’s health providers, insurers and employers can play a role in developing the Obesity Bill of Rights.  Right2ObesityCare.org explains the purpose and research-driven process and encourages a wide range of health professionals – from obesity medicine specialists and physicians to dietitians, nutritionists, exercise physiologists, health educators, and mental health professionals – to contribute their ideas.

Town Halls Chart the Obstacles for Adults with Obesity and Their Providers

Along with hearing from health professionals, the Obesity Bill of Rights will be informed by the insights of both adults with obesity and their health providers who participated in four town hall meetings that NCL and NCOA hosted across the country. Held in senior centers and churches in

California, Delaware, Mississippi, and Oklahoma between June and August 2023, the town halls involved more than 250 older adults, community leaders, and local clinicians who laid bare a healthcare system that is inhospitable to delivering quality obesity care.                                                        

When asked to share their experiences, older adults attending the town halls spoke of feeling invisible when seeing a health provider, not being listened to, and being treated with disdain when they initiated conversations about their obesity. At the same time, physicians described feeling inadequate to provide obesity care due to the limited time for counseling, not enough training in obesity management, inadequate coverage and reimbursement for obesity care, and needing better tools to help patients recognize obesity risks. This confirms research that finds adults with excess weight often feel unwelcome in the doctor’s office or believe that seeking help for obesity signifies moral failure. [3]

“This is a chronic condition that no one wants to talk about,” said Ramsey Alwin, NCOA President and CEO. “For several decades, NCOA has worked to empower older adults to better manage their chronic conditions. To break down barriers related to obesity, we held town halls that allowed both older adults and their health providers to relay their lived experiences. What we learned is that encouraging more people to seek obesity care requires an investment in science-based, easy-to-understand, accessible information about obesity; a healthcare system that encourages informed decision-making and patient-centered care; and effective public policy that requires health plans to provide access to the treatments deemed appropriate by the health provider, including lifestyle interventions, FDA-approved weight loss medications, and bariatric surgery.”

Mobilizing for Change
With the townhalls as a guidepost, NCL and NCOA are now leading a rigorous process to finalize and release the Obesity Bill of Rights to the medical community and public before the end of 2023. The process includes hosting a meeting of top experts to review a preliminary draft with recommendations for refinement. NCL and NCOA will also seek feedback from specialists in minority health, aging, and rural health, as well as health professionals and other stakeholders who offer advice through the online engagement platform.

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About NCL

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. The organization’s mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

About NCOA

The National Council on Aging (NCOA) is the national voice for every person’s right to age well. We believe that how we age should not be determined by gender, color, sexuality, income, or ZIP code. Working with thousands of national and local partners, we provide resources, tools, best practices, and advocacy to ensure every person can age with health and financial security. Founded in 1950, we are the oldest national organization focused on older adults. Learn more at www.ncoa.org.

[1] Hales CM,, et al. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. Centers for Disease Control and Prevention. NCHS Data Brief. No. 360. February 2020.

[2] Stokes A, et al. Prevalence and Determinants of Engagement with Obesity Care in the United States. Obesity. Vol. 26, Issue 5; May 2018, 814-818

[3] Gunther S, et al. Barriers and enablers to managing obesity in general practice: a practical approach for use in implementation activities. Qual Prim Care. 2012; 20: 93-103

The National Consumers League applauds the reintroduction of bipartisan legislation to give millions of Medicare beneficiaries access to safe and effective obesity treatments

July 21, 2023

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, 202-823-8442

Washington, D.C. – The National Consumers League (NCL) welcomes the reintroduction  of the Treat and Reduce Obesity Act (TROA) as a needed step to end outdated Medicare rules that leave millions of seniors with diagnosed obesity – particularly members of Black and Latino communities – vulnerable to disability, disease and premature death due to lack of access to the full range of treatment options.

Introduced by Senators Tom Carper (D-DE) and Bill Cassidy (R-LA) and Representatives Brad Wenstrup (R-OH), Raul Ruiz (D-CA), Mariannette Miller-Meeks (R-IA) and Gwen Moore (D-WI), TROA will end this regulatory logjam by expanding coverage under Medicare Part D to new FDA-approved anti-obesity medications, which are currently excluded under a policy dating back to 2003. TROA will also end Medicare Part B restrictions on intensive behavioral therapy (IBT) that limit the delivery of IBT to primary care providers and restrict the physical locations where this care can occur. Through TROA, clinical psychologists, registered dietitians and nutrition professionals will be able to provide IBT if an individual with obesity is referred by a physician.

At a time when the obesity rate among adult Americans exceeds 40 percent and is even higher among communities of color – virtually half of African Americans (49.6 percent) and 44.8 percent of Hispanics are living with obesity – passage of TROA could be a critical step in changing the trajectory of a disease that for too long has been overlooked and undertreated. The National Consumers League applauds TROA’s reintroduction in the 118th Congress and pledges our support to gain passage of this important legislation on an expedited basis.

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About the National Consumers League (NCL)
The National Consumers League, founded in 1899, is America’s pioneer consumer organization.  Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad.  For more information, visit nclnet.org.

Debunking the myth of prepared foods being cheaper and healthier

By Ryan Barhoush, Food and Nutrition Program Associate

As we finish the holiday season (maybe a few pounds heavier) and get ready to put in place our New Year’s Resolutions, we recommend making one of them NOT buying prepared foods. and Instead, commit to cooking up healthier, cheaper, and quicker meals from scratch. With minimal shopping and prep time, we can all feed ourselves and our families with healthier options. Let’s debunk a few of these prepared food myths.

Myth 1. It takes too much time to shop for healthy food 

Grocery stores in the U.S. can be overwhelming, and we all feel the stress of walking into these sometimes exceptionally large stores, but do not be intimidated!  You can easily tackle the task of shopping quickly and efficiently with some practice and shopping discipline. In fact, if you do it right, you can be in and out of the store in 20-30 minutes with a healthy grocery basket full of food for you and your family. Here is how:

  • Make a shopping list and stick to it
  • Shop online and get your groceries delivered, or
  • Identify your favorite grocery store, get to know where products are and get in and out efficiently.

Myth 2. Prepared and frozen foods have the same nutritional value as a home cooked meal.

Prepared frozen meals are loaded with sodium and sugar; home cooked meals typically have much lower levels of both, thus are healthier and more nutritional.

Let’s compare some labels to prove it.  Start with one of most popular frozen food items, pizza. We looked at the Red Baron brand and compared its nutritional content to a standard meal of baked chicken, broccoli, and potatoes.

The results are staggering. One slice of the pizza contains 810 mg of sodium. The Dietary Guidelines for Americansrecommends adults limit sodium intake to less than 2,300 mg per day—that’s equal to about 1 teaspoon of table salt!  For children under age 14, recommended limits are even lower.

So, one slice of pizza is one-third of the total recommended daily intake. High sodium in prepared foods contributes to the hypertension epidemic in the U.S. Nearly half of adults in the United States (47%, or 116 million) have hypertension, defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg according to the CDC. Hypertension can lead to stroke, heart attack and other serious illnesses.

Red Baron’s Frozen Pizza Roasted Chicken with Potatoes and Broccoli
One serving of Red Baron’s is 380 calories per slice!

 

Amount per serving 353 calories
39g of carbohydrates

 

29g of carbohydrates
18g of Total fat

 

 8g of Total fat

 

45mg of cholesterol

 

 89mg of cholesterol

 

810mg of sodium per slice* 106mg of sodium

 

* That’s 3240 mg of sodium per pizza! Almost 1000 mg over the daily recommended limit!

 

Myth 3. It takes too much time to cook healthy meals for myself or my family. 

Meal prep can be amazingly fast, efficient, and fun! There are many websites with healthy meals that can be prepared in 5-10 minutes, with cooking times of 30 minutes or less. For example, this one: The best meal of the day doesn’t have to take your whole day!  I have compiled a list of 25 easy weeknight dinners to get you in and out of the kitchen in a flash.”  

Myth 4. Prepared frozen foods are cheaper than shopping and cooking my own food.  

Wegmans and other grocery stores have suggestions for affordable nutritious meals, as low as $2.75 a serving. Each 20.6 oz. Baron Frozen Pizza costs from $4.99-6.25 plus tax and includes four servings. But if you look at the label closely, each serving is one piece of pizza and that is an unrealistic serving size for an adult’s meal. Let’s say one pizza feeds two people, that doesn’t include anything else besides the pizza, such as salad or other side dishes. That is at least $2.50 – $5 a person. Already the frozen prepared food option is more expensive than a tofu dinner with vegetables or a chicken dinner with potatoes and broccoli.

Another great place to find affordable, filling, healthy and easy recipes is the Delish website. The internet is full of great suggestions but stay away from sites that suggest using canned soups or packaged or frozen prepared foods, because they are often filled with elevated levels of sodium, sugar, and fat.

Myth 5. I only have a microwave, I do not have a kitchen, or the right kind of cooking utensils.

Do not be discouraged. With the unbelievable amount of cooking videos on social media you would think you would need a commercial kitchen just to have a normal healthy meal. Today with just a microwave you can still make many healthy meals. Check this out: 20 Easy to Cook Microwave recipes.

Also, electric stove tops are a terrific addition to any household. Even without a kitchen, just a few pots and pans and some YouTube videos; you could be well on your way to being a kitchen-less chef! Dried fruits and nuts are easy and healthy snacks that you do not have to store in the fridge. Apples and pears are great fresh fruit that do not need to be refrigerated.

As you can see, there are many ways to avoid processed foods and create healthy meals at a reasonable price. Here are a few links we include to create healthy, fast home-cooked meals that are reasonably priced. Plus, cooking for your family is fun and an effective way to get everyone together around the table. Good luck, eat healthy and enjoy!

Food safety tips this holiday season

By Ryan Barhoush, Food and Nutrition Program Associate

As we are gearing up for this upcoming holiday season, food safety  is something important to keep in mind. If this is your first time or even your 20th being the Thanksgiving head chef, it is always good to review some simple safety tips in the kitchen. There is nothing worse than getting your relatives sick…unless that is the only way to get your uncle to stop talking about politics at the table. Just kidding, of course. Here are some food safety recommendations from National Consumers League for Turkey Day tomorrow. Happy Holidays!

Roasting a Turkey this year? Don’t be intimidated but keep these ideas in mind.

  • Keep poultry separated from other items in the fridge.
  • If brining a turkey, make sure it is properly secured or in a cooler away from your other food items. Be careful of spillage or drippings from contaminating other items.
  • If thawing a frozen turkey in the fridge, allow about 24 hours for each 4 to 5 pounds of Turkey
  • Never thaw a turkey by just laying it out on the counter, this could lead to bacteria growth, even if it is frozen.
  • You can thaw in cold water, keep it in a bag to prevent contamination, and change the water every 30 minutes. It takes about 30 minutes per pound to defrost a frozen turkey.
  • Remember to wash your hands before and after handling the turkey. Every time!
  • Use separate cutting boards and scrub with warm, soapy water after use.
  • Use a thermometer and make sure your turkey has an internal temperature of 165 degrees.

Frying a turkey? Don’t be scared but be aware of the risks!

  • Never leave oil unattended, even a small amount of oil reaching a lit flame can cause a large fire.
  • Make sure your turkey is dry and completely thawed! Pat dry the inside and the outside of the turkey. Any kind of moisture can cause combustion when in contact with oil.
  • Do not overfill the fryer with oil. Pre-test the oil levels with something in the same weight range as your turkey.
  • Always fry a turkey outside, away from the house, and on level surfaces.
  • Keep children and animals away from the fryer, even after use, as oil can remain hot for hours.
  • Remember that the sides and handles will be dangerously hot.
  • Have an all-purpose fire extinguisher nearby.

Besides the turkey, here are few more things to keep your eye on in the kitchen.

  • Be mindful of the “danger zone”. Bacteria and germs can grow rapidly between 40 and 140 degrees.
  • Keep warm food with warm food and cold food with cold food!
  • Don’t leave out any food past two hours
  • Don’t put warm leftovers away in the fridge
  • Follow these steps and enjoy a safe and Happy Thanksgiving!

Consumer groups obtain TTB commitment to issue rulemakings on mandatory alcohol labeling

November 21, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 823-8442

Washington D.C. — A coalition of consumer groups today announced an important victory for the American public: the Treasury Department’s Alcohol and Tobacco Tax and Trade Bureau (TTB) has agreed to issue proposed rules requiring standardized alcohol content, calorie, and allergen labeling on all beer, wine and distilled spirits products. TTB also agreed to begin preliminary rulemaking on mandatory ingredient labeling.

TTB’s decision comes after three national consumer organizations – the Center for Science in the Public Interest, Consumer Federation of America, and the National Consumers League – sued TTB on October 3, 2022, for failing to act on a 2003 petition to require alcohol labeling with the same basic transparency consumers expect for non-alcoholic beverages and food products. CSPI’s litigation department filed the complaint on behalf of the three organizations in the United States District Court for the District of Columbia.

Based on evidence that alcohol is a significant source of empty calories and increases the risk of certain cancers, alcohol use disorders, traffic accidents, and severe injuries, the 2003 petition specifically called for listing the amount of alcohol and calories per serving, the percent alcohol by volume, the serving size, the number of standard drinks per container, and other needed information to make fully informed drinking decisions. These consumer groups also petitioned for an ingredients listing on all alcoholic beverages, something that is a standard feature for other food products and particularly important to those with allergies or other chemical sensitivities.

As a result of the lawsuit, TTB committed to publishing three rulemakings covering mandatory nutrient and alcohol content labeling, mandatory allergen labeling, and mandatory ingredient labeling within the next year.

In addition to the lawsuit, the groups applauded the House and Senate Appropriations Committee for including report language in the FY23 Financial Services and General Government bill urging the agency to take action on this critical rule.

“This is a groundbreaking day for consumers,” said Sally Greenberg, Executive Director of the National Consumers League. “Consumer advocates have been trying for 19 years to get this far. Now there is light at the end of the tunnel. We thank the TTB for finally taking this action and look forward to working closely with the agency, the industry, and other consumer advocates to make sure this is done right and that consumers are the winners.”

“All we have requested over these two long decades is the kind of information that consumers expect when purchasing other foods and beverages,” said Peter Lurie, Executive Director of the Center for Science in the Public Interest. “We hope TTB can move quickly on this long overdue action.”

Better labeling requirements for alcoholic beverages will allow consumers to make more informed decisions,” said Thomas Gremillion, Director of Food Policy at Consumer Federation of America. “Consumers have a right to consistent, reliable, and relevant information about the products they buy. For too long, the alcohol industry has kept consumers in the dark, and TTB’s announcement is an important step forward.” 

The 2003 citizen petition was submitted to the Treasury Department by CSPI, CFA, and NCL and a coalition of 66 other organizations and eight individuals, including four deans of schools of public health.

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit https://nclnet.org.

NCL applauds federal agency’s decision to require mandatory labeling on all alcoholic beverages

November 18, 2022

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, (703) 298-2614

Washington D.C. — Today the National Consumers League hailed the decision by the Alcohol and Tobacco Tax and Trade Bureau (TTB), the federal agency that oversees alcohol labeling, to require mandatory labeling on all alcoholic beverages as a “great consumer victory.” NCL is grateful to the agency for this welcome – albeit long overdue – decision.

In 2003, NCL and other consumer groups filed a petition calling on TTB to provide consumers with robust nutritional information about the alcoholic beverages they drink. Today, 19 years later, the agency acted to grant the petition. The November 17 letter from TTB can be viewed here.

NCL and other consumer groups pursued two avenues this year to get movement on the labeling of alcoholic beverages: filing a lawsuit this past fall against the agency and working with Congress.

NCL also thanks the Senate and House Appropriations Committees for their inclusion of language in the Fiscal Year 2023 Financial Services and General Government Funding Bill that urges the agency to move toward mandatory nutritional labeling of alcoholic beverages.

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit https://nclnet.org.

Nancy Glick

At last: FDA is updating the definition of a “healthy” food

Nancy GlickBy Nancy Glick, Director of Food and Nutrition Policy

It is rare when new regulations from the Food and Drug Administration (FDA) warrant a song. But borrowing a phrase from Sam Cooke, FDA’s recent proposed rule changing the meaning of the term “healthy” has been a long time coming – 28 years to be exact. Yet, as the song goes “a change is gonna come.”

Why is this a good thing? Simply put, the term “healthy” is out-of-date, both with the state of nutrition science today and with the latest Dietary Guidelines for Americans, recommendations from experts on what to eat and drink to meet nutrient needs, promote health, and prevent disease.

Going back to 1994 when FDA’s old definition of “healthy” went into effect, the agency focused on individual nutrients in a food, not the actual foods we eat. Accordingly, foods now qualify as “healthy” if they are low in total fat, saturated fat, cholesterol and sodium and must contain a significant amount of fiber and at least two additional beneficial nutrients such as vitamins A, C, D, calcium, iron, protein, or potassium. This covers about 5 percent of foods, including white bread, highly sweetened yogurt, and sugary cereals.

The problem is that many healthy foods do not qualify for the use of a “healthy” claim based on FDA’s outdated standards. This includes avocados, nuts, seeds, olive oil, and salmon because they are high in fats now known to be heart healthy. And right now, plain, non-carbonated water and plain, carbonated water cannot be labeled as “healthy,” which makes no sense.

These absurdities have been apparent to consumer organizations for decades, but the impetus for change was the introduction of the KIND bar in 2015. KIND advertised its bars as healthy because they contain whole foods like nuts and grains, but because the nuts have more fat than what FDA now allows for a “healthy” claim, the agency sent a warning letter about the use of the claim.  When KIND responded with a Citizen Petition that documented the healthfulness of nuts, FDA permitted KIND to use the term “healthy” and issued a proposed rule change in 2016, signaling its intention to revise the definition.

At the same time, nutrition science has evolved over 28 years. Not only is it clear that not all fats and carbohydrates are the same but getting the nutrients needed for a healthy diet result from making food choices based on healthy dietary patterns. This understanding is especially noteworthy because more than 80 percent of Americans consume too much added sugars, saturated fat and sodium but aren’t eating enough vegetables, fruit and dairy, according to the Dietary Guidelines for America, 2020-2025.

Based on these developments, FDA’s proposed rule will do away with counting individual nutrients in a food. Instead, FDA’s plan is to define the term “healthy” on food packaging based on two criteria:

  1. The product must contain a certain “meaningful amount” of food from at least one of the food groups recommended by the Dietary Guidelines, such as fruits, vegetables, or dairy; and
  2. The food must stay within specified limits for certain ingredients, such as saturated fat, sodium and added sugar, based on a percent of the Daily Value (DV) of the nutrient. This includes a limit for sodium of 230 milligrams (mg) per day, or 10 percent of DV per serving – an important action by itself since Americans on average consume 50 percent more sodium per day than is recommended in the Dietary Guidelines.

The proposed rule is also consistent with recent changes to the Nutrition Facts label. For example, the Nutrition Facts label must now declare added sugars to help people maintain healthy dietary practices.

Applying these criteria, a cereal could only carry a “healthy” claim if contained ¾ ounces of whole grains and no more than 1 gram of saturated fat, 230 milligrams of sodium and 2.5 grams of added sugars. This would disqualify almost all breakfast cereals now marketed to children.

To help make the new “healthy” claim meaningful for consumers, the FDA is also researching a symbol that food manufacturers can use on the front of the package. The symbol would act as a quick signal that the food contributes to a healthy dietary pattern and is part of a labeling system the National Consumers League has long supported.

FDA’s proposed rule addresses several of NCL’s food policy issues. For many years, we have been pressing for a new definition of the term “healthy” that aligns with the latest nutrition science and we support a “Traffic Light” symbol to depict “healthy” foods on the front of the package. We also have been at the forefront in pressing for ways to lower excess sodium in the diet.

But while we believe FDA’s plan is a significant step forward for consumers, there are still some shortcomings. Although the Dietary Guidelines call on consumers to limit calories from added sugars and fats, FDA’s proposed rule fails to consider calorie limits.

Moreover, the new rules won’t stop “healthy” products from being loaded with artificial colors and will have the unintended consequence of incentivizing food processors to replace natural sugar with questionable artificial sweeteners and sugar alcohols without disclosing these ingredients. Even as NCL has advocated for a modernized definition of the term “healthy,” we have been supporting a Citizen Petition to ensure transparent labeling of substitute sweeteners, which have surged in use by more than 300 percent in the last five years and can produce digestive effects. The Citizen Petition asks FDA to add the term “sweetener” in parentheses after the name of all non-nutritive sweeteners in the ingredient list, and for children’s food and beverages, to indicate the type and quantity of non-nutritive sweeteners, in milligrams per serving, on the front of food packages.

FDA published its proposed rule, Food Labeling: Nutrient Content Claims; Definition of Term “Healthy,” in the Federal Register on September 29, 2022, and is encouraging anyone interested in the topic to submit written comments by December 22. NCL plans to use this opportunity to ensure the consumer’s voice is heard and to offer solutions that will advance better food and beverage choices. We all have a stake in labeling claims that are science-based and ensure that consumers have access to more complete, accurate, and up-to-date information about the foods they consume and serve their families.

National Consumers League releases its Top Food and Nutrition Policy Priorities for 2022

July 20, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC – At a time of significant change in the food industry, the National Consumers League (NCL) today released a food policy agenda to improve food safety, reduce sodium in the diet, achieve better portion control, increase transparency in food and beverage labeling, and promote a more sustainable food system. Additionally, NCL is calling for a national strategy to ensure there will be an ample supply of safe infant formula products in the US along with aggressive regulatory oversight.

“Currently, over 335 million people live in the US, and all are consumers who deserve to be represented in the regulation of the foods and beverages they consume and serve to their families,” said Sally Greenberg, NCL’s Executive Director. “Especially now when technology is changing food production, food safety protocols, and the composition of novel and reformulated foods and beverages, NCL will speak for consumers on strengthening the food safety system, filling the gaps in food labeling, alleviating food insecurity, and reducing food waste.”

Addressing serious food safety lapses and areas where regulation has not caught up to changes in food production, manufacturing, and market trends, NCL’s agenda concentrates on 11 priorities where education and changes in public policy will have a direct and positive impact on the American public:

1. Strengthen the Food Safety System

As the Food and Drug Administration (FDA) moves forward with its New Era of Smarter Food Safety Blueprint, NCL will press FDA to finalize its Food Traceability Proposed Rule, enabling rapid traceback to the source of a contaminated food. Similarly, NCL will stress the need for the U.S. Department of Agriculture (USDA) to modernize poultry safety rules and update food safety rules, such as expanded pathogen testing in meat and poultry products and updated safe handling instructions label for these products.

2. Ensure the Safety and Availability of Infant Formula

The critical shortage of infant formula in the U.S. requires a national strategy to ensure there will be an ample supply of safe infant formula products in the US along with aggressive regulatory oversight of the safety protocols at U.S. manufacturing facilities. NCL will also advocate for policies that increase the number of companies manufacturing infant formula, and changes in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program that allow for more flexibility in the range of infant formula products available through WIC.

3. Make Alcohol Facts Labeling Mandatory

Since 2003, NCL and the Center for Science in the Public Interest have taken the lead in pressing the federal agency that regulates most alcoholic beverages – the Treasury Department’s Bureau of Alcohol and Tobacco Tax and Trade Bureau (TTB) – to issue rules requiring an easy-to-read, standardized “Alcohol Facts” label on all beer, wine and distilled spirits products. Because this

labeling now appears on hard ciders, wine coolers, certain beers and other products regulated by the FDA, NCL, CSPI and the public health community are stepping up the fight to make mandatory alcohol labeling a reality.

4. Reduce Excess Sodium in the Diet

Because Americans on average consume 50 percent more sodium per day than is recommended, NCL will continue to raise awareness of the goal set by FDA to lower sodium intake to 2,300 milligrams (mg) per day and encourage consumers to use the Nutrition Facts label to choose products with less sodium, reduced sodium or no sodium added.

5. Require Labeling of Caffeine Content

While FDA considers 400 mg of caffeine per day as the amount not generally associated with dangerous side effects, the agency only requires food labels to disclose whether there is added caffeine in the food or beverage, not the total amount. Therefore, NCL is calling for new policy requiring all products containing caffeine to list the amount of caffeine per serving and per container.

6. Ensure Transparency in the Labeling of Plant-Based Meat Alternatives

In June 2022, NCL released a new report, Education and Transparency in Labeling Plant-Based Meat Alternatives: A Consumer-Focused Agenda to Improve Understanding and Decision-Making of Plant-Based Meats, which lays out seven priorities for regulatory action, including the requirement that labels on PBMAs are standardized and clarify the protein source and that nutrition/health claims for these products undergo FDA review and are supported by available scientific evidence. 

7. Improve the Labeling of Alternative Sweeteners

Although NCL applauds FDA’s decision to include “Added Sugars” on the recently updated Nutrition Facts Label, the organization supports a Citizen Petition to ensure transparent labeling of substitute sweeteners and is urging FDA to stop misleading claims, such as “No Added Sugars” and “Zero Sugar,” that imply the product is healthier than the original without disclosing that the sugar reduction resulted from reformulating with artificial substances and sugar alcohols. 

8. Modernize Food Standards of Identity

Because many “standards of identity” – recipes for what a food product must contain and how it is manufactured – are now 75 and even 80 years old and out of date, NCL supports FDA’s action plan to modernize food standards of identity. However, NCL urges FDA to focus on several food products where updating SOIs will lead to healthier offerings, such as olive oil, Greek yogurt, and canned tuna.

9. Improve Federal Nutrition Education and Food Labeling Policies by Elevating the Role of Portion Control and Balanced Food Choices, Revising the Definition of “Healthy,” and Developing Uniform Front of Pack Nutrition Rating Symbols

NCL is implementing a three-phased strategy to improve nutrition education and food labeling policies, which entails: 1) education and advocacy that emphasizes portion control and ensures consumers know the recommended daily intake of calories is 2,000 per day, 2) furthering FDA’s efforts to define the term “heathy” on food labels by addressing if and how added sugar content is calculated; and 3) encouraging FDA to adopt a “Traffic Light” labeling system to depict “healthy” foods on the front of the package.

10. Increase Funding and Access to Federal Nutrition Programs

NCL’s advocacy to enhance the Supplemental Nutrition Assistant Program (SNAP) during the COVID-19 pandemic helped to increase access to healthy food to people in need. Now, NCL is working with partners to broaden the public health impact of SNAP by reducing the eligibility requirements, strengthening the nutritional goal for SNAP and providing incentives for healthier foods sold in retail establishments.

11. Reduce the Amount of Food Waste

Because about 90 billion pounds of food goes uneaten every year in the US, NCL is working to help the nation meet the goal of reducing food waste by 50 percent by 2030. As such, we will continue working with USDA, FDA and the Environmental Protection Agency (EPA) to raise awareness of food loss and waste and inform consumers of how they can reduce food waste in their homes.

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

A New Patient-Centered Action Agenda calls for people with obesity to have the same rights and access to care as people with other chronic diseases

July 7, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC— The National Consumers League (NCL) today released A New Patient-Centered Obesity Action Agenda: Changing the Trajectory of Obesity Through Patient Empowerment, Health Professional Intervention and Supportive Government Policies, a new report with a blueprint to change how Americans think about obesity, empower people with obesity to get the best care, and afford those with obesity the same access to care as adults with other serious chronic diseases.

Issued as a call to action, the report was prepared in consultation with a panel of leading obesity specialists as a roadmap for overcoming one of the difficult challenges affecting US adults now living with obesity: despite significant advances in the understanding and treatment of obesity, only 10 percent of people with obesity get help from medical professionals,[1] meaning the disease remains largely undiagnosed and undertreated. Accordingly, only 30 million[2] of the estimated 108 million adults living with obesity[3] have been diagnosed with the disease and only around 2 percent of those eligible for anti-obesity medications have been prescribed these drugs.[4]

The consequences of undertreatment affect virtually every aspect of the healthcare system. Obesity not only has a negative impact on almost every aspect of health and well-being, but it worsens the outcomes of over 230 obesity-related chronic diseases, from type 2 diabetes and heart disease to some forms of cancer.[5] Accordingly, obesity is responsible for an approximately 300,000 premature deaths each year[6] deaths and costs the U.S. economy an estimated $1.72 trillion annually in direct and indirect costs.[7]

“Although obesity is one of today’s most visible public health problems, it is often ignored and discounted as a serious disease, resulting in a health crisis that has only worsened with time,” said
Sally Greenberg, NCL’s Executive Director. “This report focuses attention on the numerous public perception, provider and policy-related factors that preclude Americans with overweight and obesity from getting effective treatment and must be addressed if obesity outcomes are to improve in the US.”

To change the trajectory of the obesity epidemic, the report calls for a national mobilization to overcome the “human” factors– incorrect beliefs about the cause and treatment of obesity, prejudice towards people due to their size, lack of training for health providers, access barriers, and outdated government policies – that continue to prevent Americans from seeking and obtaining obesity care. Towards this end, NCL’s patient-centered action agenda identifies nine priorities for action:

  1. Redefine Obesity for the American Public as a Treatable Chronic Disease

Although the American Medical Association classifies obesity as a chronic disease requiring treatment, three-quarters of Americans believe obesity results from a lack of willpower. Thus, redefining obesity as a treatable chronic condition will provide a new context for health providers and patients to have a positive discussion about weight, leading to more people getting diagnosed and treated.

  1. Adopt Patient-First Language for Obesity

Unlike other chronic diseases where health professionals use people-first language that puts a person before a diagnosis, practitioners routinely use terms to describe obesity that can be off-putting and demoralizing. To change this situation, the National Consumers supports the agenda of the People-First Initiative launched by the Obesity Action Coalition, which advocates for widespread adoption of people-first language by practitioners in all healthcare settings.

  1. Make Combatting Weight Stigma a National Priority

Studies show that 40 percent of healthcare professionals –physicians, nurses, dietitians, psychologists and medical students – admit to having negative reactions based on a person’s size.[8]Addressing this pervasive problem requires a unified national initiative that makes the impact of weight stigma “real” for clinicians and the public and disseminates the latest information to health providers on strategies to reduce weight stigma.

  1. Elevate the Need for Physician Training in Obesity

A recent study of 40 US medical schools finds that 30 percent of these institutions provide little or no education in nutrition and obesity interventions while one third of schools reported no obesity education programs in place.[9] These findings underscore the urgency for US medical schools to change their priorities and develop curricula that comprehensively addresses the disease of obesity.

  1. Establish Excess Weight as a Vital Sign

Besides body temperature, blood pressure, heart rate and respiration, health providers routinely measure height and weight at each visit. Thus, if healthcare professionals were to calculate and provide patients with their Body Mass Index (BMI) at the time of the office visit, practitioners could have a tool to discuss excess weight when patients are most receptive to discussing their health status.  It is recognized that BMI is a crude measure and not the sole predictor of obesity but when combined with patient-friendly information that explains the level of weight and options for treatment, this interaction could initiate a positive, respectful conversation about obesity care.

  1. Provide the Tools for a Doctor-Patient Dialogue on Excess Weight

A major reason primary care providers (PCPs) are reluctant to provide obesity counseling is the lack of informational tools to have conversations with patients about their weight status and care options. Therefore, a unified effort to make available to PCPs evidence-based, patient-friendly content on obesity will facilitate a better dialogue between clinicians and patients and promote shared decision-making.

  1. Establish Coverage of Obesity as a Standard Benefit Across Insurers and Health Plans

Although employers and insurers are starting to cover treatment options for obesity in employee benefit packages, too many people continue to be denied coverage or face access barriers, such as step therapy and prior authorization, that delay treatment. Improving obesity outcomes therefore requires supporting legislative efforts, like the “Safe Step Act” that would require group health plans to provide an exception process for step-therapy protocols. It also necessitates collaboration among payers, providers, policymakers, and advocates to establish a standard, affordable benefit for the prevention and treatment of obesity that applies across plan types and payers.

  1. End Outdated Medicare Rules That Exclude Coverage for Necessary Obesity Care

Today, the many millions of Americans enrolled in the Medicare program are denied safe and effective obesity treatment due to outdated Medicare Part D rules that exclude coverage for FDA-approved obesity drugs and Medicare Part B policies that places undue restrictions on intensive behavioral therapy by allowing only primary care providers to deliver IBT and severely restricting the physical locations where this care can occur. Congress has the power to change this situation, which is why NCL has joined with the obesity, public health and nutrition communities is pressing for swift passage of the Treat and Reduce Obesity Act (TROA). The proposed legislation would expand Medicare coverage to allow access to IBT from a diverse range of healthcare providers while ending the exclusion for new anti-obesity medications that are improving the standard of care for adult Americans with obesity.

  1. Create a Patients’ Bill of Rights for People with Obesity

For too long, people with obesity have been stigmatized, discriminated against, and have faced significant hurdles and burdensome requirements to receive care. Changing this situation will require giving people with obesity the knowledge, skills and confidence to be advocates for their best obesity care. Therefore, NCL’s patient-centered obesity action agenda calls for the creation of a Patients’ Bill of Rights for People with Obesity based on the recognition that obesity is a treatable disease and everyone with obesity deserves the same level of attention and care as those with other chronic conditions.

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About the Report

To prepare the report, NCL partnered with the Obesity Care Advocacy Network (OCAN) to host a roundtable discussion in December 2021where public health specialists, leading professional societies, the minority health field and the obesity policy community assessed the state of the science on obesity today, the scope and cost of the disease in the US and the major barriers impeding quality obesity care with special attention to the “human” obstacles that keep people with obesity from seeking or obtaining treatment. Additionally, NCL conducted a literature review to gather additional insights, especially regarding how to change how people with obesity see themselves, so they become empowered to advocate for their care as patients with a chronic disease. Based on this assessment, NCL drafted the report, which was vetted by experts participating in the roundtable, and developed the policy recommendations included in the Patient-Centered Obesity Action Agenda.

 

About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

 

[1] Stokes A, et al. Prevalence and Determinants of Engagement with Obesity Care in the United States. Obesity. Vol. 26, Issue 5; May 2018, 814-818

[2] PharMetrics-Ambulatory EMR database, 2018. Novo Nordisk Inc.

[3] Hales CM,, et al. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. Centers for Disease Control and Prevention. NCHS Data Brief. No. 360. February 2020.

[4] PharMetrics-Ambulatory EMR database, 2018. Novo Nordisk Inc.

[5] Obesity Care Advocacy Network. Fact Sheet: Obesity Care Beyond Weight Loss

[6] Allison DB, et al. Annual deaths attributable to obesity in the United States JAMA 1999Oct 27 282(16)1530–8.

[7] Milken Institute (October 2018), “America’s Obesity Crisis: The Health and Economic Costs of Excess Weight.”

[8] Fruh SM, et al. Obesity Stigma and Bias. J Nurse Pract. 2016 Jul-Aug; 12(7): 425–432.

[9] Butch WS, et al. Low priority of obesity education leads to lack of medical student’ preparedness to effectively treat patients with obesity; results from the U.S. medical school obesity education benchmark study. BMC Med Educ 20, 23 (2020)

Consumers need transparency in labeling of plant-based meat alternatives

Agenda-Setting Report Identifies Seven Priorities for Regulatory Action

June 9, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC – As more plant-based meat alternatives (PBMAs) that closely mimic the look, taste, and cooking properties of traditional meat products enter the U.S. market almost daily, the National Consumers League (NCL) today released a report with seven priorities for regulatory action to ensure that labels of so-called “meatless meats” readily identify the protein source and inform consumers of the nutritional composition of each PBMA product.

Issued as the U.S. Food and Drug Administration (FDA) is developing draft guidance for food manufacturers on the labeling of plant-based milks and alternatives to animal-derived foods,
the report underscores the importance of consumer-focused labeling to sustain the growth of the plant-based meats category, which has been fueled by consumer optimism. Findings were informed by an expert panel meeting held in 2021 that explored a standard of identity for PBMAs and based on an assessment of the PBMA marketplace which NCL conducted in 2022 to identify action steps that will significantly impact public awareness and understanding of PBMAs and can be readily implemented.

Providing up-to-date information on the issues affecting the labeling of plant-based meat alternatives, the report – Education and Transparency in Labeling Plant-Based Meat Alternatives: A Consumer-Focused Agenda to Improve Understanding and Decision-Making of Plant-Based Meats –documents promising projections for PBMA sales in the U.S. and globally. Recent polling shows that two-thirds of Americans (65 percent) consumed plant-based meat alternatives in 2021, and two in five (42 percent) ate PBMAs at least weekly.[1] Due to consumer demand, the plant-based meat category delivered $1.4 billion in sales in the U.S. in 2021 – up from $962 million in 2019 [2] – and a Bloomberg Intelligence report projects a 500 percent increase in global sales of plant-based foods by 2030[3]. Moreover, a recent market analysis predicts a growth rate of almost 20 percent globally for plant-based meats between 2021 and 2026 if consumer interest in PBMAs continues to grow.[4]

Yet, the NCL report points to marketplace challenges for plant-based meat substitutes. Currently, many brands define PBMAs differently and there is a lack of clarity about how to use traditional meat, dairy, and egg terminology on product labels. Additionally, only half of Americans were “very” or “somewhat” familiar with PBMAs in 2020 and 30 percent had no knowledge, according to a Gallup survey.[5] This lack of understanding is concerning because new plant-based meats are unique in their formulations and processing techniques– meaning products can differ in calories, saturated fat, sodium content, and levels of protein, fiber, vitamin B12, zinc, iron, and other nutrients. Plant-based meats may also contain a food allergen depending on the source of the plant proteins in the product.

[1] International Food Information Council. Consumption Trends, Preferred Names and Perceptions of Plant-Based Meat Alternatives. November 3, 2021

[2] Good Food Institute. US retail market data for the plant-based industry.

[3] Fortune. Plant-based food sales are expected to increase fivefold by 2030. August 11, 2021

[4] ResearchandMarket.com. Plant-Based Meat Market-Global Industry Analysis (2018-2020) & Growth Trends and Market Forecast (2021-2026). January 11, 2022

[5] Gallup. Four in Ten Americans Have Eaten Plant-Based Meats. January 28, 2020

 

“Plant-based meat alternatives are a popular and valued part of our food supply,” said Sally Greenberg, NCL’s Executive Director. “This is why the public needs regulatory policies that ensure the labels on these products are accurate, complete, and provide the qualifiers necessary for consumers to understand what they are purchasing.”

As the agency that regulates plant-based foods in the U.S., FDA shares this viewpoint and has sought information on a range of issues to issue draft guidance on the labeling of plant-based foods. Therefore, NCL prepared the report to articulate the consumer’s voice on PBMA labeling and lay out a blueprint for FDA and the food industry to ensure the information needs of the public are addressed. Specifically, the report identifies seven priorities for labeling, naming, and marketing plant-based meats alternatives that are in the best interest of consumers:

  1. Establish a definition for “plant-based meat alternatives” that will unite all stakeholders. Because brands define the term “plant-based” differently, FDA guidance should define what constitutes a “plant-based meat alternative” to promote consistency in labeling across the category.
  2. Ensure brand names are not deceptive. NCL’s position is it is a deceptive practice to use brand names for PBMAs that suggest a product contains meat, seafood, or eggs when none is present. Even when the label states the product contains no meat or eggs, consumers are influenced by the brand name, especially if packaging and promotional content feature pictures and iconography of animals or the type of meat.
  3. Require that labels on PBMAs are standardized and clarify the protein source. For labels of PBMAs to be transparent, the naming and labeling of PBMAs must be uniform and consistent and ensure that consumers can readily identify the protein source. Accordingly, FDA should require that all labels and advertisements for PBMAs must:
  • Use a common name that links the protein source and the form, such as “soy burger.”
  • Make clear that the product contains some animal protein in addition to plant-based proteins like soy. Qualifying terms can include “plant-based” and “made from plants.”
  • Make clear when the PBMA contains no meat. These terms can include vegan,” “meatless,” “vegetarian,” “veggie,” and “veggie-based” as well as “plant-based” and “made from plants.”
  • Place the phrase “contains no meat,” “contains no poultry,” or “contains no eggs” on the principal display panel of vegan PBMAs near the common name and in letters at least the same size and prominence as shown in the product’s common name.
  • Not use pictures, icons, or vignettes on the packaging, in marketing materials or in advertising that suggests nutrition superiority or that the product is the same as the comparable meat product.
  1. Regulate health/nutrition claims for PBMAs. Consistent with how FDA regulates the health claims allowed on traditional food products, FDA guidance must make clear that nutrition/health claims must undergo agency review and there must be significant scientific agreement that the claim is supported by available scientific evidence.
  2. Ensure website, social media, and advertising content for PBMAs conforms to what is on the product label. The guidance must make clear that FDA considers websites and social media to be an extension of the product label, meaning the claims and information that PBMA manufacturers put online must conform what FDA allows on the label.
  3. Address the nutritional composition of the PBMAs in FDA guidance. In Canada, proposed guidelines for plant-based protein foods would include nutritionally required amounts of vitamins and mineral nutrients that must be added to the PBMA product and a minimum limit of total protein content, among other requirements. While NCL supports this approach, FDA should at least recommend levels of key vitamins and nutrients in its guidance.
  4. Educate consumers about the nutritional composition of plant-based protein alternatives. It is in the public interest for FDA and the U.S. Department of Agriculture – along with nutrition societies – to conduct education programs that explain the nutritional composition of plant-based protein food products. This will allow consumers to make informed decisions based on science-based information.

About the Report

To prepare the report, NCL built on the deliberations of an online expert panel meeting – Meeting Consumers’ Needs for Modernizing Food Standards of Identity: General Principles for Naming and Labeling Plant-Based Meat Alternatives – co-hosted by NCL and the Academy of Nutrition and Dietetics (AND) in November 2021. Exploring whether new standards of identity (SOI) for PBMAs could lead to better labeling of these meat substitutes, the meeting started with a review of the U.S. market for PBMAs and featured breakout sessions where regulatory specialists, market researchers, consumer advocates and food industry leaders debated the need for a standard of identity for PBMAs and discussed consumers’ needs for education and labeling of PBMAs.

The November 2021 meeting produced consensus that there is not enough evidence to support a standard of identity for PBMAs and in fact, that a SOI could hamper innovation within this new category of plant-based foods. Yet, the meeting generated important insights on the need for consumer education about plant-based meats, a common nomenclature for describing PBMAs, and transparency in labeling so consumers will know the composition of the products they buy. Thus, when FDA announced plans to issue draft guidance on PBMAs in 2022, NCL used the deliberations from the November 2021 meeting as the foundation for developing recommendations for how FDA can ensure labels of PBMA products meet consumers’ needs. The final step was a literature review NCL conducted in March and April 2022 to add marketplace data on PBMAs and apply lessons learned from consumer research, voluntary labeling initiatives, legislation passed in different states label PBMAs, and labeling rules for PBMAs proposed or instituted in other countries.

Read the report here.

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.