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Margaret A. Hamburg, M.D., Commissioner of Food and Drugs - Remarks at the Nutrition Summit

Remarks as Delivered for Margaret A. Hamburg M.D.
Commissioner of Food and Drugs
at the
2010 Nutrition Summit
April 28, 2010

Good morning, and thank you for being here. It’s a pleasure to speak to you today at this important meeting—and I’m so glad that all of you are concerned about and working on nutrition-related issues.

Others have described for you the toll that diet-related chronic disease takes on American lives. We know that some 65 percent of all Americans are obese or overweight and 17 percent of those under 20 are obese. We know that the dangers of heart disease, stroke, and diabetes are indisputable for millions in this country. And we know, most importantly, that much of this is preventable.

So as I bring this opening session to a close, I will try to be brief—but I want to clear about the magnitude of the problem we face. Diet-related chronic disease, including obesity, is a defining public health issue of our time.

Which means we have a lot of work to do. And a high bar to reach. To be truly successful, the progress we make in this new decade must resonate for generations to come.

It’s no surprise that the way we eat today is different from our parents and grandparents. Times have changed and not entirely for the better.

But now it is our responsibility—our burden—to ensure that the way we eat will be different from our children and grandchildren, too. Only this time, it must be for the better.

No one person in this room—or any single organization represented here today—can possibly do everything needed to “change the food environment,” as we are being called on today to do. No one person or organization can possibly tackle all the scientific, economic, and societal causes of diet-related disease.

But working together, I think it is a whole different story.

It will take industry and consumer groups; it will take government…from the very highest levels to the most local. And it will take resources, brainpower and commitment from all of us—on this stage and in this room, and millions of people throughout this country.

But together, we can shift the paradigm. We will swing the pendulum from the reality of crisis to the promise of change.

And it is up to those of us in this room today to lead the way.

Certainly the fight against obesity and diet-related chronic disease is one of FDA’s top priorities—and one of mine. As a regulatory agency with a mission to protect the public’s health, FDA has a unique responsibility in this effort. We are committed to helping consumers get the information and products they need to make healthier choices every day.

Much of the Federal government’s effort to improve nutrition, and combat obesity and preventable disease, is focused on one central premise: Americans must be able to make healthier choices. But Americans can’t make good choices without good information and options.

As the First Lady has said, there’s nothing wrong with occasionally eating ice cream or hamburgers, and even French fries. Those foods are part of a normal lifestyle. It’s when people go overboard, or don’t understand how to put together a healthful diet overall, that they can get into serious trouble.

Americans need a clear, effective and—above all—easy way to get information about their food choices. We at FDA are committed to playing a leadership role in giving consumers the information they need to make healthier choices every day

That’s what the Nutrition Facts panel developed by FDA and USDA in the early 1990s was created to do. For the first time, basic nutrition information was placed on the back or side panel of virtually all packaged foods…which meant consumers had access to accurate, relatively complete information on all their processed foods. Studies showed that people grew accustomed to the label: they liked it; they used it; and they trusted it.

Still, in 2010, the limitations of the Nutrition Facts label have become clear…as Secretary Sebelius noted.

It takes time to read and digest the information on the label. But today, Americans expect quick, easy answers. In addition, people are being bombarded with all kinds of additional messages and claims.

Everyone in this room knows this is true. Because we’ve all experienced it. When we’re rushing through the supermarket on the way home, gathering things for dinner, we have limited time and energy to make choices…especially if we need to find food items for specific dietary requirements like low-fat, limited sugar or low-sodium.

For better or for worse, I think we all want to be able to scan and absorb nuanced information about our food as quickly as we scroll through e-mail on our BlackBerries. Something that we have probably gotten far too practiced at…

But the food industry figured out our wants and our needs years ago—and responded with short, eye-catching claims on the front of their packaging. Symbols labeled products as “heart healthy”; snack foods advertised their calorie totals; and lower-fat versions of popular items declared themselves “lite.”

Then, right around the time I was sworn in as Commissioner last year, industry started to move toward a new, more standardized approach. Many companies had signed onto a program called “Smart Choices.” A “Smart Choices” checkmark was intended to denote foods that met certain nutritional criteria.

But, as most of you know, these criteria were called into question—and with some gentle urging from the FDA, the program was suspended pending further research and consideration.

This particular program may not have been the answer, but it is clear that a lot of people in a lot of places believe that it is really important to devise ways to give consumers simple, easy-to-understand nutrition information on the front of food packages.

With that in mind, we at FDA have been spearheading an effort with our colleagues in government and outside to develop a system for front-of-pack nutrition labeling that will be evidence-based, easy to read…and provide clear and consistent guidance for making healthy food choices.

It’s about simplicity and accuracy…And we’re working in partnership to engage everyone involved.

We’re working with food manufacturers and marketers, with consumers and academics. We’ve studied existing front-of-package label programs, such as summary symbols that provide an overall index of diet and more detailed approaches, such as the “traffic-light” system in England that indicates sodium, sugar, and saturated fat content with green, yellow, or red circles.

And we’re also working with the Institute of Medicine and others to provide further advice on existing front-of-pack symbols and algorithms. In addition, we’ve opened a docket at FDA for industry, academics, consumer groups, the general public and others to submit relevant findings and ideas.

Consumers deserve the most accurate information possible. Toward that end, we have also stepped up some of our efforts to clarify existing labels and nutritional claims.

As you may know, we have sent advisories to a host of food companies about problems with their current labeling. And to ensure that other package information for consumers wasn’t confusing or misleading, we have also sent notices to a number of companies about certain products. I am pleased to say that most have agreed to modify their labels and product information to conform to current rules.

But specifically on front-of-package labeling, as of now, we have made no decisions—not even tentative or preliminary ones—about what the labeling will look like. So I hope that everyone here will give us their best thinking about what will work for American consumers… for you and for me, and for our friends and families.

We intend to bring the best science to bear on this challenge, and we want to engage everyone who has ideas.

And though still in formulation, we do have clear parameters for success. The labels must be based on the standardized nutrition criteria in the Dietary Guidelines for Americans… They must be widely adopted by food retailers and manufacturers… They must appear in a standard format that consumers will easily recognize… And they must be accessible to consumers with a wide range of literacy, education level and age.

I should note that much of the work in this area is being performed by our nutritionists, consumer researchers and other experts in FDA’s Center for Food Safety and Applied Nutrition.

They have been working really hard for months to gather the necessary data and to develop guidelines for an improved nutrition labeling approach. So I want to take this opportunity to publicly thank them for all they have done to further this effort.

I would also like to recognize the food manufacturers who have demonstrated a strong interest in working with us on a universal front-of-pack symbol. This kind of cooperation was not always the case.

When Don Kennedy was FDA Commissioner back in the 1970s, he, in conjunction with the Department of Agriculture and the Federal Trade Commission, proposed that all foods be required to have nutrition labeling.

As I understand it, there was such opposition at the time from the food industry that scores of trade associations and companies wrote to Congress requesting that the pay of those three agency leaders be cut as a message of disapproval. Today, the industry is working constructively with us toward the development of an effective front-of-pack system…and I’ve heard no calls to dock my pay just yet.

And I look forward to working with them on other nutrition initiatives at FDA.

Menu labeling, for example. When President Obama signed the health care reform legislation last month, it included several new requirements. Chain restaurants must post calorie information for all menu items and have additional nutrition information available upon request. And vending machines must also post nutrition information for each item sold. FDA is charged with overseeing this labeling.

The truth is consumers are besieged by tough food choices in a variety of environments. Approximately one-third of all meals are consumed outside the home and the prevalence of high-calorie menu items in popular restaurants has been well documented.

We hope that by providing calorie information on menu boards in addition to labeling on the front of packages healthy decision-making will become a part of the daily lifestyle.

Finally, I’m sure you’ve heard a lot recently about sodium—and, this morning, Secretary Sebelius and Dr. Frieden have both talked about this morning. There will be a great deal more focus on this important public health issue, including a briefing from my friend and former FDA Commissioner Jane Henney, on the recent IOM study on strategies to reduce sodium intake. Dr. Thomas Farley will also be talking about the pioneering work of the NYC Department of Health and Mental Hygiene to reduce salt. I might add that we too share a job in common…

We have a lot to learn from these efforts and there is much to be done. There can be no down that sodium is a critical concern and we have to make progress. Reducing salt in the diets of Americans is a hugely important public health concern, and a priority for our agency.

We know that there is no single action that will solve the problem. It is a complex issue that will require a unified, national approach to be effective and sustained.

Many options will be discussed, and we look forward to working closely with our partners in government, other stakeholders and most importantly with the industry to achieve substantial reductions in the levels of salt in foods and in our diets.
***
As I began my remarks this morning, I commented on FDA’s fundamental public health mission…and I want to come back to that idea as I close. Our agency was created in 1906, largely in response to Upton Sinclair’s book The Jungle, an exposé of the horrific working and sanitary conditions of the meatpacking industry. The Pure Food and Drug Act was enacted at that time to protect the public against, among other things, “misbranded, or poisonous or deleterious foods.”

A lot has changed since then, yet Americans are still at risk because of a food environment that can be harmful to their health.

We can change that—if we work together.

And only together can we fully harness the public health roots on which our agency…and many of yours…were founded.

Only together can we take the steps needed to change today’s food environment.

Only together can we deliver simple, effective, long-lasting solutions for the American people. This is the task before us.

Thank you.