California lawmaker Tony Mendoza, a former public school teacher, worried about the increasing number of overweight young people he saw. So the Democratic assemblyman introduced legislation last year to ban "bad fats" from restaurant food, and Gov. Arnold Schwarzenegger (R) signed it into law. A second California law will force restaurants beginning July 1 to disclose calorie counts and other nutritional information to customers.
"This legislation will help Californians make more informed, healthier choices by making calorie information easily accessible at thousands of restaurants throughout our state," said Schwarzenegger when he signed the bill. "By being the first state to provide this information to consumers, California is continuing to lead the nation with programs and policies that promote health and nutrition."
Since then, more than 20 states are moving in the same direction.
As Americans get heavier and state economies sink, the new legislation is aiming at curbing obesity and promoting good nutrition, while saving states money in the long run on health care costs.
Some of the laws target trans fats, which are known to increase levels of "bad cholesterol" while decreasing levels of "good cholesterol" in blood vessels, according to the Centers for Disease Control and Prevention. The fats are created when liquid oil is turned into a solid through a process called hydrogenation. Partially hydrogenated oils give food a longer shelf life.
States that are considering trans fat bans are Hawaii, Illinois, Massachusetts, Maryland, New York, Tennessee, Texas, Washington as well as the District of Columbia. Under California's new law, trans fats must be phased out of all restaurants by 2010, with a 2011 deadline for baked goods.
Other bills would require restaurants to post nutrient information. Among states with menu-labeling legislation pending in their current legislative sessions are Connecticut, Hawaii, Illinois, Indiana, Kentucky, Maryland, Missouri, New York, Oklahoma, Oregon, Rhode Island, Texas, Utah, Vermont and West Virginia.
The legislation varies widely, said Roberta Friedman, director of public policy for the Rudd Center for Food Policy and Obesity at Yale University, who has written a brief on menu-labeling legislation. The bills range from those that would give comprehensive information to one in Illinois that would require restaurants to post only a sign warning customers that menu items "may be high in calories, grams of saturated fat plus trans fat, and milligrams of sodium per serving, which has been known to cause diabetes, heart disease, and high blood pressure."
West Virginia state Sen. Dan Foster (D) is promoting a bill that would require restaurant chains in his state with more than 15 locations nationwide to post calorie counts on menus. Foster said he hopes consumers will come to expect calorie labels in restaurants and that the federal government will take note and pass similar legislation.
"This is likely one of those culture-changing initiatives, sort of like clean indoor air, that had a dramatic effect on health," Foster said.
New York Gov. David Paterson (D) unveiled a five-point plan to combat obesity in his state of the state address Jan. 7. The plan includes a trans fat ban for restaurants and calorie postings for fast food chains. The governor dropped an 18 percent soda tax and a ban on junk food sales in schools after the proposal generated intense criticism from state lawmakers and the public.
Democratic Gov. Deval Patrick's plan for Massachusetts, announced Jan. 8, includes menu-labeling regulations for large chain restaurants, Body Mass Index testing of all students in public schools and community grants for local health initiatives. BMI is a measurement of weight compared to height. Having a BMI of 30 or higher as an adult is considered obese, according to the CDC.
The BMI and menu-labeling regulations will be implemented after a public comment period that ends early in March for both regulations. They also need approval of the state Public Health Council, a group of doctors and key stakeholders, before they take can effect.
"The menu-labeling regulation was crafted really to pretty much mirror the regulations in New York City and California," said John Jacob, a spokesman for the Massachusetts Department of Public Health. New York City was the first city to implement a trans fat ban and menu-labeling regulations in July 2008.
In the United States, 11 percent of adult Medicaid costs could be attributed to obesity, according to a 2004 study supported by the CDC.
Individuals spent $75 billion in 2003 dollars on healthcare because of obesity. Of that, $21 billion was financed by Medicaid, the state-administered health insurance program for low-income Americans. Medicaid spending by the states on healthcare related to obesity ranged from $23 million in Wyoming to $3.5 billion in New York.
Obesity in the United States has increased dramatically for the past 20 years, according to the CDC. Mississippi has the greatest adult obesity rate, at 32 percent. Colorado has the lowest, at 18.7 percent, according to the most recent data in 2007. About one third of U.S. adults are obese.
Obesity prevention measures aren't new. When he was governor of Arkansas, Republican Mike Huckabee set an example by losing 105 pounds after a diabetes diagnosis. He also spearheaded a "Healthy Arkansas" initiative that was the first to require all public school students to undergo Body Mass Index testing.
The U.S. Food and Drug Administration began requiring inclusion of trans fats on nutrition information labels in 2006 after consumption of the fats was linked to increased risk of heart disease.
A February survey by Technomic, a food industry consulting firm, found that 82 percent of New York City consumers reported that calorie postings affected what they chose to order. Forty percent of the 755 surveyed said they had a great impact while 42 percent listed "somewhat" of an impact. Eighty-nine percent said they were in favor of the law.