Pretty soon, when you sink down into that cushy restaurant booth or roll up to the drive-through, you’ll see something new next to your favorite menu items – calorie contents. But healthcare establishments such as hospitals and nursing homes will be generally exempt.

New Nutrition Labeling Requirements
While some restaurant chains, such as Panera Bread, already post calories on their menus, expect to see more doing the same in the next year. That’s because section 4205 of the Affordable Care Act requires restaurants with at least 20 locations to display calorie counts (and encourages smaller establishments to voluntarily comply), but most companies are waiting until the FDA releases a final rule implementing section 4205. The FDA issued a proposed rule in 2011 and received public comments, but the final rule is expected any day now.   Until then, if the FDA preserves the core provisions of the 2011 draft version of the rule, here’s what we can expect:

Who’ll Be Affected:

  • The labeling requirements in section 4205 will apply to restaurants or “similar retail food establishments” with 20 or more locations that sell restaurant-type food, whose primary business activity is the sale of food to consumers and either present themselves as restaurants or devote more than 50 percent of their floor area to the sale of food.

Who’ll Be Excluded:

  • Establishments that serve food but aren’t primarily in the business of food service – movie theaters, amusement parks, airlines, and the like – won’t have to comply with these rules.
  • Food wholesalers, such as bakeries that sell to food retailers, not consumers, will also be exempt.


  • Menus and menu boards will need to clearly and conspicuously list the number of calories next to the relevant food or beverage item. For combination meals or other variable items, calories would be displayed as a range. However, calorie information won’t be required for daily specials or other temporary items on the menu for 60 days or fewer per calendar year.
  • Buffets and foods on display will have to be accompanied by signs listing calories per serving or item.
  • Menus and menu boards will have to include a statement about suggested caloric intake.  The proposed rule suggested, “A 2,000 calorie diet is used as the basis for general nutrition advice; however, individual calorie needs may vary.”
  • Menus and menu boards will also need to state that additional nutrition information is available upon request. Establishments will have to have written information on hand, including a breakdown of total calories, calories from fat, total fat, saturated fat, cholesterol, trans fat, sodium, total carbohydrates, sugars, dietary fiber, and protein content.

As for when the labeling requirements will go into effect, we won’t know for sure until the final rule is released.  However, the implementation deadline is likely to be 6 to 12 months from the date the final rule is published.

Effect on Hospitals, Nursing Homes, and Assisted Living Facilities
Hospitals, nursing homes, and assisted living facilities will be largely unaffected by these requirements. Healthcare facilities do not present themselves as restaurants or devote more than 50 percent of their floor area to the sale of food. Even though they provide food service, they are, by definition, not in the primary business of selling food. However, chain restaurants operating in hospital food courts and chain coffee shops operating inside facilities are expected to be subject to the labeling requirements.