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from the clear successes of eco-labeling programs for consumer products. 14 For example, eco-labels provide a simple signal to consumers that products have met environmental, social, and other sustainability standards of verifying agencies. The US federal government has a great deal of experience in developing and managing label programs. The Environmental Protection Agency’s Design for the Environment (DfE) logo helps consumers choose household cleaners that meet standards for minimal toxicity, the EPA’s Energy Star label identifies energy-efficient electronics and appliances, and the USDA’s certified organic label identifies food grown without chemicals or hormones. In each of these cases, eco-labeling and certification by an authoritative agency have contributed to the growth of markets for sustainable products.
    Whatever changes are made to foods, food labels, and the food environment, we should evaluate their impact. Surveillance systems can be established to see whether people indeed order healthier options and whether, in the long term, that change has an impact on their diet and health. If evaluations show the changes don’t work, then we should go back to the drawing board and try something else.
    Would Restaurant and Supermarket Performance Standards Interfere with Individual Choice?
    Some may argue that performance standards are a threat to individual freedom and choice. The claim is that constraining how foods are sold will prevent people from getting what they want. Yet the regulations I am proposing are directed at food establishments (not individuals) and don’t ban any particular foods. Regulations might make getting unhealthy foods less convenient, but they would not reduce consumers’ freedom to eat what they want. Performance standards are intended to change industry behavior and thus the range of choices offered toindividuals. Furthermore, the ability to make informed choices would be enhanced rather than diminished by clear, understandable designations of the health risks or benefits.
    Ultimately, adopting and enforcing stricter guidelines regulating food outlets will not preclude people from choosing what they prefer. Instead, they will guide food outlets to routinely offer foods that promote long-term health.
    Professionalizing the Food Industry
    We require all health professionals to attend accredited schools, pass comprehensive exams, and be licensed in order to ensure that they will not perform at a substandard level and potentially put their patients at risk. We monitor their performance, investigate consumer complaints, require continuing education, and often mandate recertification to make sure they stay up-to-date with scientific advances.
    We now know that food providers are in many respects also health-care providers. The food we eat can reduce or increase our risk for both infectious and chronic diseases, yet restaurateurs and their employees are not required to have any formal training in nutrition or chronic disease prevention.
    Just as other professions have raised their images by undergoing training and professionalization, the food industry should do the same. Food service employees should understand the consequences of eating the food they serve, and take some responsibility for their role in their customers’ health. Developing standards and requiring food providers to receive nutrition training are necessary so they can properly prepare, label, serve, and promote foods that won’t increase the risk of or exacerbate chronic diseases.
    Everyone from the chefs to the busboys should have some basic knowledge and certification to be able to inform customers about the health consequences of the foods they order, and make recommendations that are appropriate.
    My husband is not the only person who finds it difficult to choose what to eat for dinner in a restaurant. Often customers ask their wait-staff,“What do you recommend?” and many maître d’s make suggestions for their