 Tourism for the Vermont Chamber of Commerce and again, thank you for inviting me to come here today As you must some of you might already know the Vermont Chamber of Commerce is a statewide organization We have approximately 1500 members and over 45 percent of those members are actually in the tourism and restaurant industry The Vermont Chamber and its restaurant members really do support good nutrition We understand the concerns between the links between obesity chronic disease due to poor eating decisions Restaurants in Vermont further more have and will continue to evolve and offer healthy choices for their patrons and their children After speaking with many of our restaurants This came up a number of times and we actually spoke about this and I've been working with the American Heart Association We've spoke to them previously. I went out and actually spoke to a number of our different restaurants What I really found which was Very nice to hear that mostly all of them are we're actually offering healthy options now They're offering smaller portions healthy options We know that the local movement is really alive and well in the state of Vermont and really want to applaud our restaurants for doing that We also want to make sure we're very careful to not prohibit them from offering the foods that they want Especially on a seasonal level that helps support our farmers. It supports the entire industry of Vermont We also know that a lot of them are already offering milk and non sugary items for their children's menus So what I'm here today is really to ask you so instead of Implementing s70 which is a mandate. We were just asking if this might be an opportunity to work in partnership So my suggestions were really work in partnership with some of the Vermont restaurants To add healthy items, you know We're going out and out and actually talking to them and saying is there an opportunity Can we actually add on these are the beverages that we're being recommended by the Heart Association? This will help for monitors across the state Same thing with meals and really really offering them healthy options I truly believe that if we did an outreach with education programs with our connections with the American Heart Association With the National Restaurant Association With our support with all of the local chambers We would really be able to do a really good education partnership outreach program to these restaurants asking them To start really taking a look at all their menus and when they go into the effect to start making up new menus to really consider What's in the best interest of Vermont's children? We feel that this partnership would be a better alternative to doing a mandate And so therefore we really do prefer education and partnership over that So I'm here to say if that's an opportunity. We certainly would support it. We would do outreach We would certainly help with getting that message out to all of the businesses throughout Vermont So thank you very much and happy to take some questions Put up here and it talks about all the groups for all the chains that have already signed on to this sort of stuff McDonald's, Burger King, Wendy's, Dairy Queen, IHOP, Applebee's, Jack in the Box, Joining Subway, and Hanara They already do this and so I started in my own mind thinking along the lines You're talking about it saying if so many companies have already done it, why are we mandated this? Which goes against certain principles of mind, anyway As far as mandated something I Just wanted to applaud your Appeal here to possibly do this type of outreach and education as an alternative to let's say a bill that we mandate something Thank you Rhonda, did you provide testimony on the Senate side? I did And the same suggestion? I actually offered quite a few suggestions That was on the Senate side when it first started out was actually about the whole entire menu And I truly believe the same thing that if we worked with the restaurants in a partnership and education process We could get in fact again most of them are already doing it, but the ones that aren't we could certainly give them an education program Again the Hartman Hart Association has done a great job of formulating all of these different menus And they went up to about 20 plus restaurants and said would you support these items and they all agreed so If we find that when we're approaching businesses that they are more than willing to take this on and actually make changes then I think that's an opportunity to say let them go and do what they need to do If we have a problem down the line then we could certainly look at this But given them the opportunity to raise up to the level that we're asking for if they're not already doing so I feel would be a much better approach for the businesses They're all being impacted quite a bit with mandates and changes and things that are happening in this industry And it's just cumulatively and although it doesn't seem like it would be a large cost for a business to make a change in menu I'd prefer to have them when they're ready to do the menu changes do the menu changes instead of a forced Menu piece on there because if there was a cost involved with that I did not I apologize There's some typos in here. I'll have that to you before the end of the day was there one Chamber of Commerce organization that did say that they were supportive of the bell Ourselves have not had testimony from any business group. They were all as well as the Tourism group they all seem to have been busy last week I just thought for some reason one had which surprised me Thank you Hi Kathy, it's Ian Pugh Thank you very much for agreeing to testify By phone on Act relating to nutritional requirements for children's meals, which as you know come over from the Senate as healthy drinks And so we would appreciate Hearing the comments of the election playing a chamber Thank you very much for the invitation You were cutting out a little bit. So let me know If you have trouble hearing me, okay? So for the record, Kathy Davis with the late-chancing regional chamber of commerce I'm sorry. I couldn't In person today. I always like visiting your committee So as 70 as it was passed by Which The late-chancing chamber We had concerns with the Initial bill that was introduced in the Senate, but think that what was passed is a good sort of stuff addressing these issues and one that is manageable for And it was background on the chamber relation playing chamber has about 1500 members concentrated in Northwest Vermont The majority of our members about 85 percent have fewer than 20 employees. So the majority of our members are small And I'm happy to go into further detail or answer questions, but that was all I had Well, Kathy your testimony is very timely because well Just before we called you one of the members said doesn't One of the chambers support this bill And I don't know we haven't heard from them all and then there you did Carl Yes, just a question. So out of your 1500 members, how many are I don't have a my fingertips, but my estimate is somewhere in the 50s If you bear with me I can pull up our database and give you well while I could perhaps answer another question I can We while my hair turns growing our database open And pull that specific number for you What while she's doing that does someone have another Hi, Kathy, it's representative Keith. How are you? Good so the effective date is July 1st 2018 Yeah, it's been suggested that there's can create inconvenience in the least when the necessary turnover of Menus and well not just the menus, but the print printing of the menus themselves Has that is that something you guys have looked at? Um, we did not I think in I think that was that's probably a fair point and perhaps It was considered, you know a friendly change Maybe looking at something like September 1st. I guess is that a lot of folks would would make good That's what makes a change, you know, it's quickly a possible But you know a little I would always prefer to give our members extra time to find out about the requirement and then implement it versus having somebody sort of unwittingly run a foul You know because they haven't heard yet Okay Just one more question. So I Hadn't thought of this so you just said that but how how would a restaurant know that the law had changed? in It's now April 1st 90 days from now Maybe that's a question for our committee more than you but yeah, how are how are restaurants? How are your members typically brought up to speed on a chain such as this? We always do our best to get the word out to members when there is not falling a deadline specifically living so Think of Recent so with something on the box law that was put into place I think two years ago now we have supported that one which was removing the question about criminal background checks from employment applications and so we did provide communication to members To make them aware of course unfortunately from our perspective all the Members of our chamber So, you know, I think that there is there can be a gap in terms of How those other you know restaurants that may not be a member of an associate find out You know, hopefully again If there's I don't I can't remember if there was enforcement attached To this language Okay, thank you Now Kathy we've had to answer all these questions. Have you got a better? Guest to make this to the number of fruits and restaurants and restaurants that are members But my I'm gonna say 70 That are in in our dining category Thank you Kathy, thank you very much if there are no more questions Happy work, thank you very much for taking the time out and identifying appreciate it very much. Take care Committee on your list She's gonna be last so Jennifer Costa. Hi, Rio I do have a Few handouts I've submitted testimony as well, but if anyone wanted hard copies I have three A Few handouts Yes So I'm Jennifer Costa Thank you for having me today government relations director for the American Cancer Society Cancer Action Network And I'm here to talk to you about s70 today the Cancer Society Cancer Action Network Supports s70 we believe that it is a compromise that not only makes sense But is it a critical step to easily addressing a huge culprit in childhood obesity now We would love to have the nutritional standards attached to the bundled kids meals But if we cannot we strongly feel that removing the sugary beverages as the default option for the children's menu Is a step towards reducing obesity and the risk for chronic diseases like cancer Some of you may wonder what's why is cancer involved in this? What's the link? For most Americans who don't use tobacco the most important behaviors to reduce the cancer risk are weight control Dietary choices and physical activity. We know that excess weight increases the risk for at least 13 different cancers Including breast cancer colorectal uterine pancreatic ovarian esophageal and liver cancer And that's just a few of the 13 now when it comes to kids Nearly one in three children are currently overweight or obese in the US and we know that childhood overweight and obesity now Follows them into adulthood those behaviors the majority of children consume Diets that are too low in fruits vegetables and whole grains the Vermont Health Department's youth risk behavior survey found that 76% of adolescents in Vermont do not eat the recommended five daily doses of fruits and veggies and their Diets are too high in sodium saturated fats and added sugars As a first-time mom, I'm just now learning That pretty much everything at a restaurant and dining out becomes a fight So I am asking you why not make just this one simple choice Easier for parents who are just trying to enjoy a meal out one less fight is a few minutes of peace at the the dining table Sugary drinks are the leading source of added sugar and one of the leading sources in calories in Americans diets Nearly 40% of all added sugars come from sugary beverages and the most recent US dietary guidelines in the World Health Organization recommend reducing added sugars To no more than 10% of our caloric intake. So just for some perspective a 2000 calorie diet That would be 200 calories coming from added sugars an Average 12 ounce soda has a hundred. So that's that's half Coming from just that one 12 ounce beverage Children ages 9 to 18 what we know is that they consume 17 percent of their calories from added sugar So that's almost double what's being recommended by the World Health Organization and the US dietary guidelines Contributing to kids being overweight and obese and increasing their long-term risk for cancer Obesity rates have tripled among our children in the US in recent decades and one study even concluded that the Consumption of sugary beverages accounts for 20% of weight gain in this country and in kids from 1997 to 2007 I know that I'm throwing a lot of numbers out there. It is all in the testimony as well but Why we are so worried about the link between sugary drinks and waking is because Through our research at the American Cancer Society Cancer Action Network We recognize that excess body weight not only increases the risk of cancers coming back It also decreases the likelihood that someone will survive multiple cancers And I did want to just address as I was listening Final note on the potential costs of printing menus and this is less from the cancer society perspective and more from my own personal perspective I worked in restaurants for ten years before I Got into this job and a previous job I find that most restaurants the the menus are printed and they just slide in So it you know while I respect that that the testimony of others I'm not sure how much of an cost increase that would be and if you've ever been to we're specifically talking about kids menus Usually they're a photocopy With like the connect the dots or an activity on the back that are disposable anyway, so We're talking about Xerox It's I don't think that a lot of restaurants in the majority probably print their menus rather than like the cheesecake factory super flashy books that are You know a hundred pages that need to be reprinted So I thank you for your time for all of these reasons the American Cancer Society urges you to take this critical step in protecting our kids By the simple step of removing sugary beverages from bundled kids meals. Thank you You made this comment that just to prevent one more argument or something like that at the table I mean to me speaking as a parent also That to me it seems that that's One of our choice deteriorating things in our society is we don't want to make those decisions And we have somebody else make it for us I'd be opposed to that because I think the most of their meals are gonna be at home Or the parent is gonna have to make a decision over whether they serve Let's say a sugary drink or not, so I guess I didn't agree with you on that portion of your Think a parent should ever think I'm not gonna have this fight with my kid because I'm gonna have a relaxing dinner. I think that's always our job I Think my point is if you know you're at a restaurant with your child and there's water milk and juice and then there's soda Most kids are gonna want the soda No So I have a question and I don't know actually if you would know the answer to this and Schools have had over the years soda machines Or dispensing Including water and juice and soda and things. I don't know if that still is true today because I haven't checked Would you know? Would anyone know? Because as soon as this is years ago, this was a practice that Started and when I initially questioned why this was happening Apparently the schools get a certain amount of revenue from whatever is sold from dispensing and if these Sodas are being sold still in schools We need to do something about that because I don't think that's really appropriate myself especially given the health issues and With eating out at restaurants children's eating habits start at home. It is what we Give our kids from the time they are born so a Lot of children develop the habit of wanting the soda because they get it at home Well, I will say we also are seeing is Dining out used to be a treat and for some parents. It's becoming a more regular practice and so while I Mean personally my my daughter's only two and a half That's why I'm saying that the the testament the battle of wills is starting now But I think as parents are dining out more frequently that the treat is becoming the norm so that's a parental Decision Not not all treats have to be of a certain nature. So Yeah, parents give up a whole lot of control so anyway, sorry I I have a quick question about another part of your testimony if I may in the just-the-facts This this graph right here. Yes, I Like graphs I was looking at that What explains? the evidence Here that boys up until they reach 18 consume More sugar it seems than their female peers, but when they become adults The women seem to overtake the men as far as consumption of sugar. Why would that be? I think it's an interesting trend. I don't have the answer as to why that manifests the way it does It's uncanny in each spot like that. They discovered beer Oh Sort of a reference to what Mariano was saying school board usually make that decision So I mean at least when I was on school board we My best of my knowledge, okay, so that I think they You know those types of sodas or whatever So Jennifer to be kept your testimony if you had multiple reasons Yes There is undoubtedly a link between Obesity and cancer We know that the best one of the best ways besides not smoking or using tobacco products to reduce Your risk of getting cancer is from weight control dietary choices and physical exercise That would be our biggest and we know that one of the biggest contributing factors in America to weight Gain is sugar sweetened beverages the consumption of them and that chart that you pointed to the interesting one with the The the curve there is that Half of the US population consumes sugar drinks and every day 10% of kids have three or more Just an interesting Fact there. Thank you Yeah, yeah, kind of running around I appreciate it Oh Andrew McLean I'm with the Beverage Association of Vermont It is the trade association of the state non-alcoholic beverage distributors like Coca-Cola Northern New England, which is in Colchester. There's a Pepsi plant in South Burlington John leaders got a plant down in Brattleboro There and there's a couple other smaller ones, but that's bait. That's primarily it and then Represent polar which is primarily out of outside of Vermont a couple to I guess Basically, I got the bottom line is we are neutral on the bill at pass from the Senate I'll leave it at that. I mean I don't know don't support it don't oppose it I guess I would only I would like to say just based on a couple of the comments and things I've heard Briefly is that Based on our sales my client sales the mix of Product being sold in Vermont is changing and has changed a lot over the last five years Coke, you know Regular Coke used to be the prime seller of there. It's not anymore They sell a lot of they're branching out doing teas sugar-free drinks water Selser a lot of that is you know, they're number one sellers. So the mix is changing a lot Well, they heard about the beverages in schools The companies work together with schools and that it was decided that just wasn't you know, wasn't the right idea Wasn't the right mix etc. I think there was a mutual decision amongst the school and the companies to to Take beverage, you know sugar beverages outside of schools and that's still still is the case You know they're You know we try to do their best try not to advertise to kids The idea is not to have a three-year-old, you know with a sippy cup of a Coca-Cola. That's not the idea So, I mean, I think I think things are changing. There's a there's a national campaign between the Clinton Foundation American Heart Association and and companies that Trying to reduce calories from drinks by 20 by 20 percent by 2025 I think they're I think they're going to Exceed that now as well as the last couple years. So I mean I disagree with some of the statistics about the the root cause being Our beverages, but you know bottom line for this bill mean our position is We're neutral Yeah, I just like to know I mean you said that there is this trend to have less sugary things What do you attribute those Well, I think a couple of things I think some of it is the work of The legislature in discussions on obesity. I think that's an issue. I think that pallets are changing I mean, I think you know, it's interesting the discussion and many times you say that Advertising and companies drive Drive consumption. I think that these companies are very Attuned to the wants of their customers and I think the changing pallets of people I don't think I don't think people drink as much soda now as they used to I think the younger people don't as much as they used to so I think I think a lot of different things But I think some of it is this discussion I think I think calorie counts on menus have mean it has an impact on me when I look at and I look at some I Thought that was fairly, you know, and it's like 1200 calories. Well, you know, so I think some of this I think a lot of that's had an impact Would you attribute some of it to the educational programs as well like oh sure answer society. Oh, absolutely No, no, no Yeah, yeah, smarter for the most part absolutely smarter. Absolutely. Yep So education you think was one thing education. Yeah, mm-hmm. Thank you very much Thank you for having me I But it actually allows me to respond to some of my colleagues Peers that were testifying before so I'm Jane Kalidinsky I chair the Department of Community Development and Applied Economics at UVM and direct the Center for Rural Studies and I'm on the Advocacy Committee of the Vermont Heart Association and many of my comments are rooted in an op-ed piece That was published in several papers across Vermont Which I believe many of you have read or or have so I'd like to make just a few points the original legislation required Restaurants to meet nutrition standards for the entire meal and not only beverages and the committee and the Senate side Received a good deal of testimony supporting that broader intent but in the interest of working together and To agree on a positive a positive step towards addressing obesity health Organizations businesses and restaurants interested in the issue were able to reach this compromise bill which only includes The the beverage component I Want to say that school policies indeed have gotten rid of so many of them have gotten rid of soda in The vending machines and so there are limits to the amount of sugar that are available I also would like to comment on The comments that say parents really should control what their children eat and yes, this is true However, our own government the Center for Disease Control has swung way ago over the The spectrum from education only towards make the healthy choice the easy choice Which is really nudge or behavioral economics to help people make the healthy choice the easy choice And so my goal in my lifetime as a professor is to probably see that pendulum Swing back to the middle where it's yes We should have policies that help consumers to make the healthy choice the easy choice But they don't know how to do that unless there's education along with it so it's a combination of public policy and Education and I I strongly believe that as an educator There's another comment that I'd like to make and that's that the fastest growing category of Foods and beverages in the United States if you were to look at the trade Associations is the healthy food category and the clean label category and what a clean label means are products with fewer than five Ingredients such as water hundred percent juice and milk, which are what are being proposed to be on the menus fastest growing Component and my own work has found that when Restaurants do make these changes There is a possibility for a whole segment of consumers that you're actually missing now that choose not to eat out Because they can't find the types of foods and beverages that they would like their children to eat And so when you say we can go to the other side of the menu and we can ask for can I have the milk instead of The soda which is the default It's really no different than having the milk as the default and I as a parent if I want my children to have soda Then I would have to ask for it. It's just flipping the page a little bit. It's not really changing The situation at all Vermont is known many times as a leader in a lot of public policy issues And I believe they can be a leader in this issue as well There was a comment that said that 20 restaurants were were We're already doing this voluntarily Well the American Heart Association and I was at one of those restaurants worked with seven restaurants not 20 So it's it's not a pervasive yet It was just a pilot test to see whether or not these types of beverages and foods would be acceptable on the menu So it was never meant to be the policy It was meant to be a pilot to show that these kinds of policies actually do work and will be accepted by Consumers and while some restaurants have chosen to offer healthy drinks to kids 75% do not and Between I think it's the year 2010 and 2013 the number of restaurants that voluntarily chose to meet nutrition standards grew from 1 to 3 percent So this is a small upward climb that public policy can help move in the right direction and we're not talking that Soda is not available on the menus It's just that the default is the healthy option and if parents want their children to have the soda then indeed They can just ask for it just like I used to ask for milk Which was barely ever even available on a menu when my kids were growing up So I'm an economist and there are some economic reasons to do this I was happy to hear that the beverage industry is neutral on this bill because Industries really smart they know that if consumption of sugary beverages is going down then they will change their product mix and Develop products that consumers demand and indeed the upswing is that consumers are demanding more of these healthier Options on their menus. There was also a comment about most food is eaten at home Indeed we have just surpassed that 50% of our food dollar is spent on food away from home So the majority it's not most the majority is is spent on food away from home instead of at-home venues and As others have testified Food away from home is higher in fat calories Sodium and so on all things that lead to negative health outcomes. There are a few examples The silver diner restaurant chain actually decided to eliminate sugary drinks and fries with its Kent kids meals They saw Prophets increase and the increase in profits were greater than the surrounding restaurants So there is some indication that this is a this can have a positive effect on business and not be a burden UVMMC the University of Vermont Medical Center has for years been trending in healthier meals for The hospital patrons and I like to ask the statistic How many people do you think choose to eat at the hospital because they have no other reason to be there than to eat? But that's used to but since the menu has swung into this very healthy choices It was 13% of people have report they have no other reason to be at the hospital than to eat in their restaurants Which which is kind of an indication that this trend is really swinging towards the healthier options I have colleagues that do take their dates to the hospital And I'd also like to know that I I've taught marketing for many many years and it is I wish I could just pull up my magic My magic computer and find this statistic, but labels change every six months in general Products change their labels every six months. So it's not that maybe maybe if this bill is passed There might be some time to to ease it in but it's not like it's going to be a big burden because Labels change and it's not like you see the same menu for three years before someone reprints a menu So that burden is not going to be the burden That I believe that is the point is being made and then finally I'd like to leave you with It's an anecdote, but we used to say cigarettes when used as directed were the only legal product that killed you and I'd like to say make an analogy that say sugary beverages that only are sugar and water such as a Carbonated beverage when used as directed are a legal product that has no other Purpose than to eventually kill you because it adds to obesity cancer and negative health outcomes And so why not make the healthy choice the easy choice for our children moving forward and Support the compromise bill that says on menus. We would make the the healthy drink options the default I know you I see you coming from both angles on this that you're happy with so so much progress that has been made in terms of people voluntarily changing and habits changing restaurants obviously changing their menu based on people's Educated decisions to eat differently or drink it So that's why I'm surprised we at this point where we see this progress being made besides we're going to legislate something that makes it a law instead of the the choice of the restaurant or or the These various companies so I applaud the I thought The efforts to educate people to reduce their calorie intake especially of beverages. I guess great Because I mean it's too bad with so many people that are overweight and and also But I just don't see why we need to make the law when we see the trends going Well, I think when we go back to the that wasn't a question, would you like to respond? Yes So I'll go back to to the concept of what the CDC says and CDC centers for disease Disease control and public health policy really supports making the healthy choice the easy choice And one of the easy way easiest way is to get businesses to comply because I did say the statistic was only 3% It's increased by 2 percentage points of restaurants that would like to help With the healthy menu choices make the healthy choice the easy choice. The easiest way is to legislate it Maybe Water But on a children's menu the menu typically comes with and I'm gonna I don't need to be stereotypical I'm gonna be stereotypical chicken fingers fries and a soda So it's a package deal and so within that package deal if it's still gonna be chicken fingers and fries You can still get water on the side I believe that this bill would say you get a bottled water or a seltzer or something or a juice That's what I understand No, they don't they have one hospital that's on the cutting edge and that happens to be in our strong little state of Vermont One hospital in their state of Vermont that's on the cutting edge Well, okay, okay, so UVMMC for the last 10 years has been really pushing the envelope on healthy meals offered in their cafeterias and Hospitals throughout the state are jumping on the bandwagon because you always have to have proof of concept And what they've done is they've got this proof of concept that it works and therefore the you know, the wheels start rolling Thank you I Just entered since I was busy running around I was I have one one statistic I thought might be interesting for you Since we're in talking stats Andrew McLean again This year the Champlain Valley Fair that bastion of healthy living for the first time right because coca-cola CC N and ease the the purveyor Has a soda bit of the contract for there for the first time not non-sugar beverages for the predominant Seller at the Champlain Valley Fair. So that's saying something out Ideas have changed I just thought I just thought that was a that's an interesting that's an interesting stat We know why Now Quick question, do you have any stats on? So it isn't such in movie theaters. I do not Thank you So the next two witnesses are on the phone Looking to the answer or are you playing for now that person's name? I'll just say doctor I just No, it's not. It's not. We're going outside of here. A little bit outside. We're moving out. I'm sorry. Oh, Allison, that's Allison. I'm sorry that we did not get someone from Central Vermont and Barry. Are you taking my false record chance? We can check the hospital menu for you though. Yeah. No, this is a good one, yeah. Hi, Doctor. This is one of my services. We're calling for your testimony. Can you call us back please at 802-828-26? I got the voice mail. You got the voice mail? Do we have an email? Do we have an email for the doctor? You will in a second. Okay, perhaps you could email. Can I ask a question about the bill in general while we're waiting? Pardon me? Can I ask a question about the bill in general? Absolutely, because, I mean, we have two people who are on the phone, less two people, and perhaps they thought they were later in the day. So, that may be part of the... So, go ahead. Yeah, my question is, I don't recall the portion in here of what the penalty was for restaurants not appearing for the citizens. Well, let's pull the bill out. I don't see what you mean. I don't believe there is one, but let's pull the bill out and take a look at it. You've got to send us the fiduciary and get them to put something in there. I don't want that, but I can say, I didn't see anything in there, so I'm starting to think, you know, it's a nice to do thing to tell people. I think if they don't do it, probably people won't go there. I think that will be done. Yeah, so the market is very much along. Yes, I can sort of answer that question. Okay, I can answer it much better than I, but the penalty isn't listed in the bill, but any restaurants that's licensed, it would be the same penalty that any other restaurant would have to face if they did any kind of health violations. There is a chapter, I just don't have it with me. I think after I can get it to you in a minute. Perhaps a lawyer in the room who supports this bill can find the legislative penalty. A person who violates the provision of this chapter shall be fined. Rebecca Ramos with the Heart Association shall not be fined, not more than $300 for the first offense and for each subsequent offense, not more than $500. So it goes with everything else. That's pretty still fine. Especially if you've got four families in there a month. I think it's a one time. It's a health and safety thing. Are you coming back? Yes, of course. As we are waiting, is there anyone who is sitting on the side who has not testified who would like to testify? I've testified, but I'd like to answer it. Go right ahead. And then we may take a break as we're waiting. So I'll probably forget some of them. Representative Gamash just to answer your question about the schools and what's offered. So there's federal regulations now within the competitive food act that prohibits the sale of sugary drinks during the school day until half hour after the school day. So that's why you don't see the vending machines anymore. They're there, but more for like after school and sports and stuff are going on. Yeah, I knew that was a very active program at one time. I haven't made an inquiry, so I really didn't know where that stood, but I'm glad to hear that. Yes, and so I think that kind of speaks to why we're here too, that as we've seen with the Vermont's Tobacco Control Program, it's not going to be just one thing that's going to change behavior. And the reason we have a problem with obesity is there's a variety of reasons that's happening, right? And so with the Tobacco Control Program, they're trying to do stuff in schools, in communities, through education, through marketing, and that's what we see is effective. And so we believe that, you know, we have the nutrition standards for state government that in restaurants and early child care, in schools, that's what's going to make the difference. It won't be this on its own. It will be this as part of all these other efforts that are going on. And so I also wanted to correct on Professor Kolodinsky spoke a little bit about this. One of the things that Rhonda Burns said about the heart associations work on this issue, it is not an easy lift to have voluntary change. When she mentioned we worked with 20 restaurants, we worked with seven and we paid them stipends to do that. They didn't chomp at the bit to do that. We paid them for the food and we paid them for their time so they could create it. And then we offered it to the communities to see what communities thought about it and whether the food, et cetera. And so with those restaurants, well, we appreciate them and we had a great working relationship that change did not continue. It was two years ago, so it was a one-time event. So it is not as easy as she made it sound. It's not continuing. We did it once. Working with every restaurant in the state of Vermont will not change it overnight. And as also as Professor Kolodinsky said, what we've seen nationally over the past few years, we've only had a change of 1% of restaurants to 3% who meet nutrition standards. It is not even with consumer demand, the change is very, very small and we're spending $300 million on treating obesity in the state of Vermont. And that's just adults. That's not the cost to our kids that are growing up. And that's why we feel it's so imperative. It's not as easy as trying to work with organizations to improve nutrition and certainly we will do that and have tried to do that on our own. That's not going to bring about the kind of change that's going to save us healthcare dollars or prevent obesity. And one last thing, I'm sorry. So, and again, it's wonderful that some national change have made some progress in terms of like McDonald's and Panera and Applebee's who have the default beverage for kids being healthy. Again, that's wonderful. But again, 74% are not. So there are some, but especially all the mom-and-pop stories where the majority of Vermonters go to eat, we're not seeing it. Yes, it's great that there's change, but it's not the kind of change that's going to change behavior. These sweet waters, kids meal, age 10 and under includes one side and soda or chocolate or whole milk. And soda is the first. What was that? Sweet water. Okay, so we're going to go bury. I was trying to think of a restaurant where kids might have choice and what this means, but what I'm worried is that there's a progress from one to three percent. And there's an argument between the two. On the regular for them? Yeah, because I remember a time when if you wanted milk for each other, they didn't carry it. Yeah, I don't know because we didn't ask that question. I think so. The more just speaking in the door, just as a parent who goes out, you can find a beverage section and it's usually like the soda is more juices because juices can be managed. Alcoholic beverages as well. That's so much milk. I look at those and they say they represent the majority of the best food restaurants. And Applebee's is sort of in between and it's more of a family restaurant. That come up in a restaurant. But I was just wondering that the other thing I would say is I'd say a little soda. Yeah, for the restaurants, have the kids say one of the answers. I have a question for you. I have a question. Encouraged by the search here, I looked to Mr. Z's in Barry and for children 12 years and younger, it includes beverage. This bill would prohibit that language, correct? You could not use the word beverage to describe beverage. I think you would have to list the ones that we talked about. I guess that's a Katie question, or saying it has to include a beverage. Well, it doesn't say sugary beverage though. I don't know, that's a Katie question. Right, so the language of this bill, it is a Katie question, would have Mr. Z's change its menu? Right. Even though it's a neutral term, they're not saying soda, they're not saying Pepsi, they're not saying, but this bill would have them change their menu. Like the word shell. So chopper? Shell, the word shell. That's pretty strong as far as you can see. Did you find a restaurant that serves French fries? Uh huh, kids menu. Ladder One Grill, Ladder One Grill. A lot of kids don't go there though. It's a good drinking place. It's a good eating place. You get a free kids chocolate or caramel sundae with every kid's meal. You get that free though. Sorry, but you get all kids menu items coming with the choice of fountain soda, milk or chocolate milk. How's that? Well, you start with fountain soda. That's the first thing. Anything else on there? Chicken Fingers, cheeseburger? Try the waist sign. What's that place? We used to bring all the market kids and everything to eat. Yeah, I know. That's what the bigger bill is about. French fries. Oh, God. There's a list anyway. I don't even know. I wanted to make a comment, please. From my personal experience. If I may, as you're researching some of these, I think this speaks to one of the issues that we tried to get across here. It's the bundling of this meal that's part of the problem. You're getting the hot dog in your fries and you're getting this beverage as part of it. And as Karen Lafayette said the other day, you're trying to get a big bang for your buck, but you're getting the sugary drink that's lumped in with it and so that's part of the problem. Whether or not you intended to go get it, there you are. It's part of the deal. You wanted that Sunday, too, that's part of that. You're getting a whole bunch of not-good-for-you stuff for your children, which you can say no to, but the bundling is kind of what creates the norm. That's what kids think of and that's what parents think of as a kid's meal is all those things together. And this is not required because I just went on Al's French fries. And Al's French fries does not have a kid's menu. They just have... So it would not require anyone to have it. Right. If you had a kid's meal that had the beverage, then you would have to follow it. They should fix the adult meals as well. Yeah, I know. Because you won't have a child. That was a strong deal. I think a break because I think that the two people on the phone were thinking that we were going to be a bit later in the afternoon. Well, I did get a message from Dr. Korbalin or however he says his name. It said he was waiting for a half hour and he wasn't sure if he was going to be contacted. So I emailed him that they're trying to reach you but I have not heard a response. Okay. I'm trying. Yeah, I just... I didn't hear back yesterday. Are there any other current laws on the books that tell a restaurant or an eating establishment as to what meals they should or should not provide or what beverages they should or should not provide other than alcohol to people? I don't know about Vermont but there are 10 ordinances in California, Colorado and Maryland that do just this. That say how they've ever... So I don't know about Vermont. There are certainly other laws that restaurants have to comply with for health issues. I don't know in terms of serving things. One that was mentioned to us from a restaurant that was on our list of supporting restaurants was the composting law where she mentioned restaurants didn't like it and they grumbled on it. Then they easily did it and it's water under the bridge and that's kind of what she was making the case that happens often. So I could make my comment. Yes, please do. Okay, so my limited experience as a parent with one child and being an old hippie, we raised her making all of her own baby food. We ground everything up in a food mill and avoided children. It goes until the end of the story. Avoided all baby food. Gave her no sugar for probably six or eight years and she's 41 years old. She's never had a cavity or a filling or a pulled tooth. She runs five miles a day. She's spelt and in excellent health. So I guess my conclusion is that we did something right. Absolutely. But you did something right. You did something. We did the same thing. Food mill. No, it wasn't a food mill. May I ask one quick question? On the language of the bill here, and I just noticed this, in the fruit juice section, it's limited to not more than eight ounces. Is there a reasoning behind that? It's probably because it has natural occurring sugar and the calorie count is probably higher for that. That's probably this. Beyond eight ounces of fruit juice, it's a higher sugar calorie. A higher calorie amount then. We had originally had limitations for the milk as well. We were just, as part of the entire mill, was trying to keep calorie counts down. I would have to do some research. I can't do on the spot now, but it may have to do with recommended serving sizes for juices from both the pediatric association and the heart association too. Thank you. Would you like a difference between having a half a cup of fresh grapes as opposed to a whole... Okay. Thank you for allowing me to do that. I think this is a good place for us to take a 10 minute break and hopefully by then, our phone people will be back and so we can talk to our phone people. The two phone people are two physicians. I see so. And my question to folks is, are there other constituent groups that you were prospective that you have not heard from that you want to hear from? Who fed from the restaurants? The restaurants are... There is no longer a separate restaurant association. So that is why we heard from the two chambers. And we have one chamber, a state chamber that says don't mandate any... And the other says we support it. And again, I would have no idea how this group would respond to the testimony, but the association of homeschoolers, people at homeschools, they're children. Having nothing to do specifically with this. Who paid this bill? So unless you're thinking of amending the bill, this has to be... I would say where some of us are coming from is that we think it's really the parents' responsibility to direct what their child needs and not the state overall. So I'd be curious if a group of people that have also taken in to educate their kids would have a stronger feeling about this bill than people at large. And, you know, it would also be an interesting thing for the... I guess that's really it. I don't want to get too much into it, but I just would... And again, it made me too off the track for anybody else to be interested. You just asked me, would I... I initially was like, I don't believe this. But I mean... He's calling us... Well, he actually probably just said it. I did something right. He and his wife... No, the end result is what I'm talking about. I know. Is that the lack of sugar... Exactly, I understand. You were the one that controlled that... That was my point. But that is... Yeah, but you got your child used to eating a certain way from the time she was born. And that has carried her through her life. And that is my point, too. I mean... No, no, no. I just... I don't think so. They don't offer... As a committee, which is fine. What's the role of public policy? What is the role of parents? We're talking about homeschoolers. I'm not talking about vaccines. Is it... Do we require vaccines? Or do we let parents decide? So there's all sorts of things that we can sort of tease out in terms of what is the role of government in... in... in moving us in a direction... If this is a direction we want, which is healthy kids and less obesity. And it's okay. We'll figure out what we do. But let's take a break. I'm a little hesitant about having too much of a discussion when we have not heard from two more of the witnesses. A critical mass because people are just in. Yes, the door. And why don't we try... Have we heard from the doctor whose name I can't pronounce? No. No, I'm in her back of time and I come back at his office and he's not in the office. I'm not sure if I've checked in on this. You're a mass witness. So I'll call the other person. See you later already. Doctor, what... Do you have your house or any services? I'm calling for your convenience or testimony. Okay, I'll put you on the speakerphone. Good afternoon, Dr. Blevins. This is Representative Ampere. Coming in. Thank you for agreeing to testify on S7, which is an act relating to the nutritional requirements for children's meals. Do you have prepared remarks? Thank you. Okay, and why don't you go ahead and then after we make them we will I'm sure have questions for you. Okay. So although I'm a public health physician I'm speaking to you primarily through the lens of a mom, a teen boy. I've talked to my kids quite a bit about healthy eating for the past 13 years but I end up being a little undermined by messaging about foods, especially in restaurants. So eating has to be a great from the usual routine. It takes chance of trying new foods or a way to celebrate, but it can also be stressful for parents trying to encourage their kids to adapt a healthy diet. I know some of the children who are typically high in calories and lacking in nutrition. Most foods have some redeeming quality. There's protein and chicken, but the typical accession here is sugar-sweetened beverages, which typically offer only calories. Fountain drinks in particular offer empty calories before eating has even started. Water, milk, and to a lesser extent 100% fruit juice, if ever it is included in our family, are much better choices for children's health. Kids' meals have a strong cultural message to children as they are establishing their dietary habits. While the meals may appeal to children, they create challenges for parents trying to instill good eating habits. When it comes to eating out, parents can end up feeling that their own dietary intentions for their kids have been high dots. Offering healthy defaults drives children towards making top-tier decisions without removing ultimate choice. Our children are the first generation that may, on average, lose shorter lives than their parents due to obesity and associated crimes as used by diabetes. This provingly prediction requires support from everyone. Through proposed legislation at 70, Vermont restaurants can lead the way by replacing unhealthy default beverages with healthier choices. This would support the intentions of most parents I know and help prime children for making a life force of healthy choices as a adult. Thank you. Yep, no, I see that. Thank you very much, doctor. Mr. Committee, if they have any questions for you as a parent as well as a public, as you said, a public health doctor. Sure. Committee? I have a... Speak up. Okay, I have a question that doesn't have to do with a question to an MD. Is that something you're ready to take? I'm happy to take it. There are very specialties within the realm of an MD so I may or may not be qualified to answer that. Sure, I'm just trying to make some sense of what I'm hearing. When we talk about sugar in sodas, we're really talking about high fructose corn syrup, right? For the most part, there are some sodas that actually even advertise this cane sugar. We think that it's sugar from sugarcane much like what you might find in your own kitchen. And some people think that that's better than high fructose corn syrup, but it's still empty calories and still contributes to obesity. Yeah. I'm just mentioning that because there seems to be some correlation between the increases in obesity and when these soda companies switched from sugar to high fructose corn syrup. Yeah, and I think that people have looked at that and the science isn't completely clear on whether high fructose corn syrup is to blame, but at least more importantly, the science is more clear about it, the sweetened beverages, however they're sweetened, which has a link to obesity. Thank you. You're welcome. We have another question. Can you define empty calories for me? Because I know when my wife sees me have an alcoholic beverage, she says, oh, there's some more empty calories. I know I'm just curious because obviously empty calories can be burned up by the body that would be used in exercise or whatever, but I enjoy hearing your definition of empty calories. Sure. So I would define empty calories as calories that do not provide nutritional content. So I made this comparison with, for example, chicken nuggets, which I'm not promoting chicken nuggets, but they, at least they have some protein. They are high in calories. They're high in fat. I would not define them as a nutritional food, but I also wouldn't say that they're empty calories. So sugar sweetened beverages are empty calories because they're providing calories without any nutritional benefit. So if you take a soda, for example, that's just sugar and water and flavorings and maybe some coloring. There's nothing that contributes to a person's nutrition. And so alcohol can be viewed in the same way for the most part. I think maybe you could split hairs over wine or beer, but I agree with your way. I'd rather eat my calories than drink them. Thank you. Can we focus on the bill? Yeah, that's all right. I think I have. Yeah. I look at these when we talk about sodas. It's like if it's diet coke or diet, whatever. There's no calories in them. That's what it says. The sugar is the sweetener is the bad part, right? The sugar is linked with obesity because of the calories the person is drinking those calories. So is your question our diet so it is okay? Are they a healthy beverage? No, I keep hearing the word calories and empty calories and I'm thinking last time I looked at one of those cans and said there were no calories in them. Yeah. There's no calories in them. It must be the sweetener that's the culprit. Right, so most of the time and this is probably speaking more from experience than the statistics says that the drinks that are being offered to children are not diet sodas. They have calories they have the celeron caloric version of a soda or sugar sweetened beverage. I personally didn't feel like I wanted to give my children diet soda because it's not clear to me that artificial sweeteners are fine for them either. So we may be treating one for another. I have a comment that's somewhat associated. This is a second time today I heard the phrase that this generation the life expectancy of the upcoming generation may be lower than future partly based or mainly based on obesity and linked to sugar and so I had been looking at the report that reported that it's a 12 year old report that on the other issues that jeopardize life expectancy the opioid problem is not even mentioned. This is 12 years ago and I think that since then the evidence is that the life expectancy is going through a measurable downward change based on overdoses and misuse of drugs and so I just because it came up the second time I just thought that as this human services committee we consider things that contribute to a decreasing or less than a lowering of the rise of life expectancy there's a lot of contributing factors. Sure I think both are this is a situation where both are a play as well as other factors in 1918 a lot of young people died from influenza and so these are models and predictions which hold some value but are not necessarily true and there's many many risks out there for all of us and so the role of a public health physician is to identify what those risks are and reduce the risk that they are whether that's sugar or opioid or infectious diseases. Thank you. Do we have other questions and do you have any final comment that you want to leave us with? Dr. I think that I would say that sometimes I hear that it's up to the parents to educate their children on what to eat and that we shouldn't interfere in the restaurant or in the marketplace and so my experience has been that I do take that job seriously I continue to educate my kids about what is a healthy diet and I feel like it is really an uphill battle and I'm speaking as someone who's educated in public health and in medicine and the cultural method is from restaurants, from advertising either within our school is working against many of the initiatives that parents are fitting for us to help educate their children so I see this as one way of a restaurant being able to offer a healthy beverage as it is a false choice. It doesn't take away ultimate choice but it does say where the direction that we would like to be going in and I think it is consistent with what most parents are communicating to their children about. Thank you very much. Thanks for taking your time out for today and informing our discussion of this bill. Thank you very much. Okay, bye. Bye. I think she said give the opportunity for a restaurant to offer a default beverage because they have that opportunity right now that we have to meet a law for that. That was not the import of our testimony. I understand. We're going to try Dr. Corbillin again. Shot high. Have an able again. You have the right number at least. He says his name because of the way he smells. I'm not quoting. I can send you his written testimony that sent out the law for any of his opinion piece that he had published that he should have something from the office. A doctor. They might have other things. I'm curious. What are your questions? Where are people on this? I'm ready to vote. Does that mean you're ready to vote? Yes? Does it matter? I'll keep it close to my chest. We've heard a lot of testimony. This is I don't need to hear more testimony. Is that your question? Part of my question is do we need to hear more testimony and then a conversation about what our thoughts are about in terms of getting ready for the vote was not posted until tomorrow. Who is it possible to vote? I'm curious just in terms of where people are thinking about. I don't need to have any more testimony. I think that's where I am too. I'm not going to say that. If everybody else is happy with what we've heard so far it's fine. It's been a lot of good testimony. A lot of good reasons to do this from a health perspective. I understand that. I'm on my underlying philosophy which is not to have too much intrusion from the state to tell people what to do versus the health impacts. I didn't have to let people know that is a conflict for me to wrestle with that. I don't know which is going to win out at this moment. I'm with Carl. I always take note when there's millions and millions of dollars involved in health care for obesity or whatever condition it may be in case of cigarettes or tobacco. It's pulmonary disease, heart disease and such. My point before my story was simply that I've got to grow up to be healthy but not every parent is going to go through what we went through as parents and be able to manage that. I think some guidance in that area is a reasonable lift. Just a default beverage position in a restaurant. I don't think it imposes any great difficulties toward a few restaurants. I think the health benefits and the possible savings in Medicare, Medicaid and health costs will be worth the public policy. Theresa, welcome back. We're having a stutter stop discussion on where we are around this bill. Both Mariana and Carl talked about wrestling. Wrestling would be the concept of the health benefits but also the don't believe like regulations. Chip just said it was a good place to encourage balance and to do a regulation. I just wanted to say I'm sorry, I didn't mean to re-categorize your statement there to make it like you were supporting my position. I understand that. Not a problem. Not necessary despite I understand. At the at the rate of voluntary change on this, we would have probably two more generations of people where we would have increased risk in terms of the health issues that are here. We're not eliminating sugar, sweetened beverages for people's choice. They can still choose that they want to. I don't feel like we're I guess over-regulating or over-requiring if they're just saying this should be the first option. So I'm okay with the concept itself. I grew up in a different generation when soda pop was in the same category with it was an occasional treat. Right. And, you know, my other when I was little, my mother used to water my cooks and somebody gave me one. I took it home so that she could water it. I'm not so vegan anymore. But at the first time that I encountered soda pop as the drink for lunch was when I came to Vermont to all-day legal education and lunch was included. And I remember standing over this bin of cans of soda saying what are these doing here? Where's the tea? It was before but I was just kind of appalled that there is this notion that when you had a sandwich you also had a coke. So to me the idea that a meal is not that is... But that's changed dramatically. I mean, you rarely go to an event where there aren't many alternatives to some of these things. You probably have a chance to take a stand. Then we've been educated. So also this, I understand Sandy exactly. And that was also that was back in the time when soda pop usually was at least where I came from small bottles of Coca-Cola. The green glass bottles which were six ounces. And that was like a huge treat and that was a once in a whenever. So everything surrounding this has changed dramatically over the years conflicted. Because I do understand the idea of good public policy to help people help... help them be able to make a better choice. Have it available. I mean I remember when my daughter was quite young toddler the occasional outing it was not infrequent to find a restaurant that didn't offer milk as a beverage which blew my mind because I could never it just times had changed obviously. And now we've gotten to the point where it's at least twice as much soda in one sitting and then that can be double to triple to easily during the course of the day. Which is so I'm conflicted because yeah I think I think we do it's in public interest to help turn the tide a bit. Although now I thought Andrew McLean's testimony was interesting in that there seems to be a shift in people's attitudes and what they're consuming. I asked him to do a follow up I was real curious about movie theaters to determine in terms of their own the distribution if restaurants and movie theater outlets have seen this shift. If patrons buying habits have shifted at all. So he said he would see what he could make follow up and see if he can get me some information by tomorrow because I'm just really curious about that. So I brought this up early on in this film. I want to make sure that I clearly understand what the intent of this legislation is and I'm just going to read the first sentence here. A food service establishment serving a children's meal shall offer as a default beverage. And then the three different things is an or in between so that means to me that two and three don't have to be enough. Or, or, or. One, two, or three. One of those. They all don't have to be. They have to all be available. So when I read it it says default beverage and it says number one, water sparkling water. So that to me means they shall offer water in sparkling water. Or, if they don't want to offer that, they can offer flavored water. Or they can offer. If they don't want to offer that, they can offer milk. If they don't want that, they can show. The only two things that they have to offer as a default beverage. For my reading of this is water and sparkling water. And that's what I want clarification. Okay, so Dr. we will have who would you like clarification from? Verification from Katie? Who would you like clarification from? Yes, the one. Okay, so Katie. So rather than us trying to I don't want to get into Mullen and Sorak and all them. Because the bill has changed since they sponsored it. Correct? I think what you are I guess what I'm not clear is your question. What do these words mean? Yes. Do they have to offer anything other than water and sparkling water? They don't have to necessarily offer. This is because I'm not sure you're going to accept what we're saying. They can offer one, two or three. They don't have to offer water. They could just offer milk. They could just offer fruit juice. Or they could just offer water. Or they could offer all three. Or two or three. Can I I have a question to give away? I'm a restaurant owner. And I've got children's meals. Do I have to offer anything other than water? No. If the the drafter agrees with that. That's what I'm thinking. At this point I got to offer two things. Water, sparkling water and either water or then it gets into all the ox. So Katie is otherwise engaged. That's all I need to know. She is expected back tomorrow. We are expected back tomorrow. She's going to have a clean thing of this anyway. At this point we have not made any changes unless anyone is proposing a change. She was making the change to 80. Right. But she's also in four places. If I get that quit I'll manage it. That's fine. Because that needs the rest of it. All we have to do is offer water. That's an alternative. And the end of it is water. So we got water. That's it. I want to diet coke. I'm going to say I hope we don't have it. So we will wait and get that sort of answer. Are there other questions that we want Katie to think about and give us the answers to? Are there, is there any amendment to folks or any additions, subtractions? Now we were sent the part about that statute I think you showed up on my email or something like that. The family. In other words for enforcement. Okay. It's if you don't have water. You have to put it on the floor. If you don't have water. If you don't have water. If you don't have water. If you don't have water. If you don't have water. If you don't have water. Some of us are still connected. Which is fine. We have to figure out where they are. Topper needs to know that. And so why don't you will plan on taking this up for a vote at this point with no changes on Wednesday afternoon. Wednesday morning. Along with S280. In terms of S280 which is the poverty council strengthening families bill. Yes. I have sent it along to and she's reviewing it. Thank you for taking up me. I happen to see her in the hall. She seems to be fine. And I will have not been able to connect with Lisa Ventress. Who is the executive director of from our business round table. Thank you. Thank you. So we'll check that. We'll have that information. So thank you. Ladies and gentlemen. Oh, okay.