“We have all looked in the mirror and seen some things we did not necessarily like,” County Council member Sydney J. Harrison (D-District 9), who sponsored the menu bill, said at a recent meeting. “Change will not come if we wait for some other person or some other time.”

Harrison said in an interview that he has long been frustrated by the saturation of unhealthy chain restaurants in Prince George’s — which is in the top bracket of counties nationwide for density of fast-food establishments.

He grew up in the county and says he was born premature, in part because of poor nutritional decisions his birth mother made, and suffered learning disabilities and health problems that he links to poor nutrition.

The menu law, which has been signed by County Executive Angela D. Alsobrooks (D), was drafted with a coalition of groups including “Sugar Free Kids Maryland,” the Prince George’s County Food Equity Council, the American Heart Association and the Center for Science in the Public Interest.

In the first and second years, restaurants will be required to replace soda as the default beverage for children’s meals with either water, sparkling or flavored water, milk, 100 percent fruit or vegetable juice, or fruit juice diluted with water. That change mirrors laws passed in a variety of jurisdictions in recent years, including Baltimore City.

The Prince George’s bill is unique because it also addresses entrees and side dishes, said Andy Krauss, a spokesman for Sugar Free Kids Maryland.

In the second and third year, healthy sides must be the default option, and in the third and fourth year, restaurants must include at least one children’s meal that meets a variety of criteria, including having fewer than 550 calories and no more than 700 milligrams of sodium, 15 grams of added sugar and zero trans fats. The meal will also have to include at least half a cup of non-fried fruits or vegetables.

The council unanimously approved the bill on Nov. 17.

Enforcement will begin in the fifth year and be carried out by the health department and department of permitting, inspections and enforcement. Harrison said the intent of the bill is not to be punitive, but to make it easier for families to make healthier choices.

The legislation was applauded at a public hearing by a series of Prince George’s families who said they have struggled to find healthy options for their children at restaurants within the county.

Opposing the bill was Melvin Thompson, senior vice president with the Restaurant Association of Maryland, who said criteria outlined in the legislation was too stringent and would pose additional challenges for restaurants already being pummeled by coronavirus restrictions. He said restaurants in the county were not able to engage with the council about the bill because they were trying to keep their restaurants afloat.

Ellen Valentino, executive vice president for the Maryland-Delaware-District of Columbia Beverage Association, told the council that he association supported the overall intent of the legislation, but feels that soda makers have been unfairly vilified in public health efforts.

Among the supporters was James Tate, a health coach and father of three from Suitland, who says he often dines out in Montgomery County or Alexandria restaurants where menu options are more nutritious.

“I would rather spend my money where I live,” Tate said in an interview. “But it is nearly impossible.”

Tate was a staunch advocate of the menu bill, motivated by his own experience. He said he used to weigh more than 400 pounds and shed nearly 200 about a decade ago, mostly by changing his diet. He is especially concerned about the health of young people in Prince George’s.

A study commissioned this year by the council from the Rand. Corp., a nonprofit think tank, found that 16 percent of high-schoolers in the county are obese and 19 percent overweight, compared to 12 percent and 15, respectively, statewide. Only 10 percent of high-schoolers in Prince George’s reported having eaten a vegetable recently.

The council also approved legislation in November designating “healthy food priority areas” — census tracts, mostly inside the Beltway, where access to healthy food and transportation is low and the median household income is below $67,500.

Full-service grocery stores that locate or expand in those areas are eligible for tax credits equivalent to an 80 percent reduction in business personal property taxes or a 75 percent reduction in real property taxes for up to 10 years.

Council member Mel Franklin (D-At Large), who sponsored the legislation, said the coronavirus “revealed a lot of the inequities when it comes to access to health food and access to grocery stores,” with residents with the least access to healthy foods often being the hardest hit by the virus.

“It is critical that we implement equity and health in all policies in our county so that no community is left behind,” Franklin said.

The council also unanimously approved a resolution to promote “health in all policies,” including requiring county agencies and nonprofits to specify how much of their funding goes toward promoting health.

The resolution says the council will work with partners to develop a primary health-care system to serve residents who are uninsured or Medicaid recipients. It requests the county executive’s office share recommendations by May 1 for an integrated “health in all policies” plan.

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