File image of a Neapolitan pizza. Beginning Monday, federal rules will require restaurant, grocery and convenience store chains to post calorie counts for all standard items on their menus. Credit: Cesare Abbate | AP

Consumers can no longer plead ignorance when ordering that deep-dish pizza or triple-patty burger.

That’s because, starting in May, federal rules now require restaurant, grocery and convenience store chains to post calorie counts for all standard items on their menus.

Consumers should expect to see the labels on display boards, handout menus and digital kiosks at chains with 20 or more locations. The change will be most evident at midsize and regional restaurants and grocery stores, since most of the country’s largest chains began displaying calorie counts after Congress passed the menu-labeling law in 2010.

Labeling has proved controversial since then. While public health groups say calorie labels are needed to nudge consumers toward more healthful choices — especially in an era when people dine out often — some in the food industry have fought the rules on the grounds that they’re expensive and difficult to implement.

Even as the regulations go live, critics are pushing a bill in Congress that would significantly weaken them. And last year, the Food and Drug Administration delayed the rules at the 11th hour over industry criticism, although the agency argues that mandatory calorie labeling actually benefits businesses.

The Washington Post recently called up FDA Commissioner Scott Gottlieb to unpack that argument — as well as the future of nutrition policy under President Donald Trump. This transcript has been trimmed for space and lightly edited.

Q: For starters, can you lay out the case in favor of menu labeling? Why are calorie counts on menu boards important to public health?

A: Well, for multiple reasons — but I’ll emphasize two.

The first is that I think providing basic information about the healthy attributes of food is important for consumers to make informed choices about their diet.

We know that providing calorie information on menu labels actually inspires consumers to make smarter choices about overall consumption, when they want to. It does reduce overall caloric intake. Studies show a reduction of anywhere from 30 to 50 calories a day, on average, for consumers who are eating out — and consumers eat about one-third of their meals outside the home. So over the course of a year, that could translate into three to five less pounds gained, just from the reductions that you achieved through providing more information on menu labels.

That could go a long way toward reducing childhood obesity. Because if you look at the reductions you need to bring down obesity rates, they aren’t much more than maybe 50 calories per day — one study showed that reducing a child’s daily intake by about 64 calories would significantly reduce rates of overall childhood obesity. So menu labeling will have an impact on health and obesity, and it will help consumers make smart choices.

The other rationale is that menu labeling will inspire competition among restaurants to produce options that are more healthful. We want to create a level playing field so that consumers can make smart choices and easy comparisons from one restaurant item to the next. Then restaurants and other food producers have more of an incentive to reformulate food in ways that will have less calories.

Q: Some corners of the industry, as you know, still aren’t on board with that plan. The National Restaurant Association has backed menu labeling, but grocery and convenience stores have complained the regulations aren’t flexible enough, and the pizza industry has said the costs are still too high and fought for all kinds of concessions.

How would you respond to criticisms from those groups that the regulations unfairly burden businesses?

A: I think in the final guidance we try to accommodate the concerns of businesses in cases where they felt there were costs associated with the rule that could be reduced. We’re allowing restaurants a multitude of ways to display calorie information in a way that aligns more closely with their current business models and doesn’t require them to undertake costly renovations.

So for example, the pizza chains have a multitude of ways of complying, including putting an iPad in their store or just having a paper menu — which most of them have now. We’ve seen those menus from major pizza chains and they’re completely compliant.

From a business standpoint, I think the reason this regulation is pro-business is because it creates a level playing field for the disclosure of basic information. It allows restaurants to compete on the basis of providing more healthful, low-calorie options to consumers.

We know consumers overwhelmingly want this information, and more and more consumers are looking for low-calorie options on menus. If there isn’t a uniform standard for how this information is disclosed, and the presentation is different from restaurant to restaurant, then it becomes less valuable to consumers because they can’t make consistent comparisons.

I don’t think anyone claims that having a basic Nutrition Facts panel on the back of items in the grocery store is a bad idea or somehow anti-competitive. Quite the contrary: People say, “well, I like turning over the package in the grocery store because I know I can get basic information about sugar, fat and caloric intake, and I can make comparisons between different food products.” Menu labeling provides that same level of basic nutrition information for consumers who want it.

Q: Given all those benefits, why did FDA delay menu labeling in the first place? These rules were originally supposed to go into effect in 2017, but FDA extended the deadline at the last minute.

A: There were a number of concerns raised by industry that we thought were reasonable, and we thought that if we took a little extra time we would have the opportunity to try to address ways they could more efficiently comply with the law.

Look, I want this to be maximally beneficial for consumers. And the way that it’s going to be maximally beneficial for consumers is if restaurants can comply in a fashion that’s efficient, cost effective and timely. So to the extent that we were able to provide a clearer avenue for restaurants to comply with the law, we felt it was worth taking the extra year. And that’s what we did. We got it done. Now we’ll be looking forward to working with restaurants to continue to help them work through any lingering questions.

Q: What happens to a restaurant that doesn’t post calorie counts on May 7?

A: We’ll work with them. We’ll give them advice on how they can become compliant over the course of the first year. [Note: FDA is not enforcing penalties against noncompliant businesses until next year.] We will be doing inspections, and we’ll also be working with local partners and other third parties, such as the National Restaurant Association and other trade associations, to coordinate this.

I think a good example of where we can work with these establishments is again with the pizza chains — some of them are worried that their existing menu boards are not fully compliant because there are so many different toppings, you can’t possibly configure a menu that accounts for all the different variations. But that in fact isn’t true. You can configure a menu, and all the major pizza joints are doing it because we’ve shown them how.

Q: Let’s talk about what comes next in nutrition policy. A number of public health groups are saying their next policy push will be around kids’ meals in restaurants — banning soda as the default drink option and that kind of thing. Could you see FDA playing a role in that space?

A: I don’t envision that. I think we see our role as providing information to consumers so they can make informed choices. As long as consumers are making informed choices, that’s our primary obligation.

Q: What about health claims on food labels? You’ve said FDA plans to prioritize those.

A: We’re going to be implementing a nutrition plan over the course of the next year, and a lot of the elements of that plan are geared toward providing additional ways that food producers can make health claims on product labels. [Note: If a food company wants to make a health claim linking their product to a specific disease or ailment — such as claiming that cranberry juice prevents urinary tract infections — FDA must approve it first.]

I’m a firm believer that if we want food producers to reformulate food in ways that are more healthful, we have to allow them to talk about those attributes. If we don’t allow them to talk about the health attributes of their foods because of the regulations we impose, they’re going to formulate food in ways that taste better or have better packaging or are easier to prepare — because those are things they can talk about. Right now, a lot of these claims sit for a very long time with us. We want to make the process for how we adjudicate health claims more efficient so that we can do it in a timely way.

If producers can’t say ‘my food is healthier, my food can help, you know, reduce your risk of certain diseases,’ then they’re not going to invest in the technology and the research to formulate foods in ways that achieve those outcomes.

Like menu labeling, this is information Americans want or need to access to make decisions about the foods they eat so that they can make informed choices about their diets and health for themselves and their families.

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