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The Massachusetts Public Health Council has approved a measure requiring restaurant chains to display the calorie counts of all items on menus, including drive-through menu boards, effectively creating the nation’s strictest statewide menu labeling rules, Reuters reports. Created to address rising obesity rates, the regulations mandate that chain restaurants with 20 or more in-state outlets post the calorie count next to each menu item. The mandate, slated to take effect November 1, 2010, applies to 50 restaurant chains, accounting for 5,800 locations, according to Reuters.. Although California and New York City have passed similar regulations “the drive-through component makes the Massachusetts measure the most stringent in the country,” according to Judy Grant, the campaign director of the advocacy group ValueTheMeal.org. In addition, the state policy will not supersede regulations from other municipalities that enforce even tougher labeling rules, marking a distinct departure from California’s regulations, which nullified menu labeling regulations that had been passed in San Francisco, Santa Clara and San Mateo counties. Commenting on the measure, Massachusetts Department of Public Health Commissioner John Auerbach says it “is a major step in the right direction in fighting the obesity epidemic,” adding that, “with more than half our adult population and one-third of our middle and high school students either overweight or obese, we need to do more to make informed choices” (Szep, Reuters, 5/13/09; Kirk, Eagle-Tribune, 5/13/09).