Food and Nutrition
Can You Legislate Good Eating?
By
Oct 5, 2008 - 5:13:53 PM

(HealthNewsDigest.com) - New York City was the first place in the nation to require restaurants with more than 15 locations nationwide to post calorie counts for each item on their menu. Counties in Washington and California, and cities from San Francisco, Chicago, and Philadelphia to Washington, DC are considering following suit. Los Angeles has imposed an ordinance stopping new quick service restaurants from opening in a 32 square mile section of south LA. Senator Jeff Bingaman, a Democrat from New Mexico, has proposed the The Obesity Prevention, Treatment and Research Act.

A study to be published this month in the research journal Obesity projects that close to 79% of all Americans will be overweight by 2030. Though the statistical analysis used to project these trends has been criticized, there is no getting around the fact that Americans are getting fatter.

The overweight epidemic in this country has no single cause. It is the result of many factors acting together over time. But, you cannot dispute facts. Today, Americans spend 48% of their food budget on foods prepared away from home, adding up to over one-third of their daily calorie intake. In 1976 only 26% of the food dollar was spent eating out. Restaurant portions, during the same time were super-sized, offering more calories and fewer nutrients. We cannot ignore this trend as a contributing factor.
But, well researched scientific evidence to support these numerous legislative initiatives is inconclusive. And, the potential to change consumer behavior is questionable and may not result in the public health gains predicted. What exactly do we know?

Interestingly, the American Dietetic Association (ADA), one of the world’s largest groups of nutrition professionals, has not supported any legislative proposals for restaurant nutrition labeling. Why you ask? Because this responsible professional group prides itself on developing positions related to food and nutrition based on sound scientific evidence. Currently, the evidence is thin. The ADA has established a team of experts to conduct a review of restaurant nutrition labeling to report existing evidence, find gaps in knowledge, and recommend research needs. We need more initiatives like this to guide legislation.

All eyes are on NYC. Will their labeling regulations work? Will behavior change? More than half of all NYC adults are overweight and 1 in 6 is obese. Twenty-one percent of NYC kindergarten children are obese. Clearly, something needs to be done. Though many have heard that the NYC calorie posting regulations have been challenged in court cases, few know that the research behind this regulation may be faulty. The study that was used to support the Health Department’s menu labeling campaign was both criticized and rejected by 2 respected medical journals. It was finally published in a third research journal where one of the authors had a strong connection. Faculty scientific studies should not be the basis for legislation, even when the legislation is well intentioned.

The Los Angeles County Public Health department did attempt to see if menu labeling would be a positive strategy to use in combating the obesity epidemic in their county. Their results showed a positive trend. The study suggested that if calories were labeled, 10% of restaurant customers would reduce their calorie intake by 100 calories. That may not sound like much, but health professionals have been encouraging people for years to cut 100 calories a day to achieve a weight loss over time. The study further predicted that this modest change could reduce the annual county population weight gain by 6.75 million pounds. Small public health initiatives do produce positive results in a large population.

The problem with this very positive result is that there is no assurance that the right people will use the information provided. Studies have demonstrated over and over again that the people who make the most use of nutrition information are well-educated and already eat well. If non-obese restaurant customers use the calorie information posted but overweight customers ignore it, the impact on obesity would be far less than predicted. To be effective, calorie labeling in restaurants needs an education component to be sure the target audience makes use of the information. Interestingly, NYC has no plan in place to evaluate if calorie posting in restaurants will actually reduce the city’s obesity rate.

So far the reaction to some of the calorie postings has been mixed. Women, seem to experience the most sticker shock. Many have expressed horror when they found out a favorite salad with dressing has over 1,000 calories, or their morning muffin has 350 calories. Men and young adults are less affected and less likely to make use of the information. They claim a sign isn’t going to stop them from ordering what they like, or they are too active to watch calories. Some customers are annoyed that they are being made to feel guilty when they eat out.

This fall Harvard decided to stop posting nutrition information in the dining halls because of growing concern for students struggling with eating disorders who might misuse the information. Students can still look up nutrition facts for the daily menu on the internet or in kiosks in the dining halls.

A major drawback is the postings of outlandish ranges on some of the menu boards. Because items can be made to order you might see: large cappuccino 440 – 1020 calories; burrito 420 – 819 calories, or salad 155 – 823 calories. These wide variations don’t offer much help ordering and can lead to endless questions for the counter person, holding up the intended quick service. Restaurants are also concerned with the potential for litigation if personalized orders are not accurately represented by the calorie posting. Food preparation has many variables and not every order is exactly the same.

Restaurants are in business to make a profit. What the customer buys drives choices on the menu. If the calorie posting shifts purchasing choices, restaurants will respond. Time will tell and time will let us gather more evidence to evaluate if calorie posting has value and should become more widespread.

© NRH Nutrition Consultants, Inc.
Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of the nutrition counter series for Pocket Books with 12 current titles and sales in excess of 7 million books. The books are widely available at your local or on-line bookseller.
Current titles include:
The Healthy Wholefoods Counter, 2008
The Cholesterol Counter, 7th Ed., 2008
The Diabetes Carbohydrate and Calorie Counter, 3rd Ed., 2007
The Calorie Counter, 4th Ed., 2007
The Compete Food Counter, 2nd Ed., 2006
For more information on Jo-Ann and her books, go to www.TheNutritionExperts.com.

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