The Affordable Care Act: The Problems Just Keep Coming – Calorie Disclosure
Dec 9, 2013 - 12:06:01 AM
Interestingly, the restaurant industry was in favor of this provision to knit together the growing patchwork of regulations that were popping up state by state and in many cities. For many chain restaurants this information was already available. For those that needed to implement the provision the task was not that daunting because menus and ingredient sourcing were universal to the chain and once implemented it could be rolled out system wide.
For supermarkets and other small businesses that serve ready-to-eat, prepared food that task would not be so easy. The Senate bill (1756) (http://beta.congress.gov/bill/113th-congress/senate-bill/1756/cosponsors) and the companion House bill (1249) (http://legiscan.com/US/research/HB1249/2013) argue that the cost of compliance for supermarkets, quick-marts, vending machines, and delis far exceeds that of chain restaurants because café and deli menus may differ from location to location, may change daily, and there may not be menu standardization or a central supply for ingredients. Providing calorie information in this ever changing landscape would not only be expensive and time consuming but the effort must be weighed against the perceived benefit.
Researchers out of Carnegie Mellon University (http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301218?journalCode=ajph) showed that posting calorie information did not reduce calorie consumption. Julie Downs, the lead researcher, tested a number of options for posting calorie information in chain restaurants. In addition to the normal calorie information per menu item, Dr. Downs offered information on the recommended calorie intake per meal or the recommended calorie intake per day.
She found neither altered consumer choices. In fact those that received information on their overall calorie intake for the day ate slightly more calories, not fewer. It was just speculation, but Dr. Downs suggested that when a person is told that they need 2,000 calories for the day and a large hamburger is 500 calories, they actually thought the choice was reasonable. Then the consumer went ahead and ordered a large soda and fries, neglecting to calculate the calorie cost of the entire meal.
Counting calories all day is a pretty labor intensive job. Many people will not do this regularly enough to make a difference. Many simply cannot do these calculations in their head. Dr. Downs feels it may be an unrealistic expectation to expect consumers to keep such close numeric track of their food choices day in and day out.
In fact, the inability of calorie labeling to result in a reduction in the number of calories eaten or to reduce obesity has never been conclusively shown. In fact, most of the research shows that few people look at or use the information provided. Two studies done by researchers at the Centers for Disease Control (http://www.mywheaton.org/Taxonomy/RelatedDocuments.aspx?id=0&sid=0&ContentTypeId=6&ContentID=676592) (http://jpubhealth.oxfordjournals.org/content/early/2013/11/20/pubmed.fdt109.abstract) found that both children and adults who used chain restaurants the most were least likely to use calorie information to make better food choices. Only 36% of US adults read, but don't necessarily use, the calorie information. Women are more likely than men to look for this information.
Based on this evidence it does seems prudent that both the House and Senate have taken a commonsense approach to calorie postings in supermarkets, delis and quick-marts to exclude them from the required nutrition labeling for chain restaurants under ACA. For these businesses the cost of providing the information to the few people who might actually look at it, and perhaps use it, seems an onerous burden considering the perceived public health benefit is close to nonexistent.
Securing the public health of a population is a vital function of government. Stemming the growing tide of obesity in the US is an important public health goal. But, in taking steps to achieve this goal we need to gather and weigh the evidence carefully. Calorie posting is expensive and time consuming. Thus far, the evidence gathered on its effectiveness shows it does little to change eating habits. It is a feel-good sound bite that policymakers like to use to show that they are pushing Americans in the right direction when it comes to making food choices. What this regulation may actually be doing is driving food costs to cover the cost of calorie posting and in the end few may benefit from the effort.
© 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 sales of more than 8.5 million books.
The Diabetes Counter, 5th Ed., 2014
The Fat and Cholesterol Counter, 2014
The Most Complete Food Counter, 3rd ed., 2013
The Calorie Counter, 6th Ed., 2013
The Complete Food Counter, 4th ed., 2012
The Protein Counter, 3rd Ed., 2011
The Ultimate Carbohydrate Counter, 3rd Ed., 2010
The Healthy Wholefoods Counter, 2008
Your Complete Food Counter App: http://itunes.apple.com/us/app/your-complete-food-counter/id444558777?mt=8
For more information on Jo-Ann and her books, go to: www.TheNutritionExperts.com.
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