Menu: Childhood obesity: Requiring chains to post calorie counts won't put a dent in the nation's obesity rates

March 14 2011 4:19 PM

Who's Counting?

Requiring chain restaurants to post calorie counts won't put a dent in the nation's obesity rates.

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McDonald's menu. Click image to expand.
A McDonald's menu with calorie counts posted

Next week, the Food and Drug Administration will propose rules requiring chain restaurants nationwide to post calorie counts for the food they sell. When the agency finalizes those rules—which could take a year or more—parents who read a McDonald's menu board will see that a cheeseburger Happy Meal has as many as 700 calories. That's half a 6-year-old's recommended daily allowance.

The hope is that posting calorie counts at chain restaurants—defined broadly to include Taco Bell, Applebee's, and Starbucks—will lead people to order healthier food for themselves and their children. There's a kind of logic to this. Restaurant calories are big contributors to the obesity epidemic. Americans blow nearly half their food budget at restaurants and spend less than half the time cooking at home than they did 50 years ago. If people only knew how many calories were in that Applebee's cheeseburger (930, plus 400 more for the fries), surely they'd order something lighter. This common-sense assumption drives the public health community's full-throated support for posting calorie counts, and explains why, to name one example, the Center for Science in the Public Interest calls the new measure a "huge victory." Even the restaurant industry heaps praise: It "gives consumers one more way to live a healthy lifestyle."

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The trouble? Posting calorie counts won't help. We know because New York City has done it. Since 2008, chain restaurants in the city have had to post calorie information. In two studies, researchers at New York University compared the food choices of low-income children and adults from Newark, N.J. (where calories aren't posted) to the food choices of low-income New Yorkers. Although posting calorie counts raised consumer awareness somewhat, the researchers found that the measure had virtually no effect on what the New Yorkers actually purchased. Most distressingly, kids in New York were still eating as many calories as before. A third study looking at New York City and a fourth out of Seattle likewise found that little good came of posting calorie counts.

The ineffectiveness of similar regulations tells the same story. Since the mid-1990s, we've made food manufacturers print nutrition information, including calorie counts, on packaged foods. Time and again, however, studies show that few people notice nutritional information and even fewer use it effectively. As the FDA lamented in a 2004 report, "It may be that consumers do not take advantage of the available information on the food label to control their weight, perhaps because they do not appreciate how the information could be used for weight management purposes or perhaps because they find it too hard to apply the available information to such purposes."

This shouldn't be surprising. People may generally know that they should avoid excess calories, but they don't often know how many are too many. Even if they do, many can't do the math in their heads to tally the day's calories, much less figure out which combination of dishes would stay within the daily limit. Parents who buy food for their children don't typically keep track of the calories their kids ate earlier or will eat later. They may also have more pressing concerns than the calories in their kids' lunches that day. And parents aren't always in the loop. Adolescents often order their own food, and they rarely account for the long-term costs of what they eat.

Posting calorie counts works on the principle that giving people the right information will help them make good decisions. The same instinct motivates all sorts of mandatory disclosure regimes. Just tell people about risky mortgage terms, and they'll borrow more wisely. Just tell patients about pills' side effects, and they'll make better choices about their meds. Just tell arrested suspects about their right to remain silent, and they'll make smarter decisions about what to say to investigators. Yet with few exceptions, these sorts of informational solutions have failed dismally. Inundated by information that they can't understand and don't have time to process, people routinely ignore mandatory disclosures. And they'll ignore calorie counts, too.

Not so fast, supporters counter. Posting calories might marginally affect behavior in certain populations, as a few studies have suggested. Even if there are no direct dietary consequences, fast-food restaurants might think twice before rolling out yet another high-calorie item. Calorie counts could reinforce the importance of a low-calorie diet and have long-term effects we can't yet measure. And maybe people have a right to nutritional information, even if it doesn't much change how they act.