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Have you noticed there are so many numbers on your menus?

written by Marsha Seidelman, M.D.
on Sunday, 5th August ,2018

Over the past few years, and more commonly in the last few months, you may have noticed calorie counts on menus. Federal requirements for this information have been in the works for years, with some cities and states leading the way. New York City was at the forefront with implementation in 2008. Since these rules mainly affected chains of restaurants, having different requirements in different locations was problematic.

Other businesses that were initially included under the regulations, like movie theaters and grocery chains, successfully impeded implementation and lobbied for changes in the rules. After years of delays, a lawsuit brought by the Center for Science in the Public Interest  and the National Consumers League  in 2017, required the FDA to start enforcing calorie labeling in May, 2018. Some larger chains made the changes to their menus earlier, in anticipation of the changes, including Walmart, McDonald’s and Pizza Hut.

The current federal requirement, officially implemented on May 7, 2018, is that restaurant and movie chains and supermarkets with 20 or more locations must post calorie counts. There is yet another bill passed by the House of Representatives and awaiting consideration in the Senate - the Common Sense Nutrition Disclosure Act - that will allow retailers more leeway on serving-size definitions and label placement and permit take-out restaurants to be exempt from posting calories.

Even when calories are posted, the counts can be deceptive.  If a serving size is listed as 1 slice of pizza, you need to double the number of calories if you eat 2 slices. Unrealistic definition of the serving size is a method used to mask the number of calories you will consume. Other details on menus will include ranges of calories depending on options for that dish - for instance, small or large portion, with or without dressing, grilled or fried, etc.

Understandably, some consumers who want to enjoy a meal at a restaurant don’t really want to be shocked by the number of calories in a dish - especially one that might be considered to be healthy. Some large salads, for instance, are covered with dried fruit, crispy noodles and creamy dressing, and may have as many calories as a fried chicken meal. But, at least the salad is higher in fiber. I encourage you to check out the website for Center for Science in the Public Interest to get more details about the new labeling and to subscribe to their monthly newletter, Nutrition Action, for independent information about nutrition - or lack thereof - in supermarket and restaurant offerings. - https://cspinet.org

Of interest is that so far, research has not proven that restaurant patrons actually reduce their calorie intake in response to knowledge about food content. This hasn’t been adequately studied yet regarding shoppers' behavior in supermarkets and convenience stores. We may be at the beginning of a long process, similar to the years of regulations and restrictions regarding smoking, that finally, decades later, led to a decrease in smoking rates. A previous article on this site outlined that saga.

Obesity, like smoking, is a public health issue. One of the major contributing factors to the rise in obesity - now affecting 30% of the adult population and a lower but increasing percentage in the pediatric population - is the increased availability of high calorie foods. Providing these foods at every turn is a very profitable business. That didn’t happen by chance. Companies have done research for years about the optimal combination of fat, sugar and salt that will make consumers crave more.

To make matters worse, it has now been shown that one of the factors behind yo-yo dieting, where people gain the weight they’ve lost over and over, is that as they lose weight, their cravings for more calories increase. Having greater availability of high-calorie foods makes the struggle to keep weight off even more difficult.  Perhaps calorie information will help.  This is NOT a situation where you can say, "What you don't know can't hurt you."  Consuming massive numbers of calories can and will affect your health! Knowledge is just the first step.

Attention to both obesity and smoking are included in the field of Population Health - a focus on preventing disease in all rather than treating each person’s illnesses after they occur. We’ve got an uphill battle to fight in this country to decrease obesity rates and all the related problems associated with it, including hypertension, heart disease, stroke, diabetes and sleep apnea, all of which contribute to early mortality and high health costs. Calorie counting regulations may be just the beginning of creating awareness around this important issue and trying to improve population health, a whole generation at a time.  

REFERENCES:

Block, J. NEJM July 12, 2018 The Calorie-Labeling Saga - Federal Preemption and Delayed Implementation of Public Health Law.

Center for Science in the Public Interest https://cspinet.org/protecting-our-health/courts

National Consumers League http://www.nclnet.org/fda_menu_labeling_rule

Tags: calorie labeling, population health,

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