The Effects of NYC's Calorie Counting - Nutrition Week

ADDITIONAL CONTRIBUTORS Gabriel Bly

The “McGangBang”, which consists of placing a McDouble inside of a McChicken sandwich. Photo courtesy of didntyouhear.com.

You may have noticed that many restaurants in New York City post calorie information on their menus. This is because in 2008, New York was the first city in the nation to force chain restaurants, which have 15 or more locations in the country, to provide customers the caloric content of every item on their menu. The law applies to roughly 2,000 restaurants, or about 10 percent of the 23,000 in the city, the health department said. And in New York City that makes a big difference, as 10 percent of restaurants serve 35 percent of all of New York City’s meals.

The city has led the nation in the regulation of lead paint, trans fat, smoking, and now in this initiative. As provided by the Patient Protection and Affordable Care Act of 2010, which the FDA is currently finalizing, all chain restaurants in the nation will follow New York City’s lead, posting their caloric information next to individual prices on menus.

But is it a good idea for all America to adopt New York City’s measure, and moreover, does the mandate actually help to change the consumers’ decision making?

When the law was passed, Thomas Frieden, the city’s health commissioner, hailed it as “a victory which will give New Yorkers the calorie information they need… to make informed, healthier choices,” he added that the regulation “could prevent at least 150,000 New Yorkers from becoming obese and prevent at least 30,000 New Yorkers from developing diabetes and other health concerns over the next five years.”

The city is mainly interested in curbing its obesity epidemic, which, according to the city’s health department, is associated with the leading causes of death in NYC, where more than half of city adults are overweight (34 percent) or obese (21 percent).

The graph below, from the Center for Disease Control (CDC) and the New York City Department of Health and Mental Hygiene, shows that the percentage of obese adults in the city nearly doubled between 1994 and 2004:

The push for new regulations comes from this and similar studies that have shown that the rise in obesity directly corresponds to a change in eating habits; mainly, the fact that people are eating out more often.

Eating out at a restaurant used to be a special occasion, but now Americans get a third of their daily calories from eating out, (up from 18 percent in 1977). USDA Economic Research Service (ERS) states that each additional away-from-home meal increases the daily calorie intake of adults by 134 calories, which results in roughly 2 pounds of weight gain every year.

By implementing this new law on calorie posting, health officials are hoping to impact obesity in a similar to the one the Nutrition Labeling and Education Act (NLEA) had on public nutritional intake in 1994 when the FDA mandated that all packaged foods sold in U.S. grocery stores must have a “Nutrition Facts” label. The result was that 75 percent of U.S. adults reported to use the nutrition labels, with half of adults reporting that the nutritional information had influenced their purchases.

Unfortunately, the same results have not been met with the new calorie labeling mandate as numerous studies from the past few years have shown that there appears to be little or no influence from the nutritional information being posted in restaurants.

In October 2009, researchers from Yale and NYU published a study where they investigated the early impact that posting caloric information had on New Yorkers. The result as they saw it was that they “did not detect a change in calories purchased after the introduction of calorie labeling.”

Another study by The Boston Medical Journal showed that “the average number of calories purchased did not change appreciably from before to after board of health regulation.” The report concurred with a British Medical Journal study, suggesting that calorie labeling “doesn’t do much of anything.”

Even as late as January 2011, a Washington State county passed a similar mandate only to find that: “No impact of the regulation on purchasing behavior was found.” The article, published in The American Journal of Preventative Medicine, stated, “Trends, in transactions and calories per transaction, did not vary between control and intervention locations after the law was enacted.”

One of the reasons the new mandate doesn’t work as well as the NLEA is because most of the customers do not even see the nutritional information posted in restaurants, as companies will often try to hide the information from the customers. The chart below, provided by the New York City Department of Health and Mental Hygiene, shows how most nutritional information in restaurants goes unnoticed by the customer:

Even when customers do see the nutritional information, most of them don’t seem to care. As Eric Finkelstein, a professor of health services research at Duke University pointed out, “With that destination already in place, the addition of the calories might not have made much difference in people’s assessment of better-for-them foods.” Besides, most people who eat out have already accepted the fact that the food in chain restaurants is less healthy, as a senior advisor to the Council Health Committee stated in a press release, “people going to Burger King are not the kind of people who care about the calorie count.”

This is especially true for lower income households, where economic adversities create an incentive to replace nutritious, but expensive, produce with less costly, high-calorie products. This problem is further compounded by the fact that fast food, in addition to being less expensive and more calorie-packed, also tends to be much easier to obtain.

However, a recent study published by The Journal of the American Academy of Pediatrics, showed that parents who had menus with the calorie content information next to the price chose a meal for their child that was around 100 calories less than those parents who had menus without calorie information.

So people do understand that calories are bad for them, and they restrict their children from consuming too many calories; but they simply don’t restrict their own calorie intake. Calories are something bad, but still only a unit of energy and therefore nearly impossible to relate to on a personal level. It is this detachment that causes consumers to underestimate the potential hazards of copious caloric content in a product.

The graph below, provided by the New York City Department of Health and Mental Hygiene, shows the disparity between estimated and actual calories is larger for high-calorie foods:

Without understanding what a calorie is and which foods are calorie-heavy, it is improbable that posting their numbers next to the price will change anything to begin with. Consumers first need to understand what calories are, and their effect, in order to make healthier decisions.

This video, from Johns Hopkins Bloomberg School of Public Health, discusses more effective ways in changing unhealthy decisions by using concepts that are easier to relate to than simply posting the caloric content of an item.

If we use these more easily understood ideas, such as how long you would have to run to work off the energy consumed by an item, they might be useful in the areas of nutrition education.

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