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Growing a Healthier Apple

Posted Jul 15 2009 6:43pm

By Barbara Berkeley

From 2002 to 2004, the city of New York gained 10 million pounds.

This startling piece of data was one of the arguments used to advance New York’s pro-health legislative agenda. In December 2006, the city banned the use of trans-fats in restaurants and food service products. Trans-fats had clearly been indicted as a risk factor for coronary artery disease and few could argue with their exclusion. Soon, however, with the Big Apple threatening to become the Candy Apple, legislators tackled a more controversial initiative: mandatory calorie counts on menus.

New York City had reason to believe that calorie labeling would be popular. A number of surveys had shown that the public wanted this kind of information. In 2007, for example, a survey of 2,500 consumers had concluded that three out of four supported laws that would compel restaurants to post nutritional information on their menus. In addition, California was working on legislation that would make the entire state subject to menu labeling laws.

From March to June 2007, the city conducted a survey of 7,000 fast food restaurant customers. Their aim was to get a sense of what they bought, what calories were consumed, and what nutritional information they were offered. They found that the mean caloric content of fast food purchases was astonishingly high (see table below). Of particular interest in this data is the fact that some of the highest calorie counts were found in foods that might be considered “healthy”, such as chicken dishes.


Source: Enacting Menu Labeling Policy, Dr. Lynn Silver

Even though some fast food chains provided nutritional information on tray liners, very few people reported having seen it. Only 4% of patrons were aware of having seen any nutritional figures at all.

Data from a survey of Subway patrons, where nutritional info was posted, showed that when people were influenced by calorie counts, they ordered about 100 calories fewer per meal. But how many were influenced? Of 1830 patrons, 1237 said they never even saw the information. And among those who did, see the counts: only about 200 out of 568 acted on the information and changed their order.

Nevertheless, New York decided to go ahead with mandatory menu labeling. They limited the law to chain restaurants with 15 or more locations nationwide reasoning that asking smaller establishments to provide counts would be burdensome. Calorie counts would have to be posted on menus and menu boards and in a font that was at least as large as price. On December 5, 2006, this legislation was approved and became the first mandatory calorie posting law to be enacted in the United States.

Since enactment, the law has twice been challenged by the New York Restaurant Association. Thus far, these challenges have been struck down and the law remains in effect. Here’s what the new menu boards look like:



My personal reaction is I LOVE THIS! Information is power. And for those who complain that they would rather have the freedom to choose food without knowing its caloric impact, we can point to the studies that show that those who are not interested don’t even notice these numbers anyway.

But where’s the beef? Has calorie labeling caused any real movement (other than the rhapsodic reaction of diet docs like me)? While it’s too early to tell, preliminary signs suggest that mandatory labeling may indeed already be motivating change. New York City has taken note of a number of shifts in restaurant menus. Dishes are being re-formulated to lower those off-putting digits. Some examples? Between March 2007 and June 2008, a Dunkin Donuts glazed cake stick mysteriously went from 470 to 370 calories; a McDonald’s large fries dropped 70 calories, a Wendy’s chicken club trimmed 110 calories from its count. And there are numerous other examples.

The assumption of health officials promoting calorie labeling is that 10% of customers will purchase 100 fewer calories at each restaurant meal. From this, enormous extrapolations of potential health benefits are made. New York City states, for example, that if these changes work out, 150,000 fewer residents will be obese and 30,000 cases of diabetes will be prevented. Despite my enthusiasm for menu labeling, these predictions seem pretty optimistic. Those of us who treat obesity or who have been obese ourselves know only too well that 100 calories saved in one venue are easily picked up in another. So, it’s not the saving of a few calories here or there that makes me so excited about menu legislation.

What lights me up is the idea that we might FINALLY be making strides toward a culture that visibly supports healthy living. We all swim in a cultural sea, a kind of bath of “normalcy” that surrounds us. It is so all-pervasive that we barely feel it, but it is the air we breathe and the environment that motivates our life choices. Menu labeling is just one small way of beginning the shift toward a cultural sea that tells us that healthful choice is “normal.” Bravo for that.

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