Do they make a difference?

Recently, the new law went into effect that requires restaurants to put the amount calories an item or meal has on their menus. The thought is that this will help people make more informed choices when ordering. Does it work? Do people really change what they’re going to order if they think it has too many calories?


1125 Menu Calorie Counts TNAmerica’s obesity crisis is an epidemic that has increased rapidly in the past 50 years, with a large portion of American adults being obese, which increases the risk for heart disease, diabetes, stroke and some cancers. Since many Americans eat and drink about one-third of their calories in foods that are prepared away from home and these foods usually have more calories, sodium and saturated fat than meals, it no wonder that a report from The Hartman Group found that the majority of people believe they eat less healthfully when dining out. On average, most people eat at least one meal away from home each week. This converts to an approximate 2 pounds of extra weight gain each year and while that might not seem like much, that’s 10 pounds in 5 years. The biggest challenge for our society is that we’re more and more sedentary and what we’re eating is high in energy density, or calories. The other issue is that this food is readily accessible, which means that it’s easier for people to get it. What’s surprising is that even trained dietitians aren’t the best at guesstimating the exact number of calories they eat in a day. So, how can those of us who are dietitians figure out what to eat?

One solution that many doctors, dietitians and lawmakers are hoping will make a difference is putting calorie labeling on menus. The goal of this is to help you make informed and healthful decisions about what you’re eating. As part of the Affordable Care Act of 2010, in early 2018, the Food and Drug Administration (FDA) put into effect a law requiring restaurants and grocery stores with 20 or more locations to display calorie counts of standard menu items. This is called the Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Food Establishments law. The FDA originally published the menu labeling rules in November 2014 and set the deadline for compliance to December 2015, but the Obama Administration delayed the compliance date by a year to December 2016. Thanks to industry lobbying, it took until May 2018 for the law to actually be put in place. According to the FDA around 1,640 chains across the country has been affected, or a total of 278,600 locations. Of the 1 million restaurants in the country, that’s only 27%. The FDA estimated that in order to comply with the law, it would cost $1,800 per limited service restaurant and less than $1,000 for a full-service concept. If restaurants don’t comply with the law, they’ll have to pay and not just a fine. Since the law is government-issued, misbranding food could result in criminal penalties. If they desire, the FDA could bring a restaurant to Federal court under committing a prohibited action and the misbranded food may be seized by order of the Federal court. The data shows that if you have caloric information on menu labels, the average consumer will reduce their intake but 30-40 calories a day. While this might not seem like much, it turns out to be about 3-5 pounds a year that you can lose by just having better information to make better choices. Another hope is that the law would force fast food corporations to offer healthier options because consumers are demanding it.

In order to comply with the law, calories need to be listed next to the name or price of the food or beverage on menus, menu boards (including drive-thru windows), on restaurant websites or on phone apps. The menu labeling rule also includes certain alcoholic beverages. The food establishments are also mandated to provide written nutrition information, like saturated fat, sodium and dietary fiber, to consumers upon request. If a menu item is available in different flavors/varieties or includes an entrée with your choice of side items, the calorie amounts will be shown in one of a couple of a ways. If there are two choices, calories are separated by a slash, such as 250/350 calories. If there are three or more choices, calories are shown in a range, like 150-300 calories. There are some places that you won’t see calorie information. These can include foods sold at deli counters, food typically intended for further preparation, foods purchased in bulk in grocery stores, bottles of liquor displayed behind a bar, food in transportation vehicles (ex. food trucks, airplanes or trains), food on menus in schools that are part of US Department of Agriculture’s National School Lunch Program and restaurants/other establishments that are not part of a chain of 20 or more. Unfortunately, the people that could really benefit from transparent nutrition information might not know that it’s there or to look for it.

Despite the high hopes for the menu labeling law, it’s not clear that it’s making a difference. Some studies have found that consumers are not influenced by them at all and eat what they like without worrying about calories. According to a Gallup survey in 2018, 70% of Americans pay a great deal or a fair amount of attention to nutritional information on food packaging, 21% don’t pay much attention and 9% pay no attention at all. If you break the survey data down by gender, about 75% of women say they read food packaging labels compared to less than 60% of men. When it comes to nutritional information at restaurants, the survey found that about 50% of women and 37% of men pay attention to it. Survey respondents said they’re more likely to read labels on food packaging when they shop. All of this information led Gallup to conclude that the difference lies in where people expect to find nutritional information, and that with time, calorie menu labeling could start to encourage more people to be attentive in restaurant as well. Other studies have shown that listing the calories on menus does impact on people’s behavior. According to a study by the National Bureau of Economic Research released in August 2018, the calorie counts on restaurant menus have customers ordering less, especially when it comes to appetizers and entrées. Researchers from Cornell University completed a randomized field experiment at two full-service restaurants. Their results showed that the vast majority of the participants in the study appreciated knowing the calorie information of their food choices and by the end of the experiment, support for knowing calorie counts increased by about 10%. The latest, and largest, study to date was published in the British Medical Journal within the last month. It looked at how calorie information affects consumer purchases. Using data from a large franchise of 104 locations of a national fast-food company that has three different restaurant chains located in Louisiana Texas, and Mississippi. All of the locations had added calorie information to their in-store and drive-thru menus in April 2017, so researchers were able to take weekly aggregates of sales data from the pre-labeling (April 2015 to April 2017) period to a year after labeling began (April 2018). This is a far longer follow-up than most previous evaluations of food labeling interventions. During the time form April 2015 to April 2018, there were around 50 million transactions. The researchers found that immediately after calorie labeling started, it produced a decrease of 60 calories per transaction, or 4% of total calories purchased (which weren’t tied to menu reformulation). However, by a year later, that reduction in calories had diminished to just 23 fewer calories for each purchase made, or just 10 fewer calories if only using one rather than two years of pre-implementation data. Either way, it’s not a significant reduction in calorie intake. Upon delving further into the data, researchers showed that the initial drop in calories was more related to buying fewer items, such as sides, rather than not choosing high-calorie options. When you consider that the average calorie content per purchase was nearly 1500 kcals, or three-quarters of the average daily calorie goal of 2000 kcals per day, it’s easy to see that fast food, no matter the type, contains a ton of calories.

Since behavior change often begins with heightened awareness and knowledge, having this information readily available on menus and menu boards gives diners with a clear frame of reference for knowing what and how much they’re eating, rather than having to guess. Several studies found that even chefs were surprised by the number of calories in certain dishes served at their restaurants. However, in order for these calorie counts on menus to truly make a difference, it’s essential that customers understand how use of the information. One idea is that if the menu makes it clear you’re eating 1500 calories for lunch, maybe you’ll decide to eat less calories at dinner. A study found that the placement of the calories on the menu also played a role. Regardless of what it’s related to, people are greatly influenced by what they see first. For example, if they see “loaded chili hot dog” first, they might think, “That’s exactly what I want!” If they see that it’s “400 calories” right after, they might reason, “OK, but that’s exactly what I want!” However, if they see “400 calories” first, they might deliberate, “That’s a lot of a calories.” If they see “loaded chili hot dog” right after, they might consider, “OK, but that’s a lot of calories.” This is why placement and using numbers rather than your gut to make a snap decision can be helpful.

Since the US isn’t the only country battling obesity, we might be able to learn from other countries and implement some of their policies. In some places, fast food can’t be advertised on TV, fast food restaurants are prohibited from giving toys away with their meals and unhealthy food can’t be served in the public school system. Some countries, like Mexico, and cities here in the US, such as Berkeley, have increased taxes on sugar-sweetened beverages with success. One of the main ways to have a real change is to educate kids about nutrition as early as possible. For these widespread policy changes to happen, Congress and the Department of Health & Human Services need to push for these policies despite them being unpopular with the food industry. The good news is that restaurants don’t have anything to lose from sharing the calorie counts. According to a study done by the National Bureau of Economic Research, restaurants revenue, profits and labor remained the same despite listing calorie counts. In order to conduct the study, they pulled the data directly from fast food and chain restaurants, in this case, Starbucks. They found that the average calories per transaction decreased by 6% with the addition of the nutrition displays and didn’t have any effect on sales.

The goal of lowering the obesity rate through calorie labeling on menus and educating consumers about nutrition is a great idea, but there is so much else that needs to be done too. We can’t expect consumers to use calorie information to change their eating habits if they don’t have access to more nutritious choices. Also, calorie displays can be harmful in the sense that there are many other factors that determine what makes something healthy. The first step to finding a healthy amount of calories for you is to figure out your individual caloric needs. The general guideline is 2,000 calories a day, but caloric needs can vary depending on your age, gender and physical activity level. By knowing your calorie needs, it can help you to manage your daily food and beverage choices. The next thing to do is to look for calorie and nutrition information at the store and in restaurants. When you compare calorie and nutrition information before you order, it can help you make better decisions. Some things to keep in mind are that side dishes can add a large number of calories to a meal (vegetables and fruit are good lower-calorie options). Choosing meals or sides that are baked, roasted, steamed, grilled or broiled are better than choosing things that are creamy, fried, breaded, battered or buttered. Always ask for sauces or salad dressings on the side because that lets you choose how much to put on. Be mindful of what you’re drinking because calories from beverages, whether it’s soda or alcohol, can add up quickly. With keeping these tips in mind, not only will you can find lower-calorie options, but you’ll be eating healthier overall.

Calories on menus are a great tool for informing people about what they’re eating. It’s not the only information that people should be looking at, but it’s a start. Hopefully, as people become more aware of what they’re eating, they’ll make better choices and that’s the bottom line: eating healthy comes down to personal choice.