A couple of times, I've noted that while I'm at least theoretically in favor of requiring calorie counts on menus, I was pretty skeptical that this was actually going to work. We've had nutritional labeling on products in the supermarket for decades, and this has not exerted any noticeable downward impact on peoples' waistlines. A fair number of people responded with, essentially, a "huh?" that implied that I must have access to better drugs than they do. (Not, alas, true.)
Now the first study of New York's labeling program is out, and the results are . . . nothing. A very moderate increase in calorie consumption that is probably just a statistical artifact.
There was never any very good evidence that labeling was going to work. Most of the arguments in support seemed to rely either on self reported data, or a gut check by a handful of already pretty slender bloggers--they were sure they'd pay attention to the calorie counts, and so why wouldn't everyone else? But personal hypotheticals are at best weak evidence, and self-report is even worse. This study found that a significant minority of people reported changing their behavior as a result of the calorie information, and ordering a lower-calorie meal. But when you looked at what they actually ordered, it was no less fattening than either longitudinal or latitudinal controls.
I can think of a number of reasons for this. People may have mentally credited themselves with a savings on one item, and allowed themselves an indulgence in another: "I ordered a single instead of a double or triple, so I get large fries and a frosty!" They might just be bad at math. Or they might have wanted to look good for the interviewer, which is always a risk in these sorts of surveys. But the receipts don't lie.
There are a bunch of caveats: the study focused on poor people in fast food restaurants (on the grounds that these are the people we most want to reach.) It happened when the calorie labeling was very new, and people may have needed time to get adjusted, learning how to read the calorie counts, and remembering to do it. Public health studies of this sort are notoriously shaky, just because it's basically impossible to do a good double-blind controlled study.
But while a study like this certainly can't disprove the effectiveness of calorie labeling, what remains is that we don't have much evidence to indicate that it works. It's not that it was a bad idea. But lots of good ideas don't pan out in the real world.
Copyright © 2010 by The Atlantic Monthly Group. All rights reserved.
Well, New York could try putting skulls and crossbones on menu items, or pictures of morbidly obese people.
Or they could tell you how many other calories people are consuming and put a frowny face on your receipt if you take in more calories. Apparently, people like to be average and don't like frowny faces...
http://features.csmonitor.com/innovation/2009/09/30/energy-use-falls-when-neighbors-compete/
I wonder whether some people actually think fast food is worse than it is. I do (and I like fast food). Frequently when confronted by calorie information i find myself saying, "Oh [delicious food item X] only has 350 calories? I thought it was way worse than that!"
Yes, I remember how delighted I was when I discovered that a small McD's fry only has 230 calories and 1.5g of saturated fat -- I would have guessed at least 350 calories, possibly even 450. I treat myself to it more often now as a result.
Duder, I don't know what you're eating, but every time I go into McD's now, I find that my order is usually get is 1500+ cal.
My standard McDonald's order is 2 double cheeseburgers - under $3, and 880 calories, which is actually less than my average home-cooked dinner. It's certainly on the small side in terms of actual portion sizes, but it's a perfectly reasonable meal in terms of nutrition.
Of course, if you start getting a large fry(500 cal), a large Coke(310 cal), and a nice M+M McFlurry(620 cal) to go along with the meals, then you're into the stratosphere, and probably spending $12 to buy dinner for one besides. But if you're restrained about it, McDonald's is just fine.
Studies of this type should accompany most large-scale public health interventions, in order to learn what works and what does not.
How about some common sense?
There is only one way to make people thinner, and that is to force or otherwise convince them to expend more calories than they consume.
Every other possible method of weight loss has been studied and failed and can be confidently rejected in the future.
How could meddling thin people who are offended by overweight people indulge their compulsion to run other people's lives?
I'm sure denying that basic urge is unhealthy. We need a study.
Derek
The question was whether making calorie counts available would assist people who frequent fast food restaurants in consuming less calories. The answer, provisional because it is based on a single observational study, is no.
This is the sort of data that should inform public policy, as opposed to, say, abstinence-only education, for which there is stronger evidence that it does not work yet remains in use for political reasons.
To your first point: well, yes, that is indeed blindingly obvious, thank you for pointing that out.
To your second: non sequitur much?
If you have data, not opinion, that was that blindingly obvious, I would be interested in seeing it. Abstinence-only proponents continue to insist those programs should be funded, despite data suggesting there are better approaches. That in turn loops back to my original post, which is that programs should be evaluated for efficacy.
amygdala - Abstinence-only proponents continue to insist those programs should be funded, despite data suggesting there are better approaches.
What evidence are you referring to?
My apologies for the ugly links. For some reason I can't get the link tag to work this morning. Anyway:
adolescent sexual activity and pregnancy:
http://patient-research.elsevier.com/patientresearch/displayAbs?key=S1054139X07004260&referrer=http%253A%252F%252Fwww.ncbi.nlm.nih.gov%252Fpubmed%252F18346659%253Fordinalpos%253D19%2526itool%253DEntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
HIV prevention in high-income countries:
abstinence only: http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005421/frame.html
abstinence plus: http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD007006/frame.html
One can also make similar inferences from HIV prevention programs in the developing world. The most dramatic successes (Brazil, Uganda, and Thailand) have included comprehensive features such as promotion of condom use, along with varying degrees of emphasis on abstinence. They are not direct comparison studies or systematic reviews, however, and are also confounded by other factors, such as aggressive antiretroviral therapy in Brazil, so I did not link them.
amygdala, you need to put the URL into quotes in order to work - (a href="http://meganmcardle.theatlantic.com/")This site(/a) is the sort of code you need.
There is only one way to make people thinner, and that is to force or otherwise convince them to expend more calories than they consume.
First, I don't see any justification for forcing someone to eat less.
Also, there are many other issues here. Some people eat very little and still gain weight. Many people, studies have shown, seriously mis-estimate how much they eat and are surprised by the results when they carefully track their habits for a few weeks.
Some try to use sugar substitutes to lose weight, though studies seem to show that those are not effective.
There are ways to alter a person's metabolism. The IGF in milkfat raises hGH levels. Calcium also effects metabolism. Nightly deep sleep seems to correlate with metabolism (since hGH is produced during deep sleep.) Exercise, of course, works too. PCOS is tremendously common (but can be treated, to some extent, with metformin or possibly D-Chiro inositol. Some studies suggest myo-inositol could work as well, for some people.)
etc. etc. Some people may just need to eat less or exercise more. But some people's weight gain is a result of a medical condition such as the inability to produce D-chiro-inositol or a thyroid problem. My girlfriend, in fact has both PCOS and a thyroid problem. Without addressing that, it's very difficult for her to exercise (she'll get winded after 2 minutes) or to lose weight even when she eats less than I do.
http://theswole.com/swole/the-codex-of-leaness/
I hope your girlfriend gets some ideas if she read this. She might have some success in just changing what she eats. You already seem to have a fair understanding of what kind of foods help already.
It's a pretty good primer on how anyone really should eat to optimize fat loss.
Also Megan, scan over it would you?
1) I bet some economists will come out with some much better/conclusive studies over the next year. I can think of about 12 good studies in 2 minutes so I am sure guys near NYC are all over it.
2) Assume the findings are correct. Here is a hypothesis: Restaurants placed a higher calorie item on menus because this would make people feel healthy. A study (I can't recall the ref) has shown that putting a healthy item on the menu will make people choose healthier dishes even if they don't buy the healthy item. Maybe in NYC it worked the other way and so there was no net effect. It would be pretty easy to check - I predict a paper testing this equilibrium very soon.
3) Do you think the average restaurant manager will think of this? But, we are dealing with fast food chains. Anyone know if food service consultants were offering this advice?
Here is another hypothesis: People did not exert more calories than they consumed; even though they consumed less calories by choosing healthy foods.
Here is a another hypothesis: People deliberately choose higher calorie foods to get even with a government that they believe already controls way too many aspects of their miserable lives.
Here's one more hypothesis:
People just didn't give a flying f**k and ate whatever the hell they wanted.
Several studies have demonstrated this phenomenon. Sometimes people even go overboard and have more calories in extra dessert than they saved by getting the lighter main course.
Back in the day, British Airways did a a study to determine optimal pricing for Concorde. They found that most of the passangers had no idea how much the trip cost, as the tickets were booked by members of their staff. When asked to guess the cost, they guessed a number higher than the actual ticket price. In response, BA raised the ticket prices to what the passengers already though they were paying.
Perhapse, people are guessing that some things are higher in calories than they actually are - when they find out they aren't quite as bad as they think, they end up eating more.
If you asked me off the top of my head: How many calories in a big mac? I'd say low end 800, high end 1200. In reality its only 587.
First off this "lots of good ideas don't pan out in the real world" needs a caveat: lots of good ideas don't pan out in the real world when you let evil plutocratic republicans spoil them! This is an important point to always keep in mind: when enlightened, well-intentioned social engineering projects don't go as well as the progressives behind them planned, the fault is not with the project or the progressives but always with a shadowy "them" lurking behind the scenes befuddling all of our halting steps towards the promised utopia.
Second, this whole study is obviously flawed. As we all know, everyone is exactly the same -- that's what equality means. So the idea that poor people might have a different reaction to the new labels than the relatively rich, well-educated & overwhemingly white bloggers and bureaucrats who found them such a splendid idea is just racism, classism, ethnocentrism and possibly sexism rearing their ugly, omnipresent heads once again.
Clearly, when a moderate social engineering project like this one shows no results, the answer is a more heavy-handed approach. Expand the labeling requirements to all purveyors of anything that could conceivably be eaten. Force servers, waitstaff and cashiers to explicitly recite the caloric total for every meal ordered, perhaps with eyebrows raised.
After that proves fruitless, move on to more draconian measures: forbid high calorie items from appearing on menus, enforce maximum daily calorie orders for individuals, close fast food restarants and replace them with organic farmer's markets stocked exclusively with locally-grown produce.
As with all of life's problems, obesity is a scourge that can be defeated with the appropriate application of the power of the state.
Republicans can no longer be Plutocrats, since Pluto is no longer a planet.
Or something like that...
A good point but Pluto is still a dog and Republicans are too so I think the adjective stands...
You owe me a new keyboard.
Just put it on my tab...
Not your backspace?
"After that proves fruitless, they'll move on to more draconian measures."
How long do you think it will be until it's proposed that we just kill all the fat people?
Wouldn't Fat Death Panels save Medicare? Wouldn't this reduce carbon outputs? Wouldn't this help the population explosion problem? Wouldn't this reduce our dependence on foreign oil? Wouldn't this save pandas and polar bears and New York from global warming-caused flooding?
Isn't this the only green solution?
Wouldn't this be the final solution?
I think you're going a bit overboard here.
A far more modest proposal would be to feed the fat people to the hungry people: wipe out the twin horrors of obesity and food-insecurity in one fell swoop.
That would work, except that fat people are too high in calories and saturated fat.
That's just silly. Hungry people won't eat fat people. Anyway, the recent result is that overweight people now outnumber the underweight people on the planet. (For the first time in history, and probably pre-history)
The polar bears are another matter...
When I was younger, thinner, and poorer, I reacted to calorie information as follows: the more calories per dollar the better! I wanted taste and nutrition, but most of all, I wanted to be filled up in exchange for my limited food dollars. Maybe the people frequenting fast food places respond similarly?
Good point. Besides, calories aren't really the bad guy, they're just a measure of energy that can be exercised off. (Bad) fat and (bad) cholesterol are the real killers, aren't they?
OJ was the real killer.
"Calories are little units that measure how good a food tastes" - Dave Barry
"There was never any very good evidence that labelling (sic) was going to work."
You keep repeating this. What do you mean?
If by "work" you mean "make people thinner," then of course it was never going to work.
If, however, you mean "give people the information necessary to make informed choices without government interference in their freely-chosen level of obesity" then of course it did work.
People now have the information necessary to choose between a 3,000 calorie Whopper/fry/drink combo or a 3,000 calorie salad/ranch dressing/drink combo.
The government cannot make people exert more calories than they consume (which is the only weight-loss formula which works). The government should not be trying to do that in the first place and only wants to do it so politicians have more budget available with which to solicit graft.
If the government finds that providing health care for obese people is too expensive, then it should get out of the providing health care business and leave that chore to the private sector.
What was it intended to do? That is how we judge whether it worked.
As in, just because the current president is galvanizing the conservatives in this country doesn't mean his actions "work" -- for that you would have to know that that was his intent.
You're spot-on, at least the first part: it's a good law because it gives people information they should have access to. If they choose to ignore that information, or not to give it the weight (so to speak) someone else would give it, that's fine.
If the evidence that calorie labeling will cause people to consume fewer calories at that meal is scant, the evidence that it will make enough of a difference so they will lose weight let alone a significant enough reduction to improve their health outcomes is non-existent. As such, this program doesn't even rise to the "good idea, but" category...it's a plain bad idea.
"(Bad) fat and (bad) cholesterol are the real killers, aren't they? "
The evidence for that is pretty feeble.
I'm pretty sure the "real killer" is aging.
You can't claim that the desired effect was to "help people make a choice" because that's not what was said when the law was passed. It was specifically passed to get people to eat healthier. "Those who know better" couldn't possibly imagine that once confronted with the nutrition content in each meal, people would continue to choose that which they knew to be bad for them.
As usual, they were wrong. The law had no effect and therefore it cannot be neutral or good, it can only be bad because it forced the suppliers of a product to expend money they could have spent elsewhere on whatever it took to comply with it.
Epic fail.
Yes they could save that money on calorie labeling (such a burden) and spend it elsewhere - such as on incessant advertising and promotions to persuade consumers to super size it or order that mega size cheese crust super supreme pizza...
There are reasons other than calories that are "helpful" bits of information.
Salt/Sodium, sugars, and various types of fats all affect various people in the general population.
Even if they don't affect them, then they might just like the information for their (non)working diet plans.
Don't get me wrong. Personal responsibility/choice/motivation should always be the deciding factor in people's diets. However, I am one of those people is interested in how much is or is not in restaurant food.
Maybe, if it was a voluntary program, the "responsible" restaurants would shine through and set the example for others to follow instead of having a mandatory program that incites resistance for being forced.
OR
Maybe I've got my head in the clouds...a pie in the sky idea, so to say
If people want the extra info, they'll actually start *asking* for it from the restaurant and eventually the restaurants will see the *demand* and create a *supply* to meet it.
If there's no demand, then it's stupid to use force to try to create it because you will fail every time.
Time and time again, results show that force is not the answer. Still, in today's society, it seems like every problem we have looks like a nail that just needs a bigger freaking hammer.
We've now shown that listing of calorie and nutrition information doesn't really work - What's the newer, better, and bigger hammer we should reach for at this point? Should we actually *mandate* the nutritional content and portion sizes of restaurant dishes?
This reminds me of that movie "Demolition Man"
"Now, all restaurants are Taco Bell..."
I actually agree. I always ask for nutritional info and VERY few places (not in NY) have it. I feel like it's me against the world here...if you want it ask for it. And if there are enough of us asking..then something may happen...just maybe.
Most fast food outlets have had nutritional information available and have had for years. I have had to be on special diets for gestational diabetes (carb-restricted) and gall bladder disease (fat-restricted), and my child has multiple food allergies. Fast food and chain restaurant nutrition info is often easily available and reliable since the food products are standardized (yes, you can say it's not so wonderful then in taste etc. but kids like fast feed and when you're traveling you just want something you *can eat*). But chains and fast food places are the easiest to get detailed nutrition info from, and, bonus! online! before you go there! Which is great because there are some places that don't have *anything* that appears to be suitable...
It's not that it was a bad idea.
Yes it was.
I think the author's caveats is key:
"There are a bunch of caveats: the study focused on poor people in fast food restaurants (on the grounds that these are the people we most want to reach.)"
Think of the socioeconomic piece people.
If the study was focused on the group of people eating at fast food restaurants in the lower/est rung of the socioeconomic ladder...and it did not work, it is not going to. Try something else...like education.
There are 100 different ways to go about educating the nations families on how to make proper food choices...but the point is unless these individuals see a problem with what and how they eat...they very well may not want to change anything. A number affixed to a menu item will not change that.
Not instantly it won't.
Everyone seems to be declaring this a bad idea because there was no immediate change in behavior of (mostly) adults. Yet this type of informational campaign seems to be aimed at long term change that is most likely to have an effect on people who have not settled into a pattern of purchases.
I'm still not sure that it is a good program though.
This is going to be a good test of the intellectual integrity of the nudge people. Are they going to say:
"Well, we've identified the cognitive failing, corrected it with a nudge, and people still consume the same food. I guess people really wanted to eat that stuff in the first place."
or are they going to say:
"Well, that didn't work. Now we're going have have to figure out how to nudge them harder."
--sw
On vacation I was at a McDonald's that had calorie counts listed on the menu. I wanted something sweet to snack on and spend very little. Since I figured I'm essentially purchasing food energy (and I'm a bit of a contrarian) I did some quick math to figure out how many calories I could get per dollar and made my purchasing decisions accordingly. I appreciated the extra information which ensured I could maximize my caloric intake value for a given amount of money.
Echoing Mossy Washington, when I have access to the calorie counts, I order the menu item with the most calories. I try to maximize calories per dollar in order to save money.
I'm gonna guess that you're under 30 y.o. All I can say is, wait a few years...
I think something that may be contributing to this mess is the fact that most people a) are not aware of roughly how many calories they burn in a day and b) how to use caloric deficits to lose weight (for example, one can consume 500 calories less their daily expenditure a day to lose a pound in a week.)
How could anyone expect that publicizing calories would make a difference when few understand what those numbers mean relative to their body?
Kind of makes one wonder whether access to health care will actually improve the outcomes of a certain group. If you consider getting routine/preventive medical care as a type of lifestyle choice, then even if it's available, what makes you think their choices will be any better?
Servia, I completely agree.
I think posting the calorie counts on menus is a great idea - if one actually knows how many calories they are supposed to consume per day, both for weight loss and/or general energy needs.
Does the government assume people who frequent Mickey D's and other fast food restaurants know what their caloric intake should be? I think it's safe to admit that nutritional education is lacking in this country, so unless people are made aware that they should be eating a certain number of calories, the count next to each menu item is meaningless.
(Ex. I'm 25, healthy and college educated -- but when I ask my peers how many calories they should eat in a day and what they actually consume, most get the answers completely wrong.)
Therefore, information with recommended caloric intake for a variety of individuals (sex/age/activity level) should be provided to give the menu calorie counts some sort of context. Is this data available in the restaurants?
Has it occurred to you that the majority of people responding to the calorie counts may be the ones who already know the importance of restricting calories?
And that your peers who you feel should know this type of information are perfectly capable of finding it...if they were the least bit interested?
Which leads us to the question: What is the value of health information to people who are not interested in improving health?
Can we really force people to be healthier if they don't want to be healthier? What's next? Interventions?
They can easily find it after doing an internet search, yes, but they have to know to look for it. I agree with you, though encouraging people to be healthy is not forcing them to be. Caloric counts are a simple way to inform citizens and customers at each meal. I think it's just nice to know and don't see why people have an issue with posting the calorie numbers.
The situation I was referring to above was friend who asked me how many calories were in a batch of cookies that I made -- and when I asked him how many calories he was supposed to eat a day, he had no clue. The rest of the group also provided incorrect answers when asked the question - they are all concerned with being fit and healthy, they just didn't know to look.
I still remain convinced it's a lack of education about the topic. The depth of knowledge that people have in regards to nutrition (even the doctors I know) tends to be superficial. It's just not their specialty. People want to be healthier, but they have trouble getting the information down because it's more complicated than they want it to be.
One of the more disastrous policies was to promote eating less fat because it was frequently misinterpreted that all fat was bad. The side effect to demonizing fat was that companies found out that you could fat out of commercial products so long as you didn't cut sugar content and people wouldn't complain much. Except that fat has a lot do with creating hormones, giving us a feeling of satiation, etc. etc., and sugar is just as, if not more, devastating to health.
Also, if you've only lived in DC or NYC, you probably haven't seen the ravages of obesity across the nation.
http://jamesfallows.theatlantic.com/archives/2009/10/just_a_little_more_on_the_weig.php#more
Fallows has an interesting post here.
Also, I hope to never see a post saying exercise has little effect on losing weight in the long term again. It's more likely that study was piss poor like the study cited in this post.
I have postgraduate certification in nutrition, and I've got no idea how many calories (or kilojoules) I eat. I mean I worked it out in exercises doing courses, but I promptly forgot.
What do I care? I want to gain weight, I eat more. I want to lose weight I eat less. Who cares what the numbers are?
A case in point, calories are actually 1000 times smaller than they are labeled on the food boxes. Those are actually kilocalories. Proof that the actual numbers don't matter. All you need is some consistent method of measurement so you can compare things.
Why is it that you cite "studies" about all sorts of subject matter, but never bother to review the methodologies of the studies in question?
THE SURVEY WAS CONDUCTED OVER A SIX-WEEK PERIOD. only FOUR OF WHICH CAME AFTER THE LAW WAS PUT INTO EFFECT ! To think that any successful public program would make substantial achievements within four weeks shows an incredibly naive, or biased, perspective. Coupled with an informational campaign and reinforcement within school curricula, this project may very well have a POSITIVE LONG-TERM AFFECT across all socio-economic groups. The fact that a statistical variance doesn't present itself within such a small sample taken across such a short time period does not mean that the policy was ill-conceived and implemented.
Calorie info is only useful if you care about calorie intake. Packaged food is required to show calorie information, but obviously people still buy high-calorie, high-fat food, so why would it be any different at a fast-food restaurant?
I used to be overweight - obese, actually. I lost about 100 pounds a few years ago. When I was fat, I knew what foods were bad for me, I just chose to eat them anyway. Only when I made a concision decision to control what I ate did I lose weight.
Calorie info can make a difference at the margin - for someone who doesn't realize, say, how much that salad dressing adds calorie-wise. But it's not going to make a difference if the person doesn't care how many calories they are consuming.
You can't force people to care about their health. You can educate them, encourage them, and even penalize them, but in the end, if they're not willing to take responsiblity, no can take it for them.
Just as there are people who care little about healthy eating, there is probably a certain group of Americans who would have to be chased down and brought into a doctor's office at gunpoint in order for them to see a doctor.
It's called personal choice. Some people make bad choices.
I will admit that since the labelling began, I have not eaten a single baked good from Starbucks - I already knew they were overpriced, but for some reason the average muffin there has about 150 more calories than it should.
Plus you have to then go somewhere else to buy a decent coffee...
I heard the president of Taco Bell speak. He said they noticed a sharp decline in sales for the first two weeks after calorie labeling went into effect, and then a pretty quick return to previous sales levels.
I don't get the argument here. Why should we presume that calorie content is irrelevant simply because many consumers choose to willfully consume high calorie foods? The point is that it's an informed choice and not a crapshoot. The ultimate choice is rather irrelevant isn't it?