Hot Topics: Calorie Counts Across the Nation

The other night my friend asked me if had heard about the Health Care Reform Bill passed in the House and I responded with, “I’ve lost track, what’s still included? What’s new? Last thing I remember was the hype around Death Eaters - I mean, Death Panels.”

She responded the same way, uncertain and unsure.  Should we be excited or frustrated?  I felt silly that I didn’t know what was in this bill, especially since this legislation could greatly impact careers surrounding dietetics.

So I did some research, and here's a quick summary of a few things included in the bill:

• indoor tanning services will have a tax
• health care cannot be denied due to pre-existing conditions
• expansion of health care services in rural areas
• new plans must cover checkups and other preventative care without co-pays (haven’t come across a answer as to whether or not Nutrition Education or working with a RD is included as a preventative measure)
• AND now, across the nation, chain restaurant’s must display a food item’s total calorie on menus and menu boards.  

In regards to the last item, that sounds good - I’m always in support of educating the consumer!  New York City has been doing this for almost two years now and it’s a great success...right?

In July 2008, New York City required that all food service establishments that have more than 15 locations in the nation post the calorie total for each menu item.  One of the goals of calorie posting was to educate the consumer to make healthier choices in order to avoid excessive weight gain and fight the rise in diabetes and heart disease among the NYC population.  Additionally, there were hopes that high calorie food items would not be purchased as often, which would then cause establishments to work on creative low calorie menu items in order to maintain their profits.

I have found two published studies that address the food choices before and after the calorie postings.  Elbel et. al, investigated the food choices made at 14 fast food restaurants in low-income neighborhoods in NYC.  This study collected receipts from customers on Tuesdays, Wednesdays, and Thursdays (to capture the “regulars”)  four weeks before the calorie postings and four weeks after.  After analyzing thousands of receipts, the meals purchased prior to the posting had an average of 825 calories while afterwards the average calories per meal spiked to 846 calories!  A 21 calorie jump!  It should be noted that 54% surveyed stated that they noticed the calorie postings, and about 28% of those who noticed the postings stated that it effected their food choices.  This study suggests that perhaps those in low-income neighborhoods are unsure of what an appropriate caloric intake is for a snack or meal.  It seems that there needs to be additional information available, so that an item's calories can be compared to one’s daily caloric needs.  Otherwise the calorie postings hold no meaning.

The second study, by Bollinger et al, looked at the purchases made at all 222 Starbucks locations in New York City.  They analyzed 100 million purchases made from January 2008 to February 2009, plus they looked at purchases made by customers that used Starbucks credit cards, as representative of loyal customers.  In the end, “calorie posting does influence consumer behavior at Starbucks, causing average calories per transaction to decrease 6% (247 to 232 calories per transaction).  The effects are long lasting: the calorie reduction lasted for the entire period of the data collection, 10 months passed the posting commencement (Bollinger et al 2008).” The data also showed that the reduction in calories generally came from the food choices, usually made by consumers who were refraining from purchasing any food item.  However, there was no significant decrease in the calorie content of the beverages ordered.

So one study found an increase and another found a decrease, but even if both studies found a 6% decrease, is that enough to ward off weight gain and fight heart disease and diabetes?  Even if consumers reduce their “out of the house” calories, will they make up for the difference by increasing caloric intake at home?  I’m interested to see the trends in the long-term, 5 or 10 years from now - maybe there will be a gradual effect.  Even so, the nation is about to take on the rather costly endeavor (in NYC the average cost of new menus and menu boards was between $1,000 - $2,000 per establishment).  Will the national effect be stronger?  Who wants to start collecting receipts?