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Saturday, April 27, 2013

Requiring Calorie Labels in Restaurants

A positive caloric energy balance is the main driving factor of obesity, and therefore a direct cause of one of the leading preventable causes of death (Barness et.al. 2007). A recurring question for policy makers then is, how can we help people make better decisions as to their own diets. Calorie labels are widely available on food items in grocery stores, but most restaurants do not provide calorie information for their foods. The question now is, would implementing a law to require such calorie labels in restaurants improve the situation, and if so, in what way?

Research Problems

Finding conclusive answers to sociological questions is difficult. Laboratory settings are not ideal in recreating natural responses to everyday situations among participants, and the real world makes it difficult to isolate specific factors.

Consequently, meta studies related to calorie labels in restaurants regularly complain about the general lack of methodological rigor (Swartz et.al. 2011), noting that “[m]ore research is needed that meets minimum standards of methodological quality” (Harnack and French 2008).

When discussing findings below, we need to keep these issues in mind.

Effects on Consumer Choice

“The current evidence suggests that calorie labeling does not have the intended effect of decreasing calorie purchasing or consumption” (Swartz et.al. 2011). This summary by a meta study is quite sobering. While I do not think this is entirely wrong, the details are a bit more complicated. Studies have regularly found evidence that calorie labeling influences food choice in restaurants, but that effect is usually weak or inconsistent (Harnack and French 2008). There are many factors that need to be taken into account when looking at the effects of such policies.

One of the main points is that the effect is long-term. When comparing consumption rates at 18 months versus 6 months after introducing labeling, a recent study found a significant decrease in energy consumption by customers (Bruemmer et.al. 2012). Studies that simply compare values shortly before and shortly after introducing such labeling laws are therefore expected to find only a small effect.

But there are other factors that influence and improve the effects, too.

Special Target Groups

A study focusing on Starbucks noted that while calorie reduction effect was at a modest 6 % on average, the effect was a lot more pronounced at 26 % for customers with high calorie transactions (Bollinger et.al. 2010). If caloric information does not have a conclusive effect in general, but does affect customers with high calorie consumption, that would still make such a policy be worthwhile.

Another similar effect relates to calorie consumption by children. In a clinical setting, calorie labeling reduced the caloric value of meals parents chose for their children by 15 % (Tandon et.al. 2010). Again, if the overall caloric intake is not affected significantly, but children in particular get lower caloric meals, such labeling would be worthwhile, as child obesity is a severe problem in and by itself.

Improving Effects

In addition to these special target group effects, certain additional factors can improve the effects of calorie labels and should be taken into consideration when legislating such requirements.

General knowledge about daily caloric requirements is pretty low (Krukowski et.al. 2006). Adding recommended average daily caloric intake values to menus increased the effect of calorie labels (Roberto et.al. 2010). While caloric requirements are very individual, such added information seems like a good idea.

An even more drastic approach was used by the Texas Christian University, where they experimented with adding the equivalents of “minutes of brisk walking” next to the food items. This had a significant effect, even though calorie labels alone had none (Healy 2013). I’m not so sure about this approach, as this seems leading more into the are of scare tactics than education. We do not need to exercise all consumed calories off, as our bodies require a base energy level for normal function. This might be more applicable to snacks than to full meals at restaurants.

Effects on Business Revenue

Having looked at the effects on consumers, the next thing we need to consider is how such a legislation would affect businesses. If it incurs drawbacks, those drawbacks need to be comparable to the advantages gained by the legislation. Especially as the positive effects seem to be small in this case.

There’s a full study that addresses this very issue in detail and found that the main industry arguments against food labeling in restaurants do not stand up to scrutiny (Roberto et.al. 2009).

Indeed, when Starbucks introduced food labeling, revenue was not affected. Starbucks stores with calorie labels even saw an increase in revenue when in close vicinity to a competitor without such labels (Bollinger et.al. 2010).

Moreover, a recent study found that the availability of low-calorie foods actually increases revenue (MacVean 2013).

Conclusions

Research on the effects of calorie labels in restaurants is inconclusive. There seems to be little noticeable effect in general, but certain target groups, in particular those with higher consumption levels and children, benefit more than the average from such labels. Adding daily recommended calorie levels to the menus improves the effects.

On the producer side, the cost associated with calorie labels is low and there seems to be no adverse effects on business.

Therefore, I would conclude that calorie label requirements are a good low-cost, low-impact legislative option that can not by itself solve health issues, but can complement a larger health improvement plan.

Bibliography

  • Barness et.al. 2007: Barness LA, Opitz JM, Gilbert-Barness E. 2007. Obesity: Genetic, molecular, and environmental aspects. Am J Med Genet Part A 143A:3016–3034.
  • Bollinger et.al. 2010: Bryan Bollinger, Phillip Leslie and Alan Sorensen. Calorie Posting in Chain Restaurants. Stanford University, 2010.
  • Bruemmer et.al. 2012: B. Bruemmer, J. Krieger, B. E. Saelens, N. Chan: Energy, saturated fat, and sodium were lower in entrées at chain restaurants at 18 months compared with 6 months following the implementation of mandatory menu labeling regulation in King County, Washington. Journal of the Academy of Nutrition and Dietetics, 2012.
  • Harnack and French 2008: Lisa J Harnack and Simone A French. Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices: A review of the literature. International Journal of Behavioral Nutrition and Physical Activity, 2008.
  • Healy 2013: Melissa Healy. I’ll have to exercise for HOW LONG to work that off? Los Angeles Times, accessed 2013-04-26.
  • Krukowski et.al. 2006: Rebecca A. Krukowski, Jean Harvey-Berino, PhD, RD, Jane Kolodinsky, PhD, Rashmi T. Narsana, MS, Thomas P. DeSisto. Consumers May Not Use or Understand Calorie Labeling in Restaurants. Journal of the American Dietetic Association, Volume 106, Issue 6, Pages 917-920, June 2006.
  • MacVean 2013: Mary MacVean. Cutting calories is good business for restaurants, study says. Los Angeles Times, 2013.
  • Roberto et.al. 2009: Christina A. Roberto, MS, Marlene B. Schwartz, PhD, Kelly D. Brownell, PhD. Rationale and Evidence for Menu-Labeling Legislation. American Journal of Preventive Medicine, 2009;37(6).
  • Roberto et.al. 2010: Christina A. Roberto, MS, Peter D. Larsen, MPhil, Henry Agnew, BA, Jenny Balk, BA and Kelly D. Brownell, PhD. Evaluating the Impact of Menu Labeling on Food Choices and Intake. American Journal of Public Health, February 2010, Vol 100, No.
  • Swartz et.al. 2011: Jonas J. Swartz, Danielle Braxton and Anthony J. Viera. Calorie menu labeling on quick-service restaurant menus: an updated systematic review of the literature. International Journal of Behavioral Nutrition and Physical Activity, Volume 8, 2011.
  • Tandon et.al. 2010: Pooja S. Tandon, MD, Jeffrey Wright, MD, Chuan Zhou, PhD, Cara Beth Rogers, Dimitri A. Christakis, MD, MPH. Nutrition Menu Labeling May Lead to Lower-Calorie Restaurant Meal Choices for Children. Pediatrics Vol. 125 No 2, February 1, 2010, pp. 244-248.