NYC regulations demand that chain restaurants post the calorie content for every item on their menus so that customers can make healthier choices. The idea is that people will order the lower calorie item when given the proper information. But is that true?
To answer this, researchers from various NYC and the Robert Wood Johnson Foundation interviewed New Yorkers before and after the regulation was enforced in March 2008. Their work was published in the British Medical Journal (BMJ) yesterday. The researchers found that overall calories consumed did not decline, but one in six New Yorkers did use the calorie information and bought food with 106 calories less on average.
The researchers also saw some fast food places make adjustments to their own menus. For instance, McDonalds will be cutting its Happy Meal french-fry serving size by more than half and adding sliced apples to the Happy Meal. Press release here. Great! Because apples are more nutritional than french fries. McDonalds claims the this change will reduce the Happy Meal’s overall calories by 20%, but will overall calories consumed be lower? Or might the kids want a McFlurry too, since the fries are smaller and they were good kiddies and ate their fruit too.
Regardless of McDonalds Happy Meal evolution, what is impressive about this BMJ study is the proof of principle: at least one in six people will use the calorie content to limit their calorie intake. But is that good enough? One in six? There must be a more effective way to help people make healthier choices.
Here is the abstract from the British Medical Journal.
Objective To assess the impact of fast food restaurants adding calorie labelling to menu items on the energy content of individual purchases.
Design Cross sectional surveys in spring 2007 and spring 2009 (one year before and nine months after full implementation of regulation requiring chain restaurants’ menus to contain details of the energy content of all menu items).
Setting 168 randomly selected locations of the top 11 fast food chains in New York City during lunchtime hours.
Participants 7309 adult customers interviewed in 2007 and 8489 in 2009.
Main outcome measures Energy content of individual purchases, based on customers’ register receipts and on calorie information provided for all items in menus.
Results For the full sample, mean calories purchased did not change from before to after regulation (828 v 846 kcal, P=0.22), though a modest decrease was shown in a regression model adjusted for restaurant chain, poverty level for the store location, sex of customers, type of purchase, and inflation adjusted cost (847 v 827 kcal, P=0.01). Three major chains, which accounted for 42% of customers surveyed, showed significant reductions in mean energy per purchase (McDonald’s 829 v 785 kcal, P=0.02; Au Bon Pain 555 v 475 kcal, P<0.001; KFC 927 v 868 kcal, P<0.01), while mean energy content increased for one chain (Subway 749 v 882 kcal, P<0.001). In the 2009 survey, 15% (1288/8489) of customers reported using the calorie information, and these customers purchased 106 fewer kilocalories than customers who did not see or use the calorie information (757 v 863 kcal, P<0.001).
Conclusion Although no overall decline in calories purchased was observed for the full sample, several major chains saw significant reductions. After regulation, one in six lunchtime customers used the calorie information provided, and these customers made lower calorie choices.