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Menu labeling: preaching to the choir?

They say that knowledge is power, and some 15 US states are poised to apply that philosophy in tackling the obesity epidemic. These states are considering legislation that would require fast food chains and certain restaurants to provide consumers with nutritional information such as calorie, fat and sodium content of food items. New York and California may be the first to pass laws mandating statewide menu labeling, which could set the trend for other states to follow. The public seems to be embracing the idea, particularly in New York, where a recent poll found that 80 percent of people want nutritional tables posted in fast food eateries. The point of these laws is to encourage consumers to make informed – and thus presumably healthier – decisions about what they are eating. Ultimately, the new laws aim to curb America’s obesity epidemic – which is at an all-time high (34% of adults are obese, and 32% of school-aged children are overweight or obese) – and lower the rate of diseases associated with obesity, such as diabetes, hypertension, and certain types of cancer.

But will people actually use the information to modify their eating habits? Perhaps the best place to inquire is New York City, where a menu-labeling rule is already in place (ahead of the possible statewide regulations). In January, the city’s Board of Health voted in favor of a regulation requiring restaurant chains (businesses with more than 15 units nationally) to prominently list calories on menus and menu boards. The industry group New York State Restaurant Association has challenged the regulation, and the 2nd US Circuit Court of Appeals will probably deliberate the case for another few weeks, according to a Restaurant Association representative. Meanwhile, the FDA has sided with New York City.

I conducted an informal survey in lower Manhattan and found that, although people seem to be noticing these calorie counts, they way it drives their behavior is variable.

“For me personally, it doesn’t change what I do,” said a man I met in a fast food chain, noting that he is not concerned about his weight. “But I think with other people it does.”

“I don’t pay attention to it,” said a woman sitting nearby. “I don’t believe that a plain bagel has 300 calories,” she added, referring to the posted calorie content.

But according to the employee working behind the register, the nutritional tables are deterring customers from buying high-calorie foods—to the detriment of business. "The people, when they ask about the muffins’ calories, they don’t buy them,” said the employee, pointing at the 400-calorie ‘reduced fat’ item. “It’s affecting my sales.”

A few blocks away at a fast-food restaurant where king-sized chocolate milkshakes pack over 840 calories, patrons stopped to scan the nutrition table on the wall before approaching the register. One young woman studied the information but claimed that it would not influence her decision; she would have that bacon-double-cheeseburger no matter what. But a traffic policeman said he would chosse menu items based on caloric and fat content. “It’s very important to know the nutritional value of the food,” he told me. A couple from Argentina agreed; they used the nutritional tables to avoid the excessive amount of carbohydrates that characterizes the North American diet.

I could not help but notice that the people who said they used nutritional tables to make decisions appeared lean and fit. All this made me wonder whether menu-labeling will simply reinforce good eating habits in those who already have healthy lifestyles, rather than reform those who most need it. Critics of menu labeling have pointed out that Americans have continued to get more obese despite two decades of nutritional labeling on packaged food. Perhaps better calorie labeling will not change things. What do you think?

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Image by ebruli


Comments

The problem is that fast-food junkies will continue to eat the stuff, regardless of labeling. It comes down to personal responsibility: in most cases, obesity is preventable, simply by eating a healthy diet and getting moderate exercise. However, most people would rather take a pill or opt for surgery instead of simply changing their lifestyle.

These labeling efforts are well-intentioned, but they don't address one of the strongest correlates of modern obesity: poverty. The poor in industrialized countries are now much more likely to get fat than the rich. There are multiple causes for this, but a big one is undoubtedly our screwed-up agricultural subsidy system, which ensures that the cheapest products in the food supply are also the most fattening ones.

Check the prices and ingredients in your local supermarket, for example. The least expensive foods by far are the ones that are carbohydrate-rich, packaged in enormous, high-calorie servings, and loaded with high fructose corn syrup. Coca-Cola is cheaper than milk; Kraft Macaroni and Processed-Cheese-Like-Paste is cheaper than the ingredients for proper homemade macaroni and cheese; Wonder Bread is cheaper than artisanal baguettes. People buying the lower-priced foods generally know they're junk, but they can't afford better. Reminding them that their restaurant food is also junk won't be any different.

It will be interesting to see how the new menu labeling laws affect obesity rates. Regardless of the laws, customers are asking for this information. As a dietitian that provides restaurants with nutrition analysis (www.cookedapple.com) I am continuously shocked by the amount of calories in the dishes served in restaurants. The liberating point is that this information is available, and we have the power to make decisions about what we order and how much of it we chose to eat.

Curbing obesity epidemics is urgent all around the world, even in developing countries, since such as metabolic disorder is associated to metabolic syndrome. As a consequence, almost all NHIs perform campaigns of war against over-weight and obesity, as those referred to in the news. However, I'm surprised that neither NHIs Authorities nor Authors know that not all obese individuals are equal, i.e., only a percentage of them results involved by neither metabolic disorders nor Cardio-Vascular-Disease. In fact, physicians have to know Biophysical Semeiotic Constitution and related Real Risk (www.semeioticabiofisica.it and the linked Microangiologia) (www.semeioticabiofisica.it; Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004.), cited also in www.nature.com URL http://blogs.nature.com/news/thegreatbeyond/2008/02/confusion_after_diabetes_study.html#comments
In fact, these knowledge can highlight what accounts for the reason not all obese patients are at CVD risk, BUT exclusively those involved by obese and/or diabetic and/or dyslipidemic and/or hypertensive constitutions, showing inherited related real risk, based on microcirculatory remodelling in well-defined biological systems, characterized by newborn-pathological, type I, subtype a, ONCOLOGICAL and b) Endoarteriolar Blocking Devices (Stagnaro S. Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. Eur J Clin Nutr. 2007 Feb 7; [Medline]).

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