Massachusetts is likely to join California, New York City and Seattle in requiring some sort of calorie count next to food items in restaurant chains in the state. Jeff Jacoby writes in today’s Boston Globe about how this amounts to an ineffective attempt by Big Government to further nanny our everyday lives.

I see it differently, based upon the research.

Let’s start with the basics. More information generally helps people make better informed decisions in their lives. It helps to know, for instance, how much gas a car uses, so the government forces car manufacturers to post MPG results for each of their cars (despite the expensive testing procedure needed to produce this number). The government also compiles fatality and infection numbers on hospitals, and publishes them so that people know that some hospitals may be better places to go than others.

The government in these examples, however, doesn’t force people to make a choice about which car they buy or which hospital they choose to visit. They simply require the company or organization to make more information available to you, the consumer, so you can hopefully make a better informed choice.

Now it would be silly for us to require that the standard of enacting certain legislation be that we have hard and fast research showing such legislation will directly result in a change in people’s behaviors. I can’t imagine a bill ever being passed that required that level of proof. Government enacts bills it hopes might change certain people’s behaviors, but it can never know for certain. For instance, many state governments keep wanting to lower the legal DUI limits, despite there being no evidence that there’s any real difference between a blood-alcohol level of 0.08 and one of 0.05 (there’s a statistical difference, but no research has shown any difference in impairment levels between these two amounts).

The one study Jacoby bothers citing of course supports his hypothesis that calorie counts at fast food restaurants such as McDonald’s would have little effect — “A 2006 study by researchers at the University of Vermont found that the more often one eats in fast-food restaurants, the less likely he is to pay attention to food labels.”

Of course, if you look at the study Jacoby cryptically cites (Krukowski, et al. 2006), the researchers didn’t study people’s actual behavior of going into a fast food restaurant and look at calorie counts on the menuboard. No, what they did was to survey 964 Vermont individuals (and who knows whether Vermont, a decidedly rural, Caucasian state, is representative of the national population) and ask them about their food habits, and whether they looked at nutritional labels. The question asked was a purely hypothetical one:

If nutrition labels in restaurants were available, 57 percent of the community sample and 44 percent of the college sample say they would not use the information, though, again, a significantly greater proportion of women in both samples reported that they would use restaurant food labels to look for low calorie foods as compared to men.

Not really a good indicator of whether people would use them or not, and little indicator of whether such labels might actually help people make healthier choices in their everyday lives.

If you look at a cross-section of the research in this area, you’ll find some support for the value of calorie information on menus. A lack of calorie information leads people to try and estimate how many calories are in the meal they choose. Unfortunately, people are pretty lousy at making an accurate estimation.

Chandon & Wansink (2007b) found that people are more likely to underestimate the caloric content of main dishes and to choose higher-calorie side dishes, drinks, or desserts when fast-food restaurants claim to be healthy (e.g., Subway) compared to when they do not (e.g., McDonald’s). Because no calorie counts are available on all the food items on the menuboards for either restaurant, people do a lousy job estimating the true calorie cost of their meal. A “healthy” fast food choice becomes a lot less healthy if you add regular potato chips and a Coke to it.

The same team (Chandon & Wansink, 2007a) also found that, not surprising, larger people tend to eat larger meals and that by doing so, they often underestimate the calories in the meal they’re eating. This underestimation is simply due to the meal size being larger than average, while the person’s estimation is based upon a normal-sized portion. Having direct, simple access (e.g., on the menu itself) to nutritional information would likely help people make better estimations.

Yamamotoa et al. (2005) found that while most teens wouldn’t change their eating behavior if presented with calorie and fat content next to each menu item in three different restaurants, 30 percent of them did. If 30 percent of teenagers (who normally aren’t known for making the healthiest food choices to begin with) will change their ordering behaviors at a restaurant when presented with this information, it suggests adults might enjoy an even higher rate of behavior change. And hey, a 30 percent population change in behavior is significant for virtually any public health campaign.

Why should any of this matter? Why not let people eat what they want, how much they want, when they want?

Well, of course people can eat (and smoke) all they want. I don’t care. But obesity does have a public health impact — many tax dollars that pay for poor and indigent healthcare do so for problems related to obesity (such as Type 2 diabetes). In a 15 year study of 3,031 young adults, Pereira et al. (2005) found that fast-food consumption has a direct association with weight gain and insulin resistance (which can lead to Type 2 diabetes), so this isn’t some hypothetical connection. Higher population obesity rates may also be a contributing factor to a rise in insurance premiums.

I prefer government not have to make mandates such as this one — I prefer companies act in a consumer’s best interest, acknowledge America’s obesity issue, and publish the information on their menuboard without needing a law. But in this case, it appears such information can help people make better-informed decisions about their eating choices. It’s too bad the government has to step in to force companies to provide this information directly where and when it can make an impact in a person’s eating decisions. But I find it no more “coercive” than requiring car manufacturers to post their government-mandated MPG numbers for cars.

And I’m a big fan of making better informed decisions, in any part of our lives.

Read the full editorial: Want a warning label with those fries?

References:

Chandon, P. & Wansink, B. (2007a). Is Obesity Caused by Calorie Underestimation? A Psychophysical Model of Meal Size Estimation. Journal of Marketing Research, 44(1), 84-99.

Chandon, P. & Wansink, B. (2007b). The biasing health halos of fast-food restaurant health claims: Lower calorie estimates and higher side-dish consumption intentions. Journal of Consumer Research, 34(3), 301-314.

Krukowski RA, Harvey-Berino J, Kolodinsky J, Narsana RT, Desisto TP. (2006). Consumers may not use or understand calorie labeling in restaurants. J Am Diet Assoc., 106(6), 917-20.

Pereira, M.A.; Kartashav, A.I.; Ebbeling, C.B.; Van Horn, L.; Slattery, M.L.; Jacobs, D.R. Jr.; Ludwig, D.S. (2005). Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet, 365(9453), 36-42.

Yamamotoa, J.A., Yamamoto, J.B., Yamamoto, B.E., & Yamamoto, L.G. (2005). Adolescent fast food and restaurant ordering behavior with and without calorie and fat content menu information. Journal of Adolescent Health, 37(5), 397-402.

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    Last reviewed: By John M. Grohol, Psy.D. on 11 Jan 2009