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Can Menu Labeling Make Us Healthier, Cheaper, Better?

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Sen.Tom Harkin (D-Iowa) and Rep. Rosa DeLauro(D-Conn.) are reintroducing the aptly-named MEAL Act. "MEAL" stands -- somewhat awkwardly -- for Menu Education And Labeling. That is to say, it stands for calorie counts. Right there on the menu. Next to your food. So you know. Harkin and DeLauro want to see restaurants with more than 20 locations displaying the total calories, sodium, saturated and trans fats, and carbohydrates of each dish right next to its name on the menu. Or, as the case may be, the menu board.

This isn't the first time Harkin and DeLauro have tested this legislation. It's the third. But as The Post's Jane Black makes note of, the politics might be different this time around. Health reform is in the works. And the administration is desperately looking for ways to cut costs without denying care. One way to do that is to make people healthier so they need less care. And one way to do that is to avert the obesity epidemic.

The theory here is simple. Ignorance, as my Libertarian friends claim, might be bliss. But it also makes you fat. It's not simply that consumers don't know how many calories are in restaurant meals. It's that repeated studies show they systematically underestimate how many calories are in restaurant meals. And they underestimate by more calories as meals grow larger. We're better, in other words, at assessing the calorie load of a simple cheeseburger than an Awesome Blossom. And it's not that we're stupid. Studies show that even nutritionists tend to lowball their estimates at fast food restaurants, coming in 200 to 600 calories below the mark.

Consumers are, predictably, even worse. One study found that we tend to lowball unhealthy items by 632 calories. Certain foods really throw us off: The average respondent underestimated cheese fries with ranch dressing by more than 2,000 calories. And relative calorie counts are even harder. Fact of the day: A small milkshake at McDonald's has more calories than a Big Mac. And tuna salad sandwiches? Way worse than roast beef.

Hence: Menu labeling. The key insight here is that small changes in behavior can have large impacts on outcomes. A Health Impact Assessment (pdf) prepared for the city of Los Angeles estimated that if calorie labeling convinced a mere 10 percent of large-chain patrons to order meals that were merely 100 calories lighter, then menu labeling "would avert 38.9% of the 6.75 million pound average annual weight gain in the county population aged 5 years and older." Get 20 percent to reduce their meals by 75 calories? You've knocked out 58.3 percent of the projected 6.75 million pounds. That's huge.

And unlike a Twinkie, it actually gets better with age. The presence of calorie counts gives restaurants an incentive to reformulate their meals so they contain -- you guessed it -- fewer calories. Menu labeling, in other words, makes menus lighter, as restaurants respond to the change in consumer behavior. Think how trans fats dropped out of every packaged food as soon as they had to be disclosed. And all that with a little label.

Image used under a CC license from Flickr user Marshall Astor.

By Ezra Klein  |  May 18, 2009; 8:02 AM ET
Categories:  Health  | Tags: Calories, Diet, healthcare  
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati   Google Buzz   Previous: The FICO Scores Seemed So Innocent.
Next: The 'Japanese Experience'

Comments

What would happen if I posted a comment?

Posted by: Ezra Klein | May 15, 2009 9:44 AM | Report abuse

And a second one?

Posted by: Ezra Klein | May 15, 2009 9:47 AM | Report abuse

Ezra, it looks like your rss isn't working.

Posted by: charlesjbrown | May 18, 2009 8:19 AM | Report abuse

"A small milkshake at McDonald's has more calories than a Big Mac."

That might be the saddest thing I've read all month, Ezra. Thanks a lot!

Posted by: urbanempire | May 18, 2009 8:31 AM | Report abuse

Ezra, you hack, enough of this. Please get back to writing gems like:

"Obama's finest speeches do not excite. They do not inform. They don't even really inspire. They elevate. They enmesh you in a grander moment, as if history has stopped flowing passively by, and, just for an instant, contracted around you, made you aware of its presence, and your role in it. He is not the Word made flesh, but the triumph of word over flesh, over color, over despair. The other great leaders I've heard guide us towards a better politics, but Obama is, at his best, able to call us back to our highest selves, to the place where America exists as a glittering ideal, and where we, its honored inhabitants, seem capable of achieving it, and thus of sharing in its meaning and transcendence."

Posted by: wapo9 | May 18, 2009 8:42 AM | Report abuse

I think the federal government has more important things to do than worry about our calorie intake. Don't get me wrong, we do a lousy job ourselves. But if people want to kill themselves slowly, they will figure out a way to do it.

Posted by: atlmom1234 | May 18, 2009 8:48 AM | Report abuse

This is just like requiring the car companies to put gas mileage on the sticker -- within a couple of years it will be an essential part of the choices we make at restaurants.

For middle aged people (like me) to keep healthy, there is just no alternative -- we have to budget our intake like we budget our money. Right now a lot of weight conscious people effectively budget by avoiding restaurants because we know the food is so calorie laden.

If calories/carbs were on the menus, people would select food differently, and by their choices they'd encourage chefs to focus more on tasty low-calorie and low-glycemic food. That would be good in so many ways because restaurant chefs so often provide examples of food we then try to cook at home.

Posted by: tboyer33 | May 18, 2009 9:07 AM | Report abuse

This is an infringement of our God-given rights to wallow in ignorance, and to embargo any knowledge that we find inconvenient.

The greatest right we Americans demand--from the food we eat, to the cars we drive--is the right to live like five-year-olds.

Posted by: icoleman | May 18, 2009 9:23 AM | Report abuse

I don't understand how or why libertarians would be *against* informing the consumer as fully as possible so he or she can then FREELY CHOOSE which product (or entrée) to purchase or order.

I remember the backlash when I wrote about the COOL (Country Of Origin Labeling) legislation for your individual blog, Ezra (the legislators included Congresswoman DeLauro then, too), and the arguments contra were, oddly, that informing the consumer where his food came from was somehow encouraging racism and xenophobia! Amazing. Big Ag and Big Retail (i.e. Wal Mart) have held up COOL legislation for years now, and their multi-million-dollar lobbying efforts have succeeded in watering it down and delaying its inception, even as such country-(or countries)-of-origin disclosure on labels has been, for many years, routinely required in European countries.

You're going to see the same fight here: get ready for lots of whining that being forced to disclose calorie and fat contents will somehow lead to consumers making choices that the corporate interests involved don't want them to be able to make, only they'll frame it as "this will lead to unfairness/prejudice/hysteria against normal American dishes" or similar (you watch; they'll find a way, and if all else fails, they'll wrap it in the flag.)

What gives? The lobbyist gives, that's what.

Posted by: litbrit | May 18, 2009 9:26 AM | Report abuse

A policy wonk who quotes Sinclair? I haven't felt this kind of puppy love in 30 years.

Hey Ezra, can I buy you a Big Mac Value Meal (1170 calories) next time I'm in DC?

Posted by: CanadaTed | May 18, 2009 9:43 AM | Report abuse

To me, one of the very best things about New York's new Citi Field and Yankee Stadium is the calorie counts at the food concession stands.

I remember the bitter complaints about these before the NYC law. Now -- to me at least -- they seem so natural and helpful that it's hard to believe anyone complained.

Posted by: bcamarda2 | May 18, 2009 10:12 AM | Report abuse

The posting of calorie counts on the menus of chain restaurants in New York City has led to one big change in the way that I eat: I tend to avoid the places that have calorie counts - if I want an apple turnover in the morning, I will walk several blocks out of my way to find a coffee shop or bakery that doesn't tell me how bad it is.

The upshot: small mom & pop shops and restaurants get more business!

Posted by: cd1981 | May 18, 2009 10:21 AM | Report abuse

Tuna salad is worse than roast beef? We need this legislation....especially since many of us eat out a lot!!

Posted by: scott1959 | May 18, 2009 10:28 AM | Report abuse

Information makes markets more efficient--who knew?

Posted by: bluegrass1 | May 18, 2009 10:33 AM | Report abuse

Wow, I didn't think people like cd1981 existed -- folks who actively don't want to know what they're putting into their bodies. I hope cd takes a less Know-Nothing attitude toward the care of children. ("Knowing ahead of time that this could set off Timmy's peanut allergy takes all the fun out of candy, so let's go by trial-and-error!")

Balko doesn't seem to grasp the point of dining at chain restaurants, which is not to enjoy great variety and substitutions and a particular chef's creativity, but to get the same thing every time. Midrange chain restaurants in NYC, for example, cluster in areas like Times Square that are mostly turned over to tourists, precisely because tourists don't know which local, non-chain restaurants are good. They prefer to eat at Applebee's, where they can feel certain that in ordering the same meal they'd order at home, they'll get almost exactly the same food: with the same ingredients, same level of spiciness/ saltiness/ sweetness, and now they can be secure that it will have roughly the same nutritional content.

I don't go to the Times Square Red Lobster because I want to know what spin the anonymous chef there will put on cheddar biscuits -- I want THE SAME cheddar biscuits that I got in Northern Virginia or Humble, TX. The same is true even for smaller chains like Five Guys -- I expect the Five Guys in NYC or Houston to deliver the same fries I got in D.C.

Consistency across locations, not creativity by individual cooks, is what Americans expect from chain restaurants. Consistent levels of calories, sodium, etc. will make chain restaurants even more appealing for those who need to be careful of what they eat. Putting the information directly on the menu also allows us to be aware of it without having to pester the server for a nutritional brochure and make us self-conscious dieters in front of our more metabolically-gifted dining compansions.

Posted by: pghsm | May 18, 2009 10:42 AM | Report abuse

If you have not read it, take a look at The End of Overeating by David Kessler. It will make you appreciate a bill like this. It is about time.

Those who care will at least take pause before gorging on the addictive fat/sugar/salt insanity that passes for cuisine in this country.

Posted by: libraridan | May 18, 2009 10:45 AM | Report abuse

Is the public too stupid to realize a double cheeseburger and shake is more fattening and less healthy than a salad or a single hamburger and iced tea?? Spend the money that the industry would pay to redo all the menus on educating those under 21 on the basics of eating right!

Posted by: adwohc | May 18, 2009 11:01 AM | Report abuse

adwohc,

Without looking it up, tell me which McDonald's item has more fat and calories: a double cheeseburger or a bacon ranch salad with crispy chicken.

What about a single cheeseburger compared to a caesar salad with crispy chicken?

Nutrition isn't as simple as "always pick a salad over a cheeseburger."

Posted by: pghsm | May 18, 2009 11:24 AM | Report abuse

The caloric information movement is well-intentioned but sadly oblivious of the harmful impact that posting caloric information has to those recovering from eating disorders. People who’ve spent years trying to care less about calories then have it sort of shoved in their face. Don’t get me wrong, I’m typically for very aggressive public health interventions, but this one seems wrong-headed and actively harmful; it’s the equivalent of telling someone who is deathly afraid of water how many people drown every year, precisely as they’re getting in the pool for the first time in their life.

I think caloric information should always be available, be it on the website, or post inconspicuously on the premises, but on the menu is simply just too much and an easily avoidable harm.

Posted by: ThomasEN | May 18, 2009 9:36 PM | Report abuse

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