The good news: Sixty percent of teens notice calorie postings

Chain restaurants are required to post the calorie content of their offerings on menu boards in a prominent way in some major American cities (including my fair but fat city of Philadelphia). The new health care reform law, signed last year, will enforce such labeling nationally. Many health experts support this public policy, saying it will help consumers make better informed food choices.

There are already efforts to evaluate if calorie labels make a difference. Some studies showed reductions in intake, some showed no measurable effect.

A new study, led by Brian Ebel, and published in the International Journal of Obesity, compared kids' fast-food choices in two low-income communities: in New York City, where calorie labeling became mandatory in 2008, an in Newark NJ, were calories are not posted.

Here are the main findings:

• 349 kids, aged 1 to 17 years, were included in the study. The vast majority of these kids (90 percent) were from ethnic or minority groups

Many of the NYC adolescents (57 percent) reported noticing the calorie labels. 9 percent of participants said they took calorie posting into consideration (so of those that noticed the calorie postings, 16 percent said it played a role in food choices)

• Customers' receipts, show no effect on food purchases -- kids in the study ate on average 645 calories per meal at the participating fast-food joints (McDonald's, Burger King, Wendy's and KFC) before and after the labeling rules took effect

• 35 percent of teens in the study reported they ate fast food six or more times a week

• Asked about what influenced restaurant choice, the most important factors were ease, followed by location

• When making food choices, the most important factor was taste (72 percent), followed by price (46 percent). Only about a quarter of the kids said they were concerned with their weight and tried to eat fewer calories

• Three fourths of the kids had no clue about the daily caloric requirements of adults.

The titles of most of the many reports on this study announced the ineffectiveness of calorie labeling on kids' choices (CBS: Calorie Labels Don't Affect Kids' Fast Food Choices, Time: Calorie Counts on Menus: Apparently, Nobody Cares, Business Week: Calorie Labels Don't Affect Kids' Fast-Food Choices). But please do not despair, and bear with me while we try to look at this issue a little more deeply.

What does it take to change a habit?

Habits are hard to break. What does it take to get people to exercise more? I think that very few people get serious about exercise because their physician told them so during a checkup. Does that mean the doctor should stop advocating exercise? Absolutely not! Well-being promotion should be voiced from many sources. The accumulated message, at some point, hopefully, will sink in. Maybe only after a really alarming health scare.

Advertisers know that a consumer needs to see a message more than a dozen times, in different ways, preferably on different sources of media, before it makes any impression at all.

So did anyone think that the unpleasant message of "this stuff you love to eat, and is so convenient and affordable is not very good for you" is going to change what people do with a just few large numbers posted on a menu board?

We have the right to know

Only a small percentage of the population suffers food allergies. Even fewer have celiac disease, or phenylketonuria (PKU). Yet the information about allergens, we all agree, needs to be listed for their benefit.

There are those among us counting calories and watching their weight. 50% of American women and 25% of American men are currently on a diet. Since the calorie information already exists for chain restaurants, isn't it just common sense that it be posted prominently for the benefit of those of us who care about such things?

Should teens really be counting calories?

My general advice to kids, including my own, is to eat real, healthy food, seated at a table, eat when hungry, only until they're no longer hungry, and minimize the junk. Although I think kids should learn about nutrition, and learn as much as possible about food, I think that counting calories should not be part of a kids' routine. Since most kids have no idea how many calories they should consume in a day, putting the menu board calorie numbers in context is quite impossible.

Nevertheless, a casual glimpse on a calorie board leaves an impression-it tells the viewer, which are the calorie-dense foods, and which are lighter. Over long periods of time a general picture emerges, that helps an informed decision. I was shocked when I first saw the nutrition label of Ben and Jerry's New York Super Fudge Chunk, but I still buy it. Does that mean the information had no effect? Absolutely not! I used that information to make the decision to reduce the frequency and serving size of this treat. In much the same way, the item selection at a fast food chain may look the same, but the frequency in which a teen visits the chain may change because he learned something from the calorie board, and that calorie count, combined with the talk he had with the school nurse about his rising BMI, led him to decide six fast-food meals a week are a tad too much. This habit change can't be captured in the kind of studies done so far on the effect of calorie postings.

Kids' life, contrary to what some may think, is not worry-free, but health and safety are rarely a concern that engages young people. I'm pretty impressed by the finding that 57 percent of adolescents in this study noticed calorie labels - so it's not just sports, music and girls that are on a boy's mind. At some point this knowledge may translate into action. For now, these kids are choosing restaurants by location and convenience - and that's why McDonald situates its joints near schools.

Have calorie posting shocked you? Did they change your eating habits?

Dr. Ayala

Related post:
Calorie posting laws spread-healthier choices follow

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