Even if new federal rules requiring calorie counts on vending machines and restaurant menus do little to change the choices people make about food, health experts and advocates are optimistic that restaurants and manufacturers will change what they sell.
The Food and Drug Administration issued two final rules on Tuesday intended to shed more light on the food Americans buy. One requires restaurants that are part of a chain with 20 or more locations (PDF) to post calorie counts on menus and menu boards of the items they serve. That includes buffets, salad and soup bars, movie theaters, amusement parks, stadiums and grocery and convenience stores that offer ready-to-eat items. A second rule requires that similar information be posted on vending machines (PDF) operated by companies that own 20 or more of them.
Eating out accounts for one-third of Americans' total caloric intake, according to the FDA. “Few decisions are as critical to our health and our daily lives as those involving the foods we eat,” FDA Commissioner Dr. Margaret Hamburg wrote Tuesday in the agency's blog, FDA Voice. “With these new rules on menu and vending machine labeling, Americans can be more certain that those choices are informed ones.”
Research examining the actual impact that nutritional labeling has on people's dietary decisions has been mixed.
“There's a subset of people who definitely see this information and definitely report that they are purchasing fewer calories,” said Brian Elbel, an associate professor of population health at NYU Medical School. In 2013 Elbel was lead author of a study published in the research journal Obesity that looked at the impact of a city-mandated policy implemented in Philadelphia requiring calorie labeling at fast food restaurants. Despite an increase in consumer awareness, there was no significant change in the number of calories purchased at the restaurants or the number of visits to those establishments, according to the study. “It doesn't necessarily look like it's by itself a population-level influence on obesity.”
Elbel said the majority of research on the matter is limited in scope, focusing on fast food restaurants over the course of several months. He said long-term examination of the impact of the FDA rules, which cover a broader array of eating establishments, would be needed to understand their influence.
The FDA's rule will require menus and vending machines to post this statement to provide some context for the numbers: “2,000 calories a day is used for general nutrition advice, but calorie needs vary.”
Still, experts are dubious that the numbers will be meaningful to most consumers. Elbel estimates that only about 15% of consumers actively review and make decisions based on calorie information.
“People don't look at the numbers,” said Holly Herrington, a registered dietician at Northwestern Memorial Hospital in Chicago. “If you're aware of your calories and you are consciously counting your calories or consciously looking at what's in food, then you are going to look at the calorie count. Most people don't know what a calorie is, much less how many calories they need or what they should be having in a day.”
But a more significant effect may be that restaurants and food manufacturers change their products, Herrington and others agreed.
“Menu labeling provides an incentive for restaurants to reformulate their menu items and add new items with fewer calories,” said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest. “Once people can see the calories, restaurants will have lots of new ways that they can change menu items to make them more healthful.”
The rules stem from a provision of the Patient Protection and Affordable Care Act that required restaurant chains to disclose calorie and other nutritional information for menu items.
The National Restaurant Association, the leading trade organization for the restaurant industry, has publicly supported the rules and says it help restaurants adjust to the new requirements, which are set to go into effect Dec. 1, 2015.
“We believe that the Food and Drug Administration has positively addressed the areas of greatest concern with the proposed regulations and is providing the industry with the ability to implement the law in a way that will most benefit consumers,” said Dawn Sweeney, the association's president.
Other groups, like the National Association of Convenience Stores, are accusing the FDA of overstepping its mandate under the healthcare reform law by applying the rule to convenience stores. The group called on Congress to restrict the requirement to stores that get at least half their revenue from prepared food.
Follow Steven Ross Johnson on Twitter: @MHsjohnson
