Q&A - Question and Answer Guides

Q&A Calorie Counts on Menus: Are they Accurate, Understood, Effective, Worthwhile?

Several countries have introduced regulations for calorie information to be displayed on menus - including New York restaurants since 2008. It is time for an update on the accuracy of the information, whether it is changing people's meal choices, whether people understand and use the information and whether it is working.

Counting calories is just like balancing the household budget - balancing income and expenses can avoid debt - balancing calories eaten and burnt in exercise can avoid weight gain leading to obesity.

At the heart of the problem is how well do the general public understand calories and the concept of a daily calorie allowance. Why should they change their meal choices if they don't understand this concept. Choosing meals that have moderate calories at a restaurant or fast-food outlet will only work if it is part of an overall calorie budget. Many people see eating-out as a treat when they can 'let their hair down' and let go for once. These are some of the problems that have to be overcome for the calorie counting labels to be effective.

How Big are Fast Food Meals?

Changes in portion size and composition of the last 20 years

The Australian Consumer magazine Choice has recently crowned Hungry Jack's Ultimate Double Whopper as the worst fast food meal option in Australia. The monster burger contains 80g of fat and 1,200 calories (5000 kilojoules). This is the energy equivalent to 90 minutes of jogging to burn off those calories. Hungry Jack's Angry Angus (double) was the second worst, with 52.1g of fat and 780 calories (3276 kilojoules). If a consumer adds a soft drink and fries to Ultimate Double Whopper, the or she may unknowingly be consuming a day's worth of calories or kilojoules in a single meal.

Daily calorie requirements range from 1200 for sedentary people, to 1375 for people who do light exercise or sport 3 days/week, to 1725 for very active people with hard exercise or sport 6-7 days a week.

Some other high calorie fast foods are shown in the table at the end of the article.

How well known is the calorie content of these meals, especially in relation to the average calorie requirements?

Perhaps there needs to be more of the 'Shame & Blame Game' !

Do Calorie Counts on Menus Encourage Healthy Eating and Better Meal Choices?

A recent research study interviewed groups of customers in surveys before and after the NY law was passed in 2008. The results showed that only one in six people (15%) used the information when deciding what to buy, and most of these reduced their calorie intake in the meal. The study was published in the British Medical Journal. It was a relatively large study involving about 7,000 people in 2007 and another 8,500 in 2009 (nearly 2 years after the rules were introduced). The survey included 11 of the top food chains in NY at 168 randomly selected locations during lunchtime hours.

Some 15% of those in the 2009 survey said they used the labels and these customers bought meals withabout 100 fewer calories than customers who did respond to the calorie information.

However, overall there was no significant change in average calorie consumption before and after the new rules were introduced. The decline in calorie consumption by the aware group was offset by other who ate more calories. The mean calories consumed increased from 828 to 846 calories, but the increase was not significant. This outcome was very discouraging.

When the results were broken down further that shows that several major food chains showed significant reductions in calories purchased and this was more encouraging.

• For McDonalds mean energy per purchase fell from 829 to 785 calories
• For Au Bon Pain mean energy per purchase fell from 555 to 475 calories
• For KFC mean energy per purchase fell from 927 to868 calories
• For Subway mean energy per purchase ROSE from 749 to 882 calories. Apparently this was due to advertising that promoted larger portion sizes.
• For the 2009 survey the 15 percent of customers who reported they had used the calorie information, the mean energy per purchase fell by 106 calories (757 versus863 calories)
• Overall mean calories purchased did not change from before to after regulation 828 versus 846 calories. The reduction for some food providers was offset by increases in calories consumed by other suppliers.

The drop in energy consumption at Au Bon Pain and KFC did not occur because customers read the calorie counts and changed their behaviour.Instead, the two companies changed their menus and introduced healthier options and this lead to the average decrease. These menu changes may have been triggered by putting the calorie count information on the menus. The companies may have been responding to consumer pressure for healthier options. This suggests that the seller actions through changes in menu choices can be more important than the negative one of showing the huge calorie loads to scare the consumer away from them.

The overall conclusion was that the usage rate was rather low at only 15%. The failure appears to be related to the observation that most consumers ignored them and did not make healthier choices. It also points to the failure in the message of the need to count calories and to understand what that means in terms of a daily allowance. It points to the need for campaigns to improve awareness of the need to count calories and restrict energy intake.

The concept of putting calorie counts on menus is being adopted by several other countries. More than 32 companies have agreed to display calorie information on menus in UK restaurants, including fast food chains KFC and McDonald's. Dr Susan Jebb, from the UK Medical Research Council is hopeful that calorie count information will have more of an impact in the UK because people there are already familiar with front-of-pack labelling in supermarkets. She also stated that it is important how the restaurant or food chain acts in terms of menu choices.

How accurate is the Calorie Count Information of Menus?

A comprehensive review of the calorie content informationfor food from 39 fast-food and sit-down restaurants in three American states has concluded that generally the stated number of calories on restaurant menus are accurate. However there were some glaring errors with the actual number of calories being more than 200% of the figure on the menu.

Of the 269 food items tested about 20 percent contained at least 100 calories/portion more than the menu energy contents. On average, restaurant foods contained 18% more energy than stated; compared with about 8% for supermarket-purchased meals.

Do Calories on menus affect the food choices of Parents buying food for young children or Teenagers buying food for themselves?

Another study surveyed a group of about 350 children and teenagers, aged from one and 17 years. The young people included those who ate meals at the food outlets with their parents (70 %) or by themselves (30 %). Groups were surveyed before labels were introduced and after their introduction. The study found no significant difference in the mean calorie content of the meals bought before and after labeling. This applied to parents buying food for their children and to adolescents buying the food. This occurred despite more than half the adolescents stating that they were aware of the calorie labels (about 57% in New York City). Also about 10% of the people surveyed said that they considered the information when ordering. Clearly it did not affect their menu choices and about 75% of the adolescents reported that taste was the key factor when choosing what meal to buy.

The meals bought by the teenagers contained about 720 calories per meal and the meals bought by parents for their children contained about 600 calories per meal.

Clearly the labels were not working - kids didn't know how many calories they were consuming in their meal in relation to their daily allowance, the has no idea about these concepts or they simply did not care.

The study found that most teens grossly underestimated the number of calories in the food they purchased, some by as much as 470 calories.

The conclusion was that there was no significant difference in number of calories per meal before and after labeling started for teenagers or for parents buying meals for their kids. Parents did not alter their meal choices to lower calorie meals.

This just reinforces the need for better diet education at an early age. Teenagers should be taught about counting calories and they should know that the daily limit is about 2,000 calories a day. They should also know that eating excess calories above this could make them fat.

Fast-food chains and restaurants target their marketing to young children, and teenagers have been exposed to years of such advertising well before they begin to make their own food choices.

Health and fitness education including the concept of counting calories and daily limits needs to be taught to children when they first start at school. It is disturbing that parents do not appear to be choosing healthier, lower calorie options for their children. The message is simply not being heard.

Conclusion:

Calorie Counts on Menus do not appear to be working and most people are simply ignoring them.

---

Table 1. Calories for common fast food meals