Like many Americans, 55-year-old Washington, D.C. entrepreneur Ron Howard eats out many times a week. Unlike many Americans, he chooses restaurants based on whether he'll be able to find out the calorie count for the meal he’ll be eating.
"Without knowing the calories in something, it's too easy to splurge and you can't possibly watch your weight effectively," says Howard, who shed 40 pounds from his 6 foot 2 inch frame over the past year.
Howard is one of the people lawmakers had in mind when they included in the new federal health law a requirement that restaurant chains and vending machines post calorie information on menus, menu boards and machines. The federal regulations directing how this should be done are due out by the end of this month.
"For nearly 20 years, consumers have benefitted from nutrition labels on packaged foods, but have remained in the dark about the nutritional quality of their restaurant meals," says Sen. Tom Harkin, D-Iowa, a co-author of the menu labeling provision in the law. "The passage of menu labeling closes this glaring loophole."
By March 23, the one year anniversary of the passage of the health law, the Food and Drug Administration is required to propose labeling regulations that will govern everything from the font restaurants must use to post calorie information to how the calorie counts of items on menus are determined.
Final regulations are expected by the end of the year and consumers will see most calorie information by mid-2012, predicts Margo Wootan, the Center for Science in the Public Interest's nutrition director.
But will that information do much good? Three studies conducted in New York and Seattle examined habits at fast food chains where menu labeling laws are already in place. They found that calorie knowledge isn't enough to change most consumers' choices. That raises questions about how effective the government's new labeling rules will be in improving public health and reducing the rate of obesity, which is linked to multiple chronic diseases including high blood pressure and diabetes.
As of 2009, about 73 million Americans, or 27 percent of the population, were considered obese, according to the Centers for Disease Control and Prevention. And, a September 2010 Brookings Institution report estimates that obesity's economic impact in the U.S. could exceed $215 billion annually.
"If we can get people to eat just a few less calories and cut their weight by a modest 5 to 10 percent , it can reduce the risk factors for the majority of our chronic diseases,"said Dr. George Blackburn, associate director at Harvard Medical School's division of nutrition. "Menu labeling is a piece of this change."
Wootan isn't too concerned about the results of the three studies, which she thinks were too small and conducted too soon after the labeling rules were implemented. "This is public health," she says. "It's not as if you put information out there, that every person will see it and use it. That is an unrealistic expectation."
She also says that the studies suggesting menu labeling doesn't have much of an effect don't take into account an important behavioral result: Restaurants have started changing their menu options to offer more low-calorie food options. "Before menu labeling, it wasn't worthwhile to restaurants to provide lower calorie items because no one would notice," Wootan says.
Now national chains that are listing calories say the information has been a big hit with their customers. That indicates that, as menu labeling expands, the impact may be more favorable than initial responses in New York and Seattle.
Georges Benjamin, executive director of the American Public Health Association, says he thinks the public also needs to be educated on how to use the calorie information because menu labeling is "a tool" to help people eat better, but not a solution in itself to the nation's weight problems. He notes that it took the public decades to understand the hazards of cigarettes.
Some evidence supports Benjamin's optimism. Seattle's public health department has continued to survey people's awareness of its labeling law. It found that by the spring of 2010, 19 percent of chain restaurant customers who noticed the calorie information said they used it to decide what food to purchase. That is up from 15 percent in 2009, according to Nadine Chan, assistant professor at the University of Washington's School of Public Health.
"We are seeing some modest decrease in calories that people are buying," says Chan. "That is encouraging."