Menu Labeling: Helpful?

Creative Commons Licensing Flickr CAI "Best Practices" conference, Nov 2008 - 02 by Ed Yourdon — Creative Commons Licensing Flickr CAI “Best Practices” conference, Nov 2008 – 02 by Ed Yourdon

By Robin Allen, MSPH, RDN, LDN

Previously as an Administrative Dietitian working in a major university’s dining services, I implemented “point of service” food item nutrition labeling. The intent was not just to point out calories but to provide complete nutrition information for our consumers that included not only college students but faculty and staff. Everyone loved the nutrition labeling except for those students with eating disorders and their health care providers on campus. Many expressed concern that putting calories on the menu was a “trigger” for people with eating disorders. Menu labeling was indeed a touchy subject! Do we change everything for those few? We had the information online, but most people were not aware or did not take the time to look up the items. I chose to continue the food labeling since most people were very appreciative of the information being provided. I also knew mandatory food labeling was on the horizon and indeed had been implemented in many states. Those poor students with eating disorders were going to face with food labels whether it was at school or throughout their daily lives. Some students I indeed worked with to help them handle the nutrition information and use it appropriately.

We also learned a great deal about the foods we were serving. Some foods we had thought would be a “healthier” option was worse than the “non-healthy” food item due to food preparation techniques. Some days there would have been nothing to eat if you were looking for a lower fat, moderate in sodium diet. Menu labeling forced us to take stock and re-examine our menus to ensure were at least offering some healthier alternatives. Our goal was not to make everyone eat “healthy” but to at least provide the option and the information to make healthier food choices. Still, when finals week rolled around, all good intentions went out the window and the consumption of french fries, chicken tenders, and pizza skyrocketed! Stress eating is alive and well during finals week.
What are the advantages and disadvantages of menu labeling?

The “Patient Protection and Affordable Care Act”, passed in 2010 required calorie labeling of menus. The requirement for calorie labeling was done to help stem the obesity epidemic and to help consumers make informed and healthier decisions about foods they eat.

Some Advantages:
1. May promote healthier choices by providing the public with more information to better understand what they eat.
2. Provides consumers a guideline on what is a healthy caloric intake based on an average 1,800-2,000 calorie per day diet.
3. Focuses on the prevention of chronic illnesses such as cardiovascular disease, type II diabetes, hypertension, and obesity.
4. Provides nutrition education by requiring the visible display of calorie information and written information on other nutrients upon request.

Some Disadvantages:
1. There is an additional cost to restaurants and supermarkets for analyzing their food products to determine calorie information; printing new menus, food boards, displays, etc.
2. There is a fear that sales of higher calorie foods will drop, which are frequently the most profitable.
3. Consumers are not always aware of what is a “beneficial” food or “empty” calories.
4. To analyze menus from scratch is very time-consuming and labor intensive.

December 1, 2016, is the compliance date given by the Food and Drug Administration (FDA) for those restaurants to implement menu labeling. Food service operations covered under this ruling will have to list calorie information for standard menu items on menus and menu boards and a brief statement about suggested daily caloric intake. Nutrient information such as total calories, calories from fat, total fat, saturated fat, trans fat, cholesterol, sodium, total carbohydrates, fiber, sugars, and protein will have to be made available in writing on request. This FDA rule applies to food service operations that are part of a chain of 20 or more locations, doing business under the same name, and offering the same menu selections.

Is the labeling of calories on the menu effective in helping consumers to make healthier or different food choices? One study published in the Journal of the Academy of Nutrition and Dietetics indicated people who use menu calorie labels is associated with purchasing fewer calories. However, there are significant socioeconomic differences among customers who notice and use menu calorie labels. Targeted education programs may be needed to improve the use of menu labeling across all sociodemographic groups. Another study from New York University (NYU), found no significant differences in calories purchased before and after menu labeling was required in New York. Adolescents reported that taste was the most important factor in meal selection. This study was primarily conducted in low-income areas.

Does menu labeling lead people to make healthier food choices? Do people even know what the labels mean? Are the labels accurate? How do we help our patients navigate the new menu labeling requirements to make healthier choices? Does putting the calories on the menu cause problems or “trigger” eating disorders?

There are many unanswered questions, and this topic is now being studied extensively.

Tune into our free webinar on October 20, 11:00 pm ET to get the most up to date information on menu labeling.

Resources:

Elbel, B, Gyamfi, J, and Kersh, K. Child and adolescent fast-food choice and the influence of calorie labeling: a natural experiment. International Journal of Obesity (2011) 35, 493–500; doi:10.1038/ijo.2011.4; published online 15 February 2011

Green, J E, Brown, AG, Punam O. Sociodemographic Disparities among Fast-Food Restaurant Customers Who Notice and Use Calorie Menu Labels. Jn of the Academy of Nutrition and Dietetics, 2015-07-01, Volume 115, Issue 7, Pages 1093-1101.