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Who cares about calories? Restaurant menu labels don't work, study shows

Items on the breakfast menu, including the calories, are posted at a McDonald's restaurant, Wednesday, Sept. 12, 2012 in New York. McDonald's restaura...
Items on the McDonald's breakfast menu, including the calories.Mark Lennihan / Today

When confronted with the reality that your favorite blueberry scone, the one you buy for breakfast every day, comes packed with 400-plus calories, do you still go for the pastry? Yes, you probably will.

No matter how much calorie information is on the menu list, people still choose the food they like, not what's supposed to be healthier, researchers from Carnegie Mellon reported Thursday.

Despite the good intentions of regulations requiring chain restaurants to post calorie counts of each menu item, studies have shown such mandates do little to actually change people’s behavior. But the Carnegie Mellon researchers wondered if people were given a little more information to help put those calorie counts in context, would they choose a lower-calorie item?

They found even including calorie information for each food item, plus the recommendations on how many calories are appropriate to consume during one meal, or over the course of a day, doesn't turn people off a Big Mac (500-plus calories).

“Putting calorie labels on menus really has little or no effect on people’s ordering behaviors at all,” says Julie Downs, lead author of the new study published Thursday in the American Journal of Public Health.

It’s an important issue, as several states and municipalities across the country -- New York City, Philadelphia, California, Oregon and King County in Washington state – have already introduced mandatory menu labeling. Soon, nationwide regulations will go into effect, thanks to the new health care law – and as part of that new health care reform legislation, restaurants will be required to post daily calorie recommendations directly onto menus.

It’s a well-intentioned, but unrealistic, policy, Downs says. The new data show that providing that broader context doesn’t help people make healthier choices, either.

“The people who set these policies aren’t very representative” of the people they’re setting them for, Downs says. “They think about what they eat. They think, ‘I’m not going to eat a giant hamburger, fries and a milkshake for lunch.' "

To see how real people responded to menu labels, researchers staked out two New York City McDonald’s restaurants at lunchtime – one in Manhattan, and one in Brooklyn – and found 1,121 adults, ages 18 to 89, to participate. At both restaurants, calorie counts were prominently displayed, as is mandated in New York City. Prior to ordering, one group received a sheet of paper with the recommended calories for a single meal (650 calories for women; 800 calories for men); a second group received information about recommended calories for a day (2000 calories for women; 2400 for men), and a third group received no instructions (similar to most of the earlier studies).

What they found: About one-third of the study participants ate more than 1,000 calories in the meal. The presence of additional information about recommendations for meal or daily eating had no impact on food choice. A majority of men and women ate more than the recommended intake for a meal – and neither type of information had an impact on the number of calories consumed, compared to the group with no information.

Importantly, says NBC News diet and health editor Madelyn Fernstrom, the study found no difference between overweight and healthy-weight participants in their food choice behaviors; the obese group did not choose higher calories than the healthy weight group. And both groups underestimated the calories consumed in a meal, a finding supporting earlier research.

"These data do support the idea that many consumers choose taste, value, and convenience over nutrient density and controlled calories," Fernstrom says. "And since the study was done at a fast-food restaurant, the results might not apply to other types of restaurants."

The takeaway message of this new research is not that restaurants should do away with displaying calorie counts and calorie recommendations. Actually, one of the study's limitations is that the research failed to examine those who used the calorie counts and did eat less, Fernstrom says, Because for some people, it’s a helpful tool.

"When it comes to human food choice, no one would expect that this strategy would work for everyone," Fernstrom says. "But It certainly can’t hurt. For those people who don’t care, it doesn’t make any different; for those who seek that information, it’s a plus. And there is also likely a sub-group of people who might glean some bit of information from the calorie counts, and impact choice in a small way on choice."

As Downs puts it, "I think a lot of that comes down to, who is using the information? It’s probably people who are already ordering pretty well, pretty healthfully."

While more information and transparency about the food we consume in restaurants is a positive trend, Downs adds, “that’s not going to help curb the obesity epidemic.”

Because, Fernstrom says, "it’s really hard to count calories -- it takes a lot of focus and mental energy when done regularly." Downs believes a better option to help nudge people toward making healthier food choices might be introducing some monetary incentives – and not just negative motivators, like soda or sugar bans or taxes. “Let’s not just tax the sugary stuff, because that’s just going to piss people off -- but let’s also maybe subsidize the healthier stuff,” Downs says.

One example she suggests: Offering a small discount for people who order water or a diet soda with their combo meal rather than a regular soft drink. But for now, Fernstrom says, try downsizing your combo meal to a kid’s meal, with a low-calorie beverage.