Our Research on Menu Labeling

For the past couple years, I've been working with one of my former graduate students, Brenna Ellison at the University of Illinois, on some papers related to effects of calorie labels on menus (for those who may not be aware, "Obamacare" mandated that chain restaurants include such menu labels but the FDA has yet to release the final rules and implementation date).  

The first part of that research was finally published last week in the International Journal of Behavioral Nutrition and Physical Activity, where we report on a smaller sample from the larger study which includes the group of people Brenna interviewed after they ordered.  The results have been picked up by a couple news outlets, including this one from Reuters: 

Showing diners how many calories are in restaurant food items may influence how much they eat - especially among the least health-conscious people, a new study suggests.

That's true - but only partially true.  We find that the numeric labels mandated by "Obamacare" do not have a statistically significant effect on the number of calories people order.  The labels that we find to be (somewhat) effective are stop-light labels, in which we put a red dot next to the high calorie foods, a yellow dot next to the medium calorie foods, and a green dot next to the low-calorie foods.  As the story suggests, the labels are less influential among people who we rate (based on their survey answers) as health conscious.  The result isn't terribly surprising - people who are health conscious are probably already familiar with the caloric content of the foods they eat, and as such, adding labels are unlikely to provide new information.  Still, we'd want to know something about the cost of the label to know whether the policy was a net-plus (this is an issue we take up in our other papers still in the works).    

The result I found most interesting from the whole study was only discussed in the conclusions (and was missed all together in the news story) is the following:

Interestingly, despite the calorie+traffic light label’s effectiveness at reducing calories ordered, it was not the labeling format of choice. When asked which of the three labeling formats was preferred, only 27.5% of respondents said they wanted to see the calorie+traffic light label on their menus. Surprisingly, 42% preferred the calorie-only label which had virtually no influence on ordering behavior. These responses imply diners may want more information on their menus (the number of calories), yet diners do not want to be told what they should or should not consume (i.e., green = good, red = bad).

Fast Food Restaurants Getting Healthier

One of the reasons I’m often critical of government policies that attempt to force healthy eating on the public (say through ingredient bans or fat taxes) is that I have a different view of “Big Food” than many foodies.  Big Food is often portrayed as powerful, nefarious entity preying on helpless consumers.  I’m more apt to seeing fast food restaurants as responding to consumer demand for convenient, inexpensive, quick food.  They offer burgers and fries because this is what consumers are willing to pay for. 

However much we may want McDonald’s et al. to offer healthier alternatives, at the end of the day they must make enough money to stay afloat.  If more salads are offered than consumers want or are willing to buy, that’s a recipe for disaster.  As one organic farmer put it: the first rule of sustainability is that you have to make enough money this year to do it all over again next year.  I have little doubt that the McDonalds of the world would offer a lot more salads if they thought they could make money doing it. 

Against this backdrop, I noticed a recent study by the Hudson Institute that examined the offerings of fast-food restaurants over the past five years (it was covered by the WSJ here).  Here’s what the study found:

“between 2006 and 2011, lower-calorie foods and beverages were the growth engine for the restaurants studied. In 17 of the 21 restaurant chains evaluated, lower-calorie foods and beverages outperformed those that were not lower-calorie. In addition, chains that increased their servings of lower-calorie items saw positive returns as a result. These chains generated:

• a 5.5 percent increase in same-store sales, compared with a 5.5 percent decline among chains selling fewer lower-calorie servings;
• a 10.9 percent growth in customer traffic, compared with a 14.7 percent decline; and
• an 8.9 percent increase in total food and beverage servings, compared with a 16.3 percent decrease.”

The lesson is that you don’t always need government regulation.  The market will deliver healthy foods when the public decides that’s what they want.

The Economics and Politics of Obesity

That was the title of a talk I gave last week at the University of Alabama-Birmingham in the seminar series run by the Nutrition Obesity Research Center.  I talked about emerging trends associated with obesity (some of which defy popular narratives), the government's role in "combating" obesity, reasons why I find justifications for government action in this area less compelling than many public health professionals, evidence from empirical research on effectiveness of policies designed to "fix" the obesity problem, and finally I concluded with my thoughts on what caused the rise in obesity and what "we" should do about it.  

If you'd like to watch my talk (which runs about 50 minutes), click here.  

Obesity Myths

Last week, I gave a talk at the Nutrition Obesity Research Center at the University of Alabama-Birmingham.  It turns out that several of the folks I met with published an article in the New England Journal of Medicine a day after my talk entitled, "Myths, Presumptions, and Facts about Obesity."  Here is an expert from the coverage at New York Times, in interviews with the team leader, David Allison:

His first thought was that, of course, weighing oneself daily helped control weight. He checked for the conclusive studies he knew must exist. They did not.

“My goodness, after 50-plus years of studying obesity in earnest and all the public wringing of hands, why don’t we know this answer?” Dr. Allison asked. “What’s striking is how easy it would be to check. Take a couple of thousand people and randomly assign them to weigh themselves every day or not.”

Yet it has not been done.

Instead, people often rely on weak studies that get repeated ad infinitum. It is commonly thought, for example, that people who eat breakfast are thinner. But that notion is based on studies of people who happened to eat breakfast. Researchers then asked if they were fatter or thinner than people who happened not to eat breakfast — and found an association between eating breakfast and being thinner. But such studies can be misleading because the two groups might be different in other ways that cause the breakfast eaters to be thinner. But no one has randomly assigned people to eat breakfast or not, which could cinch the argument.

As their study shows, there are no easy "quick fixes" to the state of obesity in America.

Is Fast Food Making Us Fat?

Eating fast food might have been one of the myriad factors affecting people's weight over the past 40 years.  But, according to this new study in the American Journal of Preventive Medicine, the calorie content of fast food hasn't appreciably changed in 12 to 13 years.  From the abstract:

Spanning 1997–1998 and 2009–2010, the number of lunch/dinner menu items offered by the restaurants in the study increased by 53%. Across all menu items, the median energy content remained relatively stable over the study period. Examining specific food categories, the median energy content of desserts and condiments increased, the energy content of side items decreased, and energy content of entrées and drinks remained level.

Conclusions

Although large increases in the number of menu items were observed, there have been few changes in the energy content of menu offerings at the leading fast-food chain restaurants examined in this study.