Does Posting Calories Really Change How People Eat?

Will we, as a country, be thinner a few years from now because we are finally aware of the calorie and fat contents of the foods we buy at Starbucks or McDonald's or Subway? The answer is yes and no.
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I passed a billboard today with a picture of half of a hamburger on a bun and a whole turkey sandwich. The message said, "For 300 calories you can eat half of this hamburger, or this entire turkey sandwich." The message was compelling. If I want to get the most food for my calories, I would choose the turkey sandwich. But would everyone? Perhaps someone would look at the picture of the hamburger and think, "Only 600 calories for an entire hamburger? Why eat turkey when I could have beef for only 300 calories more?"

Have you noticed that the calorie contents of foods seem to be posted everywhere, not only on billboards, but also on boards listing the menu options of most fast food restaurants? Earlier last week I was wandering around a food court in the Philadelphia train station, waiting for someone whose train was late. I amused myself by reading the caloric contents of foods sold by various chains like Dunkin' Donuts, Auntie Anne's Pretzels and a pushcart selling ice cream. Several customers who were ordering pretzels with dipping sauce glared at me as I remarked out loud on the amazingly high caloric content of these seemingly innocuous pretzels. Would they have preferred not knowing how many calories they were about to consume?

Indeed, this is the question that is still awaiting a definitive answer: Will information about the calorie contents of restaurant food produce better food choices? Are billboards an effective way of getting us to eat fewer calories? Will we, as a country, be thinner a few years from now because we are finally aware of the calorie and fat contents of the foods we buy at Starbucks or McDonald's or Subway?

The answer is yes and no.

Yes, those who are dieting or trying to prevent themselves from gaining weight, will note the calorie content of foods they are buying and make their decisions based on this information. I asked a few people who are losing weight or concerned with not gaining back what they have lost, and how this has affected their eating. Here are some of their replies:

"I was in the mall and felt like having a muffin and coffee. But when I saw that the least caloric muffin had more than 350 calories, I just ordered coffee."

"Now I know why losing five pounds has been so hard. I am eating an extra 500 calories or more just from the whole milk in my several daily lattes. I am switching to fat-free milk from now on."

"Do you know how many calories those little containers of salad dressing contain? Here I thought I was being so good by eating plain, boring chicken and a salad every day for lunch, and then I obviously ruined it by dumping 200 extra calories of salad dressing on top."

"You know those cookies that you pass on the way to the checkout counter at Au Bon Pain? I always buy one for an afternoon snack. Do you realize that a chocolate dipped shortbread contains 380 calories and 60 percent of your daily saturated fat requirement? From now on I am eating pretzels."

But a colleague who works in obesity research told me, "Posting calories in restaurants is like preaching to the choir. What about people who are not interested in losing weight, even though they should? I doubt that giving them calorie information will change what they eat."
How will we really know? Simply asking most people this question will give false positives. Many people, especially those who are conscious of being overweight, might say, "Now that I know that a triple cheeseburger has several thousand more calories than an egg white sandwich, I will definitely choose the egg white sandwich."

Asking people after they have already made their choice may reveal more information. Think about this scenario: Someone in a food court is digging into a triple bacon cheeseburger, fries and a soft drink. You ask him, "Did you notice the calories listed for the food items before you ordered?" If the answer is no, find someone else to ask. But if the answer is yes, then find out what influenced him to buy the 1,000 or more calorie meal, compared to one with far fewer calories. The answers could range from: "This is my only meal today; I was very hungry; I just biked 50 miles; The price was right; I eat this every day for lunch; I don't know how many calories I should be eating; I don't care how many calories I am eating because I like triple cheeseburgers with bacon and love fries; I hate salads; When I am ready to lose weight, maybe I will pay attention to calories; I am drinking a diet soda so I am saving calories; and my girlfriend is always watching my weight, so when she isn't around this is what I eat."
There are likely even more reasons to rationalize ignoring the caloric content of what one eats.

Sometimes we just conceal from ourselves why we choose foods we know will make us gain weight.

Billboards and posters with healthy food suggestions are useful for people who are dieting or maintaining their weight loss. It is also useful for many of us who had no idea how many calories are in foods that don't look fattening. Who knew that fancy coffee drinks were so caloric, or that adding pesto to a sandwich drastically increased its calorie content, or that a healthy-looking cheese and spinach quiche contained more calories than a grilled chicken sandwich?

Will listing calories on a billboard or menu board halt the obesity epidemic? It's a step in the right direction. However, I suspect that significantly reversing the national trend toward weight gain will require solving the reasons people gain weight and keep it on: stress, lack of sleep, no time to exercise, work and family problems, financial issues -- the list goes on and on. In the meanwhile, seeing the calories up on that menu board gives us something to read and chew on while we are waiting in line for our order.

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