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FDA Rolls Out Menu-Labeling Rules: But Does It Really Work?

Initial Analyses Find Little Impact on Fast Food Choices

PHILADELPHIA -- At the same time the Food and Drug Administration is rolling out rules for a national restaurant calorie-labeling program, a top researcher in the field says the tactic that was supposed to alter food purchasing behavior hasn't.

In a presentation at the University of Pennsylvania's Leonard Davis Institute of Health Economics (LDI), Dr. Brian Elbel said that in the fast food venues and populations studied so far, menu labeling has had no significant impact on consumers' high-calorie food choices. Backers of the concept initially argued that if consumers were able to see that the 1,350 calories in a Big Mac, large fries, and large soda equaled 68% of the recommended healthy diet of 2,000 calories a day, they might think twice before purchasing such belly-busting fare.

Heavily lobbied
Since 2003, health advocates have lobbied Congress and state legislatures to pass laws requiring fast food restaurants to display calorie counts on their menu-board offerings. As an anti-obesity measure, New York and a handful of other states passed such laws. And now, section 4205 of the Affordable Care Act requires the FDA to create menu-labeling regulations that will affect all restaurant chains with 20 or more locations across the country.

But, for some observers, the research findings seemed to raise a question about why the FDA would nationally mandate a practice that doesn't appear to be achieving its goal.

A spokesperson at FDA headquarters in Washington said she wasn't familiar with the research and noted
Brian Elbel
Photo: Hoag Levins
Dr. Elbel is director of NYU's Nutrition and Obesity Policy Research and Evaluation Network.
that the directive to promulgate the new menu-board labeling regulations comes from an Act of Congress.

And even in the face of his own findings, Elbel feels that menu labeling should be expanded into a national requirement for chain restaurants.

"There's a chance that labeling might influence food choice in the longer term as more people see this information," he said. "But at the same time, our findings tell us we can't sit back and think that we have labeling and obesity's going to be solved now."

An Assistant Professor of Medicine and Health Policy at the NYU School of Medicine, Elbel is also director of NYU's Nutrition and Obesity Policy Research and Evaluation Network. He's been researching the subject since New York State launched its own menu-board calorie labeling program in 2008.

New York and Newark
His department's studies in fast food restaurants in New York City and Newark, N.J., gathered consumer purchasing information just before menu labeling began and again after it went into effect.

About 60% of the consumers approached cooperated with researchers by turning over receipts and answering questions. About half said they noticed
burger menu
Since 2008, New York and a handful of other states have required calorie labeling at fast food restaurants.
the calorie counts on the menu boards. Twenty-eight percent said they were "influenced" by the information. But receipt analysis showed no change in the overall calories they purchased.

"No matter how we cut this, no matter what we controlled for, no matter what sub groups we looked at, there was no difference in the total calories purchased," said Elbel.

Widespread confusion
Another part of the study found widespread confusion about how many calories it takes to maintain a healthy weight -- the number against which menu-board counts should be compared.

"We asked consumers, 'How many calories do you think you should eat to maintain a healthy weight?'" said Elbel. "The majority of people didn't have a good sense of this."

Elbel pointed out that his own studies focused on populations in low-income areas. He also cited two of the most recent menu-labeling studies completed: one by Stanford University researchers at Starbucks and another by Duke University researchers at fourteen locations of the west coast Taco Time chain.

No effect, 14 locations
The Taco Time study concluded that menu labeling had no effect on purchasing decisions. The Starbucks study
Brian Elbel
Another study done in fourteen locations of the west coast Taco Time chain found that menu-labeling had no effect on consumers' food choice.
concluded that menu labeling caused Starbucks customers to reduce their consumption by an average of only about 15 calories.

Elbel is a rising star in the field of health care behavioral economics -- the scientific discipline that explores the use of various techniques and incentives to change people's unhealthy habits. But that's a tough goal when it comes to nutrition and obesity.

"The influences against healthy eating are large, well funded and ubiquitous," said Elbel. "Everywhere you turn you're going to see another advertisement for another unhealthy product."

McDonalds: $5.5 million a day
Consider, for instance, that McDonalds alone spends more than $2 billion a year on marketing. That's $5.5 million spent every day to convince consumers around the world to incorporate Big Macs and other high-calorie fare into their thoughts and eating habits. Burger King similarly spends $430 million -- or $1.2 million a day -- to push products like Whoppers. And those two companies are only a small portion of the country's sprawling fast-food marketing juggernaut whose messages wash across all media 24 hours a day.

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