Currently browsing posts about: Calorie-labeling

Aug 27 2010

FDA proposes rules for menu labeling

When President Obama signed the health reform bill last February, he also signed national menu labeling into law.  The FDA is now proposing rules for how calorie labeling will work in practice.  The proposed rules are posted on the FDA website and in the Federal Register.  The FDA is seeking public comment on its Draft guidance for industry.

The law says that restaurant chains with more than 20 units nationally must post by March 23, 2011:

  • The number of calories in each standard menu item “as usually prepared and offered for sale” (the calorie disclosure must be “clear and conspicuous” and “adjacent to” the name of the standard menu item)
  • A statement that puts the calorie information in the context of a total daily caloric intake, and
  • A statement regarding the availability of the written nutrition information.

In my previous posts and writings about calorie labeling, I’ve been concerned about several problems I’ve observed in the implementation of New York City’s calorie labeling program.  Here’s how the FDA proposes to address them.  FDA’s rules are in black italics.  Mine are in red:

Not displaying calories at all: a “menu” or “menu board” is “the primary writing of the restaurant or other similar retail food establishment from which a consumer makes an order selection. FDA considers primary writing to include all forms of primary writing, such as dessert menus, beverage menus, or other specialty type menus. I think this means that if a restaurant has a menu board, it has to post calories on the board.  If it only has menus, the calories have to be on the menus.

Displaying calories in absurdly precise numbers: calorie disclosure should be expressed in the nearest 5-calorie increments for menu items containing up to and including 50 calories, and in 10-calorie increments above 50 calories, except that amounts less than 5 calories may be expressed as zero. This is fine.  Measuring calories isn’t all that precise anyway.

Displaying absurdly large ranges of calories: FDA will not require posting calories of variable menu items and combination meals until FDA issues a final rule. FDA will provide recommended language in the proposed rule. Uh oh. The FDA must be having a hard time figuring out what to do about this one.

Displaying incorrect values for calories: a restaurant shall have a reasonable basis for its nutrient content disclosures, including nutrient databases, cookbooks, laboratory analyses, and other reasonable meansWhat “reasonable” means is debatable but this ought to work within a an error of 10% or so.  We will have to see how this one plays out.

If you want to weight in on these proposed rules, now is the time to comment. You can do this easily at Docket FDA-2010-N-0298.

Jun 6 2010

Calorie postings go personal?

My latest San Francisco Chronicle column is about calorie labeling going national and what the FDA is going to have to do to write regulations that make it work effectively.

While we are waiting for all that, how about what Burgerville is doing.  Burgerville, a fast-food chain in the Pacific Northwest, now does personalized calorie counts.  When you get your food, your receipt displays the calories for each item you ordered.  It also makes suggestions for ordering lower calorie items: “if you like the blueberry shake, you might consider getting a blueberry smoothie next time.”

Will doing something after-the-fact like this affect future food choices?  Researchers: get busy!

Apr 8 2010

Calorie labeling in the New England Journal

Yesterday, the New England Journal of Medicine published – online ahead of publication – my Perspective on “Health Care Reform in Action–Calorie Labeling Goes National.”

Never, in the more than 40 years since I published my first scientific paper (see note below), have I had an experience like this one.

Most of the time, academic publishing is a tortuous process, fraught with endless delays, rejections, nit-picking, and humiliation.

Not this time:

  • Friday, April 2: Perspective submitted
  • Monday, April 5: Perspective accepted, edited, set into page proofs, and queried
  • Tuesday, April 6: Queries dealt with and page proofs corrected
  • Wednesday, April 7: Figure added and Perspective published online and scheduled for print publication on May 27.

Whew!  Let’s hear it for electronic publishing.  I think I could get used to this.

Note: I know you are dying of curiosity about that first paper.  It appeared in 1968 when I was a budding (alas, never flowering) nucleic acid biochemist: Nestle M, Roberts WK.  Separation of ribonucleosides and ribonucleotides by a one-dimensional paper chromatographic system.  Analytical Biochemistry 1968;22:349-351.

Mar 23 2010

Calorie labeling to go national!

The impossibly impenetrable health care bill that just passed the House has one little piece of good news buried in it: national calorie labeling.

The provision covers chains with 20 outlets throughout the country and is supposed to go into effect in a year or so.  It also covers vending machines!  These are great steps.  Calorie labeling has two effects.  It educates anyone who is interested to look and think about it.  And it encourages chain restaurants to offer lower calorie options.  See note below giving the index to this section.

Cheers to Center for Science in the Public Interest, which has lobbied for years to get this into law.

Note:  Thanks to Ellen Fried for sending me this link to an Index to the menu labeling provision.

Jan 6 2010

How many extra calories cause weight gain?

For years, some people – not me – have been saying that eating one extra 50-calorie cookie a day can make you put on 5 pounds per year.  This calculation comes from basic math: if about 3500 extra calories make you put on a pound of body fat, then 50 times 365 is 18,250 extra calories which, divided by 3500,  equals about 5 pounds.

This never made sense to me.  It is impossible to know how much you are eating each day within 50 calories let alone how many calories you are using in daily activities.  Yet people used to be able to keep their weight steady without thinking about calories at all.

This is because the body regulates weight and can easily compensate for such small changes in calorie intake or output with small changes in metabolic rate.  It takes more calories to move heavier bodies, and fewer to move lighter ones.

For years, I’ve been thinking that it must take a lot more than 50 extra calories a day – I guessed hundreds -  to make people gain weight.  I thought this for two reasons:

First reason: Portion sizes have increased greatly in recent years, and larger portions have more calories.  Sometimes, they have a lot more.  Foods eaten outside the home often have more calories in them than anyone suspects.

That’s why calorie labeling matters.  Labeling may underestimate the actual calories present in a food according to Tufts researchers (see this week’s Time for commentary and also see the industry response).  But even so, a new study shows that labeling encourages people to cut down on food intake, at least at Starbucks.  Make that two new studies: one from the Rudd Center at Yale comes to the same conclusion.

Second reason: I keep hearing from pediatricians who treat overweight kids that they have kids in their practices who drink from 1,000 to 2,000 calories a day from sodas alone.  I can’t judge whether these figures are correct or not, but several different kinds of studies suggest that many people today are eating a lot more calories than their counterparts of 25 years ago.

Now Martin Katan and David Ludwig have done the actual calculations in a paper in this week’s JAMA titled “Extra calories cause weight gain–but how much?”  Their conservative estimate is that it would take an excess of 370 calories to gain 35 pounds in 28 years.   To become obese in 25 years, you would need to eat 680 calories a day more than you expended.

To become 58 pounds overweight at age 17, they predict that a child would need to overconsume 700 to 1,000 calories a day from the age of 5 or so.

These figures are quite consistent with what those pediatricians were telling me.  By other estimates, average caloric intake has increased by 200-500 calories a day since the early 1980s, along with a 700 calorie-a-day rise in the availability of energy in the food supply (from 3,200 to 3,900 per day per capita).

As Katan and Ludwig conclude:

small changes in lifestyle would have a minor effect on obesity prevention.  Walking an extra mile a day expends, roughly an additional 60 kcal compared with resting – equal to the energy in a small cookie.  Physiological considerations suggest that the apparent energy imbalance for much of the US population is 5- to 10-fold greater, far beyond the ability of most individuals to address on a personal level.  Rather, an effective public health approach to obesity prevention will require fundamental changes in the food supply and the social infrastructure.

This is because on the personal level, prevention of weight gain means eating hundreds of calories a day less.  Moving more, useful as it is, will not do the trick unless people eat less as well.

On the societal level, we need measures to make it easier for people to eat less.

I can think of a bunch of examples.  You?

Oct 7 2009

What’s up with calorie labeling?

So the New York Times ran a story about early research on the impact of New York City’s calorie labeling postings by fast food restaurants.  The research, done by some of my New York University colleagues, looked at what customers said they were doing and compared what they said to what they actually did.  Oops.  Customers said the labeling made them choose foods more carefully but they actually bought more calories.

So, should we give up on this idea?  No way.  These are preliminary results looking at what happened during the first few weeks of calorie labeling in fast food places in low-income areas of New York City.  In such areas, restaurant choices are few, cheap food is a necessity, and people go to fast food places precisely because they can get lots of calories at low cost.

I can think of several excellent reasons for calorie labeling, none of them addressed by this particular study and all of them supported by considerable observational evidence:

  • People do not understand calories very well; calorie labeling can begin the education process especially if accompanied by materials explaining that most people require about 2,000 calories a day.
  • Some people – not all, of course – will change their behavior and choose lower calorie items when they realize how many calories are in fast food.
  • Fast food places will reduce the number of calories in the items they serve.

This last may be the most important.  Just as labeling the amount of trans fat in processed foods caused food manufacturers to eliminate trans fats from their products, so fast food sellers are looking for ways to reduce the calories in their products.  This is already happening and is the easiest way I can think of to encourage people to eat less: don’t serve as much.

Oct 2 2009

Coca-Cola reveals calories?

Well, sort of reveals.  Coca-Cola announces that it will put calories on the front of its packages (so you don’t have to search for and put on glasses to read the Nutrition Facts).  You can see what the label will look like in the story in USA Today.

calories01x-large

This sounds good but I view this action as another end run around FDA’s proposed regulations.  In March 2004, the FDA proposed to require the full number of calories to be placed on the front of food packages likely to be consumed by one person, like a 20-ounce soda for example (see figure).  A 20-ounce soda is 275 calories, not 100.

FDA

If Coca-Cola followed that FDA proposal, a label of a 2-liter bottle would have to say 800 Calories right on the front of the package.

This idea got stuck in Bush administration but there’s a good chance the new folks at FDA might take it up again.

Is Coca-Cola serious about helping people avoid obesity?  If so, maybe it could send out a press release distancing itself from those consumer-unfriendly ads run by the Center for Consumer Freedom (see previous post).

Here’s another question: Does Coca-Cola fund the CCF directly or indirectly through the American Beverage Assocation or some other industry trade group?  I will believe that they might really have an interest in consumer health when I know they have no connection whatsoever to CCF and its current ad campaigns.

Jul 28 2009

Kaiser-Permanente does menu labeling

Kaiser-Permanente hospital cafeterias in California, Oregon, and Hawaii will soon be displaying information about calories and nutrition on menu boards.  This huge not-for-profit HMO has a huge not-for-profit focus on preventive health.  It figured out a long time ago that healthy people don’t cost as much to take care of, and it constantly seeks new ways to encourage its members to stay healthy.  That’s why it sponsored a study to find out whether menu labeling helps people make healthier food choices.  Guess what: it does.

Now, if only for-profit hospitals would start doing the same….

[Posted from London]

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