June 2007

Food Fight: Calorie Labeling in New York Restaurants
By Sharon Palmer, RD
Today’s Dietitian
Vol. 9 No. 6 P. 36

Legislation requiring some restaurants to display the calorie content of their food is sparking much debate in the Big Apple.

New York City seems to be the battleground for a number of high-profile nutrition campaigns, whether it’s banning trans fats in restaurants or mandating that menus be labeled with nutrition information. While the trans fat ban in New York City restaurants has inspired other cities, the menu labeling issue is still simmering. There is much to consider when requiring restaurants to place nutrition information at the point of purchase in public dining venues. Don’t consumers bear the responsibility for choosing what to eat without spelling it out? Will menu labeling make a difference? Where will it end? Maybe someday you’ll reach for a margarita and find a nutrition label on it.

These are all questions sparking debate, but many health professionals believe posting easy-to-access nutrition information for consumers to make more educated—and hopefully wiser—food choices is good in today’s supersized society. “Labeling will benefit the public. In a city where the majority of people are eating at least one meal per day from a restaurant, I think it is wise to show consumers what they are actually eating,” says Lynn Goldstein, MS, RD, CDN, HHC, a New York City-based dietitian and counselor.

New York, New York
The restaurant menu labeling issue was pushed to the forefront due to the New York City Board of Health’s unanimous vote on December 5, 2006, to approve regulations requiring chain restaurants to place calorie information on menus. For the past five years, the New York State Restaurant Association (NYSRA) has successfully defeated state legislation to require menu labeling. But in December, the vote made New York City the first in the United States to require such action by restaurants. (Other city and state bills are pending.) The policy requires that any foodservice establishment that makes nutritional information publicly available on or after March 1, 2007—through brochures, signage, Web sites, or any other means—would be required to post caloric information on their menu boards and menus. The New York City Health Department estimated that this proposal would affect roughly one in 10 restaurants.

The city’s health department will allow alternative ways to post calories if approved in advance; change in posting to a calorie range (instead of median) for menu items that come in different flavors or varieties; a three-month grace period (July 1, 2007 to October 1, 2007) with no fines; and violations will not be considered in the pass/fail decision of routine sanitary inspections.

Fern Gale Estrow, MS, RD, CDN, a New York City-based dietitian and consultant, testified before the New York City Department of Health and Mental Hygiene on October 30, 2006, about the proposed amendment (prior to approval) for calorie labeling. Her testimony revealed background on the current health statistics associated with the New York City Head Start population, including a study conducted by the Health Department and the New York City Administration for Children’s Services in October 2004, that collected and measured height and weight data for more than 16,000 Head Start children in New York City. The study found that 27% of Head Start children were obese and an additional 15% were overweight.

Estrow reported at the hearing, “Having menus with calorie information easily accessible prior to purchase is critical for the public to make informed decisions. Putting this data on a wrapper or at the bottom of the fast-food carton is not sufficient.”

Everything seemed well with the menu labeling regulation until the chairman of the New York City Council’s Health Committee, Joel Rivera, introduced legislation that could water down the menu labeling rule. The legislation would require nutritional and calorie information to be made available in a pamphlet, on a poster, at a kiosk, or in some other written form. It would also have the Department of Health create a nutritional database that restaurants could tap into. “People going to Burger King are not the kind of people who care about the calorie count,” a senior adviser to Rivera, Michael Nieves, said in an interview regarding the menu labeling legislation, which was reported in the New York Sun on February 26. According to Estrow, there has not been any news (as of press time) regarding Rivera’s challenge to the menu labeling mandate.

Bucking Change
The restaurant industry has been successfully fighting nutrition information regulations for years. The NYSRA makes several arguments against the menu labeling mandate, pointing out that approximately 76% of all meals are eaten at home; despite labeling on grocery store products for the past 10 years, obesity rates continue to rise; approximately 870,000 restaurants nationwide offer customers a variety of venues, menu items, and portion sizes to meet their needs; since there are so many different combinations for foods (eg, a sandwich), it would make it impossible to list nutrition information for all of these combinations; and human factors can make nutrition information difficult to provide.

Even non-restaurant industry folk point out concerns. The regulations might punish the restaurants that already have nutrition information available in some form. The mandate applies to a select group of restaurants, primarily fast-food and chain restaurants. What about all of the other dining venues—from college foodservice and airport meals to mom-and-pop restaurants and star chef-owned eateries—that might be contributing to calorie excess? Will this requirement push restaurants to become so standardized that dining out will become as monotonous as eating a frozen entrée? What if consumers avoid a menu item or restaurant due to posted nutrition information in lieu of a restaurant that doesn’t post nutrition information? Is there any proof that providing nutrition information impacts consumer decisions and reduces caloric intake?

Goldstein says, “I think there is certainly controversy over just having fast-food and chain restaurants making this change. However, I think we need to start somewhere, and these types of food establishments are typically serving less-than-healthy food more so than a higher-end or privately owned restaurant would. Also, these restaurants are likely getting more business per day than other restaurants.”

Restaurants’ Responsibility for Obesity
Do restaurants have a responsibility when it comes to the public’s girth? Today’s savvy restaurant industry recognizes the need to offer consumers a variety of choices to be successful. Some customers are eating out for sheer pleasure, while a growing number are interested in healthier foods.

Because of the widespread concern over obesity and its associated morbidity and mortality, the Keystone Forum on Away-From-Home Foods: Opportunities for Preventing Weight Gain and Obesity was requested and funded by the FDA. The forum brought together a wide variety of participants from industry, government agencies, civic sector organizations, and academia to develop recommendations.

The forum report, made in May 2006, pointed out that Americans are consuming more calories today than three decades ago. According to the Health and Human Services’ National Health and Nutrition Examination Survey, men consumed 2,450 calories per day in 1971, while women consumed 1,542. In 2000, the numbers were 2,618 and 1,877, respectively.

At the same time, more of Americans’ total food budget is used for away-from-home foods. The total number of foodservice establishments in the United States has almost doubled in the last three decades—from 491,000 in 1972 to 878,000 in 2004. Portion sizes have also increased, both in restaurants and in the home, over the past two decades. Both partners in married households are working more, taking time away from meal preparation. And people may still consider dining out mostly an opportunity for indulgence, even though they are dining out more often than they used to.

Some research supports that away-from-home foods can be a factor in calorie intake and body weight. The forum report included analysis of existing databases, such as the Continuing Survey of Food Intakes by Individuals, the Nationwide Food Consumption Survey, and Coronary Artery Risk Development in Young Adults, and studies of subpopulations. The results indicated that eating out more frequently is associated with obesity, higher body fat, and higher body mass index. Women who eat out more often (more than five times per week) consume roughly 290 more calories per day than women who eat out less often. Eating more fast-food meals is associated with consuming more calories and saturated fat, fewer fruits and vegetables, and less milk. Overweight adolescents’ daily caloric intake increases when they eat fast food, but lean adolescents tend to have no overall increase in calories when they eat fast food. Further research is needed to better understand the relationship of eating out and obesity.

Shining the Light
“For the most part, the public is happy to have it,” says Estrow of menu labeling. “It can help them make decisions.” For many, nutrition information at restaurants is a right-to-know issue—after all, this is the era of information. In a recent survey conducted by Aramark, 83% of respondents said restaurants should make nutrition information available for all menu items. And according to the forum report, approximately one half of people report that the nutrition information on retail food labels has caused them to change their minds about buying a food product.

But when making decisions about eating out, consumers often do not have access to nutrition information to guide them. Sure, more restaurants have Web sites or brochures with nutrition information, but how many people check them out before ordering? Some chain restaurants are tricky about doling out nutrition information on Web sites, only listing it for their “healthy” menu items. Even if people read the stats on their favorite burger combo at home on the Internet, they can conveniently forget this information when they smell French fries and hamburger patties sizzling behind the cash register.

In reality, most people don’t have a clue how many calories are in the mega platters of quick, easy food they order at ever-increasing rates. “I don’t think consumers have any idea what they are really eating from many of these restaurants, and I think they are going to be shocked to finally see how many calories and how much fat is in many of the foods they are consuming,” says Goldstein.

According to the Center for Science in the Public Interest (CSPI), a typical dinner with an appetizer, an entrée, and a dessert can hit the 5,000 calorie mark. The CSPI points out that fewer than one half of large chain restaurants provide nutrition information to customers. Without clear, easy-to-use nutrition information, it is difficult for people to make informed choices, such as guessing that a medium chocolate shake at McDonald’s has more calories than a Big Mac. And this kind of information is especially important for the millions of Americans who need to manage medical conditions such as high cholesterol, high blood pressure, or diabetes.

The good news is that lower-calorie menu items are selling in food establishments. Case studies reveal that the keys to success for such products include substituting lower-calorie ingredients without compromising taste, employing cooking techniques that result in fewer calories without sacrificing flavor, shifting to contemporary packaging, using preportioned packaging, reflecting trends in consumer health interests, and relying on words and phrases that imply healthy attributes.

Several organizations have called for the restaurant industry to provide nutrition information. In a 2001 report on obesity from the U.S. Surgeon General, it was suggested that an increasing availability of nutrition information for foods eaten and prepared away from home should occur. In “Calories Count,” a 2004 report from the FDA’s Working Group on Obesity, a plea was made to the restaurant industry to create a nationwide, voluntary, and point-of-sale nutrition information campaign for consumers. A 2004 report on pediatric obesity by the Institute of Medicine suggested that restaurants provide general nutrition information to help consumers make informed decisions about food, meal selections, and portion sizes. The forum report developed several recommendations for food establishments, including that they provide nutrition information in a standard format that is easily accessible and easy to use for any menu item offered on a regular and ongoing basis.

Ellen Fried, an adjunct professor at New York University’s department of nutrition, food studies, and public health, calls menu labeling policy a “shine the light” issue, in which consumers are given more information about issues they know little about. “People, even nutrition professionals, have no clue what caloric levels are in foods,” said Fried at the International Association of Culinary Professionals 29th Annual International Conference in April. “There will be a segment of the population that will make healthier selections with point of purchase nutrition information.”

— Sharon Palmer, RD, is a contributing editor at Today’s Dietitian and a freelance food and nutrition writer in southern California.


Center for Science in the Public Interest (CSPI) — Menu Labeling Laws and Regulations

CSPI — Nutrition Labeling in Chain Restaurants

The Keystone Forum on Away-From-Home Foods: Opportunities for Preventing Weight Gain and Obesity, Final Report May 2006

New York City Department of Health and Mental Hygiene Board of Health

New York State Restaurant Association Legislative Update

“Restaurant Chains Promote ‘X-treme Eating,’ Study Finds.” Carib Journal. February 28, 2007

Restaurant Mega Calorie Hits

Here’s a look at the kind of damage consumers can do at popular restaurants today without even realizing it. Would they order up these dishes if they saw the calorie counts posted on the menu?

Chili’s Awesome Blossom:
2,710 calories and 203 grams of fat

Denny’s Country Sausage Bowl:
1,680 calories and 108 grams of fat

Dunkin’ Donuts Chocolate Chip Muffin:
630 calories and 26 grams of fat

Macaroni Grill Seared Sea Scallop Salad with Dressing:
1,320 calories and 91 grams of fat

Outback Steakhouse Kookaburra Wings with Sauce:
1,160 calories and 75 grams of fat

P.F. Chang’s Great Wall of Chocolate:
2,240 calories and 89 grams of fat

Pizza Hut Meat Lover’s Personal Pan Pizza:
890 calories and 49 grams of fat

Rubio’s Three Fish Especial Taco Combo:
1,420 calories and 78 grams of fat

Ruby Tuesday Colossal Burger:
1,940 calories and 141 grams of fat

Starbucks Venti White Chocolate Frappuccino With Whip:
760 calories and 21 grams of fat

— Sources: Restaurant Web sites and Calorieking.com