One of the lesser-known provisions of the newly passed health reform legislation will require restaurant chains to post calorie counts on menus and drive-through signs. Will people consume fewer calories as a result? Here’s what Brian Elbel and coauthors reported in Health Affairs last year about the effect of a calorie-count display law already in effect in New York City, based on a survey of 1,156 adults at fast-food restaurants in low-income, minority communities:

In our study of consumers from low-income, minority communities, calorie labeling increased the percentage of consumers who reported seeing calorie labels, and thereby the number of people who reported that the information influenced their food choices. This meaningful change as a result of labeling could “set the stage” for a larger influence of calorie labeling as time and public policy progress.

However, we did not find evidence in our sample that menu labeling influenced the total number of calories purchased at the population level. About half of the NYC respondents in our postlabeling sample reported noticing calorie information, and only a quarter of these reported that the information influenced their food choices. Even those who indicated that the calorie information influenced their food choices did not actually purchase fewer calories according to our data collection. We note again that our study sample consisted primarily of racial and ethnic minorities residing in relatively low-income areas; other groups may respond differently to labeling.

In an ideal world, calorie labeling on menus and menu boards would have an immediate and direct impact on everyone’s food choices. However, as has been seen in previous attempts to change the behavior of vulnerable populations (for example, smoking cigarettes), greater attention to the root causes of behavior or multifaceted interventions, or both, will be necessary if obesity is to be greatly reduced in the overall U.S. population. Future policy development must consider this broader perspective.

The March issue of Health Affairs discusses the causes of the epidemic of child obesity in the United States. The thematic issue, which was supported by the Robert Wood Johnson Foundation, also discusses potential strategies for fighting the epidemic.  One article in the volume, by Jonathan Klein and William Dietz, draws lessons for fighting obesity from the successful public health movement for tobacco control. Klein and other authors from the issue discussed their work at a Washington, D.C. briefing.

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