The proliferation of calorie disclosures

In one of my recent posts, I mentioned that calorie declarations for restaurant items were beginning to show up on TV and in web based ads. It appears that the industry is gearing up for the calorie disclosure mandate that goes into effect this December (see the Final Rules for ACA sect 4205[1]).  I have noticed that up-front calorie disclosures are becoming more prevalent in grocery stores as well.

The grocery store calorie proliferation is likely due to several factors, including the Affordable Care Act’s wide reaching mandate. Food manufacturers began adding front of pack labels some years ago (with declarations THEY are comfortable with, i.e., not every manufacturer includes calories or sugar amounts on the front of every one of their products), but one voluntary version Facts Up Front does provide info on calories and select nutrients, and it has potential.  If you click on the link above, you can scroll through some of the examples. As an example, I have noticed that most sliced bread brands have Facts Up Front labels now - with the calories displayed - but BE CAREFUL sometimes its calories per 2 slices and sometimes per 1 slice. The Institute of Medicine has recommended a standardized, mandatory front of pack label with an interpretive design, for example, 3 stars vs 1 star (I wrote about this recommendation a few years ago).  I believe that the more customers see calorie disclosures, the more they will demand them - up-front.  (The new calorie disclosure law is about ready-to-eat foods at grocery stores, restaurants and similar establishments, not packaged foods. But again, people are now expecting to see calories more easily because of laws like this.)

One of the issues in labeling, especially for packaged or self-serving foods (e.g., ice cream), is a push to present easily, or commonly, understood serving sizes.  The serving sizes (usually) accompany the calorie counts on front labels, e.g., half a cup, 2 tablespoons. I think it would be a disservice to customers, however, not to also include the weight in grams or number of ounces of that particular ½-cup or tablespoon; a ½- cup of one item may not be commensurate with ½ a cup of another item.  Recently, I was choosing between cookie brands. For each brand, the calorie amount per 3-cookie serving was 130, but the serving for one brand had 20 grams and the other had 30 grams, so in essence, I would get to eat MORE food for the same calories if I chose the heavier product. I owe my ‘per unit’ calorie comparisons to lessons I have gleaned from using UPC shelf labels, price per ounce, as I’ve mentioned in the past. 

I think that emphasizing serving size can also be context specific.  One place it makes sense for the majority of people to see calories per serving ‘size’ instead of serving ‘weight’ is the vending machine.  I say this because, the usual serving size of a snack purchased from a vending machine, or the amount customarily consumed, is the whole package. The package is the serving size.  Most people intend to eat all the M&MS, Fritos, or Lays, so by scanning across all products and knowing how many cals per pack, a person can, if they choose, pick the lowest calorie package and be done with it.  (In time, I suspect, savvy customers will figure out that even here, they can get more or less calories per package based on weight/volume.)

So that is very cool.  Calories are showing up more (this is good for people who are trying to limit calories or who simply want to choose items with fewer calories - can’t do it if you don’t know the numbers!).  The national law (again see ACA section 4205) covers more than foods – restaurant chains under the laws jurisdiction will also have to display calories for their alcoholic beverages!  Not the gin and tonic you order at the bar, but the Bahama Mama or Margarita from places like Red Lobster and Chili’s.  This is one place that the restaurant industry in general, is not giving us a prelude with its on line menus.  I went to the websites of more than 10 restaurant chains while writing this blog, and only one, Red Lobster, had its alcoholic beverage calories posted. Some of these drinks have more calories than my meals; I expect many drinks will be reformulated when the law goes into effect.  If you want to get an idea, check out Red Lobster’s menu – see page 2. Else, stick with lighter beers and wine or traditional drinks, gin and tonic should have about 100 calories as does my favorite Dee Dee Sour (Seagram’s seven and Fresca).  BTW, the Red Lobster  Caramel appletini has 160 cals and the chocolate martini has 330 – how could anyone know this without a calorie disclosure on the menu, when you are ordering?  Unless of course, it’s that ONE day a year when none of this matters (smile face!)

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[1] https://www.federalregister.gov/regulations/0910-AG57/food-labeling-nutrition-labeling-of-standard-menu-items-in-restaurants-and-similar-retail-food-estab

https://www.federalregister.gov/articles/2014/12/01/2014-27834/food-labeling-calorie-labeling-of-articles-of-food-in-vending-machines

Future Self-Control

    I am 100% in favor of mandatory nutrition information at the point of purchase for ready to eat foods at all places where they can be purchased (e.g., restaurant, vending machine, movie theater, bowling alley).  I believe that an interpretive system, like the multiple traffic light (red for high in a nutrient, amber for moderate and green for low), is crucial, but I understand that nutrition labeling as a means to change behavior will always be less effective than other strategies, like zoning laws and taxes.
    The provision of nutrition information, even with a color code or star rating system, leaves individuals free to make an informed choice.  Unfortunately, choosing food isn't the same as choosing a dishwasher (which also comes with content info and a rating system).  
   There are many things that influence a food choice.  One of my favorite theories or frames which addresses these nuances is behavioral economics.  
READ THIS GREAT ARTICLE, by Liu, Wisdom, Roberto, and Liu (2013).  
  The reason I think the traffic light labels are crucial is two fold.  First, most people do not have awareness of dietary guidelines or the nutrition knowledge that allows them to determine if a food is high or low in items that are best limited (e.g., saturated fat, sugar, salt, calories).  Second, many people are present biased in their (food) decision making. In other words, the desire for the taste or the happy memory associated with a certain food, is first and foremost in a present biased persons mind.  The needs of  'here and now' trump any consequences (weight gain, ill health) that might occur sometime in the future.
   There is another factor (noted in the article I linked earlier) that I wanted to share.  I think you will go "oh my gosh, that is so true!" just like I did.  This is the belief or confidence we have in the self-control of our future selves.  For example, on a certain day of the week, you know that you should skip dessert.  You are full and can't afford the extra calories.  But it is someone's birthday so you just have to have some, and you'll do better next time or the next day.  Then someone brings cookies to the office and you really shouldn't have any, but everyone else is having them, and they really taste good, so you eat the cookies and promise yourself that tomorrow you will have dinner with out bread.  Oh, but tomorrow comes and the waitress served bread so you have to eat it, right? etc.....

Information for Food Decisions

   The Dietary Guidelines for Americans recommend that calories be monitored on a daily basis.  The recommendation is based on the importance of consuming the appropriate amount of calories to prevent 'over fatness' - which appears to increase the risk for several diseases.
   To be fair, clear and honest, many of us do not know our calorie needs - the amount that balances with our energy expenditure.  This lack of knowledge needs to be addressed, but is not the focus of this post (calorie needs are assessed on an individual basis).  For now, lets pretend that everyone does know their personal needs- and agree that for most of us its between 1800 and 2500 calories a day (NOTE: if you need 1800 calories a day and consistently eat 2500 calories a day, you will have excess fat!)
   Presuming you need 1800 calories a day and you know this, and you obtain many of your meals away from home, to stay on target you need access to nutrition information at the point of purchase at those places . 
    I feel it is imperative that nutrition information be available everywhere  food decisions are made, but it is not.  The national menu labeling law (passed within the Affordable Care Act) amends an older law, the Nutrition Labeling and Education Act which excluded ready to eat foods, like those at restaurants- from nutrition labeling.  This oversight was a mistake and it took a new law to fix it.  The fact that the new law does not include all places that sell ready to eat foods, e.g., entertainment venues, is dumbfounding.  The FDA can fix this - they are responsible for the final rules.  It needs to be fixed now, not 20 years from now.  This is a real fight and certain industries and labeling advocates are battling it out - leading in some part to the delay of national labeling.
   The Center for Science in the Public Interest is lobbying for the expansion of nutrition labeling and today they shared the picture below from a New York City cinema.  NYC has a much broader labeling law, however, the federal law will override state and city laws.  That means even the NYC policy will not include movie theaters, (or theme parks, bowling alleys, etc.) if the federal law doesn't include them.  Take a look at the numbers below and see how important this information is to the person trying to stay in their limits.  BTW, we should all try to stay in our limits, at least most days.   
 

To take part in the campaign to expand labeling - click HERE

Just a note, the Nutrition Labeling and Education Act is the one that mandated nutrition information and nutrition facts panels on the foods you find on grocery store shelves.

Does Information Make It Easy?

   This past Monday, the Huffington Post ran an article on menu labeling that was written by two former USDA secretaries.  They were writing in support of the mandate found in the Affordable Care Act that requires restaurant chains and similar establishments to post the calorie contents of their items on menus and menu board.  
   The secretaries, Dan Glickman and Ann Veneman were specifically speaking to the debate over similar establishments, and as I have suggested here, they urged the FDA to include movie theaters in the mandate.  They also called for supermarket inclusion and alluded to sports arenas, but did not mention bowling alleys.  They appeared to be in support of having all of the venues included because they spoke of consumers being able to compare items no matter where they were choosing them.  They said that the regulations should be "inclusive."  They also said, and here is where I disagree, that having information available at all locations will make the healthy choice the easy choice.
    Though it is necessary to have information to make an informed choice and information is necessary to make one that meets your values, having it does not make the healthy choice easy.  Why not? Because information is only one factor that goes into food decisions and if survey research is correct, it is not the number one or even number two factor in this choice.  Along side those lower calorie items (on that menu) are the cheaper ones and the more palatable ones(high sat fat and sugar).  In order for the healthy choice to truly be easy, we have to do something about the unhealthy choice.  We have to find a way to make it LESS desirable.  (raise the price or limit the advertising for instance)

More on labels and calorie disclosures

   Packaged food labeling is one of my research interests and my research interests are informed by my personal dietary goals. 
I believe that in order for the population (and me) to apply the nutrition recommendations offered by our government, we need to assess the foods available to us.  In order to assess them and choose the best, we need information.  We don't need a lot of information, but we need some.  We need enough to make an informed, but quick decision among many options.  
   I prefer the multiple traffic light system for any item, but at this time that isn't likely to occur.  The multiple traffic light (MTL) grades a food on imprortant attributes, e.g., saturated fat, salt and sugar.  A food gets either a red, yellow or green light in each category.  To eat well, you choose more foods that are green from all categories.
   The Institute of Medicine (IOM) has given the FDA a proposal that will make assessing the nutrient value of packaged food easier than our current Nutrition Facts Panel. I have discussed this at length in the past, so this is a bottom line refresher.  Instead of a MTL, the IOM suggests that each food item - if it first meets an overall eligibility criteria - be given one, two or three stars for each nutrient (saturated fat, sugar and sodium/salt). An example of something that wouldn't meet the eligibility criteria is candy.  Otherwise, a food item could have 1 to 3 stars.  ALL products, per the recommendation MUST list the calories per usual(practical) serving.  Whether or not something meets the eligibility criteria for stars, the calories per serving must be placed in eye catching text on the front of the package.
   It was that part of the recommendation I was thinking of as I shopped for groceries over the weekend.  You see, one of the main reasons for the IOM report is to address the confusion caused by food makers and grocers using their own front of package labels.  It is amazing how many do not include calories, and instead tell us things we can't intrepret or do not need to know.  For example, a grocery store shelf tag in Florida said, "20 carbs per serving".  SO WHAT??  That is not enough information to help me.   Another example, "contains 10 grams of fat".  SO WHAT?  Is it the kind of fat that is good for my heart?  If so, I want to buy it.  But no matter what it is, if it is energy dense (high in calories) I will probably avoid it (unless it is loaded with good fat, like salmon). We need our standardized, scientifically governed front of pack labels and we need them NOW.

  My other nutrition information interest is meals away from home  -  you need to see this new report from CSPI for some jaw dropping belly popping calorie counts.

 (If you are curious, my overall field of study is best explained this way - Public Health Law Research specific to Food Policy, specific to Policy that makes unhealthy (nutrient poor) foods less attractive > such as, information, price increases, zoning laws on fast food places, taxes, display bans/restriction, advertising limits.)

When the average is a bad thing.

A friend shared a smart phone app with me yesterday.  It is called Fooducate.  You can visit the webpage by clicking here.  If you have a smart phone (iphone or android) you can download the free application.  The link was shared with me because I am studying the use of nutrition information in college students and my colleague thought that menu labeling wasn't going to cut it with this age group. (I plan to find out)
I went ahead and downloaded the app to test it out. You can hold your phone's camera lens near the barcode of the food item and it will read it.  Then you are taken to a webpage that gives you information about that product - including calories, saturated fat and even if it has GMOs.
To set up the application on your phone, you enter 6 pieces of information.  One of them is your weight.  When I got to that screen, there was this message "the average woman weighs 160 pounds and the average man weighs 190 pounds."  I am pretty sure it said the average American....  Let me make something very clear - the average weight is overweight or obese - greater than 60% of the US Population falls into this category.  In fact, the NHIS released data reports today that show the obesity rate is at about 30% currently.  Many women who weigh 160 pounds are not at a healthy weight.  Do NOT be comforted or fooled into thinking that  a 'normal' or 'average' weight is good. (I am not speaking to anyone individually here - a healthy weight is determined by your blood work (glucose, cholesterol etc) and blood pressure, physical stamina, physical and mental comfort, etc)
I read the statement re: 160 pounds yesterday and today the NHIS brief was in my mailbox.  I thought that was a neat coincidence. Here is the latest data - in graph form.  This comes from the CDC. 

NOTE: this is one of our Health Indicators... The goal is that white line... we want to be UNDER it.

 
Remember that excess weight is associated with metabolic dysfuntion.  This puts a person at risk for diabetes and heart disease.  The state of obesity in this country affects children and adults.  It is not okay for our normal to be unhealthy.  Adults are living longer sicker and our youth are expected to have shorter life expectancies than their parents.  Its a serious problem.