Would You Like Nutrition Info With That?

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You ever see those big posters at fast-food chains? You know, the ones filled with all that nutritional information?

Don’t worry. Hardly anyone else has, either.

New research out of Yale University published in the American Journal of Public Health shows that just 0.1 percent of customers visiting restaurants like McDonald’s and Burger King actually look at the nutritional content they display or offer in pamphlets. What the eating public doesn’t know may hurt them: Many prior studies have shown that people underestimate the caloric content of fast-food meals, which are higher in calories than food cooked at home.

Though fast-food joints alone can’t be blamed for America’s obesity epidemic, public health advocates argue they contribute heartily to the problem, with the average U.S. resident eating six meals or snacks outside the home each week. More prominent nutritional information might help them make healthier eating choices.

About half of America’s largest chain restaurants make some food content numbers available to visitors. Christina Roberto, who’s pursuing joint doctorates in clinical psychology and in epidemiology and public health, wanted to know if customers are paying attention. So she led a team that dispatched research assistants to McDonald’s, Burger King and the ostensibly healthful Au Bon Pain and Starbucks. During various times of day, they visited franchises on Manhattan’s Upper West Side, in New Haven, Conn., and in two Connecticut malls.

Researchers bought food and brought books, then sat down to observe whether customers accessed nutritional information via wall posters, pamphlets or an on-premises computer.

At McDonald’s, only one woman and one man out of 1,501 people looked at the numbers before buying food, with another pair doing so after their purchases. Out of the 4,311 patrons at eight different restaurants, just six looked at the nutritional information before paying.

“My hypothesis was that it’d be a small number,” Roberto said. “I just didn’t think it would be that small.”

To increase the chances that people will see health information, she and other health researchers suggest, municipalities should require menu labeling — including the caloric content and other nutrition data on menu boards, just as such statistics are printed on packaged food bought in grocery stores.

A handful of recent studies have indicated menu labeling’s promise. At Subway restaurants in New York City, customers who saw calorie information purchased 52 fewer calories than those who didn’t. One study by the County of Los Angeles Department of Public Health, based on relatively conservative assumptions, projected that instituting a requirement would avert 43 percent of the nearly 7 million-pound annual weight gain in the county.

New York is one of nearly 50 cities, counties and states (ranging from Arkansas to California) where legislators have introduced such laws. It’s also among the dozen municipalities where the regulations have passed. In Washington, Sen. Tom Harkin, D-Iowa, and Rep. Rosa DeLauro, D-Conn., have been pushing various versions of the similar Menu Education and Labeling (MEAL) Act since 2003.

Representatives of the restaurant industry have fought hard against the measures, even suing New York City twice (unsuccessfully) in an attempt to block its rule. The National Restaurant Association, which didn’t return calls for comment about Roberto’s study, has argued menu labeling increases costs and may deplete revenues, and that unsophisticated citizens may have trouble interpreting nutritional information. As an alternative, chain restaurants have favored voluntary actions, such as offering submenus with healthier options.

Last October, the industry launched the Coalition for Responsible Nutrition Information, an advocacy group that aims to replace the patchwork of state and local menu labeling laws with federal legislation. But instead of Harkin and Delauro’s stringent MEAL Act, restaurants prefer the Labeling Education and Nutrition (LEAN) Act, co-sponsored by two senators, Democrat Tom Carper of Delaware and Republican Lisa Murkowski of Alaska, and two congressmen, Democrat Jim Matheson of Utah and Republican Fred Upton of Michigan.

LEAN would require chains with 20 or more outlets to make nutritional data available for customers at restaurants — just not on the menus. If customers want information about items like sugar and sodium content, they must request them. In other words, the legislation requires exactly the sort of information offerings that Roberto’s research indicates has little effect.

“It’s not an effective way to disseminate information if no one’s using it,” Roberto said. “Consumers really have a right to know.”

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