Does targeting fast food joints actually help combat obesity?

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A law put into effect in July 2008 that banned fast food restaurants in a section of Los Angeles for one year may have been well intended, but missed the point, according to a study by the non-profit research organization, RAND Corporation, published online in the journal Health Affairs. Economist Roland Sturm and natural scientist Deborah Cohen team up to examine the arguments that initially set the law in motion and promptly pull them apart, beginning with the premise that South Los Angeles has a far denser concentration of fast food outlets than other parts of the city. Not so, the researchers say. “South Los Angeles has a lower density of fast-food restaurants per 100,000 residents than either West Los Angeles or Los Angeles County overall.”

Even when another measurement is used—density per roadway mile, which examines how many times in the course of travels a person would encounter different fast food restaurants—the figures were comparable between South L.A. and other parts of the city. What’s more, the researchers point out, the notion that fast food restaurants serve more calorie dense, less nutritionally valuable foods than non-chain, sit-down restaurants, is flawed. “One of the stated goals of the ban was the hope that sit-down restaurants would replace fast-food outlets, reflecting the misconception that sit-down restaurants provide “healthier” food,” Sturm and Cohen write, before listing a range of eye-popping calorie counts for dishes at slower food restaurants—1,680 calories for a sandwich at Romano’s Macaroni Grill, more than 2,000 calories in a single appetizer at Outback Steakhouse or Chili’s.

South Los Angeles, which has a large Hispanic and black population and median household income of $24,000, did have some major differences from other parts of the city—such as West Los Angeles which has a small minority population and median income of $64,000. One central difference was the number of “discretionary calories” that residents consume day to day. While physical activity and daily intake of fruits and vegetables was comparable between areas of the city, when it came to candy, cookies, salty snacks and soda, residents of South L.A. consumed far more than their peers in other areas of town. (Perhaps not surprisingly, then, average body mass index is higher in South L.A. as well.)

Yet blaming the fast food restaurants for all of those extra calories misses the point, the researchers argue. Instead, they suggest examining the food environment at large; candy bars and snacks are sold at places as varied as car washes, laundromats, bookstores and hardware stores, which may prompt people to consume unnecessary calories. “The ubiquitous availability of food can be over-whelming and artificially stimulate hunger and cravings for food, regardless of physiological needs,” they write. If any sort of policy approach in terms of business zoning were to be attempted, they point out, minimizing the concentration of of convenience stores and small corner grocery stores would be a possible solution. But this too is problematic, as it could more broadly limit access to groceries for residents.

Still, trying to take a policy approach is the right intention, they say, even if the year-long experiment in South L.A. was a bit off the mark. They do, however, offer a suggestion for future measures: menu labeling at restaurants, they argue, would give consumers the information they need to choose wisely, and avoid opting for over sized portions.

Beginning last January, chain restaurants in King County, Washington, (which includes Seattle), and a handful of other cities across the country were required to do just that—post calorie information for their food where patrons could clearly read it. So, when you walk into Starbucks mulling whether you’d like to have a Caramel Frappucino or a latte, you can take into account how many calories that decision means—specifically, 380 calories for 16 oz. of the caramel frappucino with whipped cream, and 190 calories for a latte of the same size. Armed with calorie information, consumers would be able to keep track of their consumption habits better, make healthier choices, and even slim their waistlines—at least, that was what legislators were hoping. Unfortunately, as the New York Times reports, a new study from researchers at New York University and Yale suggests that posting calorie information may not be convincing people to cut calories, and in fact, in some instances it could be having the opposite effect.

When analyzing the impact of legislation that required chain restaurants in New York City to post calorie contents, the researchers found that, though people reported making healthier choices when asked, when the researchers looked at actual receipts to see how customers were choosing, they noticed that calorie consumption had actually increased, compared with before the law went into effect.

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