We May Not Care About Calorie Counts, But The Food Industry Does

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Thanks to calorie counts on menus, we now know a Big Mac packs 550 calories, but that hasn’t deterred us from ordering the fast food burger. Those designed-to-make-you-feel-guilty numbers may, however, be changing the American eating landscape in more subtler ways.

Several studies, including a recent one released last week, confirmed that when it comes to eating healthy, numbers don’t count for much. Knowing that a serving of medium fries contains 380 calories, in other words, isn’t enough to convince us to downsize to a 230 calorie small, or to skip the spuds altogether.

In the latest analysis, published in the American Journal of Public Health, researchers recruited more than 1100 McDonald’s diners in New York City, where calorie counts are mandatory at fast food restaurants, who agreed to have the receipts from their purchases reviewed. Before placing their orders, a third of the participants were given information about the recommended amount of calories men and women should consume in an average meal; a third were provided with the recommended number of calories adults should consume in a day, and the last  group received no caloric information at all. Most of the men and women ended up eating more than the 650 calories recommended for women and 800 calories for men in a single meal, and each group contained about the same number of people who exceeded this amount, meaning the calorie information had little impact of their ordering decisions.

Those results confirm earlier studies that showed people still underestimate the amount of calories they are consuming despite the tallies on the menus, and that overall, diners are not eating less in cities that require labeling. Some early analyses of diners in New York City immediately after the city’s 2008 requirement for calorie counts went into effect showed that one-sixth of consumers were influenced by the new nutrition information to order lower-calorie items, but other studies have not replicated this finding.

(MORE: Starbucks Is Adding Calorie Counts, but Will It Curb Consumption?)

So are calorie counts a bust for healthy eating? Not necessarily. For one, it may be that the calories themselves have no context, and the numbers mean little to consumers, who have not point of reference for whether 550 calories for a burger is excessive or acceptable. Two obesity experts from Johns Hopkins recently wrote in the New England Journal of Medicine that without any context for calories, they may fall short of changing people’s eating habits. That’s why some nutrition experts are experimenting with other information, such as how much physical activity it would take to work off a burger’s 550 calories, instead. In those studies, the exercise equivalents seemed to go a long way toward changing people’s minds about what to eat.

And the requirement to post calories may be working on another level as well. Even if consumers aren’t paying much attention to the stark reminders of how much they are eating, the food industry is keenly aware of how many calories they are offering. And they are responding by slimming down their menus with lighter options — albeit slowly.

Compared to the menus that restaurants offered diners in 2005, those in 2011 were considerably lighter, according to a study released earlier this year that analyzed the nutrition quality of food options before and after the mandated calorie counts. Granted, the overall the number of “healthier” food options remained low, but there was a notable increase in the offerings after 2008 among locations that had to follow new menu-labeling laws. Healthier food options increased among these fast food stops from 13% to 20%, and the authors concluded that menu labeling may eventually motivate restaurants to increase healthier options to avoid public health backlash.

“There have been some exceptions but to date, most in the industry don’t appear to have altered their menu all that much.  But it is too early to say how this will play out when labels become more widespread,” says that study’s author Amy Auchincloss, an assistant professor at Drexel University School of Public Health in Philadelphia. “The companies we studied did not appear to be proactive about improving children’s meals. However, there is growing interest among legislators, media, and the public in improving the quality of children’s meals. Due to this pressure, some companies have made changes and others are likely to make changes in the future.”

(MORE: How Much Exercise Will It Take to Work Off a Burger? Menus May Soon Tell You)

That pressure will only increase next year, as restaurant chains with over 20 locations in the U.S. fall in line with the U.S Patient Protection and Affordable Care Act, which requires them to post calorie counts on their menus by 2014. Starbucks is one of the most recent chains to pre-emptively post calorie counts at its outlets nationwide by adding the labels to its beverages and pastries at its over 11,000 locations in the U.S. in June.

Adapting to the new regulations by adding lighter fare isn’t just in consumers’ best interests, but could benefit the food industry’s bottom line as well. A February study from the Hudson Institute, a nonpartisan policy research organization, looked at the link between menu offerings and revenues of several prominent fast food chains including McDonald’s, Wendy’s, Burger King, and Taco Bell, as well as casual dining spots such as Applebee’s, Olive Garden, Chili’s, and Outback Steakhouse. The researchers found that over a period of five years, chains that increased their servings of lower-calorie food experienced 10.9% growth in customer traffic compared to a 14.7% decline among chains that did not offer healthier foods.

The research also showed that overall, the fast food chains served 472 billion lower-calorie foods and beverages over the five years, and 13 billion fewer servings of items like French fries. That’s an encouraging trend, even if smaller studies showed that people may not be changing their eating habits to consume fewer calories. These findings suggest that in the long run, diners may decide to switch to lower-calorie options once in a while, if not at every visit. But that could eventually translate into healthier eating over time. As TIME  wrote:

To get a better idea of how real the shift toward lower-calorie items is, the researchers took a closer look at the largest chains that have more than $3 billion in sales, in which French fries make up 20% of their total food servings. Among this group, the percentage of French fry servings fell by one percentage point. “You may look at that and think, what’s the big deal? It’s just one percentage point, but when you realize that these five chains sell over 5 billion servings of French fries per year, to come down 1%, that’s a loss of 50 million servings,” says Hank Cardello, lead author of the report.

(MORE: Slim-Down The Big Mac! It May Mean Better Business)

Health experts note that eating often involves tradeoffs, and it’s important to consider how fast food restaurants are improving their food choices. Offering lighter, lower-calorie options is one thing, but if the calories that are removed come from healthy ingredients such as unsaturated fats or omega-3 fatty acids, then the trimming doesn’t end up providing a nutritious balance. Dr. Dariush Mozaffarian, an associate professor of medicine and epidemiology at Harvard Medical School and Brigham and Women’s Hospital, says restaurants could reduce calories by cutting back on healthy fats, leaving behind only refined carbohydrates and other unhealthy ingredients, similar to how baked or low-fat potato chips were created. “To lower the calorie count, the only healthy ingredient, vegetable oil, is lowered, leaving behind the same starch and salt,” he says.

MORE: NYC’s Trans Fat Ban Worked: Fast-Food Diners Are Eating Healthier

“A 12 ounce can of Coke has fewer calories than one ounce of walnuts, yet the former is clearly not the healthier choice or a better choice for preventing weight gain,” says Mozaffarian. “So, the real concern with calorie count labels is the concept itself, and whether calories alone can give one useful information about the best choices for health or obesity. If industry lowers serving sizes of less healthful foods, or consumers select smaller serving sizes of less healthful foods, that could be a win.” Calorie counts may not convince us to eat less — yet — but if they are pushing restaurants to provide healthier options, that could count as a win as well.