In March 2010, the federal government placed a mandate on restaurant chains with 20 or more locations to provide nutritional information to consumers. The federal health reform law requires the restaurants and fast food chains to list calorie data and additional nutritional information for menu items and self-service foods. The obvious idea was that consumers would be able to make educated decisions on the food choices and in effect reduce their risk for western culture disease. A new Columbia University School of Nursing (CUSON) study in the Journal of Urban Health (2012) analyzed the calorie counts for 200 food items on menu boards in fast food chain restaurants in a New York inner-city neighborhood. New York was one of the first cities to initiate a nutrition awareness program in restaurants dating back to 2006. According to researchers, "Although most postings were legally compliant, they did not demonstrate utility." In many cases, the listed individual components require math skills to determine the totals. Many provide calorie ranges based on the flavor selected or if the product contained particular ingredients like cheese and/or bacon, and if a unique condiment was used. For appetizers or family meals the caloric totals were presented, but the servings were not, making it easy to disregard portions as lower calorie.
The researchers found that, while most restaurants studied have posted calorie counts, in the majority of cases there was insufficient information to make use of them at the point of purchase. One reason for this was that the majority of the items on the menu boards studied were combination meals rather than individual items. Furthermore, it was increasingly difficult to calculate calories per meal when the posting included anything more than an individual unit of measure. Researchers also found that calorie counts became more challenging as the food items became more complex, especially combination and multi-serving items, which represented the largest percentage of items recorded. A common practice of restaurants is to list the food item as a single value or range depending on the options but then list sides separately. When ranges are used the consumer tends to assume the low end of the range. A California Chicken Club listed on a menu ranged from 1040 calories to 1670 calories, a significant difference. Add a side of wedge potatoes and the total jumps another 490 calories; add a 20 ounce soda and you’re looking at more calories for lunch than is required for the day for most people. While eating out certainly increases the risk of overeating, the confusion on the menu does not assist in reducing that risk as was the intention of the original mandate. The current labeling places more effort on the consumer to complete several mathematical and nutritional calculations, thereby reducing the likelihood of a consumer using the data effectively.
The Food and Drug Administration (FDA) is now considering how best to guide chain restaurants in posting calorie counts on menu boards. Easily understood calorie listings could be helpful to consumers trying to make healthy food choices, especially in light of the increasing prevalence of obesity among American adults and children. According to researchers, “Studies suggest that consumers are generally unaware of, or inaccurately estimate, the number of calories in restaurant foods.” The author suggests using a more direct system. “In such a revised system, a breakfast sandwich, for example, would be listed as "egg with ham/bacon/sausage 350/550/750."