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       #Post#: 413--------------------------------------------------
       Potential benefits of food labelling in restaurants
       By: agate Date: July 31, 2014, 12:34 pm
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       You go into a restaurant and order what you like from the menu.
       It's like being invited out to a friend's place for
       dinner--since you know and trust your friend, you wouldn't ask
       about what's in the food you're served or about the calorie
       counts.
       So you have almost as much trust in the restaurant as you do in
       your friends. But is that trust warranted?
       People are waking up and realizing that a restaurant that looks
       clean and bright and welcoming isn't quite the same as the
       friend you know and trust.  You have no idea what has gone into
       the food you're served, and if you ask--up until recently
       anyway--you'd draw a blank.
       Now a strong case is being made for food labelling in
       restaurants. Below are excerpts from a "Viewpoint" article
       appearing in JAMA, July 31, 2014 [references omitted]:
       [quote]Potential Benefits of Calorie Labeling in Restaurants
       Jason P. Block, MD, MPH1; Christina A. Roberto, PhD2
       1Obesity Prevention Program, Department of Population Medicine,
       Harvard Medical School, Harvard Pilgrim Health Care Institute,
       Boston, Massachusetts
       2Department of Social and Behavioral Sciences, Department of
       Nutrition, Harvard School of Public Health, Boston,
       Massachusetts
       Provisions in the 2010 Affordable Care Act will require chain
       restaurants with 20 or more US locations to display calorie
       information on their menus, including drive-through menu boards.
       The US Food and Drug Administration released preliminary
       regulations in April 2011, and the long-delayed final
       regulations are expected soon, perhaps as early as summer 2014.
       ...
       This Viewpoint discusses the reasons public health advocates
       have pressed for menu labeling and the state of evidence
       regarding its likely effectiveness. Consumers often fail to
       recognize the high calorie content of most restaurant foods, and
       people are more likely to overeat at restaurants. Restaurant
       foods also account for a large and increasing proportion of
       calories consumed in the United States. For these reasons,
       advocates have maintained that consumers have the right to
       readily usable calorie information at the point of purchase and
       have called for complementary changes to nutrition facts labels
       on packaged foods.
       In March 2014, the Food and Drug Administration released revised
       nutrition facts labels that present calorie content more
       prominently, and the plan is for these labels to start appearing
       on products in 2017. The hope is that providing consumers with
       calorie information could increase awareness of food choices in
       the midst of an environment that often undermines healthy
       decisions through constant access to and promotion of unhealthy
       foods. Importantly, the majority of consumers would like to know
       what they are eating. A nationally representative survey
       (N = 1817) found that 81% of respondents supported
       menu labeling in chain restaurants.
       Several states and municipalities have already enacted calorie
       menu labeling laws, with New York City leading the way in 2008.
       Research shows that menu labeling can help encourage people to
       order and consume fewer calories. ...
       A study conducted among 7309 New York City fast-food diners
       before and 8489 diners after calorie labeling found no overall
       association between labeling and meal calorie content (828
       calories before, 846 after). However, when researchers examined
       specific chain restaurants, they found that diners at
       McDonald’s, KFC, and Au Bon Pain purchased fewer calories after
       the law, whereas those at Subway purchased more; no difference
       before vs after labeling was found for the remaining 7 chain
       restaurants. After the law, 15% of diners reported using the
       calorie information to help guide their decisions. In another
       evaluation of the New York City law, Elbel et al surveyed 1156
       low-income, fast-food restaurant customers in New York City and
       Newark, New Jersey (not subject to menu labeling) before and
       after calorie labeling and also found no significant differences
       in calories purchased. Consumers did report greater recognition
       and self-reported use of calorie information postlabeling.
       These inconsistent results might be explained by the diverse
       methods used and settings investigated across studies. Existing
       studies have examined different sources of calorie information,
       restaurants, regions, populations, and periods before and after
       labeling. Some used control groups whereas others did not, and
       the power and sample size of studies have varied substantially.
       Studies in laboratory settings also have shown divergent
       results. All of these study design factors likely influence the
       results of calorie labeling studies in different ways.
       A major gap in understanding the potential benefit of calorie
       labeling is the absence of long-term data. Exposure to calorie
       information in restaurants over time might increase consumer
       awareness of calories, discourage eating out, encourage eating
       less, change social norms around food ordering, or generally
       raise awareness about eating healthfully. In contrast, the
       effect of calorie labeling could wane over time with more
       exposure leading to less effect. Given the mixed research
       findings, it is likely that menu labeling influences some
       consumers some of the time at some restaurants. Because people
       eat out so often, this modest effect on food choices, on
       consumption, or both could still have a meaningful influence on
       public health. Only longer-term studies before and after the
       federal menu labeling law is implemented will provide an answer.
       Even if the law does not lead to changes in consumer behavior,
       disclosing calories could prompt the restaurant industry to make
       changes. There is already evidence of some positive response
       from the restaurant industry. McDonald’s recently announced
       plans to promote salads as alternatives to french fries in value
       meals and will no longer promote soda for children’s Happy
       Meals. Burger King introduced a lower-calorie french fry option,
       and Taco Bell plans to reduce the calorie content of some menu
       items. A study in Seattle, Washington, found that chain
       restaurants decreased the calorie content of offerings after
       their menu labeling law went into effect. These industry changes
       could arguably have a greater effect on public health than
       trying to shift consumer behavior directly with menu labeling.
       Although there are concerns about the federal menu labeling
       law’s possible effectiveness, these concerns miss a broader
       message of menu labeling. Menu labeling is an important first
       step. It was the first large-scale, national policy targeting an
       environmental contributor to overeating but, certainly, is not
       the sole answer to solving the obesity epidemic. Instead,
       multiple interventions across many societal domains will be
       needed. Although information provision policies are limited in
       their ability to influence behavior, the scope of menu labeling
       is similar to surgeon general warnings on cigarette packages and
       sets the stage for additional policies.
       Menu labeling should be viewed as an early approach in
       governmental policy to address the obesity epidemic. Researchers
       should be vigilant as implementation begins. ...
       _____________
       Conflict of Interest Disclosures:
       The authors have completed and submitted the ICMJE Form for
       Disclosure of Potential Conflicts of Interest and none were
       reported.
       Funding/Support:
       Dr Block is a recipient of a grant from the Robert Wood Johnson
       Foundation Health Eating Research program and of grant
       1K23HL111211-01A1 from the National Heart, Lung, and Blood
       Institute. Dr Roberto is supported by the Robert Wood Johnson
       Foundation Health and Society Scholars program.
       Role of the Funder/Sponsor:
       The funders had no role in the preparation, review, or approval
       of the manuscript; and decision to submit the manuscript for
       publication.[/quote]
       The entire article can probably be seen here
  HTML http://jama.jamanetwork.com/article.aspx?articleID=1893542&utm_source=Silverchair%20Information%20Systems&utm_medium=email&utm_campaign=JAMA%3AOnlineFirst07%2F31%2F2014.
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