Calories on menus: do they work?

Calorie counts on menus and fast food: are they a weapon against obesity, or just more nannying from the Government? Comment from Britain:

I can afford the souvlaki — but can I afford the calories? Your lunch choice is about to become anxiety-inducing. Last summer, The Real Greek became the first restaurant chain in the country to include calorie counts of all dishes on its menus. Since then, Pret A Manger, Wimpy and the Camden Food Company have followed its lead. Pizza Hut, Harvester and several pub chains are considering making local trials national. Within two years, calories on menus could be the rule.

They are all trailblazers for an initiative from the Food Standards Agency (FSA), which believes that providing calories on menus will help us to make healthy eating choices. A national consultation ends this week and, if there is enough support from health bodies, consumers and restaurants, the FSA will push for a voluntary roll-out in all restaurants from this summer.

Yet some have raised voices of concern. Actually, say some experts, putting calories on menus makes no sense if you want to create a healthy attitude to food. “Giving people information like this doesn’t change their behaviour,” says Professor Andrew Hill, an eating psychologist. And those helping people with eating disorders worry that it may promote food anxiety. “There is a real feel of nannying about this,” says Emma Healey, of the Eating Disorders Association, now named Beat. “Calorie-counting is joyless.”

Britain is looking to follow the lead of New York City, where in 2008 new laws compelled fast-food, sandwich and restaurant chains to put calorie information on their menus. Since then, similar laws have been introduced in other US cities. The British move came after FSA research suggested that consumers would like to see such information.

“Whether people are grabbing a snack, eating in a staff restaurant or out for a meal with their family, calorie labelling will enable them to see what choices are healthier,” says Tim Smith, the FSA chief executive. According to research, he claims, people shown a calorie count pick products that have, on average, 100 calories fewer than their normal purchase. His enthusiasm for the scheme has been reflected in the response of some of the 21 companies (450 food outlets in all) that piloted the scheme from June last year by displaying calorie information on menus, boards and shelf-edges. Liz Williams, managing director of The Real Greek, says that it has been “positively received” by customers, notably women on calorie-controlled diets. Clive Schlee, of Pret A Manger, says that his company rolled out the pilots nationwide “because we liked the idea so much”.

But research to back the idea has been less conclusive. The FSA has evaluated its pilots but measured only how easy it was for restaurants to implement calorie-count menus, not whether this led customers to choose healthier products.

A New York Department of Health study in 2008-09 found that customers bought food with fewer calories in nine of the 13 food chains that displayed calorie information, while a Stanford University study on calorie-posting in Starbucks reported a 6 per cent fall in average calories per transaction.

Most of the research is double-edged, though. The Starbucks study concluded that a calorie reduction of 6 per cent would have only modest effects on bodyweight, and that people may compensate by eating more at other meals. Indeed, that is what another study, published in the American Journal of Public Health, found: diners given calorie information ate about 14 per cent fewer calories at dinner but made up for it later — and ended up eating just as many calories as uninformed diners.

In another study, 30 per cent of users of fast-food restaurants in New York said that having calories on menus had influenced their meal choice. But when researchers examined their receipts, they found that they were still eating the same number of calories as before.

Neither The Real Greek nor Pret A Manger is adopting the scheme because it believes that it will make people eat more healthily. “I think calorie counts will become the norm,” says Liz Williams of The Real Greek, “but we haven’t really seen any change in what people order.”

So why is the FSA pushing ahead so hard? Catherine Collins, chief dietitian at St George’s Hospital, London, says that giving everyone the same messages about which foods are “healthy” does not take into account the importance of variety in diet, or portion size, or how each food needs to be put in the context of others. “Calories aren’t everything,” she says, adding that the FSA should promote the idea of eating the right balance of starchy foods, fruit and veg, dairy, protein, fat and sugar, and not “demonise” calorific foods. “We are losing that feeling of comfort in food, so we are either eating junk meals or making a fetish of measuring calories.”

A 2008 Ofsted survey indicated that a third of ten-year-old girls were worried about their body shape. According to Emma Healey of Beat, eating disorders are caused by genetics, personality type and “a soup of other influences, such as magazine images”. Calories on menus may add to that confusing soup, she says. “We know that for people recovering from eating disorders, seeing information on the calorie content can throw them back into a world where they obsessively counted calories.”

The FSA will announce its final recommendations in the summer. So far, dieters, trendy chains and policy people love the idea; foodies and small restaurateurs (who see it as hard to implement) hate it; junk food chains will go along with it; and those most at risk of obesity don’t really care.

As a recovered anorexic, I have long since left behind those dark days when I recorded every calorific unit that entered my body. Part of getting better was learning how to eat healthily again.

My counsellor had far better advice than to keep eating until I reached the recommended 2,000 calories a day, then stop. She simply reminded me that for every meal my plate should be balanced, with something such as a third carbohydrate, a third fruit or vegetables, then the next third should have a good chunk of protein with a bit of fat thrown in there, too. This may not be a particularly scientific way of doing it, but it does ensure nutritional balance — unlike counting calories.

Splashing the calorie content of food all over menus will only encourage an unhealthy attitude to food. Eating fewer calories is not necessarily better for everyone. What’s in those calories is just as important. Broadly speaking, people know what food is good for them and what is not. Every day most of us choose to eat food that we know is not particularly good for us. Nobody going into a burger joint is looking for a healthy meal. Isn’t it somewhat pointless, then, to display the calorie counts in such places?

And let’s not forget the “live and let die” argument. I’m not advocating that we encourage obesity and an early grave. If people want dietary advice, it should be available — there is certainly plenty of it out there. The same goes for those who want to give up smoking. But if individuals weigh up the pros and cons and decide that they would rather not restrain their eating, taking the risk of shortening their life, then that should be their choice.

The tentacles of the state increasingly threaten individual choice. Alongside a myriad health and safety measures of the no-conkers-in-the-playground type, recent suggestions range from screening the contents of children’s packed lunches to the banning of butter. For goodness sake, let each of us decide how to feed ourselves!

If your jeans are feeling a bit tight and you want to lose a few pounds, by all means hold off on chocolate, take the stairs at work or get off the bus one stop earlier. Enjoy the freedom to decide for yourself how to approach the battle of the bulge . . . if you want to. In the meantime, let’s reserve the right to dine out free from calorific judgment.

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The newest chapter in the bizarre world of statin drug dangers

They REALLY don’t want you to think too much about this one. Both Reuters Health and HealthDay News ran nearly identical lead paragraphs in their reporting about a new study of cholesterol-lowering statin drugs. The finding: Statin use increases risk of developing type 2 diabetes.

And along with that message, of course, they had to report that this risk is really a very small thing, hardly worth mentioning in light of the magnificence of the life-saving properties of the wonder drug…the Great Statin. It’s as if they’re delivering bad news to a grouchy king who LOVES statins and is likely to have a lowly reporter beheaded if he even suggests that the adored heart drug is less than perfect.

Here’s the Reuters headline: “Cholesterol Drugs Raise Diabetes Risk, Just a Bit.” Do they have any idea how hilarious that is? You can imagine a Reuters reporter holding his thumb and forefinger really close together, up near his eyeball, and squinting when he says in a high squeaky voice, “Just a bit.” Just a teeny weenie bit, Your Highness.

HealthDay went one better, adding this quote from a news release about the study: “In view of the overwhelming benefit of statins for reduction of cardiovascular events…” Yes, the benefits are OVERWHELMING! Why, a reporter might swoon under a spell of the vapors just thinking about the wonderfully overwhelming benefits of statins.

So? Ready to be overwhelmed? Collateral damage, damage, and more damage

University of Glasgow researchers examined the results of 13 large statin trials that included more than 91,000 subjects. Results showed that for every 255 patients treated with statins for four years, one would develop type 2 diabetes. Well that doesn’t sound so bad. Just one little old diabetic for every 255 statin users? Since the benefits are grossly exaggerated (I’m sorry…I meant to say “overwhelming”) what difference do a few extra diabetics make?

A huge difference. About 20 million people take statins in the U.S. So, one case of type 2 diabetes for every 255 patients comes to well over 78,000 people who will develop or already have developed diabetes as a statin side effect. (You can forget about the “four years” business because statin users are users-for-life.)

But if you’re convinced statins are life-saving wonder drugs, then I guess thousands upon thousands of cases of diabetes are acceptable. Not to mention the untold cases of muscle damage, kidney damage, liver damage, and cognition damage.

One of the Glasgow researchers told Reuters Health that the results of their study should put a stop to statin overuse, and the drug will be given “when appropriate for the right reasons.”

Aw, that’s adorable! He must have missed the news that the FDA recently OK’d the use of the statin Crestor for people who don’t have high cholesterol. And that approval came in spite of a Crestor study that showed a link to — yep — increased risk of type 2 diabetes. The world of statins is a world gone mad (and not just a bit!).

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