Will calorie listings curb our fast-food habits?

(PhysOrg.com) -- Would you turn your back on deep-fried cheese curds if you knew that a single serving packs in 569 calories?

People in the Dairy State will join others across the country in facing that question if Wisconsin passes a proposed law that would require chain restaurants to post nutrition information.

New York City was a leader, with a menu law that went into effect in July 2008; California and Massachusetts have passed similar bills, and there is a federal version in the current health care bill.

Expect to see more such "labeling laws," says Tom Oliver, associate director for health policy at the University of Wisconsin Population Health Institute, as states ease their way into stronger regulation of industry and consumer behavior associated with major health problems such as obesity.

"Providing accurate information to help people choose healthier diets is a small but constructive step that government leaders are likely to try out before more controversial strategies such as taxes or bans on particular foods and beverages," he says.

Such policies are driven by ballooning obesity rates - 26.6 percent of Americans were obese in 2008, up from 15.9 percent in 1995. They're also a response to the fact that the percentage of meals eaten in restaurants has nearly doubled to 32 percent since 1978.

"Doing a better job at preventing health problems such as obesity and cardiovascular disease is good fiscal policy as well as health policy," says Oliver, a professor of population health sciences and an expert on health system reform. "We need to keep people healthier to slow the growth of health care costs to individuals, employers, and government programs."

After reviewing state and local menu-labeling laws for a UW Population Health Institute publication, Tiffini Diage says that they are a matter of consumer rights.

"Consumers should have equal rights to know about their food," says Diage, a graduate student in public health at the UW. "Why is it that when I go to the grocery store, I have a right to know the calorie and nutritional content of the packaged food I buy, but when I go to a restaurant, I don't?"

She says the issue is especially important for people in poor neighborhoods, "nutrition deserts" where fast food may be the only choice.

So far, research on New York City's law shows mixed results. A recent Stanford University study analyzed sales data from every New York Starbucks store, and found that the calories ordered dropped six percent between January 2008 and February 2009. (Among customers who ordered more than 250 calories per purchase, calorie consumption fell by 26 percent.)

But another study, done at fast-food restaurants in poor New York City neighborhoods, found that calories per order actually increased slightly after the menu-labeling law took effect. Those results are troubling because the poor are already at greatest risk for obesity and diabetes.

"It may reflect that when people are struggling to feed their families, the priority for cheap food competes with the priority for good food," Diage says.

Menu labeling could create even bigger health disparities in the same way that anti-smoking campaigns have succeeded in convincing wealthier and better-educated people to quit, but have largely failed to help the poor and poorly educated. Still, information can empower anyone who is trying to change his or her life for the better.

Dr. Aaron Carrel, a UW Health specialist in childhood obesity and diabetes, thinks that for those motivated to eat better, calorie listing will help.

"I commonly see families who greatly underestimate the calories of foods they eat in restaurants," he says. "And because more meals are consumed away from home, this could be important to many more people than it would have been 10 years ago."

While choosing lower-calorie fast food is just one step towards improving health, Carrel says, "I'm a believer in the idea that small changes can add up to a big difference."

Even if menu listings don't create immediate change, they create awareness that some food choices are healthier. At Subway restaurants, which have voluntarily listed calories, customers on average order 54 fewer calories per meal than patrons of restaurants without menu labeling.

"In the long run, I think it will not only change purchasing habits, it will also change the food foods offered on the menu," Diage says. "I think once this information is available, people will begin demanding healthier food options."