Let’s Abstain from Mandatory Calorie Counts

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Conor Duffy

Conor is a neuroimmunology Ph.D student based in Dublin. He's particularly interested in science and health policy, liberalism, and how the two interact.

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57 Responses

  1. Avatar fillyjonk says:

    I will say there have been times I’ve gone places with the thought of getting a “treat” (e.g., an ice cream) and wound up getting something totally different – often not the thing I actually wanted – because I felt shamed by the calorie counts, and could hear “dear, do you REALLY think you should be eating that” whispered in my ear by the ghost of various well-meaning relatives.

    I think sometimes our culture has become obsessed with stealing joy from others. Because going somewhere thinking of, I don’t know, getting a double cheeseburger and ordering a salad instead does seem like joy has been stolen.

    One other thing I find myself doing is calculating how long I need to work out to justify some “indulgence,” and even as I know that’s disordered thinking, I still do it. Because I’m a woman, and specifically a fattish woman over 40, in our culture.

    FWIW: I rarely eat at restaurants, maybe once or twice a month. Maybe calorie counts make more sense to people who eat there daily, I don’t know, but for me, all it does is tell me, “You should have eaten something more healthful at home” and I don’t like that.

    At least here in the US, non-chain (one-outlet) restaurants don’t have to post calorie counts, so I can still go to my favorite little BBQ place and have a pleasant bubble of ignorance about how much “damage” I’m doing with my plate lunch.Report

  2. Avatar Jaybird says:

    One of my favorite juxtapositions is to place this 2010 column by Ezra Klein called Why we need calorie information on menus right next to the one that came out a mere 3 years later called Here’s how calorie counts can backfire.

    I go back to my own personal bugbear: We (or law-passing countries in general) need to have sunset provisions for laws that do not do what they were intended to do… or worse, make things worse.

    “If we pass GoodLaw, BadThing will go down by 3%!”

    If we pass the law and BadThing goes up by 5%, we should seriously consider whether we misunderstood the dynamics behind BadThing. As it is, it’s a lot more likely that people say “Well, BadThing *WOULD* have gone up 8%! Looking at it like that, GoodLaw is a roaring success!”Report

  3. Avatar Chip Daniels says:

    We’ve had mandatory calorie information on packaged food in the US for almost as long as I can remember, and mandatory calorie counts at restaurants here in California for about a decade.

    Rather than speculate about the wonderful or dire consequences I think it would be helpful to look at actual empirical evidence and see what results have occurred.

    One the one hand, no, there doesn’t seem to be a significant lessening of obesity here. But we also haven’t seen a marked collapse of fast food restaurants either.

    As for me personally, now that I am of the age where careful monitoring of my health is important, calorie counts do make a significant effect on my choices.Report

  4. Informed customers make more informed decisions. One of the most curious quirks of libertarianism is simultaneously believing this but then balking when push comes to shove. “Yes, yes, more informed consumers make more informed choices,” libertarians will acknowledge, “but forcing companies to inform those consumers is oppression!”

    And that’s before we get into the reality that the health impacts of public policy can take a loooooooooooooong time. Anybody that believed that posting calorie counts would immediately lead to a particular outcome – less obesity, less heart disease, whatever – was being a weirdo.

    But the final issue, and perhaps the biggest one, is the assumption that because the author is not interested in the information, surely that is representative of the bigger truth. Let’s suppose the author represents 75 percent of the total population; why exactly should 25 percent of it be denied information they want to make informed decisions?Report

    • Avatar Jaybird says:

      So I see in there the argument that the benefits are intangible, the results will take a long time to see, people who thought that the benefits would be immediate and measurable were weirdos, and that there is a bigger truth at stake than measurable outcomes.

      If I wanted to paint the pro-calorie count position as a moral sentiment, I doubt I could have done better than this comment.Report

      • Avatar Chip Daniels says:

        Couldn’t this also be said about the early environmental movement, or safety regulations?

        The reason these arguments sound familiar, is because they are.
        The pro side is using the analogy of environmental and safety legislation, which had insignificant impact immediately, but over time had a smashing success.

        The anti side is using the same playbook that opposed those efforts. I don’t know why this is supposed to be persuasive.Report

        • Avatar Jaybird says:

          I’m pretty sure that I could point to immediate tangible numbers for the early environmental movement and for safety regulations.

          (Should I bother to do research?)

          If there was a point in living history where we did not have an obesity crisis and if what changed between the not having it and having it was not the calorie count, then I’d suggest pouring efforts into “more information” is pouring effort into something that allows for multiple interpretations of how successful it is rather than pouring effort into figuring out what changed and whether what changed is reversible.

          (Is it the corn thing? It might be the corn thing!)Report

          • Avatar Chip Daniels says:

            Yes, go ahead and do the research.

            You can’t find immediate tangible results of lets say, cleaner air for any single piece of legislation because the sources of such a vast problem as “Air Pollution” were diverse and widespread, coming from everything from tailpipe emissions to backyard incinerators to smokestack emissions to evaporation of oil based paint.

            Which is the point!
            Obesity likewise isn’t the sole fault of Hardees, or Doritos, or television or automobiles but is the end result of some portion of all of these.

            It can be said that the goal of modern industrial society is to make the acquisition of calories cheap and easy, and the burning of calories unnecessary. So there will never be a One Weird Trick to changing us from obese to healthy.Report

            • Avatar Jaybird says:

              So, “the early environmental movement” happened at least after tailpipes.

              We’re in a weird place. We’re comparing the early movement’s failures to get legislation passed to what happened after the legislation was passed years/decades later.

              So, like, I can’t point to the legislation that ended Acid Raid as relevant or the bans on chlorofluorocarbons to the ozone hole getting patched because these won’t count. Probably because they’re not related to the early environmental movement (with emphasis on the early).

              So we’re stuck in a place where if it hasn’t worked, we only know that it hasn’t worked *YET*.

              Which makes the whole “morally imperative language” thing all the more confusing.Report

              • Following things like the 1939 St. Louis smog and the 1952 Great Smog of London, legislation was passed pretty promptly that had almost immediate beneficial effects. Oxen were gored in the process. The Cuyahoga River fires in 1969 were a major motivation for the Clean Water Act and lawsuits against the big polluters of the river, with near-immediate improvements (ie, the river quit catching fire).

                Youth obesity could be greatly reduced in a relative short period of time by mandatory Marines-level physical activity.Report

              • Avatar Chip Daniels says:

                The way you write ‘morally imperative” is like it is some negative thing, or something that doesn’t lead to tangible outcomes.

                Is that your intent?Report

              • Avatar Jaybird says:

                If you want to sell me on outcomes, give me something measurable.

                If you want to sell me on your moral sentiments, you’re going to need an argument rather than assertions about the quality of your moral sentiments.Report

      • Avatar Sam says:

        There’s no moral component at all. It is just information. Why deny consumers information that they might want?Report

        • Avatar Jaybird says:

          If the point is that information is good, please know that I am 100% down with more information being good.

          If the point is that more information will lead to good outcomes, I’m going to ask what happened the last time we did something like this and made sure that there were calorie counts and then I am going to post articles talking about why the more information didn’t lead to good outcomes.

          So is that the argument? More Information == A Good, In And Of Itself?

          For what it’s worth, I agree with that argument.

          (Probably to the point where you’d disagree with it.)Report

          • Avatar Mike Dwyer says:

            Based on at least 1,000 other conversations here, even if we have the information, how it is interpreted and used is a whole other conversation. Once equipped with that information, how long before the public starts to insist on cafe standards for food?Report

    • Avatar LeeEsq says:

      I think the author’s argument is that companies will willingly provide the information that consumers want provided but will not give information that consumers do not want. Therefore, if companies are not giving out information freely it is not really information the majority of consumers want. Accordingly, the companies should not have to provide this information. This argument is hooey because there is a long history of businesses withholding some quite necessary information, say regarding the health risks of tobacco and asbestos.Report

      • Avatar Jaybird says:

        This isn’t an argument about ingredients (hey, pine nuts can kill!) or an argument about nutritional information (hey, it’s lent and there are carbs that people might be avoiding!) but an argument about the moral import of including the calorie count and the benefits provided thereof.Report

        • There is no moral argument here. It is information. Insisting that this is about a morals is beyond silly.Report

          • Avatar Jaybird says:

            Really?

            Because I was pretty sure that the arguments were given in the service of combating the obesity epidemic and the lack of this information was resulting in bad outcomes that will, inevitably, reverse once the five-year plan of posting the caloric information comes to fruition.

            I mean, seriously, have you not seen arguments about how people without this information will be making less-than-optimal choices?

            Were you not making these arguments above?Report

    • Avatar JoeSal says:

      @ Sam
      The unresolved truth component in social objectivity is, as you have stated:
      “represents 75 percent of the total population; why exactly should 25 percent”

      There is nothing in unresolved social objectivity scenarios that justify mandatory policy.

      If people want products and restaurants that have displayed calories, they should purchase those. If people have preferences to not have calorie displays, they should be able to purchase those.

      This allows for the highest degree of fulfillment of subjective value in a economy that has unresolved social objectivity.

      (this can be the winner in a market place of ideas thing)Report

      • Denying customers information does not allow for the highest degree of fulfillment.Report

      • Avatar Mike Dwyer says:

        “If people want products and restaurants that have displayed calories, they should purchase those. If people have preferences to not have calorie displays, they should be able to purchase those.”

        This is where I am at. As I said in my other comment, when it comes to chain restaurants where things are very standardized, I like knowing the calorie count. It makes it a lot easier for me to stay on track with eating healthy. If I’m going to a non-chain restaurant, especially one that changes their menu a lot, I am not nearly as worried about it. So for me, I vote with my feet and I’m not sure I would feel comfortable mandating calorie counts. Basically, they are nice to have but not a deal-breaker for me.Report

      • Avatar Stillwater says:

        If people have preferences to not have calorie displays, they should be able to purchase those.

        This is new. Normally the dispute in these types of things pit the consumer’s interest in having more information against a mandate imposed on businesses to provide that (accurate) information. Your argument seems to be that some people *don’t want that information*, and policy should prioritize their interests above the other considerations. Am I understanding this correctly?Report

        • Avatar JoeSal says:

          I think so. Basically if you don’t want to see the calories on a fudge sundae go to the place that doesn’t have the calories printed to every damn item.

          [fish…I can’t even tell what territory we’re in… is this calorie nazi….or calorie commie territory?]Report

        • Avatar Jaybird says:

          I like the argument that “more information is better”.

          It’s something that can be challenged with measurable outcomes of before/after calorie counts were posted.

          We can look at articles talking about why calorie counts didn’t work the way we thought they would and enjoy articles talking about how calorie counts aren’t accurate because cooks just use measurements like “handful” or “spoonful” instead of weighing it out or measuring it out.

          Anybody who has ever been to Chipotle knows the joy of getting the counter-person who gives you a huge heaping spoonful of guac instead of getting the counter-person who just gives you a small amount. Or the big spoonful of rice rather than the amount that you might consider “half”. Or the meat! There was one lady who I always tried to get because she gave big spoonfuls of steak and I didn’t feel like I needed to order double-meat (like I did with the other lady back there).

          I digress.

          Calorie counts are more information and I agree that more information is a good in and of itself.

          But more information doesn’t have the outcomes that were expected last time.

          I suspect that they won’t have the expected outcomes this time either.Report

          • Avatar Mike Dwyer says:

            I would also agree that it’s a bit cavalier to suggest that simply because consumers demand it, it should become law. There’s an associated cost with tracking and publishing that information. That might mean the difference between hiring that extra cook this year at a small restaurant.

            It’s probably a good idea to actually consider downstream effects of decisions before codifying them.Report

            • Avatar Jaybird says:

              Eh, enough people want something, change the law.

              That’s how democracy works.

              Sometimes it’s good, like with weed.
              Sometimes it’s bad, like with weed.

              But that is the system we’ve been blessed by.

              (As for tracking and publishing that information, there’s a periodic article that comes out that says “The menu says that this appetizer is 1700 calories. We bought one and tested it in our lab… the *REAL* calorie count will *SHOCK YOU*!” Which strikes me as being a recipe for pre-packaged ingredients being sold by Sysco to those chain restaurants. I suppose the upside is that maybe pre-packaged ingredients will hasten automation.)Report

          • Avatar JoeSal says:

            @ Jay
            We’re not even talking ‘information’ anymore, we’re talking ‘mandatory information’.

            If we cross that bridge, I’m perfectly fine with the state tattooing peoples mandatory IQ score to their forehead. I mean if “more information is better”, and it’s better to not spend to much time conversing with idiots, no worries.Report

  5. Avatar LeeEsq says:

    Mandatory calorie counts work for me at least. If you are naturally health conscious and don’t want to be obese or fat, calorie counts are great. It’s just that many people really don’t care that much. When it comes between being healthy or being social/eating delicious food, they will pick the latter.

    As to whether modern society is obsessed with death, we have nothing on the Victorians. Now that was a society obsessed with death and every complex rituals around mourning. I’d argue that because people live longer, reaching your seventies or eighties is normal rather than exceptional, we don’t want to deal with things that can cut our life short. Since we have a smaller percentage of the population that believes in the afterlife, people are not going to like death that much. It is easier to accept death when it is more present because people die earlier for a variety of reasons and you think you are going somewhere else after you die. At least that is the theory. My personal belief is that the past was filled with many people suffering from Post Traumatic Stress Disorder because of near constant death, pain, and suffering. What we are dealing with is a society where PTSD is a lot less common than it was in the past.Report

  6. Avatar atomickristin says:

    Hey, I really enjoyed this. Thanks for writing it.Report

  7. Avatar Aaron David says:

    For the first time in the history of the world, we are rich enough as a species that we have too much to eat.

    And yet some people think this is a bad thing. The ghost of Paul Ehrlich lingers.Report

  8. Avatar Marchmaine says:

    This is the main reason why calorie counts are unhelpful.

    “Food is more than just an energy source. It’s vitamins that bolster your immune system. It’s minerals that keep your blood healthy. As we’re increasingly coming to understand, it’s information that has a huge impact on your metabolic rate. This can all impact on how you process energy and lose weight. Reducing this to a calorie count may actively mislead consumers into selecting low-calorie but nutrient-poor food over meals that are healthier overall. If it’s quality rather than just calorific quantity of food that matters, then calorie counts might lead consumers to think they’re making informed, healthy choices when the opposite is actually true.”

    Calories only make sense assuming we’re all eating nutrient dense foods from scratch. At which point, managing the input of your nutrient dense foods might make sense… or be a helpful measure.

    But, mandating calorie counts with our diets fundamentally broken is a (dubious) solution to the wrong problem. Very simply, while a calorie is a calorie, not all food calories are of the same nutritional benefit. Counting the calorie when not counting the nutritional density is unhelpful.Report

  9. Avatar fillyjonk says:

    Honestly, I’d be happier with calorie counts slapped everywhere happening AFTER complete ingredient labeling (to include EVERYTHING, not just common allergens like wheat) happens.

    I am allergic to celery. Mildly so, fortunately – I get hives and indigestion instead of dying. Because it can be very hard to determine if “spices” or “natural flavors” in a thing includes celery or celery seed. I’ve gotten mystery hives (on my MOUTH people, hives on my MOUTH) after eating something that maybe did and maybe did not contain celery. I mean, I can use common sense: I will not eat cole slaw or chicken salad unless I made it myself, from scratch. But stuff like jarred sauces and some restaurant foods – well, you can ask, but won’t always get a correct answer.

    My friends know of my allergy and either fix food without it, or inform me if a dish at a potluck contains it. But stuff like canned tomato sauce? You don’t always know.

    If I actually were someone who went anaphylactic upon ingesting celery, I’d have to eat one-ingredient foods and cook everything from scratch, and never use spice blends.

    A related problem to this: counts and measures are not always accurate. I read somewhere that sodium labeling can be off by quite a bit and as someone who has to limit sodium (high blood pressure), it’s kind of maddening. What’s to say the calorie counts aren’t mostly a fiction, and the “weight loss didn’t happen” after they were posted is NOT because the people they were aimed at DIDN’T change their behavior, but because everything is higher calorie than claimed?

    I know, there’s supposedly some policing of this, but considering how thinly stretched the staff that actually tests wholesomeness of food (like, for presence of E. coli) is these days, I doubt we’re getting independent verification and just have to trust whatever Panera or whoever claims their food contains on the order of calories. (Or on the order of ingredients: when I complained to a processor once about “undeclared celery.” their reponse was that they had to be “nimble” and able to change as suppliers changed)Report

  10. Avatar Pinky says:

    Calorie counts don’t tell you everything, but they tell you that a Shamrock Shake is 560 calories. That’s not the be-all and end-all of nutritional information, and if I’m reasonable in my intake, I can afford a shake every now and then. But I never would have guessed that they’re so high in calories, and that extra information is helpful.

    If I’m ever on death row, I want to be executed this time of year, so my last meal can be two boxes of Girl Scout Thin Mints and a McDonald’s Shamrock Shake.Report

  11. Avatar George Turner says:

    New research is showing the futility of a simple calorie count because people digest food quite differently. Even a simple study to show how different food types affect blood sugar in the short term left the researchers frustrated that they can’t predict anything because it varies by the person. Some people spike after eating carbs, some people crash.

    Calories are a great way to measure the energy content of foods, but only if you’re burning them in a calorimeter, power plant, or internal combustion engine. If instead you are digesting them, you’ll get a different set of results.

    The measure is far less sophisticated than the way farmers measure the food value of hay, and boy do they measure it, focusing on the digestible calorie content, which is quite a bit less (50 to 70% as much) than the calorie content assigned by hay-burning European power plants. Much of the hay is burnable but not digestible.

    Farmers get a lot of very accurate data points by carefully measuring a farm animal’s weight gain on different types of food. In contrast, most of the US human nutritional data comes from self-reported food intake, data that we know is wrong because if the respondents were truthful, they’d also be dead because they claim they’re eating less food than people dying of starvation in North Korean labor camps. The data is also in wild contradiction to what we know grocery stores sell daily.

    As an aside, a dozen briquets of Kingsford charcoal have about 2,000 kcalories. Eat those and some vitamin pills and you’ll still come up short by about 2,000 kcalories because we can’t digest charcoal.

    Power plant operators know that hay has more energy content per pound than meat, and zookeepers know this too, but neither would try to feed hay to a lion. It just doesn’t work, even though the calorie data says lions should get fatter on hay.

    Omnivorous humans are even more complicated, as are our gut microbiomes. Two people can get quite different nutritional values out of exactly the same meal because we don’t all digest food with equal efficiency, or equally on even finer scales of fats, proteins, and particular types of sugars or carbs. Japanese can digest seaweed that Europeans cannot because the Japanese gut biomes took up plasmids than can break down the cell walls of seaweed. To everyone else it’s not food, just roughage.

    As for the obesity epidemic, it started when we introduced wide scale antibiotics to children just after WW-II. An obesity map of the US and a map of antibiotic prescriptions per capita is the same map, varying wildly by state and region (places like Utah use almost no antibiotics and have almost no fat people), and that seems to hold worldwide. It even holds in Africa, where aid organizations who’ve been supplying antibiotics are now encountering lots of obesity within starving families, of all things.

    So the calorie labels, although informative, might also be a bit useless for the intended purpose.

    People already knew intuitively how much they’re eating regarding meat, fruits, and vegetables, with one weird exception. Researches find that people are really clueless about a blend of fats and carbohydrates (potato chips, cookies, and many deserts). That’s a mixture not found in nature and which didn’t really exist prior to farming and the common extraction of food oils. It seems our cooking has gotten ahead of our evolution, and the only way forward is by the continued survival and reproduction of those who don’t eat the whole g****** bag of chips, and the early and untimely death of those that do. Then the Oreo resistant genes will spread through the gene pool, and we’ll all be okay again.Report

    • Avatar Maribou says:

      While there is some factual basis to some of this comment, much of it is vastly exaggerated.

      For example, a fact check of “almost no fat people” leads to this map:
      https://www.stateofobesity.org/data/

      Not almost no fat people.

      The rest of the factual claims in this comment are a similar blend of fact and creative exaggeration.Report

      • Avatar Dave says:

        The thing I like about you the most is the creative and diplomatic ways you go about responding to what I would call bullshit. 😀Report

      • Avatar George Turner says:

        The CDC data is based on a telephone survey asking people if they’re fat. What that actually seems to measure is social norms about honesty and self-opinion. The obesity rates in the South looked much higher in comparison to northerners based on phone surveys as opposed to doctor’s patient data, and it turned out that it was caused by a difference in culture, and similar to the decades of dietary questionnaires were almost nobody was fessing up to eating all those Snickers bars.

        The long-running REGARDS study, published in the journal of Obesity in 2014, brought in individuals from the nine census regions and measured their height and weight. The data collected disagreed with the data in the CDC’s phone survey used to create the following chart. REGARDS found that the West North Central region (North Dakota, South Dakota, Minnesota, Missouri, Nebraska, and Iowa), and East North Central region (Illinois, Ohio, Wisconsin, Michigan, and Indiana) were the worst in obesity numbers, not the East South Central region (Tennessee, Mississippi, Alabama, Kentucky) as had been previously thought. Dr. P.H., professor in the Department of Biostatistics in the UAB School of Public Health George Howard explains that “Asking someone how much they weigh is probably the second worst question behind how much money they make,” “From past research, we know that women tend to under-report their weight, and men tend to over-report their height.” Howard said as far as equivalency between the self-reported and measured data sets, the East South Central region showed the least misreporting. “This suggests that people from the South come closer to telling the truth than people from other regions, perhaps because there’s not the social stigma of being obese in the South as there is in other regions.”

        Islands like Palau, Samoa, Tuvalu, Tonga, Kiribati, and Trinidad have a far worse obesity problem, and even Egypt is worse than the US, while Iraq, Libya, Kuwait, Mexico, and even El Salvador and South Africa are way heavier than Canada and most of Europe and not far behind the US.

        That doesn’t make a lot of sense if the problem is American fast food.Report

        • Avatar Maribou says:

          @george-turner The REGARDS study is more than a decade out of date and completely excludes respondents of self-reported Hispanic origin as well as anyone under the age of 45. It also deliberately oversampled the so called “stroke belt” in the southeast.

          It is no doubt more accurate but if people are under-reporting, that is going to lead to *more* people in Utah (and like states) who are fat, not *no* people or almost no people
          .
          The map I linked to combined measures based on several different ways of finding out the situation, not just the CDC’s, and it wasn’t “me doing an indepth effort to find the best data” it was “just how wrong is this particular comment” level checking.

          It turns out the comment was pretty full of wrong, and you pointing out flaws in the methodology of my gut level fact check doesn’t make it less full of wrong.

          Whether or not there is an influence of antibiotics on American obesity is an open question to which I personally lean toward … maybe. There’s some data (not the stuff you said) which does indicate it, and there’s a common-sense argument that if we evolved to survive under a high parasite and/or symbiote load, messing with that could throw off metabolisms.

          But that has nothing to do with most of the word salad you’re posting here as though it’s a set of facts supporting an argument.

          Also, if you’re going to block quote large citations, you really should link or cite rather than copy and pasting them in with no way for people to see where you got the info.
          In this case, the wikipedia entry https://en.wikipedia.org/wiki/Obesity_in_the_United_States

          Which puts estimated obesity rates in Utah at…. somewhere between 21-28 percent depending on who you ask and how far back you’re willing to stretch.

          Which, again, is still not “almost no”.

          Which, again, is merely one of a litany of factual claims that were actually mixed fact and fiction from your original comment.

          I cannot be bothered to do the same kind of thing for this comment.

          But every so often I like to make sure other people know how superficially constructed some of these castles in the air that you post are.Report

          • Avatar Maribou says:

            I mean, my personal take is that all of these measures are a crock because they all depend on BMI and BMI is a steaming pile of doody, before we even get to the self-report vs directly measured issue.

            But just because the stats themselves are dumb doesn’t mean your assertions become accurate.

            There are lots of fat people in Utah.

            Etcetera.Report

            • Avatar George Turner says:

              Not nearly as many as in other states. Some surveys put Utah at the top, and some put it a bit lower down.

              The difference in childhood obesity is also significant. From StateOfObesity.org:

              The obesity rate for youth ages 10 to 17 ranged from 8.7% in Utah to 26.1% in Mississippi, according to the most recent state-by-state data from the 2016-17 National Survey of Children’s Health (NSCH).

              As for BMI, it’s obviously a bad measure because it says Jason Mamoa is overweight with a BMI of 28.5 and Chris Hemsworth, when playing Thor, is overweight with a BMI of 26.9. Percent body fat is obviously a better measure but one that’s much harder to determine over the phone.

              So comparing the childhood obesity data by state with the number of restaurants per capita, the Pearson correlation coefficient is 0.224, which is weak, and the XY data plot looks like a random shotgun blast.

              When I bin one of the antibiotic maps (several are found in links below, or just Google antibiotic map) into six levels (as some of the maps do), and compare that to the above obesity data that I used for restaurants per capita, the Pearson correlation coefficient is 0.6271, much higher than the 0.244 correlation with restaurants, which should correlate to diet somehow.

              And the WHO’s childhood obesity bulletins feature pictures of wildly obese Turks, Greek, and Italian kids, as their problems are about as bad as here and getting a lot worse. They blame food commercials, but whereas the US prescribes 2.5 times as many antibiotics per capita than Sweden, we prescribe less than Greece and Italy. Paper comparing antibiotic prescription rates of the US and EU. Turkey tops the list of increases in antibiotic use. Daily Mail chart.

              Here’s an antibiotic map of the US, which looks surprisingly like our obesity maps, with a big band running through the south and up into West Virginia and the Dakotas.

              And as an aside, although some researchers are publishing on antibiotics causing obesity in children and mice, via some mechanism or other, almost all the antibiotic data is from tracking antibiotic resistance versus prescriptions, and they get down into the details of it by specific antibiotic, provider network, and location, and then put almost all the information behind paywalls. Kind of irritating if you ask me.

              The US seems to switch to new antibiotics earlier than Europe, and prescribes more heavily than Europe, and it’s highly likely that it’s not antibiotics in general but a few particular classes that would be causing any problems with body weight, so if someone had detailed data on antibiotic type by location, any strong positive correlation to obesity should pop right out, if there is one.Report

  12. Avatar Mike Dwyer says:

    I personally like calorie counts at most places. When you’re trying to lose weight and sticking to a certain daily target, you quickly become a creature of habit. I also still really love fast food but now I know that since I try to keep my dinners around 600 calories, I can get two chicken snack wraps (no ranch) or one Chick-fil-et sandwich or whatever. It’s also nice if my wife and I want to run up to Chili’s after work because I can very quickly choose from the 3-4 menu items that I know are in my target range (usually a 6oz sirloin, rice and grilled asparagus). I find that as long as I track my calories daily (I use an app) I will lose weight. As soon as I start saying, “It feels like I am around 1850 calories for the day,” I will underestimate and start to gain again.

    With all of that said, if I go to a nice restaurant or a pizza place, I know it’s going to be a bloodbath or I want to simply enjoy my meal, so I don’t need to see the calories on the pasta or the cheeseburger or whatever. That would just be cruel.Report

  13. Avatar Dave says:

    I guess I’ve been doing it wrong all along.Report

  14. Avatar Dave says:

    Ok…not that I know much about any of this kind of stuff…

    “The reasoning is simple enough. Consumers currently don’t know what the calorific content of most restaurant meals are…”

    I’m not troubled by this, and even if they may think they know what the calorie counts are, they still won’t know for more reasons than I need to discuss here. One reason – think about the calorie count for a serving of salad dressing and if you get dressing on the side, you notice that the amount of dressing looks three to four times the size of a serving size.

    “This, we assume, will lead to people selecting lower-calorie and healthier food choices, helping them lose weight..”

    Or just helping people with healthy food choices.

    “A review of outcomes in 2013 found that “current evidence does not support a significant impact on calories ordered””

    No surprise. Think of comments like Mike’s above – they’re going to go eat out, enjoy something and not worry about the calorie counts. Very common and reasonable. I wouldn’t even call that a “bloodbath” given that puts the wrong kind of connotation with food. Not that it matters in Mike’s case, but I’ve seen that go into dark places.

    “Great! But once we go to longer time periods, things get tricky. Calorie counting may help with short-term weight loss, but that’s true of many so-called “fad” diets too. A study in The Journal of the American Medical Association with over 600 participants even found that “there was no significant difference in weight change between a healthy low-fat diet vs a healthy low-carbohydrate diet”. The same study also asserted that “no one dietary strategy is consistently superior to others for the general population.””

    Weight loss is a function of a caloric deficit, whether or not people realize they’re in one. With fad diets, keto comes to mind, as much as they sell people on the fact that calories don’t matter, the fact is that people lose weight because they’re in a caloric deficit. This is why weight loss results are almost the same across different kinds of diets.

    “Further to this, in a recent article for Tufts Nutrition Magazine, numerous quoted nutritional experts with various views on healthy eating could agree on one thing: calorie counting doesn’t work.”

    This is VERY dependent on context. What I understand from the source is almost a vulgar form of calorie counting where you’re told to hit a number and you can eat whatever you want so long as you come in at/below that number. Sure, that can be a disaster and completely unnecessary. People on the standard American diet can cut back on sugar and eat a more balanced diet of whole plant and animal foods and lose weight without counting a damn thing.

    I track my calories but I have different goals, objectives and interests.

    “The reality is the average consumer isn’t a nutritional scientist, and it’s unreasonable for us to expect them to have the knowledge of one.”

    It’s almost sad to think that my knowledge of nutrition puts me well above the average person in society because what I know isn’t rocket science.

    “Reducing this to a calorie count may actively mislead consumers into selecting low-calorie but nutrient-poor food over meals that are healthier overall. ”

    Have you heard of IIFYM?Report

  15. Tracy Downey Tracy Downey says:

    I’m all for calorie counting. I cut my average in half to be at a caloric deficit. If I ate 2400 a day i’d go to 1200-1500, then increase my cardio. Now that I’m pushing 50 its harder to shed hormonal poundage. So, cardio 4-5 days a week, eating balanced meals, watching macros and I’m happy to report that I am down 14 pounds since beg of Jan. 😊. I was tempted to go on my V8/Snickers diet for Lent. But…. On a different program.

    No joke I lost 27 pounds eating one snickers and a V8 for lunch then two balanced meals with two snacks. It satisfies.😂Report

  16. Avatar CJColucci says:

    I’ve recently lost 35 pounds by paying attention to the calorie (and sugar) counts of things I had been eating. Not all the time, of course. I still hit the BBQ joints, but I now have a better idea what I am thinking of eating and have eliminated or greatly reduced things that had been fattening me up for the slaughter. At the chain restaurants where posted calories counts are required, I have often been surprised to learn that what I thought was a healthier option wasn’t, and have changed my selections accordingly.
    Am I surprised that there hasn’t been widespread weight loss? No. It’s damn hard, even with information. But it’s a lot harder without it.Report

  17. Avatar Patrick says:

    So, about that evidence…

    … one thing about epidemiological studies is that they test populations. That is, they’re not testing specific interventions for efficacy if the interventions aren’t actually intervening. This is why epidemiological studies are good evidence for vaccinations in countries where most people are vaccinated but they’re not good evidence for avoiding wolf bites because the vast majority of population ain’t messin’ around with wolves.

    This is why the studies referenced in the AJPH meta-analysis are tagged with the conclusion “Although current evidence does not support a significant impact on calories ordered, menu calorie labeling is a relatively low-cost education strategy that may lead consumers to purchase slightly fewer calories. These findings are limited by significant heterogeneity among nonrestaurant studies and few studies conducted in restaurant settings.”

    That is, the authors of this paper think the findings are limited (for reasons more fully fleshed out in the full paper) and that there’s insufficient evidence to show that calorie counts *don’t* work.

    Related: when experts summarize their own findings in the conclusion, they’re applying not only the study that they did but their domain knowledge of the subject.

    The question that we ought to be asking is not “do calorie counts reduce weight across the population” because of some obvious confounders, namely:

    (a) The vast majority of folks are not actively trying to lose weight, generally, so a population study is going to skew *heavily* to very small result.

    (b) Of the minority of folks who are trying to lose weight, those who go to restaurants either
    (i) Will benefit from the calorie count because they have additional information
    (ii) Won’t benefit from the calorie count because this is their night out, dammit, and managing their diet is what they are doing Mon-Thur

    That doesn’t mean the epidemiological studies are useless (there’s some interesting work in those papers that are referenced), just that a strong finding is (a) not expected and (b) because it’s not expected, not finding one doesn’t tell us much.

    Or, as has been shown in multiple places on this thread: when folks are actively managing their food intake (which is something folks generally should do if we want better health outcomes), the information is helpful.Report

  18. Like Fillyjonk above, I’d probably prefer full-ingredient listing before (or in addition to) calorie and other nutrition information. Ingredients are easier to get right while calories and RDA’s are probably harder to get right.

    Whether such reporting should be required by law? I don’t know. I agree with the OP’s point on cost margins. I generally believe that anyone who proposes a regulation needs to consider and acknowledge the costs and not claim that it’s merely a question (in this case) of giving information. A regulation compels people to do something they otherwise might not want to do or in a way they might not want to do it. [ETA: And the effects usually go downstream so that others have to pay the costs. Or there are unintended or collateral consequences that are sometimes worse than the problem the regulation is meant to solve, or if not worse, than different. In the case at hand, I could see large chains that can afford to supply the information to have an advantage over smaller firms. I’m not one to worship small firms or want to protect them overmuch, but they might have a legitimate complaint here.]

    But that doesn’t mean I oppose all regulation. Sometimes the cost is worth it. Is it worth it here? I can see both sides. And especially if we don’t limit ourselves to calories, I’m actually more inclined to favor a regulation. Maybe there’s a middle ground to make things easier. A larger chain might have the resources to provide accurate nutrition information while a smaller firm might have to have some leeway, either an exemption or permission to get by with disclosing only ingredients. Or maybe we make it all voluntary but maybe have a way to verify that all info that is disclosed is accurate. Perhaps we can help create information exchanges that help those restaurants that wish to opt in with getting accurate info.

    By the way, I sign on to others’ skepticism here about what the evidence shows and doesn’t show concerning consumers’ use of calorie and other information. It’s probably true that in the aggregate, people do pay little attention. But anecdotally, I, and apparently some others here, do. That information doesn’t always, or even usually, guide my choices. However, I’m glad the information is there (when it is), especially because in the last few months, I’ve had reason to have monitor what I eat more closely than I’ve had to before.

    Finally, I’ll note that my comment is being a bit unfair to the OP. The OP focuses specifically on calorie counts and I’m expanding the issue to talk about other information in addition to (and probably in preference over) mere calorie counts.Report

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