Calorie Counts on Menu Boards?

Calorie Counts on Menu Boards?

Baseball is a numbers game, and few teams produce more impressive stats than the New York Yankees. Their new stadium opened in 2009 and promptly delivered the team's 27th World Series win. To stroll amid the sights and smells of the food vendors is to see another legacy at play, one that will linger for a lifetime in the hearts of Yankee fans.

Nathan's Famous foot-long beef hotdog clocks in at 500 calories before condiments. That's one-quarter of the roughly 2,000 calories you need in a day. At Moe's, the "nachos supreme" set you back 1,410 calories. Elsewhere, a jumbo popcorn is 1,484 calories, and the souvenir bucket is 2,473. Add a couple of beers (286 calories for a large Beck's) and you see why, when the Yanks moved from their circa-1920s stadium, they widened the seats by as much as two inches.

In the Big Apple you know in a New York minute what your food costs - in dollars and in calories. Both numbers have equal prominence on the menus and menu boards of the city's chain restaurants - by order of the New York Department of Health and Mental Hygiene. It's an attempt to stem a frightening increase in obesity, an epidemic also killing Canadians and compromising the health care system. Unlike in Canada, there is political will in the U.S. to take action. By next spring, the Obama administration's sweeping health care reform bill requires U.S. restaurant chains to post calorie counts on menu boards, drive-throughs and vending machines. It was one of the few non-contentious parts of the bill - a recognition by legislators, and the American restaurant industry, of an anti-obesity measure whose time has come.

Not so in Canada. Don't expect to find a quick, easy calorie count on either the restaurant or national political menu anytime soon - despite what the Public Health Agency of Canada calls "an alarming increase" in obesity and attendant health problems. And even though measures similar to the U.S. law are endorsed by the Dietitians of Canada, the Centre for Science in the Public Interest, the Ontario Medical Association, by weight-loss specialists, by the B.C. government and by Dr. Kellie Leitch, a federal adviser on healthy children and youth.

Leitch's 2008 report, Reaching for the Top, dealt extensively with overweight youth. The prominent display of calories at restaurants was among her recommendations to then health minister Tony Clement. As a pediatric orthopaedic surgeon she sees in her own clinic a "frightening" increase in Type 2 DIABETES among adolescents, the result of poor diet, little exercise and excess calories. "We will have a generation of children that is projected to not live as long as their parents," she told Maclean's. She expects the government to eventually act on some of her obesity recommendations but so far she's heard nothing.

Lobbying against a calorie law is the well-connected Canadian Restaurant and Foodservices Association (CRFA), which purports to know better. Singling out calories "doesn't meet the needs of our customers," says Ron Reaman, a vice-president with the CRFA. "Our customers have a wide array of dietary concerns." Limiting the menu information to calories wouldn't help those worried about things like carbohydrates, sodium or trans fat, he says: "Never mind allergies." You can't put all that on the menu, the thinking goes, so none of it belongs.

Instead, the association has a voluntary "nutrition information program." Some 33 participating restaurant chains provide an array of nutritional information in varying formats and degrees of visibility. Most have extensive information on company websites; others have brochures or, in the case of McDonald's, descriptions in exhaustive detail on the back of tray liners. "We believe that this is a responsible approach that responds to the needs of our customers," says Reaman. "We think it is actually a better approach than what they're doing in the U.S."

"Ron's full of it, but that's his job," says Dr. Yoni Freedhoff, founder of Ottawa's Bariatric Medical Institute, which specializes in non-surgical weight management. "It's a ridiculous assertion to suggest that people are looking for [all] that information," says Freedhoff, also the author of the lively obesity website weightymatters.ca. "When we go shopping for things we look at price tags before we buy them so we can determine whether they're worth it to us," he says. "When we eat things, the currency of our weight is calories." Certainly estimating calories isn't always intuitive. Even without checking Kelsey's restaurant website you might guess their fully loaded nachos (at 2,160 calories that's a day's worth of eating) had best be shared. But would you think a chicken quesadilla and accompanying rice top out at 1,130 calories? Or that, at Casey's Bar & Grill, a vegetarian pad Thai is 740 calories, a side of sweet potato fries is 760, but an order of one-piece fish and regular chips is just 330 calories?

Reaman claims the restaurant association's position is backed by the Dietitians of Canada. "They've been on the record in the past in suggesting a calorie-only approach to communicating nutrition information is probably essentially misleading," he says.

In fact, while the dietitians want a full spectrum of nutritional information available, their association endorses calorie counts on menus. "Our rationale is that anything that makes the healthier choice the easier choice is what we should be supporting," says Judy Sheeshka, a dietitian and an associate professor at the University of Guelph. She researches food and nutrition policy, and wrote the position paper on the issue.

Reaman says the CRFA's information program meets public needs, and Health Canada seems inclined to agree. "We continue to closely monitor this voluntary initiative," said spokesman Philippe Laroche, "to determine if a model for regulatory compliance could be developed that would be both practical and enforceable." Critics, however, say the program is of limited use. Sheeshka dispatched her students to participating Guelph restaurants. In many cases the information was only on websites. In others, front-line staff had to find managers before a binder or a handout was produced. "Sometimes it was posted on a wall outside a washroom or some obscure place where you wouldn't look before you ordered," she says.

If the method of educating the public is in dispute, there's no doubt North Americans need to curb their eating habits. Obesity rates have doubled in the U.S. in 30 years and Canadians waddle not far behind. Two-thirds of Americans are overweight or obese. One-third are obese, defined as having a body mass index (the relationship of weight to height) of 30 or more. In Canada, one-quarter of Canadian adults are obese and many more are overweight. "We have a country where it's abnormal to have a healthy body weight," says Freedhoff. Even among those aged 12 to 17, some 26 per cent are overweight or obese. The estimated cost of "obesity-related chronic conditions" in 2005: $4.3 billion, says the Public Health Agency of Canada.

In the U.S., just three years ago, the National Restaurant Association in the U.S. was as opposed to posted calorie counts as its Canadian counterpart. The industry sued the New York health department in a failed bid to overturn its calorie law and threatened to sue other jurisdictions that followed suit. But when the calorie law got bipartisan support in the national health reform package, and first lady Michelle Obama began her campaign against childhood obesity, the industry had a dramatic conversion on the drive-through to Damascus. It decided one federal law was preferable to a growing hodgepodge of regional regulations.

The same arguments that the Canadian association uses (ineffective, impossible to implement, too calorie-focused, too confusing) were abandoned overnight. "The passage of this provision is a win for consumers and restaurateurs," American restaurant association president Dawn Sweeney said this spring. "We know the importance of providing consumers with the information they want and need, no matter where in the country they are dining."

Advocates like Bill Jeffery, national coordinator for the Center for Science in the Public Interest, say Canadian restaurateurs are delaying the inevitable. Packaged food in stores has had nutrition labels for years, he says. "Their customers are making informed choices. It's not going to be too long before they're saying to government, 'Why is the restaurant industry getting a free ride?' "

In Ontario, New Democrat MPP France Gélinas is reintroducing a private member's bill calling for calorie labelling. Her previous attempt - opposed by the CRFA - died when the Ontario legislature prorogued in March. Ontario Premier Dalton MCGUINTY has said the federal government should take the lead on obesity issues, a position supported by Ida Chong, B.C.'s minister of healthy living and sport. Meanwhile, though, she says her department has had preliminary talks with restaurants about a sodium reduction strategy and prominent calorie displays "very similar" to the U.S. law.

If the federal government doesn't take the initiative, B.C. is prepared to act alone, she told Maclean's. With the U.S. taking the lead, the job is much easier, she said. "People will realize the sky will not fall if you do this."

If so, calorie counts on menus may soon be as accepted as the no-smoking signs on restaurants and bars - another initiative the CRFA once opposed.

A plus-sized world

Nearly half of Canada is overweight. Worryingly, experts believe the statistics are far too low, given they're based on self-reported data.

Percentage of population who are overweight or obese

CANADA 47%

U.S.A. 67

BRITAIN 61

FRANCE 37

JAPAN 25

Maclean's June 14, 2010