With strong support from health professional groups, the food industry, and consumer groups, the president signed into law The Nutrition Labeling and Education Act requiring that the majority of food products under FDA authority carry nutrition labeling. The year was 1990, George Bush Sr. was in the White House, and obesity rates in America hovered around 16 percent.
Fast forward. Tucked away on page 455 of the massive health care reform act signed into law by President Obama in early 2010, is a provision requiring that restaurant chains with more than 20 units post calorie counts on print, display, and drive-thru menus (law also requires the same for vending machines). At the time the law passed earlier this year, the National Center for Health Statistics pegged obesity rates in America just north of 33 percent.
As with the nutritional labeling law passed two decades earlier, health professional and consumer groups applaud the new menu labeling law as a victory for consumer rights and a new arrow in our quiver of tools to fight obesity and disease in America. Motivated by a growing body of scientific evidence linking dietary habits with obesity and chronic diseases such as cardiovascular disease, diabetes and some types of cancer, a growing number of states, such as New York, got out ahead of the new law having already required similar calorie disclosures for years (those rules will be superceded by the new federal law).
Given that obesity rates in America have doubled since federal law required nutritional labels in the grocery aisle, its reasonable to ask: Do labeling regulations help consumers choose more healthful diets? Referencing the initial food labeling law passed in 1990, the Calorie Counts report prepared by the FDA’s Obesity Working Group in 2004 notes that “Despite reports of a positive correlation between label use and certain positive dietary characteristics, the trend toward obesity has accelerated over the past decade.” The more than doubling of obesity rates in America since 1990 does not imply labeling regulations have not been ineffective in stemming obesity. That said, what exactly has been the effect of mandatory nutrition labels on obesity in America?
Surprisingly, despite being of considerable public policy interest and a lower lumbar on the backbone of preventive population-level intervention strategies advocated by health professionals/groups and the U.S. government, there has been very little empirical evidence on the subject. According to researchers at the Economic Research Service of the USDA, even though a few studies have looked at aspects of labeling laws “none has studied its effect on obesity.”
The fact the government is requiring by law that calories be displayed on menu boards, even though the impact on public health has not been empirically demonstrated after 20 years of food labeling in the grocery store, is both ridiculous and completely sensible. The lack of government-sponsored scientific and empirical study of what is clearly a broadly implemented and relied upon public health strategy for reducing obesity in America is made more disheartening when you consider the NIH’s funding of the National Center for Complementary and Alternative Medicine (NCCAM) throughout the last few years. As the name implies, this pet institute sponsored by Senator Harkin has poured more than $1 billion of your tax dollars into funding alternative strategies for improved public health. One of my favorite studies funded by NCCAM is the “Polysomnography in Homeopathic Remedy Effects." One would think that the implied broad sweeping impact of nutritional labeling would receive at least the same amount of funding attention as "sleep medicine."
Advocates of the menu labeling law point to a limited number of studies such as the Starbucks Study as proof of its potential impact on public health. Stanford researchers found that calorie posting at a New York City Starbucks led to a 6 percent reduction in calories per transaction, from 247 to 232 average calories per transaction. To put this in perspective, that 15 less calories per transaction is the equivalent of eating one less large french fry a day.
As a business that promotes better tasting and better for you fast food, Naked Pizza is expected to support without question labeling laws. Right? While we will comply with the law in 2011 as we pass the 20-store mark that mandates compliance, we are not convinced the law will make a difference and in fact, the real question we are asking is will it do more harm than good?
Are well-intended population-wide strategies to improve environmental contexts for healthful eating such as nutritional labeling actually having an unintended consequence as evidenced by our soaring obesity rates over the last 20 years as we have become obsessed with calorie counting with the aid of nutrition labels? In public health policy, you either have to believe evidence that can be tested and verified will lead to a better understanding of reality, or you don’t. In the absence of any empirical evidence that nutritional labeling improves or harms public health, all we have is the anecdotal evidence. At face value the news is not good.
In addition, the new menu labeling law is further concerning when you consider it only applies to those restaurants with 20 or more units – i.e., chain restaurants. According to our friends over at the Nation’s Restaurant Association, this means the new law only affects 20 percent, or 200,000 of the nearly 1 million eateries in America. So, 80 percent of the places we eat will not be required to post calorie information to the consumer. For an important public initiative that key researchers in the field said needed to happen to increase awareness about the calorie content of typically fast-food meals, 20 percent of the places we eat appears to be good enough.
The move forward on menu labeling despite no scientific consensus on nutrition labeling in general will only guarantee continued fouling of our nutritional nest and, worse, delay any meaningful discussion on improving health and well-being. With each new perceived victory by public health officials and health groups, such as the hard fought battle over implementing calorie postings, the public and those same health officials will often stand down just a tad and rest on its victories after expending so much precious energy and political capital, and precious time passes.
With each new nutritional red herring that comes down the pipe every few years, we continue to turn a deaf ear to our biological bodies and the understanding of how health grows and prospers. Human biology is ancient poetry that only says what it means. If we listened, then we would know that our bodies treat 500 calories of ice cream differently than it does, say, 500 calories of broccoli or that same 500 calories of broccoli raw or steamed.
Counting calories is, from an evolutionary and biological perspective, meaningless. If we stopped trying to escape our biological reality we would know that our bodies cannot tell the difference between dieting and starving and compensates accordingly by reducing energy output and actually driving hunger to almost unbearable levels; hence why reams and reams of scientific research shows that dieting does not work for most of us, or that we can’t exercise our way out of this problem. We ate our way into this problem, we will need to eat our way out.
Doing it the biological or natural way has the potential to change the way we think about food and public health initiatives to make us healthier. Until we to decide to start paying more attention to the blueprint laid before us in our biological past, we might practice what the Okinawans in Japan call Hara Hachi Bu, which roughly translates into eat until you are 80 percent full. With the greatest life expectancy of any population on earth and the highest percentage of folks over 100 years of age, wisdom of the Okinawan's might be worth considering.
Jeff Leach is the co-founder of New Orleans-based Naked Pizza. Jeff is currently completing his PhD in anthropology and has published widely in nutrition, medical and anthropological journals. Through Naked Pizza, Jeff hopes to influence public health policy in the U.S. and demonstrate that pizza can be part of the solution rather than part of the problem.