Can the 'nanny state' approach reduce obesity?
There is no question that obesity is a serious problem among a wide range of demographics in the U.S. The economic implications of childhood obesity leading to subsequent diabetes and metabolic dysfunction are well documented.
In an attempt to reduce caloric intake among infants and teenagers, a number of jurisdictions have impose mandatory posting of calorie counts for meals served in quick service restaurants. While this approach would appear to be comforting to public health officials and legislators, the effect of their good intentions should be critically evaluated to guide public policy in the future.
A recent publication in the International Journal of Obesity, authored by Dr. Brian Elbel of the New York University School of Medicine and colleagues in Seattle and St. Louis, reported on a survey in four national restaurant chains in New York City to determine whether posting calorie counts for meals had any effect on orders. Customers were requested to provide receipts to determine caloric intake before and after the restaurants posted calorie values. There was no significant difference as a result of the mandated display of caloric levels for either individual teenagers selecting meals or parents purchasing on behalf of their infant children.
It is noted that 90% of the respondents were minorities and it is not clear whether these customers had a clear understanding of the importance of caloric levels in relation to obesity and health. It is probable that their purchases were motivated by taste, habit, financial restraints and conformity to ethnic food choices.
In contrast, a study conducted by the University of Washington in Seattle demonstrated that there was an approximately 15% to 20% reduction in the caloric content of meals ordered following posting of the caloric levels when parents purchased meals for their children aged 3 to 6 years. It is apparent that the subjects on either coast responded differently to the posting of caloric values. Studies should now be directed at how best to educate consumers and to determine the most appropriate depiction of information. It is evident that applying broad “nanny state” regulations do not work in all situations.
It is however justified to remove a deleterious ingredient from meals served at all restaurants and from all processed foods. Examples in point are mandatory deletion of trans fats and reduction in sodium content of foods and meals both of which have undesirable health effects.
The message from the New York study is that well-meaning and simplistic solution to complex problems seldom work. It is necessary to approach a situation of national significance such as childhood obesity with a clearly defined knowledge of the motivational factors and mechanisms which determine the purchase decision with respect to meals and foods. It is obvious that increasing pressure on the food industry to upgrade labeling and to introduce more sophisticated and complicated nutritional data is worthless when dealing with consumers who are either innumerate, unable to appreciate either the numbers displayed or their implications when making choices at the order counter or the supermarket shelf.