PUBLIC HEALTH
August 4, 2012

Health on the Menu

The Affordable Care Act will require that more restaurants put calorie and fat information on their menus. How much does it help?

A little over three years after chain restaurants in King County, Washington implemented menu labeling, small improvements in the nutritional profiles of entrée items are being reported. While the changes are certainly nothing major, they are a step in the right direction.

Menu labeling legislation was implemented in Washington State in January of 2009. The regulations required any restaurant that had 15 or more locations in the United States and at least $1 million in annual sales to post the calories, fat, and other nutrients for their entrée items.

The saturated fat content of entrees at sit-down restaurants fell by about 2 grams per meal - from 18 grams to 16 grams - and sodium levels were reduced by about 300 milligrams.

In order to determine if menu labeling had had an impact on the nutritional profile of restaurant foods, researchers from the School of Public Health at the University of Washington in Seattle reviewed entrée items that were on the menu at 37 chain restaurants on two occasions – six months after the regulations went into effect and again 12 months later.

The calorie content of entrée items were found to be a bit lower and some improvement in sodium and saturated fat was noted. Sit-down restaurants showed more improvement than quick service restaurants in calorie reduction. Sit-down restaurants, like Applebee's or Denny's, cut 73 calories from their meals while quick service restaurants, like MacDonald's and Burger King, only showed a reduction of 19 calories in entrees.

In addition to slightly fewer calories, the saturated fat content of entrees at sit-down restaurants fell by about 2 grams per meal — from 18 grams to 16 grams — and sodium levels were reduced by about 300 milligrams. Still, though, the average entrée racked up nearly 1,000 calories, 1,900 milligrams of sodium, and 16 grams of saturated fat.

At quick-service restaurants, a typical entrée had 18 milligrams less sodium after the menu labeling law went into effect and there was little difference in the amount of saturated fat.

None of the meals looked at from either sit-down or quick-service restaurants was anywhere close to meeting the 2005 Dietary Guidelines for Americans in terms of recommended limits for calories, sodium, or saturated fat. Fifty-six percent of the entrees exceeded the recommended limit for calories, 75 percent surpassed saturated fat guidelines, and 89 percent contained too much sodium.

The Supreme Court's recent decision to uphold the Patient Protection and Affordable Care Act means many more restaurants will have to begin complying with the law that requires restaurants with 20 or more locations in the United States to post the numbers for calories, fat, and other nutrients on their menus. National guidelines from the Food and Drug Administration are expected later this year.

Hopefully, the food industry will respond to these requirements by reformulating menu items so that they are healthier and smaller portion sizes will be offered. Restaurant menu labeling is considered to be a public health promotion strategy to encourage better dietary choices by consumers and fight at least one prong of the obesity epidemic.

The study was published online in advance of publication in the August issue of the Journal of the Academy of Nutrition and Dietetics.

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