17 February 2011

Unhealthful News 48 - It turns out that almost everyone disdains giving people information

A couple of years ago, New York City started requiring chain restaurants to post the calories for their food items.  It is not a perfect rule in its details but it seems like something no one could seriously object to.  Unlike New York's efforts to ban hydrogenated oils or force reductions in salt, this does not take away anyone's options.  Even if it does not have much effect it has little downside.  And it definitely has some effect – I have changed my ordering choices several times when visiting New York, with a moment of "wow, really, that many calories? I guess I really don't need that". 

Yes, perhaps the results are limited, in terms of making people become less overweight.  But where is the harm in educating and informing, and inevitably it does lead to some healthier choices.  The effects were very limited in a newly published study that looked at:
A total of 349 children and adolescents aged 1–17 years who visited [McDonald's, Burger King, Wendy's and Kentucky Fried Chicken] with their parents (69%) or alone (31%) before or after labeling was introduced. In total, 90% were from racial or ethnic minority groups.
They reported the result, "We found no statistically significant differences in calories purchased before and after labeling."  I will set aside for another time the fact that "no statistically significant" is not a result (actual measures are a result, reporting only statistical significance is a result mostly in the sense that it is a result of bad epidemiology education).  Instead, I want to note that you could probably not find a subpopulation that was less likely to reduce their calories in response to the labels.  First, we have no idea how many of them should have been reducing their calories.  Moreover, I know that when I was 17, I would have probably seen more calories as a way to get more food value from my limited budget; such an effect might even cancel out those who reacted the "right" way.  Obviously those particular establishments do not exactly attract the most health-conscious consumer; either they eat badly in general or are ignoring health for the moment.  At these restaurants, other than leaving out the fries or ordering smaller sizes (which do not take numbers to recognize as calorie reducing), there is really not a lot of room to maneuver with respect to calories. 

To interpret this study as showing that the calorie labels are not doing any good is an example of the Mythbusters fallacy.  It is not clear that the study authors made any such mistake.  So the question is why this single study, of a population that is far less likely than average to respond to the information and perhaps had no need to cut calories, and thus an equivocal result translated into dramatic, general, and definitive headlines like:

"Calorie Labels Have 'No Effect' on Food Choices" (Associated Press
"Study confirms calorie listings don’t have much bite" (American Council on Science and Health)
"Calorie labelling has no effect on food choices" (The Telegraph)
"Calorie Counts on Menus: Apparently, Nobody Cares" (Time)
In fairness, some other news outlets did qualify their headlines by reporting that the result applied only to kids (though not noting the focus on poorer kids who were eating at the must junk-foody restaurants).  Others, though, compounded the error, like the New York Times's article that included a photo of calorie counts on Starbucks pastries.  Starbucks is the opposite of what was studied, perhaps the best-case scenario for calorie labels.  It attracts customers who are more likely to understand and care, and offers some items that are very highly caloric but also choices that are less so.  Indeed, Starbucks is one place I have found the labels to be quite informative.  Could it be that something fails to have a measurable effect on one subpopulation, but still has a benefit for another?  Apparently it would just be too difficult for someone writing a news story to try to explain that (or perhaps even understand it).

It was interesting that those media outlets that usually rush to report any claim about the increasing scourge of obesity were so quick to dismiss the value of the this intervention.  Perhaps they could at least recognize that the information could trickle through and have some overall effect, even if one observation about someone's fast food order did not reveal that.  Maybe the reminder even caused the study subjects to make up for their splurge with a bit less food that very same day.  Even more interesting is that among those who seemed most eager to over-conclude from this study, and then conclude that the labels are pointless, were media outlets whose politics makes them quick to condemn aggressive government interventions and to say that consumers should be able to make their own informed choices.  Apparently what they really mean is that companies should be free to sell what they want and consumers should be required to make their choices without being informed.

Maybe this was a perfect storm of those with different political biases wanting to spin the same tale of failure.  Those who object to all regulation jumped on board to call for an end to the labeling regulation.  Those who favor action, either more aggressive education or choice-restricting interventions, saw an opportunity to demand that something be done beyond providing information.  Either way, the actual health science, a modest project with a fairly boring and unsurprising result that is nothing more or less than one useful bit of our growing overall knowledge about the topic, was turned into headline news because that offered the chance to editorialize about the topic under the guise of reporting.


  1. Well.. as a second-best solution opposed to downright prohibiting the "junk-food", mandatory labelling seems better; however, I wouldn't treat opposition to the labelling so bad. It really increases costs (especially if you are not a big McX company). And, after all, the customer can make an 'uninformed' decision not to buy, unless given the information. And, I found that if I want the information, I usually can get it - either from the producer, or, when it is interesting, from some consumer magazines.

    So, in this case, I would say most people don't care; those who do, already have the information (it's not that hard to browse the internet). And, in the end, it's hard to argue that it costs 'nothing', if just for selling you some food on has to comply with hundered and hundereds of pages of regulations...

  2. Ondra, I would not characterize it as some kind of substitute for prohibition. There is nothing about this policy that acts like an attempt to keep people from making the choice they want. Perhaps many of those who supported it are prohibitionists at heart, but here they did something good instead.

    As for costs, I never said it costs "nothing". The merchants face some costs of printing the information in their menus, though this is pretty minimal (especially after they figure out the logistics in the first place, which is now done). As you note, these chain restaurants already have the information, so it was just a matter of printing it. And it seems like something quite reasonable to ask them to do.

    It may well be that most people do not care (though many more might care than act on the information during a particular purchase -- the general education might be useful), but that does not detract from the value for those who do care. But I definitely do not think that a large portion of those who care already have the information. A few people with very regimented diets (allergies, some weight-loss plans) look up the information, but most of us do not, even when we are curious. Sometimes it does not even occur to people to ask, or that they could. That is why the right to informed autonomy imposes a duty on others to actively provide information.


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