Move to put calories on menus is definitely a good idea, writes JACKY JONES
DOES THE Government’s new policy to put calories on menus make Ireland a nanny state? Contrary to popular belief, nanny often does know best and public policies have improved population health more than any other intervention.
Getting people to change their behaviour is impossible without regulation to make the healthier choice the easier one. Seat belt legislation was resisted in many countries, but in the US alone seat belts saved 180,000 lives between 1975 and 2005 and save $50 billion (€38 million ) every year in medical expenses and lost productivity. Smoking legislation is another example of nanny state at its best.
From January 1st 2012, tobacco can only be sold in Australia in plain packaging. The tobacco industry launched a massive media campaign in response, portraying the state as a stern nanny and exhorting adults to oppose the plain packaging law because it interferes with individual choice.
People who make nanny state claims get media attention but they are up against science. Research over the past 40 years shows that population health policies work and they work much better than lifestyle education. Nanny state critics purport to be on the side of personal freedom when they are really using magic tactics. Misdirection manipulates the public into thinking the government is abusing its power.
Interestingly, the public demands immediate action on infectious diseases because they fear contagion and are quite happy to comply with any public policy. They are not so keen on restrictions when the health problem is more long term, such as alcohol abuse or obesity.
Resistance to government policies has existed since at least the sanitary revolution of the 19th century. Laws to regulate dwellings and provide everyone with clean water and lavatories were fiercely resisted by the developers and industrialists of the time who said it would cost too much and have dire consequences for jobs and society. Does this sound familiar?
The Food Safety Authority of Ireland is consulting the public about putting calories on menus to help people make healthier choices. Predictably, chefs and restaurant owners have come out against the measure on the grounds that it is too costly, that exercise is more important, and more lifestyle education is needed. This is misdirection and the naysayers are wrong on all counts. For a start, a person would have to walk six miles every day for a week to lose 1lb. A small change of 100 calories less a day leads to a 10lb weight loss in one year.
Putting calories on menus is definitely a good idea. A 2011 study showed that 15 per cent of customers in 168 food chains in New York City used the calorie information provided and purchased, on average, 106 fewer calories. This seems like a small effect but is massive when translated into population health terms. In Ireland, it adds up to 1.5 million pounds weight loss each year. The biggest benefit of calories on menus is, not so much that customers will make a healthier choice, but that it will force food businesses to use healthier cooking methods, less processed foods and, more importantly, reduce their portion sizes.
There are downsides. Calories on menus may increase health inequalities because people from better-off neighbourhoods are nearly twice as likely to make healthier choices as those from poorer areas. This may be because healthier options are too expensive or there is less choice on menus in poor neighbourhoods.
The evidence also shows that 85 per cent of customers pay no attention to calorie information. This is consistent with findings from previous research which shows that information is not enough to change behaviour. Healthier choices have to be affordable and available.
In spite of the downsides, putting calories on menus is a good public health measure. Food 4 thought, a cafe in Galway, voluntarily put calorie information on the menu and, in the spirit of action research, I tried it out for lunch. Baked potatoes had 317 to 547 calories depending on the filling. A breakfast bap is 748 calories compared to a portion of porridge at only 73. I chose a chicken and broccoli pie with 240 calories instead of tuna bake at 617. So it does work and knowing I made a healthier choice enhanced my dining experience.
Putting calories on menus will not solve Ireland's obesity crisis, but it is one step in the right direction. You can have your say about this new public policy on fsai.ie. The consultation process closes tomorrow.
Dr Jacky Jones is a former regional manager of health promotion with the HSE