Why calories can count

You may have noticed the recent outcry in the media about the new government regulations that have come into force requiring calorie information to be displayed on menus in England. You would be hard pressed to find many in favour of this initiative, at least publicly, as it feels like there has been a complete dogpile on any dissenting opinions. To recap, critics of this new law say that simply shifting the responsibility onto customers by giving them the calorie counts of meals and then expecting them to make healthy choices is hardly going make a dent in the obesity crisis. Displaying calories on menus may also cause anxiety and stress to those who are vulnerable or who are already suffering from eating disorders. As a Registered Nutritionist, I cannot disagree with either of these criticisms. But I am going to have to also stick my neck out to say that I am think cafes, restaurants and takeaways should display the calorie information of non-prepacked food and soft drink items that are prepared for customers. In fact, I would argue that the more readily available information we have about our food and drink, the better.

To start with, the UK has one of highest obesity rates in Europe and this costs the NHS £6bn per year. The rates of overweight and obesity are still continuing to rise and particularly among children. Alarmingly, more than a quarter of children at Year 6 are already obese with another 15% being overweight (or what some might cynically call, ‘pre-obese’). The rates are even worse among adults with almost ⅔ of all adults being above a healthy weight and 28% being clinically obese. However, the evidence clearly shows that the root causes of obesity are both manifold and complex, and requires a multifaceted solution directed at a population level. In other words, it is all very well to educate people about healthy eating but as an individual, your ability to make healthy choices is not solely dependent on whether or not you have the willpower to do so. Clearly there are much larger forces at play that are out of your control and affect whether you have access to affordable healthy food and the means to then cook it. So to be clear, there is no quick fix or single governmental policy that can tackle obesity on its own and these new regulations will be no different. Nonetheless, does displaying the calorie count of foods on menus help people to make healthier choices?

Although the number of studies and the quality of the evidence is still relatively low, the findings indicate that listing calories on menus may make a difference. A number of studies including a Cochrane review found that when the calories of food items are displayed on menus, it can result in a decrease in the amount of food ordered and eaten. Interestingly, a further study by the Economic & Social Research Institute showed that this difference was increased significantly when the number of calories listed for items was given the same prominence and displayed to the right of the price on menus. Of course, further studies and research is needed to measure the effect of listing calories on menus and whether it is also long-lasting. But maybe there is a more important question we should really be asking. Why shouldn’t we have more information about what goes into our foods and drinks and what we are putting into our bodies?

The main criticism of displaying calories on menus as a means of encouraging heathy choices is that a measure of calories, itself, is too rudimentary to have any meaning. Simply put, not everything that is low in calories is relatively ‘healthy’ or nutritionally balanced and vice versa. However, many restaurants have been displaying their calorie information on their menus for years and some already use it to highlight their list of healthier options. For example, Pizza Express’s Leggera menu includes dishes that have ‘at least a third fewer calories’ than their main menu whereas McDonalds have both a Mains under 600 and a Mains under 400 calories menu. So using calories as a means of identifying a ‘healthier’ option isn’t something that the public hasn’t already seen before even if there will be some lower calorie dishes that are still lacking in nutrition.

However, this doesn’t mean that calories cannot be used as a tool for comparing like for like dishes. In other words, if you are faced with a menu containing several types of pizzas with their respective number of calories, it doesn’t take any effort to see where the difference in energy is considerable. Why shouldn’t we know it when a Calabrese pizza has almost twice the calories of a Margherita? Some would say that if they are out for a meal they don’t want to think about anything other than pure enjoyment and that starts when they peruse the menu. But we are only talking about a number written beside an item on a menu. What you do with that information is still entirely down to you. It can be an uncomfortable truth to know just how highly calorific some of your favourite meals are but why shouldn’t we know the truth about our food and drink?

And since food establishments are now levelling with us on the number of calories, why shouldn’t we also have more information about how dishes are prepared and where the ingredients are sourced from? Many larger restaurants, cafes and takeaways will have information about their commitment to sustainability on their websites, but why shouldn’t we also see the carbon footprint of foods and drinks on the menu at the ‘point of choice’?

Having more access to information about our food and drink readily available on our menus may actually help push restaurants to make changes for the better. For example, looking again at listing calories on menus, if we assume that this makes even just a small effect in that there is an increase in the number of lower calorie versions of the same type of dishes ordered, then any smart business would want to respond to the demand and offer more of them. Especially when the new regulations require that in addition to now publishing the calories of food and drinks on menus, establishments must also display a statement of daily calorie needs that ‘adults need around 2000 kcal a day’. I cannot imagine that there will not be many restaurants who are comfortable with displaying this message boldly on their menus that also feature dishes containing close to the same number of calories as an average adult’s daily requirements. In other words, simply coming clean about the number of calories they are dishing up can encourage restaurants to reformulate their dishes to make them less calorific which may ultimately also make them healthier.

Finally, I accept that displaying the calorie count of foods and drinks on menus has the potential to cause anxiety and stress to the number of people who are vulnerable or who are already suffering from an eating disorder. It will also come as no comfort that although the regulations allow restaurants, cafes and takeaways to provide a menu without the required calorie information where the consumer expressly requests it, it is at the businesses’ discretion. So unless you are confident enough to call attention to yourself by asking for a menu without the calories, it may now be even more challenging to go out for a meal. However, this doesn’t mean that if you are vulnerable to an eating disorder, eating out is an impossible feat. In my experience, eating out is almost always going to require some advance planning and using support strategies such as making menu choices in advance to reduce anxiety. And not only is there much more awareness but there is also a lot of support out there to help you through this including some great advice on eating out from the fantastic eating disorder charity, Beat.

Ultimately, eating and sharing food with others is an important part of life, but as a nation, we need to reduce the number of us who are becoming overweight and obese. Displaying the calories on menus will certainly not be the silver bullet to halt this rising unhealthy trend but it may just encourage us to make healthier choices and cause restaurants to rethink what they are serving up. I, for one, believe that we should be more honest and have more access to information about what is in our food and drink, and how it affects our bodies and the health of the planet. Because until the root causes of obesity are effectively addressed by our government rather than treating the dire symptoms of rising numbers with simple regulations, the only tools we have at hand to use as individuals is information.

And with that in mind, here is a healthy recipe for an Easy pizza dough that will rival any takeaway.

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