Calorie Labelling on Menus - Helpful or Harmful?

Starting from the 6th of April, all restaurants in the UK that employ more than 250 people will be required to place calorie information on their menus. This is part of a new government initiative to help combat obesity.

However, critics argue that this measure is ineffective and may even do more harm than good. They point out that most people don't make decisions about what to eat based on calorie counts, and that for those who do have eating disorders, this kind of information can be triggering.

What's more, with the UK's out of home dining sector just beginning to recover from the COVID-19 pandemic, this could potentially derail progress.

In this article we're going to cover;

- Why the legislation was introduced

- What data supports the legislation

- Potential for harm for vulnerable groups and sector recovery

- My personal opinion

Why did the UK introduce mandatory calorie labelling on restaurant menus?

It is believed that the NHS is crippled by obesity with government and independent organisations estimating that it costs the nhs between £5 to £6.5 billion per year to treat obesity.

These figures are contentious (as are the claims that obesity is "crippling" the NHS, albeit I'm very much on the side of large scale changes being made to address the issue) but, at the very least, provide some rationale for why calorie labelling is being introduced.

The government's published impact assessment document states "Children and adults are consuming too many calories. Eating out accounts for a significant proportion of people’s energy intake. When eating out, however, there is limited access to energy information making it difficult for consumers to identify healthier options for themselves and their families. Ensuring this information is available will allow consumers to make informed choices, supporting Government policies to reduce childhood obesity."

Let's address some of those claims shall we?

Is the change to introduce calorie labelling justified?

We'll answer this question in two ways;

- Addressing the claims in the government's impact assessment document

- Looking at the effectiveness of the intervention itself

"Children and adults are consuming too many calories..."

At it's most basic level obesity is the result of unhealthy behaviours and excessive body fat accrual as a result of consistently excessive energy intake (via nutrients from food).

However, obesity is, and isn't, as simple as energy balance; our genetics, the obesogenic environment, socioeconomic status, circumstances, race, disability and more all factor in to the individual risk of developing obesity.

That being said, anyone can see that there is a growing obesity problem in the UK. While you can contend just how much of a drain it's having on the NHS, it's clear to see that prevalence of overweight obesity is increasing and continuing to increase at an alarming rate.

Obesity levels have almost doubled since 1993 (15% to 28%) and 3/4s of those aged between 45 and 74 are categorically overweight and or obese.

The rates of obesity in children are equally, if not arguably more, alarming. 1 in 7 children are obese by age 5 with 1 in 4 obese by age 11. Deprived children are more likely to be obese, and the gap has widened.

So, yes, we are eating too much (or at least living unhealthily) and changes need to be made...

"Eating out accounts for a significant proportion of people’s energy intake"

This claim is difficult to critique because there isn't a definition provided of what the developers of this mandate consider "significant".

Data representative of a UK population shows that adults who ate meals out at least weekly had a higher mean daily energy intake consuming 75-104 kcal more per day than those who ate these meals rarely. The equivalent figures for takeaway meals at home were 63-87 kcal.

Children who ate takeaway meals at home at least weekly consumed 55-168 kcal more per day than those who ate these meals rarely. Additionally, in children, there was an interaction with socio-economic position, where greater frequency of consumption of takeaway meals was associated with higher mean daily energy intake in those from less affluent households than those from more affluent households.

Ultimately, one of my biggest gripes with this mandate is that it's not addressing the actual elephant in the room; those from less affluent households eat less nutritious but more energy dense meals.

"When eating out, however, there is limited access to energy information making it difficult for consumers to identify healthier options for themselves and their families."

I would argue against this to some degree. Most restaurant and fast food chains do provide nutritional information online and or upon request.

Poor dietary quality associated with less affluent households has been consistently found to not be an issue of education but rather one of poverty.

Affordability, accessibility, cooking skills, access to cooking equipment, free time to cook and energy value per money spent are all actual barriers to achieving a healthy, nutritious diet; Not just education.

Image from; Urban poverty and nutrition challenges associated with accessibility to a healthy diet: a global systematic literature review

"Ensuring this information is available will allow consumers to make informed choices, supporting Government policies to reduce childhood obesity."

Ahhhh but does it though?

It all really depends on your definition.

The study which the government has used to justify this intervention does indeed back calorie labelling as an effective means of reducing the number of calories consumed in one meal.

The paper found that including this kind of calorie labelling reduced energy intake when eating out of the home / having takeaway by 81 calories per meal (on average).

For anyone who has ever dieted before and or been on a calorie aware weight loss journey, i'm sure you rolled your eyes at that figure.

You know that it is such an inconsequential number that it may as well not exist. Especially considering that we'd only be making this saving when we go out for food. Ah yes, saving 81 calories the two or three times you go out for food per month really makes having those menus labelled worthwhile doesn't it...

I'd also say that the study they used involved American and Canadian populations; not exactly representative of the UK (and, quite honestly, I find that using the US as a whole population to be a bit iffy as is because it is so incredibly diverse - it's essentially a multititude of smaller countries all falling under the banner of USA with each of these smaller countries having their own different legislation and cultures (to a certain extent)).

An additional major gripe that I have is that they never conducted any form of pilot study to justify the legislation.

That'd be the equivalent of rolling out the vaccines as soon as they were initially made with zero testing while hoping for the best. Not only that, but then going further to justify it by saying "we're doing this for your good even though we're not sure if it works or not and it may actually be potentially harmful in some situations but we mean well!"...

The closest study I found which was recent, representative of the UK and involved the kind of intervention the government are introducing (calorie labelling being introduced on the menus of several cafeteria sites) literally had zero beneficial effect on reducing calorie consumption per meal.

In fact, in the one site that showed some positive benefit (which was noted on the first day of the intervention), the researchers found that, over time, food selection and calorie intake returned to normal. Basically, the novelty wore off and no one cared to engage in calorie reducing efforts.

Potential for harm and sector recovery issues

Having calorie labelling on menus is not without risk and poses a considerable (but not considered by the government) threat to those with a history of eating issues.

Tom Quinn, the director of external affairs for beat, said there was evidence that calorie information causes anxiety and distress for people affected by eating disorders.

"It can increase a fixation on restricting calories for those with anorexia or bulimia, or increase feelings of guilt for those with binge eating disorder," he said.

"There is also very limited evidence that the legislation will lead to changed eating habits among the general population." (quote from BBC article).

Aside from those with history and or present eating issues there are others who will suffer from this mandate.

The consumer firstly; the quality of the dining experience may be hampered by venues feeling like they need to meet certain "calorie quotas" with chefs and cooks sacrificing flavour and creativity for lower, and possibly more desirable (given the mandate and our cultural obsession with smaller bodies), calorie numbers.

Culinary professionals would also suffer, not just for the reasons given, but venues which may provide certain cuisines or dishes that are more calorific may come under increased pressure and scrutiny to change. Reviews may no longer be about the experience, flavours, sights and sounds of a meal out; reviews may become an exercise in describing which dish tasted the most tolerable for the least amount of calories.

On that note, we also have to consider the practicality of consistently accurate nutritional information being provided. By placing the nutritional information for the consumer to be aware of you're also asking the chefs and cooks to ensure that each and every portion is exactly the same.

I don't know about you, but I certainly feel for the culinary staff; I just don't think that it is practically possible to expect them to meet these demands on a consistent basis.

You also have to worry about the sector itself in totality.

Not only the unknown implications of how this could affect profits and sales but what about future generations of chefs and cooks and other kitchen staff?

Could this disuade those interested in pursuing these careers to explore job opportunities?

Will there be any jobs there to pursue if the sector takes a significant financial hit?

But sure, why would the government care? They've done their bit and now it's up to the rest of us to sort it out...

My personal thoughts

More misguided, ineffectual and potentially harmful public health interventions by the "experts".

Shifting the blame away from the obesogenic environment they've been complicit in creating by letting multinational corporations influence legislation and run riot with marketing, targeting the impoverished.

The ever-widening socio-economic divide is not going to be fixed by adding calories on to menus.

This will, given the available, relevant data we have do little to nothing.

This is a tokenistic intervention. Showmanship and false virtue without addressing the real issues that they've allowed to exist and develop.

Calorie labelling on menus is the equivalent of using a very small water pistol which is being pointed in the wrong direction trying to put out a rampant housefire.

In summary, I'm skeptical.