What's all this about putting calories on menus? 

If you're not one for daily news updates or social media scrolling and you've managed to avoid the swathes of media backlash, then you might not be aware of the latest Government legislation that has come into force to tackle the ongoing obesity epidemic in the UK. As of 6th April 2022, all cafes, restaurants and takeaways who employ more than 250 staff are required to display the calorie content of all meals on not only their physical menus, but also their websites and delivery platforms.  

'Why now?' you might ask. Well, the reasoning behind the new policy is relatively clear-cut. In the UK, 64% of adults are classed as overweight or obese, putting them at a heightened risk of long-term health conditions, including cardiovascular disease and diabetes. In turn, the rising incidence of such diseases puts further strain on an already under-resourced national health service, not to mention the physical and psychological well-being of those living with such conditions. It is hoped that increasing the public's awareness of the calories in the food and drink they consume outside of the home will contribute to healthier food choices and support them to lose weight and maintain a healthy lifestyle. Is it really that simple though, or is there more to the issue of calories on menus than meets the eye?  


Marginal gains 

As with most things, there are two (or likely many, many more) sides to every argument, and this latest hot topic is by no means an exception to this rule. A handful of fast-food chains (including the likes of McDonald's and Wetherspoons pubs) have actually been displaying their calorie content for over a decade, but has it had the desired impact? What can past research and insights from behavioural science tell us about how people really respond to calories on menus?


Overall, evidence to date does not suggest that providing calorie counts on menus alone is effective in prompting sustained behaviour change. For example, one study found that the use of calorie labels resulted in just a 3% reduction in calorie consumption, excluding drinks and desserts (i.e., calorie intake from these did not change) and a more recent study concluded that whilst calorie labelling at McDonalds generally increased the predicted probability to noticing calorie information (e.g., increasing awareness), it was not associated with significant changes to the calorie content of orders, suggesting that the displaying of calorie content alone is not sufficient to change behaviour.


The science suggests that an average calorie deficit of 3500kcal across the course of the week is necessary for the loss of 1lb of fat so one meal out is unlikely to tip the balance considerably. 


Furthermore, a recent review of studies exploring the effectiveness of nutrition information in restaurants concluded that calorie-labelling alone did not have the intended effect of reducing calories consumed, but contextual and interpretive cues could help to inform the selection of lower-calorie food options when eating out. These findings suggest that nutrition information needs to be communicated in a way that is both understandable and relatable for an individual (e.g., providing a representation of the exercise time required to 'burn off' calories, or showing how much of their recommended daily intake a meal contributes). 


One positive influence on behaviour could be the mere exposure effect, whereby the more often people are exposed to something, the more likely they are to engage with it or view it favourably, and only time will tell whether this is something that comes into play for the masses with this legislation. On the other hand, overexposure can sometimes have the opposite from desired effect as people begin to ignore something that they are continuously exposed to, as it is no longer novel and does not therefore catch or maintain their attention. Our brains tend to make shortcuts (cognitive biases) when we are faced with lots of information, and things need to stand out in some way to us if we're really going to take notice of them in the longer-term. On a larger-scale, the legislation could prompt the restaurant industry to make changes to their food offerings if they fear that their higher-calorie dishes will plummet in popularity. This would shift responsibility away from the individual, making it easier to order 'healthier' choices as they are the default option (and as humans we tend to opt for the default option because it reduces the burden of decision-making). Ultimately, however, it is still down to the individual to consistently engage in the behaviour and relies on them not adjusting other lifestyle factors to compensate for their reduced calorie intake (e.g., selecting a low-calorie option and then doing no physical activity that day because they don't feel they need to). 


Clearly, there are several justifications for the decisions to pass the recent legislation, but to better understand whether these marginal gains will amount to systemic behaviour change it is important to be aware of the potential longer-term negative physical, financial, and mental health consequences that could outweigh such perceived benefits, impacting individual motivation for change. 


Unintended consequences


Not only has there been little evidence to suggest that widespread displaying of calories on menus will contribute to widespread behaviour change, but it has also left a sour taste in the mouths of many, from restaurant-owners and waiting staff, to individuals battling with debilitating and life-threatening eating disorders whose attempts at recovery are further thwarted by pervasive messaging about restrictive eating and counting calories. In the following section, three potential drawbacks of the legislation are explored, providing a more in-depth look at how different individuals are likely to respond differently to the widespread introduction of calories on menus. 


1. Reaching the wrong audiences


Whilst the introduction of calories on menus is predominantly targeted towards obese and overweight individuals who would benefit from adopting healthier food choices, the entire population will be exposed to them when going out to eat. This, in turn, could lead to undesirable consequences among subsets of the population whose behaviour will also be impacted - it is currently estimated that around 1.25 million people have a diagnosed eating disorder in the UK, with hundreds of thousands of others battling with disordered eating cognitions and behaviours that may have not been formally diagnosed. Many eating disorder charities and organisations have spoken out about the harmful consequences of calories on menus for those who already have, or are susceptible to developing, unhealthy relationships with food, and over 28,000 people have recently signed a petition to stop the legislation being put into place (although it has now been implemented).


GP Dr Hilary Jones recently caused outrage with his comment that "people with the most serious eating disorders, anorexia, don’t go to restaurants and they know exactly how many calories are in everything so I don’t think that’s a problem", as it just reinforces the stigma surrounding such conditions and could cause those in recovery to avoid going out to restaurants completely. Research suggests that people who are more health conscious are most likely to take notice of the calorie counts, whilst people who are more concerned by the taste and volume of the food they eat are in fact more likely to order food with higher calorie content.


Even if we take people currently struggling with disordered eating cognitions and behaviours out of the equation, a forced fixation on calories can be dangerous for those who do need to lose weight for health reasons, as they too can develop unhealthy relationships with food (e.g., labelling foods as 'good' and 'bad', shaming themselves for eating certain foods), leading to binging and restricting. Calorie counting is known to be one of the strongest predictors of future eating disorder onset. Past evidence showing that calorie-counting is related to unhealthy weight-control behaviours and can even contribute to overeating in some cases, raising the question, "is the legislation targeting one epidemic by contributing to another?"


Furthermore, just as individuals who are less health-orientated may disregarded calorie information on menus, lower-income households who struggle to afford more nutritionally dense foods, alongside those who may not be well educated when it comes to making healthier food choices, may also be less likely to take notice of calorie information, or could even be drawn to higher-calorie options in the belief they are getting more for their money.


2. Numbers do not represent nutritional value


Another reason why reducing meals to a single number representing their calorie content is that it completely overlooks its nutritional profile. Just as the main measure of obesity (BMI) is an arbitrary number that does not take body composition (i.e., lean body mass, body fat percentage) into account, displaying the total calorie count of a food item or meal provides no information about its nutritional composition (i.e., the amount of protein, carbohydrate, fat or micronutrients it contains).


A calorie is simply a numeric representation of the amount of energy contained within a food or drink source, just like BMI is simply a calculation of an individual's body mass in relation to their height; despite this, we have been consistently told to associate higher values with 'naughty' unhealthier foods or with 'being fat', when in actuality it may mean a food is more nutritionally dense and filling (discouraging snacking on low-calorie snacks that lack vitamins and minerals and are often loaded with sugar) or that a person has a large proportion of muscle (some may remember very fit and healthy friends or family members in the mid-noughties being told  that they were obese by the Wii Fit software on their Nintendo games console!).


Take a moment to imagine you're sitting in a cafe on a break from work and you want a boost of energy to combat the afternoon slump. You see that a 'green smoothie' containing apple, banana, avocado and spinach comes in at 240 calories, whereas a KitKat is just 104 calories. You've been socially conditioned to assume that the lower the calories, the better; naturally, you opt for the KitKat, only to find your stomach rumbling again as soon as you're back at your desk. Not only would the green smoothie provide almost your entire '5 a day' in a single sitting, but it's also full of antioxidants,  with the healthy fats in the avocado likely to have you feeling fuller for far longer, not to mention their proven positive impact on brain function. In contrast, the KitKat might be a tasty snack, but it provides little to no nutritional value, with its refined sugars giving you a short-lived boost of energy but also the inevitable 'sugar crash'.


3. Replacing fun with fixation


Many of those opposing the recent introduction of calories on menus argue that it serves to remove the joy from special occasions and social gatherings that centre around going out to eat (see these BBC and The Guardian articles for recent public reaction). Rather than being a source of social connection or the exploration of new tastes and cuisines, for some eating out could instead become a competition to see who can order the least calorific meal, earning their invisible halo of health and the right to feel virtuous, with any feelings of culinary joy substituted with shame and embarrassment for those who select 'unhealthier' options.


For others, going out for a meal may still be considered a 'treat', where the sole focus of doing so is not to eat 'healthily' or restrict calorie intake. Therefore, whilst people may initially take notice of the numbers in front of them, their motivation to choose the lower calorie option is likely to be outweighed by perceived costs of doing so (e.g., choosing something less palatable that does not fill them up and instead prompts them to order dessert or overeat later in the day).  


Previous MasterChef winner Sven-Hanson Britt recently tweeted: "kids will grow up in restaurants, hotels and cafes only looking at that little number below a dish. Choices will be made based on a number alone. The love of flavour, ingredients, history, cooking craft or nutrition will be lost and masked by a newly perceived focus." 


Finally, there are several longer-term financial, physical and psychological impacts of the new legislation that will have a bearing on society, with regard to the hospitality industry and at an individual level. Food outlets with more than 250 staff are having to invest considerable time and money into providing accurate calorie estimations to avoid any legal repercussions. Since the mandate came in just a matter of weeks ago, it has faced backlash from many food outlets, including pubs and restaurant chains, with Wagamama's already pledging to provide a version of their menu that does not display calorie count


So, what's your take on the new legislation, and how do you think it might influence your own behaviour? However you feel, hopefully this blog has given you an understanding of what all the social media commotion has been about, providing an insight into several sides of the story that can help you to make informed choices that will benefit you, depending on your own personal lifestyle and health goals.