McDonalds + Math = F

Calorie postings are too complex to be useful

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(RxWiki News) Unless fast food restaurants hand out calculators with their calorie amounts, the nutritional data required by the new federal health law may not help customers as much as intended.

A new study reveals that the calorie amounts posted throughout one New York City neighborhood were too complex and confusing to actually help a person determine how many calories they would eat when ordering their food.

"Order the smallest size of fast food meals to minimize calorie intake."

Elizabeth Gross Cohn, R.N., N.P., D.N.Sc., and assistant professor of nursing at Columbia University School of Nursing, led the study investigating calorie counts on 200 menu items in fast food chain restaurants throughout Harlem.

New York City has had a calorie labeling law for restaurants since 2006 that includes some of the federal requirements that are part of the national health reform law passed in March 2010.

The federal requirements require restaurants with 20 or more locations to provide nutritional information, including calories, for menu items and self-serve foods.

To test how helpful this posted nutritional data is, Cohn's team recruited volunteers to work in pairs going from one block to the next in Harlem, looking for fast food chain restaurants.

They used digital cameras to photograph 70 menus from 12 chains that included 200 different foods with calorie data. They then rated the "practical utility" of the data provided.

They considered how much a "single serving" was and how many calories were in a single serving. Then they used this measurement with FDA guidelines to create a "menu rating tool" for analyzing the usefulness of the data posted on the menu.

Cohn's team found that the calorie postings, even while following the letter of the law, were confusing - or at least weren't helpful enough for consumers to use them at the moment of ordering to help them make a good decision.

"Although most postings were legally compliant, they did not demonstrate utility," the authors wrote. "Menu postings for individual servings are easily understood, but complex math skills are needed to interpret meals designed to serve more than one person.

For example, calories were often posted for a meal deal but not for the individual items in that combo. They also found it was difficult to calculate the number of calories in a meal when the information provided was for more than a single serving.

"In some items, calories doubled depending on flavor, and the calorie posting did not give enough information to make healthier selections," the authors wrote.

The largest percentage of menu items with calorie postings were the combination and multi-serving items. The researchers said the complexity of the math required to make nutritional calculations with these items may be especially difficult for the residents of lower socioeconomics neighborhoods where many chain restaurants often exist.

In one example, a bucket of chicken was said to contain 3,240 to 12,360 calories, but it wasn't clear how many pieces of chicken made up a single serving size.

Another combination meal was posted as having 500 to 2,080 calories, but the posting did not explain how it would be possible to order the meal and ensure the calories were closer to the 500 mark.

The study was limited by the fact that only one neighborhood in one city was studied and that the menus themselves were the subject of the study rather than people's purchasing behavior.

However, they point out that their research reveals the need for making posted calorie amounts and nutritional information more straight-forward and useful. One suggestion they make is to use slashes or dashes to separate the options in some meals, such as listing an "egg with ham/bacon/sausage 350/550/750."

They concluded that the nutritional data postings would be more useful to consumers if they were simplified so that little or no math was required to determine how many calories a particular order might include.

The study appeared online February 16 in the Journal of Urban Health. The authors reported no conflicts of interest.

Last Updated:
February 27, 2012