A few weeks ago, Globe and Mail columnist Margaret Wente lamented that Ontario's proposal to list calories on chain restaurant menus won't work and that such an effort represented governmental nannyism.
To make her case she cited a number of studies that indeed failed to demonstrate that calorie listings on menu boards made a difference to those who ordered. What she failed to cite were the many contrasting papers that did in fact report that posted calories influence purchasing behaviour, especially for those individuals who prior to ordering reported caring about calories.
As Wente herself notes, as far as why society is struggling with weight, the answer isn't simple, but rather it's incredibly complex. She rightly notes that many factors are conspiring to make weight a struggle, "the explosion of screen time, the demise of outdoor work and play, the rise of two-income families with no time to cook. To say nothing of impulse control, at which human beings are not very good," to which I'll add tens of billions of dollars of sophisticated advertising explicitly designed to take advantage of both human psychology and physiology, laxity in front-of-package labelling laws which allow boxes of highly processed foods to claim healthfulness, crop subsidies that help support the production of foods engineered to be hyper-palatable, misguided public-health interventions that suggest we're capable of out-running the amount of food on our forks (we're not), a national Food Guide that suggests juice is a fruit and that milk is so important its liquid chocolate-bar equivalent should be sold in schools.
Not to mention an unregulated morass of a weight-management industry, nonsensical reality-television shows that teach Canadians suffering is a prerequisite to success and, of course, the normalization of junk food or candy to christen every event in our lives no matter how small, to fund-raise for every cause no matter how healthful, and to reward, pacify and entertain our children in place of creative programming and thoughtfulness.
And honestly, I could go on.
So given this incredible complexity, the bulk of which has to do directly with our food environment as a whole rather than ourselves as individuals, could a singular intervention truly be expected to have a dramatic impact on our collective waistlines?
Of course not, but that doesn't mean the intervention is folly. The analogy for all of this that I like best is Yale's Dr. David Katz's, whereby he has referred to our struggles with diet and weight-related chronic diseases as a flood. There's no doubt that learning how to swim would be wise for anyone living in a flood plain, but there's also no doubt that to stem a flood, levees need to be built and that sandbags work together, not alone. And when it comes to levees, pointing at a single proposed sandbag and suggesting that we ought not to fill it because it alone will be insufficient to stem the flood underscores a true lack of understanding of the problem at hand.
And as for the claim of menu-board labelling as nannyism, I struggle with the notion that providing consumers with information that might help to further inform their choices is nannyism. Ultimately, calories are in fact the currency of weight and they are anything but intuitive – especially in restaurants. And so for instance, while posted calories would never prevent Wente from ordering Milestones's Signature Breakfast Wrap, her knowing it contained the calories of nearly three Milestones's Chicken Spinach Asiago Sandwiches and more calories than many grown women burn in a daytime, might lead her to consider the wisdom of that choice.
Dr. Yoni Freedhoff is an assistant professor of family medicine at the University of Ottawa and the founder and medical director of the Bariatric Medical Institute – dedicated to non-surgical weight management since 2004. Dr. Freedhoff sounds off daily on his award-winning blog, Weighty Matters, and you can follow him @YoniFreedhoff. His latest book, The Diet Fix: Why Diets Fail and How to Make Yours Work, will be published by Random House in March.