Most people know that the world is in the midst of an overweight and obesity epidemic. In the United States alone, more than two thirds of adults and about a third of children are overweight or obese. Why? Primarily because we eat too many calories.
Americans consume nearly one third of their total food and drink calories outside the home. Because these meals often have large portion sizes and are higher in fat and other less-desirable ingredients (like salt and sugar), they are a significant contributor to America’s weighty problem.
In an effort to address this growing national health crisis, the federal government wrote into the 2010 Affordable Care Act a requirement for calories to be listed on restaurant menus. In response, the U.S. Food and Drug Administration (FDA) passed a new rule in November 2014 to help people make better choices.
Research shows that most people either don’t know or seriously underestimate the calories in restaurant meals. Starting December 2015, calorie counts will be required on menus and signage in restaurants and other retail food outlets that are part of a chain with 20 or more locations of the same name and offering basically the same menu items. The rule covers:
To help consumers put this information into context, menus and menu boards must also state ”2,000 calories a day is used for general nutrition advice, but calorie needs vary.”
You might wonder how we got to a place where we need a government intervention to protect us from ourselves. Several issues come into play — it’s not just a lack of self-control.
For one thing, a majority of people either don’t know or are incorrect about how many calories they should be eating for their age, sex, and activity level. Another factor is some people simply don’t understand the correlation between weight gain and eating too many calories.
A third factor is the disparity between Americans’ perception of their weight and their actual weight. In one survey 25 percent of people who were overweight described themselves as being at their “ideal weight,” and 76 percent of people who were obese described themselves as “overweight.”
Listing the calories per item and the 2,000 calories per day guideline on menus could be an important step in helping people understand the relationship between calories and obesity. But it’s really too soon to know to what extent this will affect people’s eating behavior. As one recent review of existing studies noted, menu-labeling research is in its infancy, and so far, studies have shown mixed results.
“Certainly no one knows if there are any long-term effects,” said Edward Abramson, PhD, author of “Emotional Eating: What You Need to Know Before Starting Your Next Diet,” and professor emeritus of psychology at California State University, Chico.
But there is a high degree of support for the measure from health organizations, the National Restaurant Association, and the public. Some cities, states, and counties have already implemented calorie labeling requirements.
Why do we eat things we know are bad for us? Genetic makeup is part of the answer. When our prehistoric ancestors were foraging for food they learned that sweet foods were generally safe, whereas sour or bitter tasting foods may be poisonous.
“So we may have evolved to prefer sweet,” Abramson said.
We also evolved to move more.
“Once upon a time, food was not as plentiful as it is now and people were considerably more active than they are now. When I was a kid you had to get out of the car to open the garage door, and 100 years ago people were on the farm or working in factories, not sitting at desks typing on computers,” Abramson said.
We’re not only battling our subconscious urge for sweets. Our environment also influences our food decisions. Restaurants are notorious for serving portions large enough for two, sometimes three, people.
“There’s no physical need to eat the amount of food that is typically presented in a restaurant meal,” Abramson said.
Although it’s easy to point the finger at restaurants, we’re also guilty of overserving ourselves.
“There’s ample evidence that home cooked meals are considerably larger than what they used to be,” Abramson said. A study of the trend toward larger portions found that even cookbooks showed fewer servings for identical recipes in more recent volumes, meaning portions are intended to be larger.
“We seem to think we need more food, and why that is I don’t know,” Abramson said. “Our environment is kind of pushing us toward gaining weight.”
Messages influencing us to consume are ubiquitous. Fast-food restaurants and coffee shops are on every corner, and practically every other ad on TV or the radio is screaming about the next big thing at some restaurant chain.
“I tell people if you don’t pay attention, if you just go about your business, you’re going to get fat,” Abramson said. “It’s part of the environment and if you make your way through the world then you’re going to be confronted with it. You have to learn how to deal with it.”
Strategies can help us disregard the constant noise telling us to eat more. Awareness of how many calories we need and how many we are really consuming may help. If you travel or sometimes can’t avoid eating out take steps to minimize calories.
But the best way to avoid unhealthy food and have more control over how much you eat is to cook for yourself.
Accepting that being healthy and an appropriate weight comes from a lifelong commitment to good eating habits, not a quick-fix diet or a miracle solution, is also important, Abramson said. Focusing on eating for health instead of depriving yourself to lose weight may help you make this mental shift. The benefit?
“The clear benefit is health risk. Obesity has been associated with not just diabetes and hypertension, but even things like some forms of cancer . . . . Surgeries are more difficult, pregnancies are more difficult with obesity. So the health benefits of a normal weight are really considerable,” Abramson said.
Need more motivation? Do it for your kids. It’s really important for parents to model appropriate eating behavior. Obese children are horribly stigmatized, and as early as kindergarten, Abramson said.
”So there’s a real social price to be paid, and an economic price as well. Job discrimination, discrimination in applying to colleges . . . when someone is overweight. The motivation is clear,” he added.
If you need to lose weight it’s important to set reasonable, achievable goals. Many people set the bar too high and give up when they fail. Keep in mind, you didn’t gain the weight overnight so you’re not going to lose it overnight, Abramson said.
“It would be nice to look like an 18-year-old model, but that probably is not going to happen. What we want to do is improve our health risk and even a modest weight loss of 5 to 10 percent of body weight significantly improves health risks,” he said. “You can still be somewhat over your ideal weight but significantly improve your health risks.”
July 15, 2015
Christopher Nystuen, MD, MBA