Healthy Choices and the Need for Menu Labeling

by Marlene Schwartz

The other day I went to Panera's with my oldest daughter, Anna, to get lunch.  I figured that it was probably a healthier restaurant than the Friendly's next door, the TGIF's at the other end of the shopping center, and certainly better than the McDonald's across the street. After all, Panera's has things like soups, salads, and sandwiches - those are usually pretty healthy, right?

Anna and I spent some time figuring out what to get.  She ended up ordering the chicken noodle soup and half of a tuna sandwich, with the apple as a side.  I got the Portobello & Mozzarella Panini and the apple on the side.  We both had water to drink.

Since I know that New York City has been trying to get restaurants to post calorie information on their menu's, I decided to  see just how hard it was to get this information in Connecticut. As the cashier was ringing us up, I asked if I could see the nutrition information.  He looked at me with a puzzled expression and said he'd have to ask the manager.  The manager then came out and I asked again.  He wanted to know what nutrition information in particular I was interested in seeing.  I said I would like to see the nutrition information for the items that we had just ordered.  He went into the back of the store, brought back a very big notebook, and started trying to look through it to find our items.

Meanwhile, the people behind me in line were starting to get annoyed because this was taking a long time.  Sensitive to that fact, I offered to just take the notebook with me to my table and look up the information myself.  The manager said he couldn't let the notebook leave the area behind the counter.  I offered to sit at the table that was about 4 feet from the register - in clear view - and stay there so he could keep an eye on his notebook.  The annoyed looks from the people behind me in line probably helped him decide to let me do that.

So, I sat down and started flipping through the pages.   It was actually quite easy to navigate, as every menu item had a page and there was a nutrition facts label just like the ones you see on packages of food.  I found the items we ordered and started adding things up.  I found the 1/2 tuna sandwich and chicken soup first. The chicken noodle soup was pretty reasonable at 100 calories for 8 oz.   A whole tuna sandwich is 720 calories and 44 grams of fat, but Anna was only getting half of a sandwich, thank goodness, so her total with the apple (50 calories) was 510 calories.  That was pretty good, I thought.

Then I looked up my sandwich.  I was stunned to see that the Portobello & Mozzarella Panini was 750 calories and 37 grams of fat.  Adding the apple, my total, was 800 calories.  That seemed like a lot to me, but at this point I had already ordered my food so it was too late to figure out something else to eat.

When I got home, I looked up nutrition information on a few different website to get a better sense of the calories in some typical lunches.  I went on the McDonald's website, looked up a Big Mac, and was stunned to see that it was only 540 calories and 29 grams of fat.  I could have had that and a small fries (250 calories), and I would have still come in under the 800 calories of my supposedly healthy meal at Panera's.

My point here is that we need restaurant menu labeling. I probably spend more time than the average individual thinking about nutrition and good choices, yet I can still get duped into eating in too many calories at restaurants.  If restaurants want to help customers make "healthy choices," then they should put the nutrition information up front on the menu so it is there when we can use it.  I urge all of you to try my little experiment next time you go out to eat at a chain restaurant and see how much you are eating, and also, how hard or easy it is to get that information when you need it.

Comments

[LeslieT]

Strong agreement! Making good eating choices is hard when information is lacking.

For several years I was a participant in a diabetes prevention experiment that required me to track all of my calories and fat grams. It was very difficult when eating out - most places did not supply nutrition information and I would have to try to estimate the various components of a dish - guessing the amounts of each and then looking them up individually. I'm sure that many of my estimates were wrong. I eventually got rather good at judging calories simply by how full something made me feel.

Even when restaurants do provide nutrition information, there is no guarantee that what you actually get at a restuarant actually matches the item they are describing. I know that when I get fries or ice cream at McDonalds the amount I get varies widely depending on who is doing the dispensing. And when a dish is prepared, how can you know if an individual chef might through in an extra tablespoon of butter or ounce of cheese, which can easily add another 100 calories to the count.

The best solution I've found is to just avoid certain types of foods in restaurants entirely. Fried items, mayonnaise, salad dressings, cheese, anything cooking in butter or oil - all of these are likely to come out high in the calorie/fat count. That doesn't leave much - turkey, lettuce and tomato on whole wheat, hold the mayo, is the standard "safe" sandwich. It's frustrating, because there are many more healthy possibilities, but most places just don't offer them.

[Shefaly Yogendra]

Very interesting! I am going to send this link to many friends, who think of Panera as virtual food heaven.

That said, I recently wrote about how obscure labelling practices mean that either a lot of aisle-arithmetic (TM) is to be performed, or that customers in a rush will simply buy the foods believing things that are not quite correct or accurate. Both premises generated a flame-war from a reader from the United States, which indicates the kind of forces that people like you, who are in favour of education and informed choices, must face in your nation.

[Jeremy]

Although the total calories consumed from day to day is extremely important, I disagree that 750 kcals (or 800 with the apple) is bad for lunch. You figure you need around 2,000 kcals a day for a woman and 2,500 (or more) for a man, then 750 is reasonable.

750 for lunch, 750 for dinner, and 500 for breakfast would make 2,000 kcals. If one is restricting calories to lose weight than eating out anywhere is almost impossible.

The problem arises when people consume the Big Mac, larges fries and large soda. This total has traditionally been 1,340 calories. If you do that twice a day and 600 for breakfast, then the total easily exceeds 3,000.

A common misperception is that our diets should be filled with a lot of low calorie foods such as fruits, vegetables, skim milk, etc. This is one reason the scientific evidence shows most individuals do not comply with diets. They are not satieting enough; people can eat calorically dense foods such as fatty fish, avocadoes, nuts, etc. Entrees that top 700 calories are fine provided the meal is high in fiber, low in saturated fats, low in sodium, low in sugar, and high in fruits and vegetables. All these individual factors have effects on diseases that are independent of obesity.

Does this mean you can eat foods like Big Macs on a regular basis? No, because the problem with fast food (even the food at Panera) is the high sodium, high saturated fat, low fiber content.

The portobello + mozz. sandwich at Panera is 14 grams of saturated fat. There are some sandwiches at sandwich shops that top 20 grams of saturated fat!
If this was 35 grams of total fat and 3.5 saturated, it would be totally benign in respect to its ability to raise serum cholesterol.

The sodium is 1,190 mg. Although the Dietary Guidelines says 2,300 mg. is ok for the day, the IOM (Institute of Medicine) says 1,500mg. should be the limit.

One could argue that even that no sandwich would qualify as healthy - the Mediterranean veggie is low in saturated fat (3 grams) and 590 calories but has 1,450 mg. of sodium. The smoked turkey breast is low in saturated fat as well but has a whopping 2,450 mg of sodium!! That is one day's worth according to the USDA and 1.5 days worth according to IOM.

[Yoni Freedhoff]

Calorie information on menus is a complete no-brainer good idea.

When I go shopping for anything, I always make sure to look at the price tag before I buy in case something that I think I can afford is in fact a great deal more expensive than it looks.

When I eat anything, I always make it a point to try to determine the Calories because of course Calories are the price-tags of weight and that their inclusion of menus would dramatically impact on consumers' choices.

It doesn't take a degree in dietetics to know that higher calorie options will have a great impact on weight.

The suggestion by the food industry that it's difficult is of course simply their effort to not post Calories as the second that they do, there will be a great deal of menu retooling going on.

[Alexis Kenne]

Researchers estimate that about 10 percent of Americans will develop diabetes during their lifetime and about twice that number will develop a milder form of diabetes called impaired glucose tolerance, or pre-diabetes. Diabetes and pre-diabetes often do not present any symptoms until a complication arises, making the disease difficult for patients to detect.