Making Calorie Postings Count: Improving Menu Boards in Fast Food Restaurants

Federal law requires chain restaurants to post calorie counts, with the aim of helping consumers make healthier choices. Yet according to a study by Elizabeth Gross Cohn, RN, MS, DNSc, and colleagues at Columbia School of Nursing, most postings, though legally compliant, are far from helpful. The researchers looked at menu boards in Harlem, New York, a low-income urban neighborhood. The calorie counts were least clear in fast-food chain restaurants, which in low-income neighborhoods are more prevalent than sit-down restaurants.

Most difficult to interpret were the calorie counts for items that came in various flavors, with different combinations of ingredients, or in multi-serving portions. A scrambled egg and cheese breakfast sandwich at one restaurant, for example, was said to contain 320–540 calories; with ham, bacon, or sausage added, 350–720 calories. For multi-serving items, such as buckets of chicken, restaurants posted a total range, such as 3,240–12,360. Not only is such a large range almost useless, but the consumer has to do the math and may not have all the information necessary to determine a serving size—all while standing on line to place an order. The authors propose the use of slashes instead. In the breakfast below, for example, the range for Ham, Bacon or Sausage (350–720), would be replaced by Ham, Bacon or Sausage (350/550/720), which would allow customer to quickly make the healthiest choice. The FDA is currently considering suggestions on ways to make calorie postings clearer.

The study was published online in the Journal of Urban Health on February 16, 2012.