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Momma said wonk you out

ASSIGNMENT DESK: COMBATTING OBESITY BY FIAT.

Professor Dark Heart asks, "why can't the government just reduce obesity by fiat?

OK, that was the provocative way to put it. But the infants and young children who are eligible for WIC are in large part also the ones who are going to go on and get free breakfast and free and reduced-cost lunches at school. The government has a lot to say about what they eat for a pretty significant portion of their childhoods (and these are the kids at highest risk for obesity). Right now, most school lunch is a giant calorie-dump to get rid of surpluses produced by subsidies for Big Agriculture."

In fact, he's right: Contrary to my statement yesterday, the government could certainly reduce obesity by fiat. They could ban vending machines and junk food from schools. They could force all restaurants with more than five locations to post caloric information on the menu. They could subsidize fruits and vegetables rather than grains, corn, and meats. They could orient food stamps and the Women's, Infant, and Children nutritional program towards healthier foods. All these moves would reduce obesity, though it's arguable by how much.

If you wanted my pick among them, it would be posting caloric content in restaurants. It's a bit rich to watch libertarians and associated anti-government types oppose a regulation that gives consumers more useful information. This, after all, is how markets are supposed to work best. Consumers have better information, can pursue their preferences in a more coherent manner, and the market can provide, adapt, and innovate in response. Take trans fats, which have disappeared from just about every food save margarine now that they need to be listed on the package. If caloric information was posted, a lot of currently popular items would become unpopular (the awesome blossom, say), and restaurants would innovate towards lower calorie, but still filling, foods. In the absence of that information, the incentives to do so are weak. It's one of those soft ways of making the market work better towards a social end: We agree that people should be healthier, people agree that they want to be healthier, and all this would do is give them the information to make healthy decisions. It would not actually bar any foods from production or sale. But because there's some odd desire among some on the right to lionize unhealthy decisions (smoking!) and defend existing business models, whatever they may be, to the death, this regulation faces a steep uphill climb.



COMMENTS

The libertarian position would be to give you the choice as to whether to frequent a restaurant which refuses to post caloric information. They don't have to post, you don't have to eat there.

a lot of currently popular items would become unpopular (the awesome blossom, say)

Really? Are there a lot of people ordering the awesome blossom now who are under the impression that it's some sort of health food? It's not exactly a secret that deep-fried food isn't the best thing for you, so I'm not sure why saying that on the menu should make a huge difference.

but there's onion underneath the fried! that's a vegetable!

signed,

the girl who occasionally counts starbursts as her daily fruit intake.

The so-called "free market" is a fantasy construct which has never existed and never could exist. Markets are social constructions, not forces of nature. In order to exist, they require comprehensive and ongoing regulation. The questions are not whether, but how they are to bee structured and regulated, and for whose benefit.

Capitalists chant the "free market" mantra when they don't like some proposed regulation or intervention, and they conveniently forget it whenever they want government to do something for them.

One of the counterfactual premises that underlies the fantastical and nonsensical theory of the "free market" is the assumption of perfect information. Of course it can never be satisfied, but product labeling requirements are an effort to get a little closer to it. Even the most ideologically committed and rigid liberatarian, to be consistent and not a hypocrite, ought to support such regulations in every case. But of course they don't, because they are hypocrites who don't even understand their own theories.

Ezra-- I have libertarian leanings, but could be talked into the restaurant regulation. A law that merely requires meaningful disclosure and doesn't cost too much is fine by me.

I could quibble over the threshold (five strikes me as a bit too low), but I have a more fundamental concern: I wonder how well it would work. It's easy enough for McDonald's to post the information on their website, since their food is formulaic and you can be highly certain that your big mac is essentially the same everywhere; consequently, it's easier to provide uniform caloric information. What about places that have a bit more variety? It seems that the number of calories in a Red Robin burger will always be high, but vary depending on how it's prepared; I'm thinking particularly of different amounts of cheese and mayo, and how a "side" of fries is interpreted. If it promotes uniformity, it might actually undermine the quality of food, making it not worth it.

I'm also curious about enforcement-- how would calorie counts be audited?

Just Saying, there's no reason why an exact count is needed. Indeed, an exact count is almost certainly wrong, as (for instance) one ribeye might have slightly less fat than the next ribeye.

What you need is an acceptable range. You need a method by which you can compare the dishes to each other, not an exact number to compare against an abstract perfect caloric intake.

From there, informed customers could take over. I love duck, and as a customer knowledgeable about duck I could surmise that most of the fat content is in the skin thereof. If I don't eat the skin, it would likely be leaner than the chicken. But if I'm unsure or not as knowledgeable I could make other decisions.

C.S.-- Interesting point about a range. I suppose a 10% margin for error-- coupled with light penalties if any error is truly in good faith and more severe ones if the error is intentional fraud-- would do the trick.

"COMBATTING OBESITY BY FIAT"
I once owned a FIAT when I was younger and slimmer, so I know that these are quite small cars. But the idea that they will keep their owners from becoming fat seems to be a bit farfetched to me...
:D

Given a choice between:
1. Adding some nutritional value to the "nutrition" subsidies given to low income families
2. Adding some nutritional value to the "nutrition" subsidies given to students
3. Shifting the production (and hence advertising and promotional) focus of agribusiness
4. Adding a Calorie footnote to menus ...

... the most useful policy choice is Option Number Four???

I presume that this is because obesity among the middle class is a problem, while obesity among people at lower income levels is just normal?

"[...]why can't the government just reduce obesity by fiat?"

Two words: corn subsidies.

What is an awesome blossom?

Ginger, see here. It's a large onion, cut and deep fried to look like a chrysanthemum. Outback Steakhouse has something similar called a Bloomin' Onion -- indicating it surely must be a traditional Australian dish.

I'm all for restarants including calorie count (and/or other nutritional information on menus, number of servings of veggies, grains, and meats, for example), but I don't know how much impact it would have on what people actually choose to eat. Sometimes when I go out, I go out specifically because I'm craving an awesome blossom and it's just not the sort of thing I'm going to make at home. Or a giant plate of cheese fries. Or whatever it is. I know it's got 10,000 calories and more than enough fat to offset whatever nutritional content it might have, but dammit, sometimes you just want something unhealthy. And, sometimes, when you go out you order the grilled salmon with steamed broccoli. Most people know what's good for them and what's not. Putting nutritional information on menus for the purpose of basically guilting people into not eating something they might want won't work. I think providing tasty food that is healthier is a better idea and would make people more likely to choose healthier food more often than they do now (but they'll still want an awesome blossom sometimes).

New York makes chain restaurants post caloric info on ads. I think that's an excellent policy.

When Dunkin Donuts tries to sell me a new mini-pizza, they have to tell me some solid facts about what they're suggesting I put in my body. Like the fine print on drug ads but much, much less onerous.

I think there are two problems with your trans-fat analogy:

1. As KCinDC said, most people already have a decent idea of which foods are high-calorie and which ones are low. Whereas you wouldn't necessarily know if a food contained trans-fats unless the package/menu told you so.

2. The backlash against trans-fats partook of a good dose of chemophobia -- trans-fats are hidden, artificial, and have an unnatural-sounding name. (This is not to say people were wrong to oppose trans-fats, just that they're an easy thing to oppose because they push a lot of psychological buttons). Calories, on the other hand, are a natural and necessary part of our diets.

I just bought this 32 oz jar of mayonnaise at Trader Joe's, and right on the front label it says "NOT A LOW CALORIE FOOD." Is this a requirement or is TJs just trying to be nice to people who think mayo is health food?

Also, I just noticed that my TJs peanut butter offers no such warning about caloric content, despite being an equivalently caloric food! Should I blame an overly powerful peanut lobby or a weak canola lobby?

and these are the kids at highest risk for obesity

How much higher?


In fact, he's right: Contrary to my statement yesterday, the government could certainly reduce obesity by fiat. They could ban vending machines and junk food from schools. They could force all restaurants with more than five locations to post caloric information on the menu. They could subsidize fruits and vegetables rather than grains, corn, and meats. They could orient food stamps and the Women's, Infant, and Children nutritional program towards healthier foods. All these moves would reduce obesity, though it's arguable by how much.

We really do not know if this will work. This is an area where the science is very far from settled. Fat seems to help us too feel satisfied and so has it defenders in the obesity debate.

posting caloric content in restaurants

Posting caloric content in restaurants tends to favor big chains over little immigrant run businesses.

Isn't another problem with the trans fat analogy that some jurisdictions have actually banned trans fats rather than simply requiring labeling?

most people already have a decent idea of which foods are high-calorie and which ones are low.

It's not as simple as that. Most people can easily sort into pretty good v. pretty bad, I'd say. But there's a lot of stuff out there that clocks in way further up the scale than I think most folks would generally assume - like Ruby Tuesday's 1000+ calorie Turkey Burger (before the fries). Or the chocolate chip cookie at Starbucks when I worked there years ago, with 45 grams of fat and more than 900 calories. I'm guessing a lot of people are going to think twice about those with it staring them in the face, and not because they were kidding themselves that it was healthfood before.

For a paper on a related subject, see Phillip Leslie and Ginger Jin's paper "The Effect of Information on Product Quality: Evidence from Restaurant Hygiene Grade Cards" about the change to mandatory display of restaurant grade cards in Los Angeles.

Abstract: We show that the grade cards cause (i) restaurant health inspection
scores to increase, (ii) consumer demand to become sensitive to changes in restaurants’ hygiene quality,
and (iii) the number of foodborne illness hospitalizations to decrease. We also provide evidence that this improvement in health outcomes is not fully explained by consumers substituting from poor hygiene restaurants to good hygiene restaurants. These results imply the grade cards cause restaurants to make hygiene quality improvements.

So would the sainted taco trucks from a few weeks ago have to post their calorie content? If bad food is bad food (or bad for you food) what difference does it make if you have one, five or five hundred restaurants? Or do you just not care that the taco trucks are killing the children? I guess you just hate kids . . .

I think posting caloric content is incredibly effective. I've always known starbucks pastries are not good for me, but once upon a time i'd say, "ahhh what the hell, i'll take a marble pound cake..." but now that there's a little placard staring me in the face telling me that whim is worth 470 calories...well forget about it! Not anymore!

(The article is in Quarterly Journal of Economics, you can get it here: http://www.stanford.edu/~pleslie/)

So would the sainted taco trucks from a few weeks ago have to post their calorie content? If bad food is bad food (or bad for you food) what difference does it make if you have one, five or five hundred restaurants?

The point about the number of restaurants is that figuring calorie counts is easy for chains with standardized menus. A local restaurant might change it's recipes frequently, or the chef may ad-lib on the spot.

I believe they have to send the dishes to the lab to figure out calorie counts. McD's can easily afford to do that; a taco cart probably can't.

With the increasing price of fuel adversely affecting the airline industry, fatties should be required to pay a hefty (pun intended) surcharge to travel by air.

The posting of caloric info on menus seems to me to be an illogical and ineffective solution. Here's why.

1) There is a high correlation between being overweight and having a low income. Of course, the lower one's income, the less likely one is to be educated. Therefore, a high percentage of severely overweight people have little education and/or little income. A day spent at McDonald's will confirm this demographic analysis. People falling into this group are either a) not going to be able to adequately interpret the caloric information on the menus, or b) not going to care because they are getting a lot of bang for their buck. In the end, the information would likely be misunderstood or ignored.

2) Those who are educated enough to interpret the caloric information probably do not need that information to know that the food is unhealthy. As someone pointed out above, most people know what they are eating is bad for them...they just don't care.

The real issue to me seems to be one of individual choice. Many people are making bad choices (like eating unhealthy foods every day and not exercising) and it is costing those of us who make good choices (like eating those foods once in a while and getting adequate exercise). The only answer seems to me to be a combination of better education and some sort of penalty for being overweight - like, for example, higher insurance premiums or the cancellation of insurance until weight restrictions are met. It's kind of becoming like the rides at an amusement park: "sorry sir, but your weight would put others at risk; we can't let you ride."

I hear you screaming how biased or prejudiced that would be, but I don't see it that way. There is no bias or prejudice. If someone costs the system more, they should pay more. This would not be "prejudging" anything; just judging according to the data and creating a policy based off that data.

Not on topic but related:

BTW
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1448278
Results. Compared with their normal-weight counterparts, obese women with higher education or in upper white-collar positions had significantly lower income; a smaller income disadvantage was seen in overweight women with secondary education and in manual workers. Excess body weight was not associated with income disadvantages in men.

How's the Drug War going?

Cheesecake Factory Cheesecake

When you buy a pie in the store you get the nutrional info.

98% of the total saturated fat in one slice.

I wonder how much different it is in the restaurant

Cost too much is a red herring. This isn't rocket science. You can look most of this stuff up on the labels, and what you can't is usaually available on the web for free.

BTW, herring is here, as an example ;-)

Hope the link works.
Bethany

Floccina, the post said "post caloric information in restaurants with more than 5 locations." Few, if any, "little immigrant run" restaurants have more than 5 locations. In fact, I think if you have 6 locations, you are not little.

KCinDC, I think people are generally aware the onion blossom is not healthy, but often stuff like this is more unhealthy than people dream, as the average diner underestimates their caloric intake when eating out by 93%. In other words, they're consuming almost double the calories they think they're consuming.

http://health.yahoo.com/experts/eatthis/4653/lose-weight-eating-restaurant-foods/

Don, I don't think anyone's arguing that we should ban cheesecake. They can have my cheesecake when they pry it from my cold, dead hand.

Cost too much is a consumer decision. If they want to pay more for the information, let consumers pay for it. People can pay a premium to find out how much fat and what kind of crap they are eating....

Wait a minute. I'm pretty sure people would pay money to not find out how much they are pigging out, instead of having to be constantly reminded about what kind of stuff they are putting in their body. You're better off removing all the fat subsidies that you mentioned yesterday instead of this silly notion that people would love restaurants that posted their nutritional information and would be healthier as a result. Maybe the super health conscious would pour over those nutritional facts, but rest of us would just ignore the damn label.

First of all, thanks for taking up the issue, Ezra, but: I'm a she!

and these are the kids at highest risk for obesity

How much higher?

It varies from group to group; African American girls and Mexican American boys are 10 to 12 percentage points more likely to be obese than their white counterparts. Across ethnicity, low-income children of all ethnicities are more likely to be obese, though the correlation varies among different subgroups. A Princeton-Brookings joint program on children's issues did a childhood obesity issue last year that explores a lot of the factors involved.

In fact, [s]he's right: Contrary to my statement yesterday, the government could certainly reduce obesity by fiat. They could ban vending machines and junk food from schools. They could force all restaurants with more than five locations to post caloric information on the menu. They could subsidize fruits and vegetables rather than grains, corn, and meats. They could orient food stamps and the Women's, Infant, and Children nutritional program towards healthier foods. All these moves would reduce obesity, though it's arguable by how much.

We really do not know if this will work. This is an area where the science is very far from settled. Fat seems to help us too feel satisfied and so has it defenders in the obesity debate.

It's true that there needs to be much better data, but also true that whether or not it helps with the obesity epidemic, there's not much of a downside in investing in healthier school food and physical eduction, and pursuing research into what kinds of initiatives seem to help. For obese kids in particular, it's probably not enough to make moderate improvements in these areas. But if school health services were more involved in screening for problems early on and making referrals to targeted programs in the health care sector (integration!), it could conceivably make a big difference. Of course, WIC and prenatal services at all income levels could do a better job at early prevention of obesity, supporting breastfeeding more actively and offering better parent education about nutrition. But the reason the schools might be a good place to insert help (especially if the increased prevalence of pre-K programs means that kids are entering the educational system earlier) is that low-income neighborhoods often present obstacles to physical activity and the availability of healthy food that no amount of education is going to change.

As far as adults and impulse control go, I'm all for posting nutritional content. I have never been able to bring myself to eat either a Cinnabon (790 calories, 24g fat) or a Starbucks Monster Cookie (420 calories, 18g fat) after finding that info out. I'm pretty conscious about food and nutritional values, but the chain stores manage to pack a lot more calories and fat into their food than there would be in whatever version of it I would make. So it really makes a difference to me to know when my rule-of-thumb guesses are so far off from reality. I know I'm indulging when I eat such things, but I'd like to be able to choose my indulgences more wisely. That cinnabon is like four days of normal chocolate chip cookies!

I'm not sure how posting that info would harm small restaurants; people don't have any problem going to them without knowing the nutritional value of their food now. I'd also assume that restaurants cooking with real food wouldn't be so deceptively calorific; they're less likely than chains to be packing their food with fats and sugars to mask the fact that they're entirely composed of corn-based foodlike substances.

Many people keep pointing out that we all know certain foods are unhealthy. Yes, we all know that a carrot is healthier than an awesome blossom, but as JoshA notes above, this doesn't mean everyone automatically has a good sense of just how unhealthy certain foods are relative to one another.

I just looked at the nutritional information chart for Chili's. The awesome blossom has 203 grams of fat for a single serving. That's worth about 5 of the Culver's hamburgers I already prefer. I would not have guessed there was such a huge differential. And I would rarely order something if I knew it had such a high fat content. Thus, I would find the information helpful, much more so at the point of sale.

I am not arguing that a government requirement is necessarily a good idea. As many other people have pointed out, not all menus are standardized. Nor is the information free. But the superficial answer that "we already know it's not a health food" is not very compelling. It assumes all foods can go into roughly two categories.

Clearly, there is a vast range, and figuring out where things sit on the continuum requires some hard numbers, not just common sense about what is or is not a health food.

I have been looking for a chart to show how much more likely the poor are to be obese than the rich and middle class.

http://www.cherp.org/cherpdocs/issuebriefs/Policy%20Brief_Fall2005.pdf


This is just for a county but it shows that the difference in rate is modest.
http://www.larimer.org/compass/overweight_obesity_h_ph_charts.htm
What this chart shows: Percentage of Overweight and Obesity by Income Level - Larimer County, 2004-05

BTW Ezra if you want to avoid being a caricature of a democrat, you should admit that some things are beyond the scope of governments. Obesity being one of those.

Quite honestly, the whole idea is irrelevant. And this is why.

It's not what we eat, or even how much. It's what we don't do with the calories we take in.

If you want to reduce obesity eliminate restaurant parking lots and drive thrus. If you want to reduce driving while drunk, eliminate parking lots at bars and clubs.

Just getting people to walk 20 minutes a day would change the whole picture. Sure 30 minutes would be even better, but anything is better than what we have now - driveup dinner, driveup breakfast even.

Adding caloric content to menus would have 1 and only 1 major effect. It would make menus larger.

In the general: People arent doing comparitive analysis when looking at menus, they arent thinking of healthful versus not .


People ordera burger because thats what they want.. and what o you order with it? Fries. Its automatic. We have burgers on our menu at the restaurant I run, but no fryers, hence no fries. People still order them..

People DO order the healthful alternative when it is available AND there is some other force pushing them in the direction. Many people that surprise me order salads that we have available as sides. One for instance because he was denied the opportunity to go sky diving, as he was overweight.


If caloric count made such a difference you would be able to go to the grocery store and see people scouring the sides of cartons and filling their carts with the healthier option. It doesnt work that way, they buy what their bellies and the sugars and fats their addicted to tell them to buy.

It would work for people like you EK. Your inquisitive, concerned with your health, and very aware of your diet and the elements that go into it. ..you're also relatively thin.

Ok there would be a 2nd major effect. Lots of skinny people would be shocked to see what other people are eating.

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About Ezra Klein

Ezra Klein is an associate editor at The American Prospect. An archive of his articles for The American Prospect can be found here.

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