Last weekend, I was faced with the choice between meusli for 290 calories and a ham and cheese croissant for 490 calories. I was in New York City and I needed some breakfast at a deli.
My gut wanted something cheesy and savoury and carby. My brain told me that a 500 calorie breakfast makes it hard to meet an overall calorie target of 1700 per day, which is what someone of my height and activity level needs to eat in order to lose weight. The croissant meal is tricky with respect to the target because, in addition to the croissant, I also got a latte and a banana for fibre. Bam. 750 calories before 9am.
So I got the meusli. Lesson 1: Calorie counts changed my mind.
It was really, really delicious but it in no way hit the spot of my craving for savoury/carby/cheesy. This didn't matter, I totally forgot about the craving the moment we hit the pavement and headed to the Yankees game. Lesson 2: Cravings are temporary.
New York State started mandating the posting of calorie counts in stores, bakeries and restaurants in 2008 and the Supreme Court affirmed this in 2012. The New York Department of Health wrote about why these changes were enacted in this Health Affairs commentary. Nationally, the same is happening and Marion Nestle over at FoodPolitics.com explains the legal evolution here.
All weekend - at Yankee Stadium, Au Bon Pain, Shake Shack and almost everywhere else - I saw calorie counts beside menu items. If asked before if I thought these would be influential for me, I would have said no. I've become pretty good at intuitive eating and try to listen to my body when it comes to making decisions about what I eat and when. Mostly good at it, not perfect and I do tend towards portions that are larger than they should be. I was in worlds of trouble years ago when driven by calorie counts, constantly doing math in my head about what I have consumed and what I've burnt. It was a steel cage, one I've written about plenty on this blog. And I've come through the other side much better off because eating is less stressful when I am a little bit ignorant about it.
But I made better decisions when I could see the caloric value of my choices. Knowledge informed my choices. Most sandwiches worth eating are between 550 calories and 750 calories. Even the vegetarian ones. Those are high values and they limit my choices later in the day if I want to ensure I don't accidentally eat 3000 calories. Intuitive eating has its role, absolutely, but for people who are obese or descend from generations of obese, our intuition is a little hormonally broken.
So I was a bit shaken to see that I still responded to those numbers on the menu board. Was that me falling back into old disordered habits? Did I feel an increased sense of worth because I managed to eat less? I am not sure, actually. I can't tell you. I like the idea of knowing more about the caloric and macronutrient value of what I eat but I also want to be free to eat what tastes good, feels good, is good. Sometimes those things feel at direct odds.
At a population health level, it probably doesn't matter anyway. The researchers who have been asking the question "Does calorie labeling reduce calorie consumption for NYC eaters?" have found that the answer is "not really." The most well-known study was published in November 2015 in Health Affairs and found that the labeling did not reduce the number of calories purchased and only about 30% of people actually noticed the calorie counts.
Maybe people like me are primed to notice and so the calorie counts just affect the people who are already health literate. Maybe people who notice think, "Well, I am eating fast food, there is no use in eating slim fast food. I will reduce my calories at another meal today," which would be reasonable if there was evidence that New Yorkers who eat fast food also lost some statistically significant amount of weight over the implementation period. This would mean that they are moderating their intake based on the data. We don't have that evidence.
We didn't eat fast food all weekend. We had some stellar Mexican food in DC. We went to Craft in Manhattan. The laws don't apply to restaurants with fewer than 20 locations so our experience took place in the caloric void. My calorie counting skills are still pretty excellent, so I estimate the Heirloom Tomato Salad and the Veal Ricotta Meatballs with homemade capellini pasta cost me about 900 calories. Worth every last one. In my assessment, though Lesson 1 meant that I ate fewer calories at that meal, I probably made it up later in the day by walking for miles and trying a bunch of restaurants we don't have in Canada.
Maybe it's just a New York Thing? Maybe if it weren't a place that people go to eat, the results of the studies would be more demonstrative of the effects of calorie knowledge on calorie consumption. With the national roll-out underway as part of the Patient Protection and Affordable Care Act, national data will start to roll in and labelling will have its day in the evidence-based public health sun.
Until then, I am going to start introducing more 'calorie awareness' into my normal intuitive approach to decision making around food. I think there is something to the idea of a caloric budget , even for those with disruptions in the satiety-hunger hormone axis where the budgets can seem so unrealistic. I am well are that all diets - low-carb, high-carb, high-meat, paleo, air-itarian, etc - have some short term efficacy secondary to the calorie reduction but these reverse quickly in every major study on the topic. Of course there are exceptions for individual people but these are outliers in the data, and the exceptions do not take down this kind of rule.
Calorie awareness is especially important when eating out because the salt, sugar and fat ante is way upped outside of your own kitchen. I am not recommending diet-level regimes around calorie reductions - I know how easy it is for me to eat more than 1700 calories a day and I know these hard limits set me up for failure - but I am saying there is a role for gentle awareness of what you're taking in, even if you're choosing to eat something particularly calorie dense. Don't feel guilt about it.. Don't enter the shame spiral. But just accept it as fact and see where the awareness takes you.