"Counting Calories When Dining Out" By Allen Weiss, MD, MBA, President and CEO

Counting Calories When Dining Out

November 15, 2010 - It is said, “We are what we eat,” and, as a nation, we are eating too much! Further, we don't fully understand what we are consuming. Americans increasingly rely on restaurant dining. In 1970, we spent just 26% of our food dollars on eating out whereas today's modern family spends 46% on away-from-home meals. The average American today consumes about one-third of his or her food calories at restaurants and other food-service establishments, while 30 years ago only 18% of our calories were consumed in restaurants.

With the above facts in mind, let's understand where we are going as a nation, with the new national Health Care Reform Act requiring posted calorie and nutrition information for chain restaurants with more than twenty locations.

In the past, eating out was an occasional treat. Now, with working families, eating out is so common that the “treat” aspect has disappeared. In the “old days” when we ate out rarely, it was a special treat; dietary discretion wasn't necessary. This lack of discretion has spilled into our contemporary culture as we over indulge in our much more frequent out-of-home dining experiences.

Ever wonder why you feel so full when you leave certain restaurants? The advocacy group Center for Science in the Public Interest studied eating habits in restaurants, as opposed to eating at home, and found that nearly everyone underestimates the calorie count of restaurant meals. Children also consume twice as many calories at restaurants as they do at home. These facts were first reported in 2003 and can be reviewed in a very well-written, fact-filled, and understandable report, Anyone's guess: the need for nutrition labeling at fast food and other chain restaurants (www.cspinet.org/restaurantreport.pdf).

Studies have shown a direct correlation between eating out, higher caloric intakes and higher body weights. When we eat at home we have an advantage. The 1990 Nutrition Labeling and Education Act mandates that calorie and nutritional information be placed on most everything edible that we buy in a supermarket, which helps us make wise decisions. People who want to be aware of—and exercise control over—what they eat at home, now at least have the information needed to make informed choices.

This new national law codifies local laws, which have been in place in many areas around the country. New York City, for example, has been sharing calorie numbers in restaurants since 2008 and reports a decrease in calorie intake of about 10%. An early study of restaurant consumers in low-income areas showed more modest decreases in calorie intake. This population segment noticed the new information but had few other choices in their neighborhood. In 2009, California, Oregon and Maine initiated calorie-labeling regulations in “chain” restaurants.

Lately, many “chain” restaurants are modifying the portion size and composition of their menu items in an effort to be more calorie-conscious. McDonald's has decreased the calorie count in a large order of fries by 30, and Starbucks has followed suit with decreased calories in many of their beverages. However, it is not uncommon for a restaurant entrée to contain half a day's calories, be saturated with trans fat, and loaded with sodium, according to Anyone's Guess.

Only an estimated 12% of Americans eat a healthy diet; however, the U. S. Department of Agriculture's Healthy Eating Index has shown a slight but significant improvement since 1989, with increased consumption of fruits, vegetables, and grains.

Generally, portion sizes are still much too large. As has been shown many times in the past, the bigger the serving size the more likely a larger volume of food will be eaten. Consumers perceive larger portions as better “value-for-dollar.”

So, what should we do? Let's encourage our restaurants to be proactive in sharing information about our choices. Everyone will feel better, be more prudent in selection, and still have a good time while not adding to our national obesity problems. Taking a portion home rather than stuffing one's self is also a good tactic. If restaurant patrons select more fruits, vegetables and grains, the chains and smaller establishments will respond by offering more and better choices in these food groups.

As a nation, we can achieve a virtuous eating cycle. We just have to know more, be prudent and then our new habits will become the norm.

Past Health Advice Articles

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.