Calories on Menus Don’t Change Kids’ Choices

Study Suggests Calorie Labels in Fast-Food Restaurants Won’t Ease Obesity Epidemic

From the WebMD Archives

Feb. 15, 2011 -- Listing calories on the menus at fast-food restaurants doesn’t seem to affect kids' choices or those that their parents make for them, finds a small study in the International Journal of Obesity.

“Labeling is not going to be enough to influence obesity in a large scale way,” says study researcher Brian Elbel, PhD, MPH, an assistant professor of medicine and health policy at the New York University School of Medicine in New York City.

Part of the problem is that unhealthy, calorie-laden foods are often directly marketed to kids. “Numbers can’t compete with Ronald McDonald,” he says.

Cost is also a hard-to-beat factor. “Unhealthy food is cheaper than healthy food and the gap is getting wider,” Elbel says.

Checking the Impact of Calorie Listings

Researchers analyzed receipts and surveys from 349 kids and their parents as they were leaving McDonald’s, Burger King, Wendy’s, or KFC both before and one month after mandatory calorie labeling took effect in New York City in 2008.

Results were compared to a group in Newark, N.J., where there was no mandatory calorie labeling. Fully 90% of study participants were from racial or ethnic minority groups.

There were no differences in the number of calories purchased before and after the labeling went into effect, the study showed. One month after this initiative, 57% of teens in New York and 18% in Newark said they noticed the information, but just 9% said the calories made them think twice about which food items to purchase.

So what does affect kids’ food choices? Taste was most important, and price was a consideration for more than half of teens in the new study.

“This is a pretty small study in low-income areas,” says Elbel. “A larger study could have different results.”

More Education Needed

“Part of the problem is that there is no real education about what these calorie levels mean,” says Kelly Sinclair, MS, RD, a dietitian at Children’s National Medical Center in Washington, D.C. “If they don’t know how many calories they are supposed to have, how can calorie labeling guide them to a different choice?”


As a result, many people rely on restaurants or servers to help them make healthier choices. The thinking is “they have marketed this meal for children so it must have what my child is supposed to have and they must know more than I do.”

“Restaurants need to be more responsible and put forward meals that are healthy not just things that make money,” she says.

“Kids will eat real food,” Sinclair says. “We shortchange our kids by thinking they will only eat chicken nuggets, pizza, and french fries.”

Scott Kahan, MD, co-director of the George Washington University Weight Management Program in Washington, D.C., agrees. “Calorie labeling only has marginal utility unless you give them a context to understand what the calories mean,” he says.

“Putting calories in their proper context will make this information more usable, but it will not be a cure for obesity in adults or kids and it is not supposed to be,” Kahan says. “We need to make the environment more conducive for people to make healthy choices so it is just a little bit easier.”

WebMD Health News Reviewed by Laura J. Martin, MD on February 15, 2011



Kelly Sinclair, RD, MS, dietitian, Children’s National Medical Center, Washington, D.C.

Brian Elbel, PhD, MPH, assistant professor, medicine and healthy policy, New York University School of Medicine, New York City.

Scott Kahan, MD, co-director, George Washington University Weight Management Program, Washington, D.C.

Elbel, B. International Journal of Obesity, 2011.

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