Would knowing there are more than 400 calories in a plain bagel with cream cheese from Tim Hortons deter you from eating it?
For consumers, the question is largely theoretical. Detailed nutrition information at fast-food outlets often doesn't get the type of prominent placement necessary to be a major decision-making factor.
That may soon change as a growing number of health experts and policy officials look for novel ways to tackle obesity. But not everyone agrees caloric labelling is the answer they've been looking for.
In the United States, fast-food chains with more than 20 outlets will soon be required to post caloric information on menu boards under a new provision in the country's health-care changes signed into law last week. It will even require snacks sold in vending machines to have caloric information consumers can see before they buy. The national measure is similar to those already adopted in places such as New York and California.
In Canada, federal politicians voted down a private member's bill in 2006 that would have imposed calorie counts in restaurants. A similar Ontario bill died when the provincial government was prorogued last month. But for health organizations and advocates that want the change, the new U.S. law is encouraging.
Calorie labelling on restaurant menus has become a new cause du jour for those involved in the fight against obesity. And like most trendy causes, some experts fear the movement is overshadowing important questions about whether it will even work.
"Simply putting labels on fast-food menus seems not to make that much difference in what people buy," said Rogan Kersh, associate dean for academic affairs and professor of public policy at the New York University Wagner Graduate School of Public Service.
Prof. Kersh and his colleagues conducted a study, published online last October in the journal Health Affairs, that looked at consumer response to calorie labels on fast-food menu boards in low-income neighbourhoods with high minority populations in New York. For comparison, they used neighbourhoods with similar demographics in Newark, N.J., which had not introduced calorie labelling. They focused specifically on low-income areas where people typically have more difficulty getting access to fresh, nutritious and affordable food.
Although nearly 30 per cent of the New Yorkers said they saw the caloric information and it influenced their purchasing decisions, the mean number of calories purchased was 846, compared to 826 in New Jersey.
"In other words, this policy by itself doesn't seem to appreciably change consumers' decisions," Prof. Kersh said.
Prof. Kersh cautioned that his study was done soon after calorie labelling came into effect and that results could change over time. But he is concerned policy-makers are too focused on piece-meal approaches that won't make a dent in the obesity epidemic.
"We keep trying one policy solution at a time," he said. "It's almost like shouting into a void."
A handful of other studies have yielded mixed results. A January Stanford University study showed New York Starbucks patrons purchased items with 6 per cent fewer calories after the law took effect compared to before. Another study published the same month in Pediatrics found parents told to pick hypothetical meals for their kids chose lower-calorie items when given caloric information. A December 2009 study in the American Journal of Public Health found people who saw calories on menus compensated by eating more later. But another group in the same study consumed less overall when given caloric information on menus and told that the average person should only consume 2,000 calories a day.
Canada's restaurant industry has come under heavy criticism in recent years for not being transparent about its nutritional facts. In response, the Canadian Restaurant and Foodservices Association developed a program in which restaurants can voluntarily disclose all nutritional information.
Ron Reaman, an association vice-president, knows the program isn't perfect. For instance, a significant number of restaurants, including large chains, don't participate. But he says a large segment of the industry is trying to respond to consumer demand by providing nutritional information, and he worries that forcing them to single out calories could be misleading. For instance, he said, Diet Coke has fewer calories than milk, but it's not healthier.
"There's an oversimplification when people are calling for things like calories to be posted on menu boards," Mr. Reaman said.
But proponents of calorie labelling say they know it's not the answer to the country's obesity woes. They see it as a way to get consumers - and restaurants - to think about the kind of food on the menu.
"The message is that people should be able to make informed choices," said Mark MacLeod, president-elect of the Ontario Medical Association, which has been advocating calorie labelling. "In the scenario where peoples' food choices are limited … I think the least we can do is to provide them with options."