"Is there a healthy future? Obesity and with it diabetes are getting worse. The human and financial costs are enormous. There is emerging evidence based on how to address obesity both from a public health standpoint and from a policy standpoint. I do not think that we can wait for perfect evidence and in fact I think the existence of evidence will be facilitated by action with programs which are implemented and then rigorously evaluated. The question I think before us and what we have to weigh as a group as we consider the weight of the nation is whether we as a society are willing to take the actions necessary to reverse the epidemic of obesity."
That was Dr. Thomas Frieden, Director of the Centers for Disease Control and Prevention in July of this year at the first ever conference on obesity, The Weight of the Nation, in Washington, DC. The statement struck me at the time, because the public health community - particularly the academic side - is very focused on the need for evidence. However, sometimes, you just have to try something and see if it works. The current obesity epidemic couldn't provide better justification for trying new ideas.
This was the kind of thinking that led New York City to institute menu labeling for chain restaurants in July of 2008. Thirteen other cities have followed suit and an additional 17 are considering it. The Robert Wood Johnson Foundation provided emergency funding to researchers in New York to determine whether this intervention strategy would help change and inform behavior. Last Tuesday, we got our answer.
It doesn't work.
Now what?
It turns out the menu labeling heightened awareness around calorie consumption, but didn't facilitate healthier eating. That is, people thought they were making healthier choices, but weren't consuming less calories. The researchers specifically looked at low-income and minority communities - where obesity prevalence is highest and leads to the highest rates of diabetes and other chronic conditions.
The researchers specifically analyzed consumption patterns during regular meal times to determine what people were eating as meals, not snacks or special treats. It turns out information wasn't the most important variable for the consumers; price was the number one determinant of purchases.
Despite the results, the research and energy beyond it is vitally important. The public health community must continue to dream up new solutions, implement them, and evaluate in real time, to create emerging evidence. Menu labeling interventions are not dead - in another community, with a different set of fast food restaurants, the results might be different. With a cheaper set of alternatives, combined with increased information, the results could be drastically reversed. Additionally, the results show that people want information about what they are eating and have the potential to use it to make healthier decisions. This is only one part of the emerging solution in fighting the obesity epidemic.
Catherine Morrison, Legislative & Public Affairs Associate
Tags: CDC, menu labeling, obesity, Public Health, thomas frieden
