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Can Calorie Labeling on Fast Food Menus Help Boost Children's Physical Activity?

Last fall, the Food and Drug Administration released new rules requiring restaurants with 20 or more locations to begin posting calorie information for standard menu items, per a section of the Affordable Care Act. However, certain other types of calorie labeling could help boost physical activity among youths, suggests a study published online Monday in the journal Pediatrics.

The study authors surveyed 823 parents of children ages 2-17, presenting them with one of four types of hypothetical fast food menus: no label, labels containing calorie information only, labels with calories and the number of walking minutes needed to burn said calories, or labels with calories and the number of walking miles needed to burn the calories. The parents were asked to imagine they were placing an order for their child using whichever menu they received. At the end of the survey, they were asked to rate how much each type of menu label would influence their ordering and their potential to motivate their child to exercise.

Among the 189 parents who had no label on their menu, they ordered an average of 1,294 calories for their child, while the remaining 600-plus parents with one of the other three types of labels ordered roughly 200 calories fewer. There was no statistically significant difference between the other three label groups in terms of the amount of calories ordered.

Of the 823 parents in the survey, 30 percent said calories-only labeling would be "very likely" to influence their fast food selection for their child, while labels with any physical-activity component—dubbed physical activity calorie expenditure (PACE) labels—earned even higher marks from parents. Health literacy status also played a role in parents' understanding of labeling—just under 60 percent of parents with low or marginal health literacy said any type of labeling would be at least somewhat likely to influence their food choice, while nearly 70 percent of those with adequate health literacy said the same about any of the three types of calorie labels.

Well and Good

The authors found similar results in terms of parents promoting exercise for their children based on calorie labels. Twenty percent of parents said calories-only labeling would be very likely to encourage their children to exercise, while 38 percent and 37 percent, respectively, said the calories-plus-minutes and calories-plus-miles labels would do the same. Likewise, a far greater percentage of parents with adequate health literacy would potentially encourage their children to exercise if greeted with calories-plus-minutes or calories-plus-miles labels compared to parents with low or marginal health literacy.

"PACE labels may influence parents' decisions on what fast food items to order for their children and, uniquely, encourage them to try to get their children to exercise," the study authors conclude. "The potentially resulting combination of fewer calories consumed with greater physical activity could help begin to curb childhood obesity."

In short: Health literacy is crucial in terms of combating childhood obesity, as parents simply may not realize they're ordering 1,000-plus-calorie meals for their children. Students often fall victim to the same trap. A December 2011 study in the American Journal of Public Health found youths to be more likely to drink water over sugar-sweetened drinks if provided with clear, easy-to-understand information about the caloric content in the latter. The teens were nearly twice as likely to buy non-sugar-sweetened drinks after learning that sugary beverages contained roughly 10 percent of their daily expected calories, or would require 50 minutes of physical activity to burn off, the study found.

"People generally underestimate the number of calories in the foods they consume," wrote the study's authors.

With PACE labels in chain or fast food restaurants, it could be much more difficult for people to make that same mistake, as the Pediatrics study found.

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