Posts Tagged ‘HSE’

Calories on Menus – A dietitian’s perspective

October 2, 2012

After a well publicised consultation process which took place during the month of February 2012, a total of 3,390 people had their say. The majority of these (86%) were consumers. Taking into account firmly held opinions from the food industry, other relevant bodies, as well as from many members of the public, The Food Safety Authority Of Ireland launched their report in July. The full report can be downloaded at this link, but

http://www.fsai.ie/news_centre/press_releases/calories_on_menus_report/04072012.html

Here are 2 summary paragraphs:

“The calorie on menu scheme is intended to empower consumers to make more informed choices when purchasing foods from food service outlets such as restaurants, bars and cafés. The report’s findings reveal an overwhelming demand by consumers (96%) for calorie menu labelling in all or some food outlets, with 89% saying that calories should be displayed beside the price of food and drink items on the menu. When asked whether calorie labelling should apply to outlets serving alcoholic drinks, 84% of consumers said calorie labelling of alcoholic beverages should apply in all or some outlets.

Nearly three in four food service businesses (73%) were in favour of calorie menu labelling in all or some food establishments. However, when considering the technical aspects of implementing such a scheme, the numbers of food businesses in favour of calorie menu labelling fell to just over 50%. The main concerns food businesses have revolve around their lack of expertise to calculate calorie content of the food they sell, the potential cost, and the time involved in implementing calorie menu labelling”

 

So it clear that 96% of consumers want this information to be displayed to help them make informed decisions.

I can totally appreciate why restaurants are having a hard time understanding why the Minister appears to have targeted them. But their reaction seems to be based on a misguided perception of the factors that affect and fuel the obesity epidemic in Ireland. Obesity is a very complex condition with several different factors playing a role – including nutrition, exercise, genetics, metabolism, medical conditions, social and cultural factors, social class, level of education, stress, occupation…. the list goes on! But for today let’s just look at a few aspects of nutrition….

Foods eaten outside the home are higher in fat and calories, primarily due to large portion sizes. I get tired of hearing people fob off the obesity crisis as being simply due to an over consumption of fast food & processed foods. This is just not true! Processed foods do not make people fat, excess calories do (and it doesn’t matter what kind of food the excess calories come from). Surprisingly, eating healthy food will not necessarily keep you at a healthy weight or indeed lead to weight loss – it depends how much you eat and exactly how many calories are in it! So it all comes back to portion size and calorie content.

Having been involved in national nutrition research for 3 years, I have first-hand knowledge of the habits of Irish adults in relation to eating out. There are distinct urban & rural differences. In rural areas, the tendency to eat out is relatively small, but in urban areas “eating out” can account for up to 100% of an adult’s food intake, especially for people who have long commutes to/from work.  For the purposes of the research the definition of ‘Eating out’ was also expanded to include foods prepared outside the home but eaten at home or on the run e.g. fast food/takeaways & dashboard dining (eating/drinking in your car/van/truck). The most common items in this category are hot drinks, soft drinks, snacks (chocolate crisps), hot food to go (eg breakfast roll, wedges, sausage rolls) & other deli items (takeaways sandwiches). A sandwich can contain anything from 250 calories up to 1000 calories – depending on the size and the filling. If calories were posted at the point of sale for items such as this, sales would not be affected but rather informed decisions could be made as most members of the public don’t have a clue how many calories are in anything!

If every person in Ireland was found to have all the genes associated with increasing their risk of obesity, then they could still only become obese if they have a plentiful supply of calories! There are no obese people in third world countries, and even though it is highly probable that a significant proportion of them would be genetically predisposed to obesity, it simply cannot  and will not occur in the absence of nutritional abundance (i.e. too many “calories”).

Most people I meet either professionally or socially seem to think that nutrition and healthy eating is everything on moderation, a low fat diet or indeed all common sense! However, what may be moderate to one person is another persons’ idea of gluttony! Despite supermarkets shelves laden with low-fat products & health foods, obesity continues to rise! And as far assuming that it’s only ‘all common sense’, believe that at your peril! Nutritional science is a very exact science but the main problem why there is such a palpable level of confusion about what constitutes a healthy diet is the fact the main sources of nutrition information amongst Irish adults is radio, television, print media, the internet, family, friends, work colleagues, neighbours,  – the list really is endless! Why don’t people seek the advice of qualified dietitians if they need nutrition advice? Thankfully the professional term dietitian is soon to be protected by law, but the vague title of nutritionist is less well defined and not protected, so anyone can call themselves a nutritionist without having ANY qualifications! So just beware, be very aware, and if you are thinking of taking advice from someone claiming to be a nutrition expert, check on http://www.indi.ie to see if they have recognised qualifications.

All manufactured food sold in supermarkets must adhere to mandatory nutrition labelling which provides information on the energy (calories), protein, fat & carbohydrate content per 100g of the product. That’s only relevant or helpful if you know the exact weight (in grams!) of how much you have consumed! Research shows that ‘back of pack nutrition labelling’ is well read but not well understood! However recent research carried out by Safefood shows that ‘front of pack labelling’ (such as GDA nutrition information per serving) is much easier to understand, so that is why calories on menus need to be written beside the food item/price at the point of sale, not tucked away in a separate document or on a website.

37% of Irish adults read food labels for nutrition information, and 35% look for calorie content. Only 6½% of people actually know the difference between Energy and Calories. If you are in the other 93.5% you might be surprised to know that they mean the same thing! 7% of adults said they have no idea why they read food labels, but read them anyway!  32% of people claimed to know the difference between salt and sodium, but only 8.8% actually knew the difference!

 

So will calorie posting change behaviour?

Studies form the US show that when calories are posted on menus, 20% of people change their choice at the point of sale. Restauranteurs may be surprised to hear that not everyone chooses to order or eat less based on this information! Men are more likely to order MORE food because the calories are much less than they had thought! That’s where education programmes need to slot into this campaign, because without education, the calorie information alone will have a limited impact in the long term.

Dr. Donal O’Shea consultant physician who I have huge admiration for in trying to bring this initiative to Ireland said on RTE radio1 last week after this report was launched that “for every €1 spent in health promotion/prevention measures, it saves €14  later on in healthcare costs”. The HSE have pumped billions into other areas of primary care and they need to make significant financial grants available to restaurants who want to give this ‘a go’ during the voluntary period. If it will save billions later on, and they expect food businesses to jump on board, they must provide financial assistance. Otherwise what I see happening is the food businesses might ask their teenage children to work it out using a phone App or equivalent! In the few restaurants where I have seen calories displayed to date, I would be 100% sure that the figures were wrong, up to 100% error in some cases! Phone apps and other online nutrient calculation sites are generally based on US food data, which bears little or no resemblance to Ireland and UK food data. For example a steak from Irish beef fed on grass is worlds apart (nutritionally) from US food data on beef fed on a diet of grain! And that’s just one example!

If the calories on menus are not accurate, I would certainly envisage a situation where the FSAI will have no option but to legislate so that it can be policed and the public can make informed decision based on accurate information, rather than inaccurate information being provided for the sake of ticking a proverbial box.

Having worked a dietitian for 19 years, I would have to say there is a staggering level of confusion about nutrition and healthy eating.  People need help & education to make informed decisions. The RAI will be glad to hear that I do not think it is fair to make them carry the burden of cost, as many of them are already struggling on a daily basis to keep their doors open.  When the swine flu epidemic hit Ireland in the recent past, the HSE swung into action immediately with nationwide vaccinations programmes. I can only imagine what the cost was but no doubt is was a staggering chunk of money. It was a serious and urgent public health matter, so the Dept of Health/HSE paid for it. Obesity is also an urgent public health matter which will in the not too distant future cripple an already over stretched health system, so instead of putting the financial burden on the restauranteurs, the calorie posting should be phased in over a number of years, where technical experts (including food technologists, accredited laboratories & qualified dietitians) are made available to businesses to work with them on implementation, rather than working fiercely against each other as it currently stands.

Calorie labelling must be accurate. Displaying the amount of calories on food and beverages is a form of food labelling & is governed by food labelling legislation. The most important rule of food labelling is that the consumer must not be misled”

As present, it’s a no win situation, and absolutely futile; food businesses have to foot the bill, no one is policing it, accuracy is irrelevant & any old information will do as long as some kind of calorie information is displayed!  At best, it could be guessed, and no one would be any the wiser! As I say, absolutely futile, a total waste of time, energy & money.

Obesity in children is already at epidemic proportions. Over 300,000 Irish children are overweight or obese – 25% of boys and 35% of girls between the ages of 4 and 18 years. Adults are the ‘gatekeepers’ for children including their health, so parents need to be educated to recognise when their child needs intervention and treatment for childhood obesity. It is predicted by health experts that children may well die before their parents in this generation due to obesity related conditions, so something needs to be done, and it needs to be done quickly.

In conclusion, there are countless numbers of specific and expensive health promotion programmes & disease prevention strategies being run by the HSE / Dept of health – such as smoking cessation, cardiac rehab, mental health campaigns, cancer prevention initiatives ALL funded by the HSE / DoHC and rightly so. Obesity is currently costing Ireland €3000Million per year, and if this new calorie posting initiative is not funded then the short term and long term cost of obesity is likely to rise sharply. Food businesses need financial support to implement this initiative, and as per research stats, every euro that is put into a programme like this will SAVE €14 euro in the long term.

Written by Niamh O’Connor BSc Dip RD MINDI, Freelance Consultant Dietitian & Clinical Nutritionist.

Posted on 2nd October 2012.