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Public health and health policy, with commentary.

Friday, January 05, 2007

Natural experiments with food regulations 

New York City has recently required restaurants with uniform menus to post calorie content on their menus with a font size equal to the prices. This initiative may not decrease obesity, but if we're able to gather good data, posting calories on menus could help us better understand how people choose food.

Currently, we don't have a good understanding of how people choose what they eat. Observations of people's food choices through nutritional surveys and food diaries tell us only what people will admit to eating. Laboratory experiments tell us how people who volunteer for psychology experiments choose foods in a new environment, but may not generalize to larger populations in real life situations. Non-laboratory experiments with vending machines have found that people will buy more healthy foods when healthy food is "subsidized" and when less healthy food is "taxed", but nutritional information is not immediately available to subjects even in these experiments: the foods which were manipulated were pretty obvious candidates for healthy and unhealthy foods such as carrot sticks and potato chips.

We also don't know how much knowledge about food people have: when someone chooses a high calorie food, we don't know whether they have chosen that food in ignorance of its calorie content or despite its calorie content. Putting calories on the menu in a visible way gives consumers information which is more readily available than on food packages, and reduces the second problem: some people will read the calorie content of their food when making their choices, and the calorie content may influence their choices.

If calorie information becomes widespread, we could even begin to discuss an elasticity of demand according to both the price and calorie content of the food, as well as a willingness to pay for fewer calories. Just thinking about the McDonald's menu, people can minimize the number of calories they eat by choosing either the least expensive (basic hamburger + fries) or the most expensive items on the menu (salads, grilled chicken).

Some have speculated that posting calorie information on the menus won't affect behavior at all because people choosing to eat at places with unhealthy food can't expect lower calories, but that seems naive. After all, even people shopping at expensive stores are somewhat price sensitive, and all retailers go to lengths to make people feel as though they are getting a bargain.

The inclusion of calorie information on menus gives a tremendous opportunity for social scientists, if only we can get sales data suitable for a quasi-experiment (pre-post with control). Any ideas?

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