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Feature Public health

The fattening truth about restaurant food

BMJ 2008; 337 doi: (Published 18 November 2008) Cite this as: BMJ 2008;337:a2229
  1. Karen McColl, freelance writer
  1. 1Savoie, France
  1. karen{at}

    Going out to eat is often a disaster for the waistline. Karen McColl reports on US efforts to make diners more aware of what they are eating

    Customers going into restaurant chains like Burger King or Starbucks in New York can now take calories into account when they choose what to eat. Since May, chain restaurants in the city have been required to include calorie contents on menu boards, menus, and item tags. The law applies to restaurant chains with more than 15 branches nationally.

    Similar menu labelling, or “calorie posting,” laws came into force in September in San Francisco and Santa Clara County in California, and the requirement will soon apply to the whole state. Arnold Schwarzenegger has now approved an amended version of a menu labelling bill that he vetoed last year, making California the first state to pass a menu labelling law. Around 20 cities and states across the US are considering menu labelling legislation. But the restaurant industry is fighting all the way.

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    “It’s just the most astonishing thing I’ve ever seen,” says Marion Nestle from New York University. Professor Nestle is an academic nutritionist with decades of experience advising on nutrition issues. Yet, since calories have been posted on menus in New York she has been surprised. “For someone like me who thinks that they know about these things, I’m stunned by the number of calories in fast foods. I had no idea.” As examples, she cites a blueberry and pomegranate smoothie that provides 1180 kcal (4.9 MJ) and a pizza for one person with more than 2000 kcal (8.3 MJ).

    Professor Nestle is not the only nutrition expert to have difficulty assessing the nutritional content of fast food. The Food Commission recently asked 66 nutrition experts at an international obesity conference whether they could …

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