Expert: Many Underestimate Calories

Obesity rates continue to spiral out of control in this country. At the current pace, today's children may be the first generation in American history to live sicker and die younger than their parents.

The obesity epidemic is caused by many factors, but nutritionists say one main reason is how dependent we've become on eating out.

When you cook at home, most ingredients in your cupboard have mandatory FDA nutrition labels. But restaurants are exempt, so when you place your order you can only guesstimate how many calories you'll be putting in your mouth.

Now one of the most powerful health officials in the country wants to change that by forcing chain restaurants like McDonald's and Wendy's to spell out exactly how fattening their food is -- right when you decide what to order.

As correspondent Lesley Stahl reports, the idea is gaining support nationwide, but also faces fierce opposition from the restaurant industry itself.

"We think it will encourage people to choose lower calorie options because that information will be available to them," explains New York's health commissioner, Thomas Frieden.

Frieden is in charge of regulating New York City's $11 billion restaurant market, and tells Stahl the restaurants "really hate" having to do this. "There's no question about that," he says.

"Now most of the chains have the nutritional information somewhere," Stahl points out.

"Usually on a Web site hidden somewhere," Frieden says. "Or on the package liner or the tray liner, after you've bought the product."

Asked why that isn't enough, Frieden argues, "No one is going to check a Web site, then go to the local burger joint and decide what to buy. People do look at the menu board. The menu board is the most prominent thing within a fast food restaurant."

The regulation would cover mainly big chains, like KFC, Burger King, McDonald's and Starbucks.

Frieden wants people to see as they order that some combo meals, like one from Burger King, pack 2,200 calories -- more calories than many adults need in a day. Some Starbucks drinks are more fattening than Big Macs. And even what seems good for you might be anything but.

"You might think that tuna salad, because it says it's salad, is healthier. But you might see it's many more calories than a roast beef sandwich. And you might prefer the roast beef sandwich, too. You were having the tuna salad because you thought it was healthy," Frieden explains.

Brian Wansink is a nutrition and marketing professor at Cornell University. He uses the mall as a laboratory, observing the food-court crowd like other scientists study rare tribes.

Wansink, who even wrote a book called "Mindless Eating," finds that people always underestimate calories, but they get it especially wrong when they're eating something they think is healthy.

On one of his recent "observation trips," Wansink concentrated on meals from Subway, which markets itself as the healthy fast-food alternative. He asked people to estimate the calories of an especially caloric combo: a foot-long Subway sandwich with mayo, chips and juice.

"Now for this you estimated that it had about 300 calories," Wansink pointed out to a man. "In reality it has 1,390."

"When people are eating in a restaurant that they think is healthy, people grossly underestimate how much they eat by about 50 percent," Wansink explains.

"So they eat much more than they think they're eating?" Stahl asks.

"By about twice as much," he says. "That mayonnaise you ate probably was not healthy. The extra cookie you ate probably wasn't that healthy. The chips probably weren't that healthy."

"Well, let's say for instance that we would have had the calories listed on the menu when you ordered something like that. Would that influence what you ordered?" Wansink asked a man.

"Absolutely. I don't think I would have gotten it. I mean, 1,350 calories for a Subway," the man replied.

The calorie labeling in New York would not apply to "calorie Meccas," like Chinese restaurants, delis, and fancy French bistros. The chains were singled out because they already publish nutritional information about their food, the idea being that they've already done the calculating.

Wendy's spokesperson Denny Lynch say's that's unfair. "In essence, you are penalizing the restaurant chains that are voluntarily providing information to consumers," Lynch argues.

"But if you weren't already providing it, you were exempt?" Stahl asks.

"Yes. That is absolutely right," Lynch says.

"What was the thinking on that?" Stahl asks.

"You'll have to ask the board of health," he replies.

"The industry feels you're picking on the chains because they were doing something positive and they get whacked for it," Stahl tells Commissioner Frieden.

"We're saying, 'If you're doing it, put it where people will actually see it. Empower your consumers,'" he replies.

But what's healthy for consumers may not be healthy for business. In 2003, the chain Ruby Tuesday tried listing calories on its menus. Sales dropped. Soon, most calorie numbers vanished.

"Aren't you truly afraid that by listing the calories you're going to lose money?" Stahl asks Wendy's spokesperson Denny Lynch.

"Absolutely not," he says. "If we were afraid to provide the information, why would we voluntarily provide it?"

"What restaurants are doing now is a sham. They're putting information on Web sites. And they know perfectly well that very few people see it there. They put it there so they can say they're doing something good," Frieden argues.

"What do you say to parents who are concerned that their children are overweight, and they want this information?" Stahl asks Lynch.

"I say to them that if you have a computer, log on to our Web site, and you can see that information," he says.

"That's not easy! You're going to go take your kids out to dinner, you've worked all day, and you're telling them to go to a computer?" Stahl asks.

"We think that the poster is a good solution," Lynch says.

The poster Lynch is referring to was introduced last year by Wendy's with lots of nutrition numbers, calories amongst them. But as opposed to other displays in bright colors, the poster is drab and easy to miss.

"If people are interested in calories or they're interested in…," Lynch says.

"But what if they're not interested in calories?" Stahl asks.

"They're probably not going to look anywhere for it. If they're not interested…," he replies.

"Well, if it's on the menu board, there it is. They won't have to look for it," Stahl remarks.

"If you can provide accurate information," Lynch says.

He says that because Americans love to customize -- adding cheese or extra mayo -- providing accurate information is nearly impossible and would certainly take the "fast" out of fast food. Lynch showed 60 Minutes a Wendy's menu board that lists the combos.

"At Wendy's we offer five substitutions for the fries and then three types of drinks. So you can order a combo 234 different ways," Lynch says.

He then showed Stahl what it would look like: a dense, cluttered board, with tiny type. "Obviously … no one can read it. And you would have to see this from eight feet away," Lynch explains.

"Let me see. This is absurd. Oh my gosh," Stahl remarks.

This problem isn't unique to Wendy's. Consider Starbucks, where you can order drinks 87,000 different ways. A cup of Joe can be five calories, but order a Vente White Chocolate Mocha, add milk and whipped cream, and it nears 800 calories. Dunkin' Donuts made a mocked-up menu board to show Commissioner Frieden it would be unreadable.

"This is what they said they would have to do," Frieden says, showing a menu-board with small letters and numbers.

"Ok. Well, that is pretty tiny and I think if I were in the store and that was way up high I would have trouble seeing it," Stahl remarks.

"Very hard to read. So we asked our print shop at the health department, couldn't you do this more clearly? And in just a couple of hours they came back with this," Frieden says, pointing out an easier-to-read health department version of the same menu board containing all the same information.

While the battle of the mock-ups was being waged, Subway decided to do it for real. Over the summer they began posting calorie values on their menu boards in New York City. Bill Schetinni, head of marketing at Subway, joined Stahl, as she ordered her first calorie-informed sub.

"Oh, I can really see the calories, it's very clear," Stahl remarked, looking at the new menu board.

The board is not cluttered, but would it reflect her order? Roast chicken was listed at 310 calories.

"I want a foot-long, Italian bread," Stahl decided.

But the calorie number on the board is for a six-inch sub, so she had to double the number in her head. Calories for bread were already figured into the calorie number.

"I want mayo. I like mayo. Good. Now, how do I check on my calories?" Stahl asked.

"That kicks it up 110 more calories," Schetinni remarked.

"Where do I see that?" Stahl asked.

"Well, it would be on the sneeze-guard cling back here," Schetinni explained, pointing to a separate posting near the ordering counter. But the mayo wasn't listed there either.

"Sorry, it's not in there, but it is in the brochure," Schetinni said.

"Already I'm confused," Stahl remarked.

Her sandwich actually came in at over 700 calories. No matter how you slice it, complying could take the fast out of fast food. But Subway is determined to try, unlike the rest of the industry which argues calorie labeling is not only confusing -- it's downright condescending to you, the customer.

"We've given you the option to find this information, to look up this information, to use this information. You're telling me that you're not taking the choice. But that is your choice," Denny Lynch says.

But the chains are up against a formidable foe, because Thomas Frieden has a record of making big industry bend to his will. He's the one who forced smoking out of city bars and artery-clogging trans-fats out of city restaurants. Both those bans spread nationwide, which is also happening with his new crusade.

Following New York, Seattle passed a calorie labeling law, as did the California legislature. And 18 other cities, counties, and states have similar laws in the pipeline.

"Do you think you're going to have to go in and fight this in Seattle, in California, and in the other states that are now seeming to want to have their own regulations like this?" Stahl asks Lynch.

"We are engaged in conversations in each one of those markets." Lynch replies.

"Separately?" Stahl says.

"Separately." he replies.

And so for the chains it's war, which they're fighting with lawyers and lobbyists. In California the industry convinced Governor Arnold Schwarzenegger to veto menu labeling, calling it impractical. And in New York, the state restaurant association successfully sued to stop calories from going up on the board, because the city had singled out those voluntarily providing the information. But Dr. Frieden is now re-writing the regulation, and is certain it will pass.

There's still the ultimate question: will the menu board labeling work? Professor Wansink says his research shows there's a possibility it could backfire.

"Do you ever see people ordering the low-fat meal, main course, and then saying, 'Well, I didn't eat anything,' and then ordering a hot fudge sundae for dessert?" Stahl asks.

"Well, absolutely. And actually, this is called calorie compensation," Prof. Wansink says. "And what happens is you think you're doing yourself good, and so you reward yourself later on."

"If they believe they ate this nice, healthy lunch, they're more likely to eat snacks and eat more calories of it later on it the day," he explains.

There's little scientific evidence that posting calorie numbers will make people eat less, but Commissioner Frieden says it's worth the try. And he says there's the shame factor -- he hopes that restaurants will be embarrassed into being more responsible.

"Obesity is a terrible epidemic. We don't understand all the causes of it, but we do know that it is undermining the health of our society in so many ways," Frieden says. "We need to take action. This is one measure that we think will make some progress in this area. It's not going to solve the problem, but it's part of a solution."
Produced By Shachar Bar-On