Tacoma - OK, so you open the menu and see the dirty details all laid out.
The Reuben sandwich you wanted has 1,730 calories and 4,490 milligrams of salt.
A. Choose a healthier option.
B. Order the Reuben.
C. Complain to the manager for ruining your lunch.
If you’re like two-thirds of restaurant patrons in Pierce County, you go with the Reuben.
That’s what researchers at the Tacoma-Pierce County Health Department found in a recent study, the results of which were published last week in the American Journal of Public Health.
The study, conducted by the Health Department’s Elizabeth Pulos and Kirsten Leng, was designed to see whether displaying nutritional information on menus changes customers’ minds about what to order.
“Obesity is a growing problem, and more and more of us are living busy lives and eating meals outside of our homes,” said Pulos, an epidemiologist and the study’s principal investigator.
“If we want to regulate our weight, it’s important to make smart decisions in restaurants.”
Consumers generally support menu labeling, Pulos said, but how effective it really is at changing behavior had not been conclusively demonstrated.
The Pierce County restaurants that participated in the study were the Fife City Bar and Grill; Wild Orchid, Doyle’s Pub and the Organic Comfort Food Cafe in Tacoma; The Friendly Duck in Puyallup; and Midtown Station in Sumner.
In the study, Pulos and Leng compared entrees sold in the month before the labeling with entrees sold during the month after. They also surveyed patrons.
Their results showed that the nutrition numbers did make a difference, but only for 1 of every 3 people.
On average, entrees sold after the labeling contained about 15 fewer calories, 1.5 fewer grams of fat and 45 fewer milligrams of sodium than entrees sold before labeling.
In follow-up surveys, 71 percent of patrons said they had at least noticed the information.
Slightly more than 20 percent said they ordered an entree lower in calories as a result, and 16.5 percent said they ordered an entree lower in fat. Overall, 33.7 percent of people said seeing the nutrition information changed their minds.
Pulos sees a clear public health benefit in labeling.
“Not everyone saw or paid attention to the nutrition information that was there,” she said. “But for those who did, a substantial number of them changed their food choices.”
The six restaurants that participated in the study displayed total calories, fat, sodium and carbohydrate content for every item regularly on the menu – but not for beverages or daily specials.
Because the program was voluntary, restaurants could display the information any way they wanted. Most chose to do it with four numbers separated with slashes. A key elsewhere on the menu explained what the numbers meant.
Two of the six restaurants prominently labeled the numbers.
“The numbers by themselves were pretty cryptic,” Pulos said, “and people had to know enough about nutrition to know if the number represented a large or not so large amount.”
Pulos suggested that a statement accompanying the numbers that said, “A normal adult should eat about 2,000 calories a day,” would increase behavior change.
From a public health point of view, another positive aspect of the experiment was the response of restaurants when they saw the laboratory analysis of the food they were serving.
In several cases, they either dropped items or changed recipes to make them healthier,” Pulos said.
Wild Orchid, a Thai restaurant, removed the nutritional information from its menu after the study.
“Some customers don’t like it, to see what’s inside the food,” said owner Po Lin. “Sometimes they don’t want to know about it. You want people to be happy. If they’re not happy, maybe they don’t come back.”
Diana Prine, chef and owner of the Fife City Bar and Grill, said she completely supports the labeling concept. Hers was one of two restaurants that spelled out the information to make it as clear as possible.
“All of our food is naturally cooked anyway, so I just said, ‘Let’s go with it,’” Prine said.
“You have some people who don’t want to see it,” she said. “They’ve got kind of a ‘see-no-evil’ attitude, you know. But most people really like it that we’re willing to expose what we put in our food.”
Prine was one of the chefs who changed recipes after seeing the lab results.
For example, she cut back on the cream in the sauce for her grilled king salmon with artichoke and pesto ravioli, knocking the calories down from 950 to 840.
Other entrees, such as the Reuben, seemed to defy change, she said.
“It kind of is what it is,” Prine said, adding, “Sales went down when people saw the amount of sodium in a Reuben.”
“But it’s like anything,” she said. “It helps you make a choice. If you have a Reuben for lunch, maybe you can make up for it at breakfast or dinner.”
Rob Carson, 253-597-8693