See the menu -- see the calories

Chicken tenders, a baked potato and a slice of carrot cake. A tad indulgent, perhaps -- but not too awful, right? In fact, a five-piece order of Arby’s chicken tenders has 630 calories. A baked potato with butter and sour cream at Ruby Tuesday has 459 calories. And a slice of carrot cake at the Cheesecake Factory packs 1,560 calories.

After years of grand-slam breakfasts and ever-expanding dinner platters, we may not be eating calorie-blind for much longer. In a much-trumpeted move, New York City health officials voted Dec. 5 to bar all restaurants and bakeries, with minor exceptions, from using more than minuscule amounts of trans fats in their foods.

At the same time -- in a move that got far less attention -- they also voted to force chain restaurants that already offer nutritional information to display the calorie count of their fare on menus or menu boards -- hard-to-miss revelations that will probably come as shockers to many consumers at restaurants ranging from McDonald’s to Denny’s.

The move, to take effect next year, was hailed by the nutrition advocates, doctor groups and politicians who have spent years fighting for similar measures across the country against dogged industry resistance. Like smoking bans, they say, such a move could do wonders for people’s health by cajoling them to clean up their eating acts while providing incentives for restaurants to offer healthier fare.

Cities and states around the country are watching closely to see what the effects are in New York City. Some may follow suit. Chicago is considering not only banning trans fats in restaurants that make more than $20 million a year but also requiring restaurants that make $10 million or more to print calorie, sodium and saturated fat counts on menus in sizes large enough to be easily read. Los Angeles and New Jersey are also considering restaurant labeling measures, and more are expected in the new legislative session starting next month.

“This legislation is really quite groundbreaking,” says Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University in New Haven, Conn. He believes that health officials should take diet-busting menus as seriously as E. coli outbreaks.

“If you eat food and it makes you sick immediately, they’re all over it,” he says. “But if it kills you over a longer period of time, there has not been a precedent for jurisdiction. Now there is.”

In some ways, the move is not as profound as it might at first seem. Calorie counts and other nutritional information have been available in some eateries for years -- but only for the diner who knows where to look or bothers to ask for them.

McDonald’s, for example, started providing fat and calorie counts to customers in the mid-1980s as part of a settlement with several state attorneys general over charges that the chain was misrepresenting its chicken nugget ingredients. At the same time, Burger King, Wendy’s, KFC and Jack in the Box agreed to do likewise. Although the original agreement lasted a year, all these companies still provide nutritional information.

And more restaurants are jumping on board to inform curious consumers, including well-known chains such as Arby’s, Starbucks and Red Lobster (the latter just gives facts for lighter fare). Today, about half of restaurant chains voluntarily offer this information through brochures, websites, posters and in-store computers. In addition, a new industry-backed website, www.healthydiningfinder.com, offers nutrition facts for just a handful of healthy choices from tens of thousands of restaurants around the country. The site will officially launch in March.

Such voluntary efforts are more effective than mandates, says National Restaurant Assn. spokesperson Sue Hensley.

For consumer advocates, however, these voluntary efforts are far from enough. For one thing, they say, it’s not ideal that people have to actively request the information -- besides, it’s often not available anyway. In a study published this month in the journal Preventive Medicine, researchers at the consumer advocacy group Center for Science in the Public Interest in Washington, D.C., found nutrition information was available at only 60% of the district’s McDonald’s outlets. The researchers often had to ask two or more employees before they got it.

And even when nutrition facts are available, they’re usually stashed at cash registers, on tray liners or online, and people don’t see the numbers until too late, says Margo Wootan, CSPI’s director of nutrition policy.

That’s why Wootan and others favor a rule that, like the one in New York, requires nutritional information be placed on the menu or menu board. Such regulations, she says, should spur restaurants to offer healthier options, just as new trans fat-labeling requirements on grocery store-bought foods inspired food producers to reformulate recipes. Lab analyses, she adds, show that chains can accurately estimate the calorie counts of standardized menu items.

Hensley of the National Restaurant Assn. disagrees. She argues that New York’s decision is bad for calorie-conscious consumers because the menu-labeling rules apply only to certain chains -- ones that already post nutrition information elsewhere, such as on a flier or website. The rest get off scot-free. Restaurants that don’t already offer nutrition facts will be discouraged from doing so, she says.

Chef-driven variations make it too difficult to standardize calorie counts, Hensley adds, and in any case, diners customize 70% of orders with, for example, “no sauce” or “extra cheese,” making accurate nutrition counts hugely challenging.

“Our industry,” Hensley says, “is not a box or a can.”

The push for disclosure is based on research suggesting that America’s habit of eating out may be doing a number on the nation’s waistline and general health. A recent report, released in May by the Food and Drug Administration on eating outside the home, showed that people who eat out more consume more calories and saturated fat, fewer fruits and vegetables, and less milk. One study published in 1999 found that women who eat out more than five times a week take in about 300 more calories each day than those who usually eat at home. Most Americans get one-third of their daily calories from restaurant food, according to the FDA.

Mega-portion sizes and an abundance of calorie-dense options are probably to blame for overindulgence at restaurants, says Penn State University nutrition researcher Barbara Rolls, who helped compile the FDA report. In a soon-to-be-published study, she showed that people in experiments eat more and more as the portion sizes they’re offered are increased.

In other experiments, Rolls has shown that people can consume up to 800 fewer calories a day and still feel full when given smaller portion sizes and foods that are high in water and fiber content but lower in calories.

Even when diners have healthy intentions, they are often at the mercy of what restaurants serve. And studies show that people consistently underestimate calories in food servings by as much as 50%. In a 1997 study by researchers at CSPI and New York University, for example, even dietitians low-balled their calorie estimates of fast-food meals by up to 600 calories.

Other research shows that people buy healthier food and consume less when given nutritional information. “If you’re going to make any inroads into the obesity epidemic,” Rolls says, “you have to make it easier for people to make these choices despite themselves.”

Surveys by advocacy groups show that about three-quarters of Americans support legislation requiring restaurants to put nutritional information on menus.

About 20 cities and states, including California, Chicago and Seattle, have already considered proposals similar to New York City’s new rules, Wootan says. (It’s widely believed that New York was successful first because its Board of Health, and not politically influenced legislators, passed the regulations.)

Former state Sen. Deborah Ortiz (D-Sacramento), whose term as chair of the California Senate Health Committee ended last month, worked on two state bills that would have required menu labeling akin to New York’s. Both bills died in 2003, despite extensive negotiating with the industry.

Still, she says, she worked for three years before she finally got a bill passed that took soda out of schools, and she expects that menu labeling will probably face a similarly long haul.

“We’re on the front end of the learning curve,” Ortiz says. “I would predict someone in the California legislature is going to continue this battle. There is an opening now, given what New York has done.”