Beginning next year, consumers walking into a chain restaurant anywhere in the country will get an eyeful — calorie counts next to their favorite triple-triple burger with extra everything. While many jurisdictions, including California, already require mandatory calorie disclosure, President Obama’s Affordable Care Act will make this a national rule in 2014 to give Americans the information they need to make healthy choices and blunt the climbing obesity rate.
But in places where this is already required, are consumers more likely to be scared off from ordering the gargantuan sour-cream-loaded burrito because of its astronomical calorie count?
Disclosing the amount of calories of food in restaurants doesn't necessarily lead to calorie-wise choices, researchers have found.
In other words, people who are already fit and watching their intake are more likely to pay attention to calorie counts than those who really need to consider them.
For their study done a couple of years ago, Leslie and colleagues Bryan Bollinger and Alan Sorensen at the Graduate School of Business at Stanford University, were able to get transaction data on what consumers were purchasing at Starbucks locations in New York City after restaurants were required by April 2008 to post calories on menus.
The researchers examined every transaction made at Starbucks outlets in New York City for more than a year, and compared them to purchases made at Starbucks stores in Boston and Philadelphia, where there was no calorie posting. What they found was that calorie posting had a small impact, but nothing that could make a dent in people’s waistline. The average number of calories per customer transaction fell by 6 percent. That drop in calories came primarily from food purchases, not drinks.
"There was almost no change in the calories of drinks that were purchased," Leslie said. "Looking at the effect on food purchases, it was somewhat small. It’s hard to imagine that this could have any effect on obesity."
The researchers did detect that calorie posting affected purchases at Starbucks outlets located in wealthier, more educated neighborhoods more than in poorer neighborhoods, Leslie said. 
But while calorie posting may not be the "silver bullet" that some policymakers think could solve the obesity problem, Leslie and his colleagues in an earlier study validated the strong impact of what is now seen by many as the "gold standard" of consumer information — the hygiene grade cards that are displayed in restaurant windows.
Phillip Leslie is an associate professor and economist at the UCLA Anderson School of Management, who studies how information influences consumer decision-making
"It’s easy to understand, it’s information that’s available at the point of purchase, and consumers see it prior to making a decision about whether to go in or not. Consumers don’t have to work to acquire this information," Leslie said.
In a widely circulated paper published in 2003 in the Quarterly Journal of Economics, Leslie, then an assistant professor in economics at UCLA, and Ginger Zhe Jin, a Ph.D. student at the time, analyzed the impact of the grading system in Los Angeles County. The paper is frequently cited by those in environmental health, epidemiology and health departments as well as academic economists and policymakers.
In 1998, Los Angeles County introduced hygiene grade cards that had to be displayed in restaurant windows. To evaluate whether the grading system had any impact, the researchers looked at data from 1996 to 1998 about the outcome of every restaurant health inspection in the county, the quarterly revenue for individual restaurants and the hospitalizations for food-related and non-food-related digestive disorders.
The grade cards had an impact, they found: Health inspection scores increased by an average of 5 percent, and consumers became sensitive to changes in restaurants’ hygiene grade. What’s more, the number of hospitalizations for foodborne illnesses substantially decreased, partly due to consumers substituting restaurants with poor hygiene for others with good hygiene, and partly due to restaurants making actual hygiene improvements.
"What this paper showed is that when you increase the provision of information to consumers, not only does that affect decision-making by them, but it also affects the behavior of restaurants, and it also leads to a measurable and real improvement in health outcomes for consumers as well," Leslie said.
Leslie and some colleagues are currently working on creating a national database that pulls together restaurant hygiene data as well as specific health outcomes from all jurisdictions — cities, counties and states — to make this information accessible to researchers, the Food and Drug Administration, health departments, consumers and others.
The task is complex, he said, because restaurant hygiene is evaluated by jurisdictions in many ways, a fact that befuddles restaurant chains which must meet different regulations, depending on the location of their restaurants. Leslie is also working on research that questions whether the grade cards are actually changing the behavior of health inspectors.
So far, the researchers have collected data on more than 600,000 restaurants from over 50 different jurisdictions. "We’ve got coverage of about 50 percent of the restaurants in the country at the moment, and we’re adding more each week. We’re hoping that once this national database is in place, it will help health departments think about how they can redesign their own inspection methods to become more consistent and implement best practices," Leslie said.
