Calorie-Count Labels May Thwart 'Freshman-15' Weight Gain

Marlene Busko

November 10, 2014

BOSTON, MA — A simple intervention — repeated exposure to foods clearly labeled with calorie counts — may help students avoid the "freshman 15," or having their weight creep up by 15 pounds during their first year of college.

In a new study, college freshmen living in university residence in Scotland were more likely to fill their tray with lower-calorie foods for supper when given this option. Notably, they were also half as likely to gain weight over the school year compared with their peers who did not have this calorie-count information.

This striking finding is the first long-term evidence for an impact of calorie labeling on body weight.

It suggests that a simple, low-cost intervention can prevent weight gain in young adults, a group that is vulnerable to piling on the pounds, Charoula Konstantia Nikolaou, who conducted this study as part of her PhD research at the University of Glasgow, Scotland, told attendees here at Obesity Week 2014. The study was also published in the November issue of Obesity.

"Calorie labeling can be quite useful, but it needs to be prominent [and sustained]," she stressed to Medscape Medical News.

The study shows that "these [typical] young adults…very clearly welcomed the provision of information and changed their meal choices toward lower-calorie options," coauthor Dr Mike Lean (University of Glasgow) added.

If these young adults can continue to prevent excessive long-term weight gain it can lower their risk for certain cancers, type 2 diabetes, and heart disease, he noted.

Speaking on behalf of the Obesity Society, Dr Sara Bleich (Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland) said although large chain restaurants are encouraged to present caloric content for menu items, "this study reminds us that there isn't any legislature for cafeterias at universities, schools, or workplaces to display this type of information."

The sooner policy makers "better understand these associations between calorie labeling and weight loss, the closer we will all be to making better food choices," she said in a statement.

Making Informed Choices in the College Cafeteria

To help consumers make better food choices, the 2010 US Federal Patient Protection and Affordable Care Act has mandated that fast-food chain restaurants must display the calorie content of their menu items, Ms Nicolaou said, and the United Kingdom's Responsibility Deal encourages similar labeling.

However, little is known about the impact of this legislation, and previous studies of calorie labeling examined one-time food purchases as a "snapshot" of consumer behavior and did not look at college cafeterias.

The researchers examined the effect of a calorie-labeling initiative conducted at the College of Medical, Veterinary, and Life Sciences, in Glasgow, Scotland.

They compared the weight change over the 9-month school year in 120 freshmen who lived in residence in 2012–2013 (when a food-labeling initiative was implemented) vs the 120 freshmen who lived in residence the previous year.

All students were given a questionnaire asking about weight, height, and age at the beginning and end of the year.

The students who lived in residence in both years were very similar; they had a mean age of 19, a mean body mass index (BMI) of 22, and a mean body weight of 66 kg; about half were female.

The researchers worked with the caterers and university dieticians to develop calorie-count labels for each of the items on the three-course supper menu.

Half of Students Watched Labels to "Eat Healthy"

The college students who were offered supper foods labeled with calorie content chose meals with 15% to 25% fewer calories than meals selected by their peers in the previous year.

On average, students who were provided with this calorie information lost 0.15 kg during the 9-month school year.

On the other hand, students in the previous year gained 3.5 kg (7 pounds) over the school year — which is actually a more typical weight gain, as opposed to 15 pounds, according to Dr Lean.

"Regular, consistent exposure to calorie-labeling of main meals was associated with halving the likelihood of young adults' gaining weight," the researchers note.

Indeed, said Ms Nicolaou, "We were glad to see that exposure to our very prominent calorie labeling for an entire school year did not just reduce weight gain in these students but eliminated it altogether for the group."

About 40% of the students reported that they consulted the calorie labels to help watch their weight, and more than half said they used them for "healthier eating."

The caterers also liked the calorie-count labels. They adjusted their menus and purchased less meat and cooking oils, which lowered their costs by about a third.

Meanwhile, the more than 1000 freshman students who lived off campus each year gained about 2 kg during the school year.

The labels were deliberately kept simple. "We do know that calorie content correlates strongly with fat content, [and] it's better to have just one [type of information] rather than giving all the [nutritional] information and having people confused," Ms Nicolaou told Medscape Medical News.

In reply to a question from a attendee at the meeting asking how calorie labels might affect students struggling with anorexia, she said that only two students had contacted them asking that the calorie labels be removed.

The benefits for the larger student group could be substantial.

Overall, this "study presents valuable new evidence that regular daily exposure to prominent calorie-labeling may 'nudge' long-term alterations in food choices sufficient to reduce the weight gain of young adults…and [this approach] deserves support as a low-cost, transferable intervention for public-health strategy," the authors conclude.

The authors have reported they have no relevant financial relationships.

 Obesity. 2014:22:2277-2283. Article

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