MR. KOJO NNAMDIFrom WAMU 88.5 at American University in Washington, welcome to "The Kojo Nnamdi Show," connecting your neighborhood with the world. Later in the broadcast, a global perspective on the future of news. The old model for newspapers might be dying, but the relationship between people and the press is evolving in surprising ways. That, and a dramatic announcement by media mogul, Rupert Murdoch, in London today.

MR. KOJO NNAMDIBut first, counting your calories and making smart or not so smart decisions. Walk into any restaurant chain in Montgomery County, Md. and you'll come face to face with a stark reality. That burrito or burger you're about to eat, 800, a 1,000, maybe even 1,500 calories, dangerously close to your entire daily recommended calorie intake. You know this because a law in Montgomery County requires all chain restaurants to list them.

MR. KOJO NNAMDIThese statistics can be eye popping, but will they actually change the way you order? Probably not, according to a handful of new studies that merge the worlds of public health, psychology and behavioral economics. Joining me to discuss this is Michael Rosenwald who's a reporter with the Washington Post. Mike, good to see you again.

MR. MICHAEL ROSENWALDThanks for having me.

NNAMDIAnd joining me by telephone is Dr. Brian Elbel, professor of medicine and health policy at the New York University School of Medicine and the Robert F. Wagner Graduate School of Public Service at New York University. Brian Elbel, thank you for joining us.

DR. BRIAN ELBELThank you for having me.

NNAMDIMike, New York and Montgomery County, Md. are two of a handful of jurisdictions that require large restaurant chains to post health information on their menus. But such laws could soon be norm across the country as part of a health care bill passed in 2010. How and why did these labeling laws come about?

ROSENWALDWell, they came about as part of public health experts efforts to slim us down. And there was -- there's obviously a huge concern about obesity in this country and three-quarters of the country being overweight. And so that got people concerned and people started to say, well, what could we do? And one of the ways that they came up with was to tell people just how bad certain things were for them before they actually consumed them, hoping that they would make better choices.

ROSENWALDBut in many cases, if not most cases, people don’t make better choices. They can still consume generally the same amount of calories and in some really weird circumstances, actually consume more.

NNAMDIYou'd like to join this conversation? Have you seen nutritional labeling when you've eaten out? Does that sort of information sway you in terms of your food decisions? Call us at 800-433-8850, send us a tweet @kojoshow, email to kojo@wamu.org or simply go to our website, kojoshow.org, and tell us right there. Brian Elbel, it's a relatively simple idea, we assume, that people make bad dietary decisions, in part, because they have bad or no information.

NNAMDIIf we don’t know whether this food for -- whether the food is bad for us or how bad that food is, we really can't expect people to make smart decisions. But your research is starting to indicate that you just can't remedy this situation with food labels.

ELBELI think that's right, Kojo. And it's a simple idea that's clearly going to work for some people. Some people are seeing this information and they're going to utilize it. But for many people, particularly some of the groups we've studied which are low income individuals or individuals in low income communities, we found that this isn't really driving their behavior and other studies have born this out as well.

ELBELAnd I think part of the reason for this and what we're increasingly realizing is that nutrition is just one of many factors that influences people's food choice and many other things, such as taste, convenience and price are more important to people. And it's not that people don't necessarily -- it's not that they don’t care about their health, it just doesn't always trump some of these other factors.

NNAMDIBut I'm looking at these lists. A large order fries from, I guess, is Five Guys, 1,474 calories. The beer battered fish and chips at Cheesecake Factory, 2,160 calories. There's a grilled turkey burger that's 1,370 calories. Mike Rosenwald, I guess, this takes us to a seemingly straightforward, but, I guess, profound question. Why do we eat what eat?

ROSENWALDWe eat what we eat, particularly when we go out, because we are there to have a good time and we're there to have a good meal. If you go into any restaurant, you know, in the country, basically, and you'll find people having a good time, you'll find that food, obviously, is a way for us to sort of form some kind of community. We're not just going out to eat, to eat. We're going out to be together with friends.

ROSENWALDAnd one of the ways you want to do that is not only to have a rich conversation and rich company, but very often you want to have rich meal, you want to eat. And, you know, in the '60s and -- '50s and '60s, going out to eat was sort of a treat. We did it for special occasions. We did it on Sundays. Now, going out to eat is a regular part of our diet. I mean, we consume a majority of our calories outside of the home these days, versus inside of the home. So eating out is pleasurable, it's fun and we often really, really, you know, gorge ourselves into, you know, this sort of food coma that we always get.

NNAMDIIs it different for when we cook at home? Because it's also relatively easy to figure out how healthy our home-cooked meals are because pretty much everything you buy in the grocery store has health information on the back. Are practices different at home?

ROSENWALDWe -- yeah. We consume more food outside of the home than we do inside the home. It's obviously prepared in different ways. There's more salt. There's more oils. There are more ingredients, you know. There are more fried things. Not a lot of people have deep fryers in their homes. So, yeah, we are -- when we eat out, we eat, you know, pretty, pretty darned differently than we do when -- then when we're at home.

NNAMDIMichael Rosenwald joins us in studio. He's a reporter with the Washington Post. Joining us by telephone from New York is Dr. Brian Elbel. He's a professor of medicine and health policy at the NYU School of Medicine and the Robert F. Wagner Graduate School of Public Service at New York University. Brian Elbel, New York was one of the first jurisdictions to begin calorie labeling and you conducted one of the first scientific studies about whether the new policy would lead to behavioral changes. You tested two different lower income neighborhoods. How can you measure something like that and what did you find?

ELBELYes, so you're right to say that we did focus on the low income communities and low income neighborhoods. So it's not necessarily the case that the results that we find in our studies is going to translate into other areas so that's an important thing to know right off the bat. What we did is, we stood outside these fast food restaurants, our research assistants, and we collection people's receipts as they came out of these restaurants and then that gives us a pretty objective measure of what it is that they ate, what it is that they purchased.

ELBELAnd we did that before labeling in New York City and in Newark, New Jersey, just over the water there which didn't actually pass labeling, and then we did it again after labeling was introduced and we looked to see if there was a potential change in New York City that didn't happen in Newark. And what we found is that, you know, most people are seeing this information, just over half of the people coming into these restaurants are seeing it.

ELBELBut of the people that see it, only about a quarter say that the information mattered to them or influenced their food choice. What we didn't see, though, as you eluded to, is any real change in the number of calories purchased. And this was true both for adults, for the choices that adolescents made for themselves and for the choices that parents made for the children that were with them. And so, you know, some noticing this information, not necessarily translating at this point, though, into a change in the number of calories that people are purchasing.

NNAMDIThese findings are similar to studies conducted at Starbucks and a taco franchise in -- on the West Coast, is that correct?

ELBELThat's exactly right, yeah. These studies are fairly consistent and, you know, the Starbucks study being the one exception that did find a very slight small effect, but it's, you know, it's a pretty slight effect on the order of 12 calories or so difference after labeling was introduced for the entire population. So, you know, this information isn't translating into changing people's behaviors at this point. I think a lot of what Mike's describing is part of the reason for that. We go out to celebrate and we have been going out more and more. But still think of it as a celebratory meal.

ELBELI think, it's, you know, some other things are in play for low income populations as well. I think these are groups for whom there aren't necessarily a lot of other foods around for them. These are the foods that are very ubiquitous in their communities and happen to be a lot cheaper than healthy foods, at least at face value. And so, you know, I think that's part of what's driving some of these trends as well.

NNAMDIMike, we all like to think of ourselves as rational beings but it turns out that we might not be so rational when it comes to our food decisions. Why is that?

ROSENWALDWell, you know, that's what really got me started on this piece. I was sitting out -- I live in Montgomery County. My wife and I were actually having dinner at Cheesecake Factory and the labels were on there, the calories were there. And I looked around and the restaurant's crowded, everybody's eating, everybody's got full plates. I don't see many salads and everybody's having a good time. I said, what is going on here? Well, humans, as you've probably found in the course of your research, are totally irrational.

ROSENWALDAnd we are completely irrational when it comes to food. It's not so much that the -- that we're disregarding the information. It's that we have no self control when it comes to this stuff. And we have a very difficult time understanding that, well, one meal now isn't going to make me obese. But, you know, over the course of a lifetime, this may happen. So in the case of smoking, you know, one researcher told me, he said, well, there's a really easy but, you know, sometimes hard to do cure for smoking. You stop smoking. You can't stop eating. So, you know, so there's that angle of it.

NNAMDIYeah.

ROSENWALDBut then, there's some really tricky, interesting stuff going on with behavioral economics where some people have shown that actually disclosing information causes a person to let their guard down in regards to sort of how they approach, you know, use the information. So you could be...

NNAMDIAnd now I know exactly how many calories I'm eating.

ROSENWALDExactly, exactly. So I'll eat it, right? And, you know, if you're in some foreign country and the cab driver shows you a list of the prices, you think, wow, this guy's on the up and up. And then, you get to the end of the cab ride, you didn't realize that the prices really stunk. So there's that part of it. And, you know, overall, you know, when you factor all these things together, you're going to get some really sort of confused people.

ELBELYeah. And I think Mike's right. You know, everyone wants to start a diet, they just want to start it tomorrow. And they say the same thing tomorrow and the same thing tomorrow. And so, you know, I think that calorie labeling didn't do a whole lot to break people out of that mindset or to offer them other ways that they could more quickly, in the short term, make some changes that necessarily didn't, you know, hit them so hard and these other things that really matter to them, things like taste, price and convenience there.

NNAMDISpeaking of other ways to do this, we got a tweet from planetmikeus who says, "Let's stop trying to make average consumers into chemists. Just have a five-star quality rating. Sugar free isn't good."

ROSENWALDWell, you know, some researchers are trying to put colors on things rather than calorie count. Red light, green light, that sort of thing. And that hasn't been that successful so far either. You know -- when I went out and talked to people about this, particularly in restaurants like the Cheesecake Factory, everybody said yeah, I saw the calories. I just didn't feel like using them. You know, they -- and the other question, if you ask a person how many calories do you need in a given day to maintain your weight or lose your weight, you get all sorts of wild answers, even amongst really educated people.

ROSENWALDPeople don't know how much they have to eat. So they're looking at these numbers and they just don’t even fit into any calculation. And what's really interesting all about -- about all of this, is that the National Restaurant Association and the restaurant groups, they support these menu labels. And they support these menu labels because it puts the onus, it puts the responsibility on the consumer. The restaurants get to say hey...

NNAMDIOh, yeah.

ROSENWALD...we told you. We told you. And the consumer gets to say, oh, you know, oh, sorry.

NNAMDII knew. Here's Michelle in Silver Spring, Md. Michelle, your turn. Hi, Michelle...

MICHELLEHi.

NNAMDI...you're on the air.

MICHELLEOh, hi. Thank you so much for taking my call. I wanted to just recount that I had an experience with my 11-year-old daughter about eight months ago that has really altered her whole attitude about fast food. Think of the most familiar fast food place that comes to mind. And we were in a habit of...

NNAMDIMcDonald's.

MICHELLE...the (word?) size...

NNAMDICorrect, yes.

MICHELLE...of buying shakes and frozen drinks there. The first time we drove up to a drive thru and saw the calorie listings, her jaws dropped. I mean, as parents, we have a job to model good self control for our kids. I don't think that calorie label is going to really change adult behavior. I'm not sure it is. But when my child saw that the difference between the large and the small drink was 350, 400 calories, believe me, that made an impression on her.

MICHELLEAnd instead of each getting our own drink we bought a small one and shared it. She said, mommy, I don't want to get all those calories from this one drink because I want to have a nice lunch. So I think that is the whole point and it has really change her behavior at a time where I want her to feel empowered about making choices and not feel like I'm telling her, yes, no, good food, bad food.

NNAMDIWell, thank you very much for sharing that with us, Michelle. Maybe we should sometimes let the children lead. Dr. Elbel, the data -- this data can tell you whether people are changing their consumption patterns, but it can't necessarily tell you why, can it?

ELBELIt can't and so we're trying to do some other work to try (word?) out if people are changing, why? And if they're not changing, why not? And one of the things that we're finding is really resonating with a lot of the things we just discussed.

ELBELYou know, there are lots of other things that influence people's food choice and they sort of already knew that these foods were not the best for them anyway. And so in some sense, it means we need to start thinking about what other public policies might be influential and influencing food choice on a larger scale way and not assume that just because we have labeling, we're all set there in terms of what other policies might be effective.

NNAMDIOkay. Thank you very much for your call, Michelle. Here's Kareem in Alexandria, Va. Kareem, you're on the air, go ahead, please.

KAREEMKojo, how are you? This is a great topic. I am in Alexandria. I have a mass curriculum company called Mapalicious (sp?) and just to contextualize this, because it strikes me that if you just throw out numbers of calories, a lot of people don't know what to do with that.

KAREEMLike, what is 1,000 calories? I mean, we can make it relative to what we're supposed to eat, but how about this? It turns out that when you run, you burn .087 calories for every minute per pound. So 100-pound student -- we do stuff for K-12, so 100-pound student would burn 8.7 calories a minute, right?

NNAMDIYes.

KAREEMNow, if you look at a double quarter pounder extra value meal at McDonald's, that's about 1400 calories and so to contextualize that. If 100-pound student ate that, he would have to run for 160 minutes or at an 8-minute mile, he would have to run 20 miles. So basically from the District to -- I don't know, BWY to burn off a double quarter pounder extra value meal.

KAREEMSo, you know, this seems sort of tongue in check, but, again, I mean, I think it does go to something really profound. Mainly, humans have a really difficult time understanding what big numbers mean. And when I look at a calorie board, I don't know what that means, but I definitely know what 20 miles means. And at that point, maybe, you know, maybe the fries aren't worth it.

NNAMDIOkay. Thank you very much for your call, Kareem. Mike, we got this email from Emerson, in Burke, Va. "I love having the calorie count readily available and it positively influences my food choices. The upshot for me is that I feel like I can still go without wrecking my dietary preferences. I wish the law was national." That wish is probably going to come true at some point.

ROSENWALDIt is going to come true. Senator Harkin and some other very powerful legislatures on Capitol Hill pushed to have this -- a national requirement that chains of restaurants that have over 20 locations do this nationally and that the FDA is working on the final rule for that and that should go in effect sometime.

ROSENWALDNext year, you'll be seeing, not only in the Washington D.C. area and New York and Kings County, Washington, but everywhere. And so menus are changing and it's -- we're going to have to live with it and, you know, even though there is a concern that the science has sort of gotten -- that the policy has gotten ahead of the science, it's happening.

NNAMDIHere is Allison in Washington D.C. Allison, your turn.

ALLISONYes, I just wanted to mention that I kind of feel that calories becomes kind of an old-school way to measure and it kind of goes back to the food pyramid days a little bit. And we now know that there's so many ways to measure how the body metabolizes and, you know, how we break down fat.

NNAMDIYes.

ALLISONAnd I think it's really interesting. What it shows is that people value other things more than they value a calorie. Like, perhaps, it's, you know, with their friends than having, you know, food that tastes good to them. But I do think it's interesting and kind of oversimplified to think that people are going to change their decision on just the unit of a calorie.

NNAMDIOkay. I'm glad you brought that up Allison because, Brian Elbel, your studies have primarily focused on lower-income communities, which makes sense. The so-called obesity epidemic has disproportionately affected poor people. But I'm curious, in the context of what Allison just says, how much of this has to do with economic purchasing power? But how much of it has to do with other factors, like cultural factors?

ELBELSo we know that each of those things, both economic factors, cultural factors, other things happening in one's community tend to drive food choice much more than something like nutrition or just a calorie number does. So it's a huge part of this. And one way we could potentially really address the obesity epidemic in addition to these policies that focus on nutrition is try to focus on some of these, of course, economic status sorts of things.

ELBELWe know that those are incredibly hard to deal with at a policy level, which is why we focus on something like calorie labeling. But it doesn't mean that aren't other some other temporary steps as well, but I think it's absolutely true that some of these larger factors are likely what's driving the epidemic more than other things.

ROSENWALDAnd the other thing that's interesting also is that in some communities, I've found some research, and maybe Brian could talk about this, that people associate higher calorie count with better taste of food and they're going to get more for their money with a higher calorie meal. That's a rather perverse effect of disclosing information, that it may cause people to actually choose more.

ELBELYes, and so -- and they may -- it's true that some very early experimental studies did show that that's maybe the case and it's definitely something we were looking for in our work and it's not an unreasonable thing to think that if you're on a very, very fixed income you ought to be trying to maximize calories...

NNAMDIExactly.

ELBEL...for your dollar and so luckily that hasn't played out in a large scale way. It may be playing out for some individuals, but it's definitely something we're keeping an eye on.

NNAMDIDr. Brian Elbel is a professor of medicine and health policy at the NYU School of Medicine and the Robert F. Wagner Graduate School of Public Service at New York University. Brian Elbel, thank you for joining us.

ELBELThank you for having me. I appreciate it.

NNAMDIMichael Rosenwald is a reporter with The Washington Post. Mike, good to see you again. Thank you for joining us.

ROSENWALDThanks for having me.

NNAMDIWe're going to take a short break. When we come back, a global perspective on the future of news and a dramatic announcement in London today. I'm Kojo Nnamdi.