Americans are dining away from home more than ever, 4.8 meals per week on average. But when a reservation is what you're making for dinner, the odds of finding a meal that won't increase your weight and risk of chronic diseases are pretty slim.
Most restaurants create conditions that encourage eating food that contains more calories, salt, sugar and fat than recommended for consumption at a single meal. And the good stuff, like whole grains, fruits and vegetables are often no-shows on American menus.
The content of food at restaurants is no small problem. An analysis of 30,923 menu items from 245 restaurant chains showed that 96% of meals served do not meet USDA nutritional guidelines. Beyond serving extra-large portions and failing to offer fruits or vegetables other than potatoes with most meals, many restaurants compound the threat by adding limitless quantities of bread or chips and providing free refills of sodas.
That's why a group of 21 experts in the areas of nutrition, public health, obesity, law, and business recently developed restaurant performance standards intended to protect consumers from potentially harmful serving practices. The standards we came up with are not complicated, infeasible or heavy-handed. They mainly require restaurants to offer meals that contain one-and-a-half cups of fruits or vegetables and no more than 700 calories for adults and 600 calories for children. We also suggested that restaurants not automatically serve food that customers do not request. Restaurants could adopt these standards voluntarily, or state and local jurisdictions could use them as the basis for regulation.
In many other areas of life, our society prohibits businesses from placing consumers at risk of injury or disease. For instance, water quality standards protect people from routine exposure to toxins and carcinogens and building codes guard against dangerous construction practices. But when it comes to food, the attitude often is that adults shouldn't need help in protecting both themselves and their children from the risk of obesity, overweight and chronic diseases.
Yet there is a wealth of evidence to the contrary. Multiple studies have demonstrated (PDF) that when people are served more than they need, they eat more than they should. Part of the problem is that when people eat too much at one meal, they often fail to compensate by eating less at subsequent meals. Routinely failing to consume a balanced healthy diet is what leads to the extra pounds and the increased risk of developing diabetes, heart disease, high blood pressure and even cancer.
Most people eat healthier diets when they prepare food at home, where portion size and the nutritional content of food is easier to control. But the demands of modern life make dining out hard to avoid. And while it is true that a single meal may play a tiny role in the development of chronic diseases, consuming restaurant meals day in, day out, raises the risks considerably.
Given the high prevalence of obesity and chronic diseases and their enormous societal burden, every restaurant, including fast food outlets, should offer healthier meal options and discourage over-consumption. Moreover, eating establishments should apply effective marketing tools to promote healthier choices over options that increase the risk of chronic diseases. Restaurants should be part of the solution to ending the epidemic of obesity and chronic diseases.
Making healthier options available won't prevent people from ordering what they want, or even ordering more than they need. But with the average American eating out five times a week, it's time to meet the needs of consumers who prefer health over heft.
Deborah Cohen is a senior natural scientist at the RAND Corporation, and the author of “A Big Fat Crisis: The Hidden Influences Behind the Obesity Epidemic—and How We Can End It.”
This commentary appeared on usatoday.com on March 25, 2014.