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Supersize America: Whose job to fight obesity?

Banning extra-large sugary sodas. Blocking fast-food restaurants in some neighborhoods. Requiring calorie counts on menus. Kicking snack foods out of public schools. Are anti-obesity campaigns crossing the line into nanny state intrusion?   

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In 2007, the Los Angeles City Council instituted a two-year moratorium on new fast-food outlets in low-income South Central L.A., the first health zoning law in the US. In 2010, the town of Baldwin Park, Calif. – the reputed birthplace of the "drive-through" restaurant – put a nine-month ban on the construction of new drive-in food emporiums.

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"The recent efforts by L.A. to decrease fast-food consumption in South Los Angeles through restrictive zoning suggest that this may be an increasingly popular strategy for local governments to address the rising obesity epidemic," Ms. Vestal says. "If zoning restrictions for fast-food restaurants can positively change the local food environment and decrease excess calorie consumption among residents, then there is a potential to significantly improve the community health." But she also has a cautionary note: "Fast-food consumption is not the only contributor to obesity and, thus, limiting one source of unhealthy food may not have the intended effect of reducing obesity."

As for mandatory calorie counts on menus at chain restaurants, they are required statewide in California and Vermont, as well as in five counties in New York State, New York City, Philadelphia, Montgomery County in Maryland, and King County in Washington. The menu requirement is also part of President Obama's 2010 health-care law, although the administration has not issued final rules on compliance.

"Three-dozen studies show eating out more frequently is associated with obesity, higher body fatness … and menu labeling is helping to reverse that," says Ms. Wootan, citing two recent studies:

•Consumers ordering off menus with calorie counts order meals with about 120 fewer calories than when using menus without such counts, according to a 2011 survey by market researcher NPD Group.

•Parents of children ages 3 to 6 presented with McDonald's menus with calorie labeling ordered meals for their children totaling 100 fewer calories, on average, than parents with menus without labeling, according to a 2010 survey published in the journal Pediatrics.

Some restaurant chains – Applebee's, Starbucks, Au Bon Pain, and Denny's, to name a few – voluntarily include calorie counts or have added low-cal meals to their menus.

"The whole obesity epidemic ... is explained by an extra 100 calories per person per day," Wootan says. "Seemingly small changes make a bigger difference than most people in the press and public really understand."


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