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Expressing Calories as Exercise Equivalents

Author: Stan Reents, PharmD
Original Posting: 02/28/2017 01:53 PM
Last Revision: 07/27/2018 06:41 AM

When we launched www.AthleteInMe.com® in January 2005, included in the web site was a simple calculator that converted the calories in franchise restaurant menu items into minutes of exercise. This information was presented as minutes of walking, jogging, bicycling, and swimming, specific for the user's body weight. We called it the "Exercise Calorie Converter."

Then, we created a mobile version that ran on PDA's (remember those?!!). This was several years before Apple launched The App Store in July 2008.

Very quickly, the mobile app marketplace exploded. So, we dropped the PDA version of our Exercise Calorie Converter, and, in December 2010, released a mobile app for both Apple iOS devices and Google Android devices. In the summer of 2013, we released Version 2.0. In February 2017, we released Version 3.0, followed by Version 3.3 in February 2018.

Thus, we've been promoting the concept of expressing calories as "exercise equivalents" for over a decade.

Why is this a better strategy? Because presenting calorie info in this format has a stronger impact on people. As any clinical psychologist might acknowledge, changing human behavior is difficult. Generating an emotional response is more effective than simply presenting facts. Fear, embarrassment, happiness, pleasure...each of these emotions can motivate people to act.

Provoking an emotional response in the mind of the consumer is a fundamental strategy in marketing and advertising to increase sales:

There's a rule in sales that goes like this: "Sell the sizzle, not the steak." So, for example, if you want to sell a car, you impress the customer about its acceleration, its handling, its sexiness, how great they would look driving it. You don't focus as much on the compression ratio of the engine, the power-to-weight ratio, or the size of the tires. Those are boring statistics. However, you might explain gas mileage, or, the efficiency of the catalytic converter once you become aware that the customer is really concerned about air pollution or its carbon footprint.

"Sell the sizzle, not the steak..."

Think about those Pantene shampoo commercials you see on TV. They always show a woman with long, thick, straight, silky hair waving back and forth in slow motion. Those images generate an emotional response: they're hypnotizing, captivating...and effective. Even I want to buy that shampoo when I watch those commercials!

For the same reason, expressing calories as exercise equivalents is more effective than simply listing calorie amounts on food labels and restaurant menus...ie., it generates an emotional reaction.

LISTING CALORIE AMOUNTS DOESN'T WORK

In May 2016, the FDA announced changes to the design of the Nutrition Facts panel on packaged foods: the "Nutrition Facts and Supplement Facts Label and Serving Size" ruling. The compliance deadline for food manufacturers with $10 million or more in annual sales is January 1, 2020. For manufacturers with less than $10 million in sales, the deadline is January 1, 2021.

One new requirement is to display the Total Calories value in a larger font. Making the Total Calories value more legible is a good idea, but, I doubt that it will have much of an impact. The Nutrition Facts panel has appeared on packaged foods in the US since 1994. Yet, obesity rates in the US have continued to increase steadily.

What about adding calorie values to restaurant menus?

As part of the Patient Protection and Affordable Care Act of 2010, the federal government required chain restaurants with 20 or more locations to include calorie values on their menus.

Even though this requirement only went into effect on May 7, 2018, some restaurants have already complied. (Panera Bread began displaying calorie values on their menu boards in 2010!) And, some US cities passed similar regulations years ago. For example, New York City began requiring chain restaurants with 15 or more locations to display calorie amounts on their menus in December 2006. Thus, a fair amount of published research has already evaluated the consumer response to displaying calorie values on menus.

Unfortunately, the majority of these studies show that simply reporting the calorie value of foods and beverages hasn't produced the expected response:

• Researchers at the School of Public Health at UNC Chapel Hill reviewed 7 studies that evaluated the impact of including calorie information on fast-food restaurant menus. Only 2 of the 7 studies found that providing calorie amounts had any meaningful impact on menu selections (Swartz JJ, et al. 2011). A separate analysis of 19 studies by researchers at Harvard's School of Public Health revealed that, when diners did consider calorie values, the reduction in calories ordered was a whopping...18 calories! (Long MW, et al. 2015)

• When customers in New York City entered a McDonald's, they were given a slip of paper informing them of either recommended calorie intake per day, or, recommended calorie intake per meal. Yet, more than half still ordered meals with excessive calories (Downs JS, et al. 2013).

• A study of adolescents in Hawaii revealed that providing calorie amounts on menus from Denny's, McDonald's, and Panda Express had very little effect on their selections (Yamamoto JA, et al. 2005).

• In 2017, Sara Bleich, PhD, and colleagues at Harvard reviewed 53 studies of restaurant menu labeling. They found that "there is limited evidence that menu labeling affects calories purchased at fast-food restaurants, though some evidence demonstrates that it lowers calories purchased at other types of restaurants." (Bleich SN, et al. 2017). When you think about it, it makes sense that people don't care about calories when they eat at fast-food restaurants: ie., if you've made up your mind to grab a couple tacos at Taco Bell, then you're probably not going to change your mind when you get there!

While some diners simply ignore calorie facts, others are actually confused by their meaning:

• An Australian study revealed that consumers perceived higher-calorie foods as healthier and providing sustained energy (Watson WL, et al. 2013).

• A Canadian study found that one-third of consumers could not properly comprehend basic information on food labels (Sinclair S, et al. 2013).

CALORIE RESTRICTION (DIETING) DOESN'T WORK

Ask people who have struggled to lose weight and they will tell you: dieting (ie., calorie restriction) doesn't work. Yes, there may be some decent weight loss in the first few months, but, often, this is due to loss of water weight. After that, the rate of weight loss really slows down.

One of the key reasons is that you can't fight the sensation of hunger very long. It's too powerful.

But, there's another reason: our physiology actually works against us. When the human body senses a substantial decrease in calorie intake, it responds by lowering metabolic rate. This is the body's way of preserving life.

In modern society, we can obtain limitless amounts of food at grocery stores and restaurants. But think about how humans lived 20,000 years ago: Food was only available sporadically. At some point, a group might dine on an animal that was killed. For 1-2 days, there are plenty of calories available. Then, they might go another 2-3 weeks before their next kill. Fruits and vegetables were also hard to find. Thus, the body had to have some way to preserve life during these periods of very low calorie intake. Reducing resting metabolic rate is a protection against starvation.

Perhaps even more frustrating, our bodies store fat any time we consume excess calories. Here again, the body is trying to protect against starvation...in this case, future starvation. It doesn't matter if you are normal weight, 30-lbs overweight, or 300-lbs overweight. If you overeat, you will store calories. It would be great if our bodies didn't store excess calories when we didn't need them, but that's just not how our physiology works.

500 Calories per Day = 1-lb per Week

Here's a simple rule to always keep in mind: If you consume 500 extra calories that you don't burn, and do that every day for 7 days, after 1-week, you will have gained 1-lb.

Now, stop and think how easy it is to consume 500 calories: a couple cookies, a dessert at any restaurant, 43-oz of soda pop. Further, 500 extra calories won't make you feel like you overate. But, do this on a regular basis and it's not surprising why, at the end of the year, you may have gained 20-30-lbs.

EXERCISE DOESN'T WORK EITHER

The mission of AthleteInMe.com® is to promote health by encouraging regular exercise. Sadly, as much as I hate to say this, exercising to promote weight loss isn't as effective as you might think. TIME magazine published a lengthy article on this topic in their August 9, 2009 issue. Since then, additional research has validated this disappointing truth.

Why is exercise so ineffective? The answer is because you have to perform an awful lot of exercise to burn off a relatively modest amount of calories.

Brisk walking is defined as walking at 3 miles per hour. If you walk at 3 mph for 1 hour, you will burn -- get ready -- about 300 calories. Pretty demoralizing, isn't it?

Take a look at the screen shot of our Exercise Calorie Converter to the right: To burn off the calories in Outback Steakhouse's "Bloomin' Onion," a 178-lb person would have to walk for 345 minutes. THAT'S ALMOST 6 HOURS OF WALKING!! Now, of course, no one is going to eat the entire appetizer by themself, but, still, you get the point.

Let's put that in perspective:

It's correct that you burn calories every minute of every day...even when you're sleeping. But research shows that a 30-60-minute exercise session accounts for only a small percentage of the total calories you burn in any 24-hr period (Hamilton MT, et al. 2007). Unless you exercise like a Tour de France cyclist, or, a marathon runner, you burn most of your calories each day by performing your daily tasks: doing the laundry, washing the car, mowing the yard, etc. However, if you have a sedentary job, such as driving a cab or a truck, or a desk job, then the calories you burn each day is greatly diminished. And, at the end of your work shift, you're not going to go out and walk for 3 hours, or, jog for 2 hours.

So it's far easier to consume excess calories than it is to burn them off.

There needs to be a better approach to maintaining a healthy weight...

PREVENTING WEIGHT GAIN IS THE ONLY RELIABLE STRATEGY

The fact that (a) weight gain occurs so easily, (b) dieting to lose weight doesn't work, and (c) most people can't perform enough exercise to produce adequate weight loss means that the only reliable strategy for maintaining a desirable weight is to avoid gaining weight in the first place.

Americans obtain one-third of their calories from dining out. So, empirically, it would seem that including calorie values on menus is a good thing. But, as stated above, many diners ignore that information and others are outright confused by what it means.

Presenting those values as "exercise equivalents" has more impact. Consider these 2 statements if you saw them on a menu:

  • "This entree contains 1000 calories."
  • "You will have to walk for 3 hours to burn off the calories in this entree."

Which of those 2 statements had a stronger effect on you? I'm pretty certain it was the 2nd one.

That's why I created the Exercise Calorie Converter. Not only does it put the calorie amounts of thousands of restaurant menu items in the palm of your hand, it converts those values into minutes of exercise. When I show it to people, they react by saying "wow!"...every single time. This is that emotional reaction I was describing earlier, ie., it has a dramatic impact.

RESEARCH SHOWS THAT REPORTING CALORIES AS "EXERCISE EQUIVALENTS" WORKS

But don't take my word for it. Several university-based research studies have recently been published on this topic:

Displaying "Exercise Equivalents" on Signs Inside Convenience Stores

Johns Hopkins Study (2012): In this study, signs were placed inside 4 convenience stores in West Baltimore near middle schools and high schools. The signs reported how much exercise (minutes of jogging) would be necessary to burn off the calories in sugar-sweetened beverages. The purchases of Black adolescents were monitored for 6 weeks. Although purchases of soda pop didn't decline, fewer purchases of sports drinks and sugar-sweetened iced tea occurred. Purchases of water increased (Bleich SN, et al. 2012).

Displaying "Exercise Equivalents" on Computer Simulated Menus

Anthony Viera, MD, MPH, and colleagues at U. North Carolina have published several papers assessing the impact of exercise equivalents on menu choices:

U. North Carolina Study (2013): In their 2013 study, a computer-based simulation, 802 subjects (university employees) selected foods from one of 4 menus: no calorie information, traditional calorie data, calories expressed as minutes of walking, or calories expressed as miles of walking. The fewest calories were ordered when calories were expressed as miles of walking (Dowray S, et al. 2013):


INFO DISPLAYED CALORIES ORDERED
• No calorie info 1020 calories
• Traditional calorie info 927 calories
• Calories + MINUTES of walking 916 calories
• Calories + MILES of walking 826 calories

U. North Carolina Study (2015a): In a subsequent study, Dr. Viera and colleagues, again using a computer-based simulation, had 1000 adults from 47 states select foods from the same 4 menu types as their prior study: no calorie information, traditional calorie data, calories expressed as minutes of walking, or calories expressed as miles of walking. This time, the least amount of calories was ordered from the menu reporting minutes of required walking (Antonelli R, et al. 2015):


INFO DISPLAYED CALORIES ORDERED
• No calorie info 1580 calories
• Traditional calorie info 1200 calories
• Calories + MILES of walking 1210 calories
• Calories + MINUTES of walking 1140 calories

U. North Carolina Study (2015b): Dr. Viera then examined how menu labeling might affect the meals that parents ordered for their children (Viera AJ, et al. 2015). The results were as follows:


INFO DISPLAYED CALORIES ORDERED
• No calorie info 1294 calories
• Calories + MILES of walking 1099 calories
• Traditional calorie info 1066 calories
• Calories + MINUTES of walking 1060 calories

U. South Florida Study (2016): Researchers at the University of South Florida in Tampa repeated the study from the U. North Carolina and found that providing calorie details in the form of "exercise equivalents" did not produce a reduction in calories ordered during a computer simulation (Lee MS, et al. 2016):


INFO DISPLAYED CALORIES ORDERED
• Calories + MILES of walking 1046 calories
• No calorie info 1041 calories
• Traditional calorie info 1022 calories

How can the same type of study produce different results? In the 3 UNC studies, the subjects were adults. However, in the USF study, the subjects were undergraduate college students interested in psychology (they were given credits that could be applied to a future psychology class). Also, more than 80% of the college students in the USF study were regular exercisers. These differences in the subjects may explain why these 2 otherwise similar studies yielded different conclusions.

Displaying "Exercise Equivalents" on Actual Menus

Meena Shah, PhD, and colleagues published 2 studies on this topic:

Texas Christian Study (2015): In the first one, 300 subjects, mostly college students, ordered and consumed lunch from a McDonald's menu presented in 1 of 3 different ways: no calorie info, traditional calorie values, or calories expressed as minutes of brisk walking. But this study also measured calories consumed. It was found that ordering from the menu with exercise equivalent info resulted in consumption of the fewest calories (James A, et al. 2015):


INFO DISPLAYED CALORIES ORDERED CALORIES CONSUMED
• No calorie info 902 calories 770 calories
• Traditional calorie info 827 calories 722 calories
• MINUTES of walking 763 calories 673 calories

Texas Christian Study (2016): In their 2nd study, Dr. Shah and colleagues followed a similar protocol, ie., having subjects order lunch from a McDonald's menu with 1 of the following 3 formats: no calorie info, traditional calorie values, or calories expressed as minutes of brisk walking. This time, the subjects ranged in age from 18 to 65 and were Hispanic. Statistical analysis revealed that there was no difference in the calories ordered regardless of which type of menu was used. However, though the difference was not "statistically" significant, it's enough of a difference to affect body weight if it occurs repeatedly over a period of many months:


INFO DISPLAYED CALORIES ORDERED
• Traditional calorie info 790 calories
• No calorie info 785 calories
• MINUTES of walking 752 calories

Displaying "Exercise Equivalents" on Packaged Foods

U. Waterloo Study (2013): Canadian researchers examined the impact of adding a calorie recommendation statement ("A 2000-calorie diet is used as the basis for general nutrition advice..."), or, adding an exercise scale ("Ten minutes of running burns about 100 calories") to labels on packages of muffins and donuts. They found that including (a) a calories value, (b) the calorie recommendation statement, and (c) the exercise scale each led to a reduction in calories ordered compared to food packages where no calorie information was provided (Pang J, et al. 2013):


INFO DISPLAYED CALORIES ORDERED
• No calorie info 333 calories
• Exercise equivalents scale 310 calories
• Traditional calorie info 302 calories
• Recommended calorie intake 298 calories

EXERCISE EQUIVALENTS IS RECEIVING WORLDWIDE ATTENTION

The studies summarized above were conducted in the US and in Canada. This concept of reporting calories as "exercise equivalents" is receiving worldwide attention:

• One study evaluated the reaction by consumers to reporting calories as exercise equivalents in France, Germany, The Netherlands, and the UK (van Kleef E, et al. 2008).

• In 2016, Shirley Cramer, CEO of the Royal Society of Public Health in the UK, called for food labels in the UK to display calories in the form of exercise equivalents. This was reported in The Guardian on January 14, 2016 and again in the British Medical Journal on April 6, 2016.

Which country will be the first to report calorie values as exercise equivalents? If Michael Bloomberg were President, I would predict that the US would be the first. As Mayor of New York, Bloomberg focused a lot of attention on nutritional issues. (New York City was the first in the US to require that franchise restaurants display calorie values on their menus.) However, considering that it took 8 years for the restaurant menu regulation to go into effect nationwide, my bet is that the UK will be the first.

SUMMARY

Because it's far easier to consume extra calories than it is to exercise them off, preventing weight gain before it occurs is the key to maintaining a healthy weight. Avoiding calorie bombs when you dine out is critical, but most people gain weight because they overeat modestly on a regular basis. Maintaining an ideal weight requires making smart food choices....every single day.

Unfortunately, you can't identify high-calorie items on restaurant menus by simply looking at their names. You need to know the calorie amounts of all items before you make your choices.

And, seeing how long you have to exercise to burn-off the calories in menu items has the greatest impact. Use our Exercise Calorie Converter mobile app to help you make smarter choices when you dine out!

FOR MORE INFORMATION

Readers may also be interested in the following reviews:

EXPERT HEALTH and FITNESS COACHING

Stan Reents, PharmD, is available to speak on this and many other exercise-related topics. (Here is a downloadable recording of one of his Health Talks.) He also provides a one-on-one Health Coaching Service. Contact him through the Contact Us page.

REFERENCES

Antonelli R, Viera AJ. Potential effect of physical activity calorie equivalent (PACE) labeling on adult fast food ordering and exercise. PLoS One 2015;10(7):e0134289. Abstract

Bleich SN, Economos CD, Spiker ML, et al. A systematic review of calorie labeling and modified calorie labeling interventions: Impact on consumer and restaurant behavior. Obesity (Silver Spring) 2017;25:2018-2044. Abstract

Bleich SN, Herring BJ, Flagg DD, et al. Reduction in purchases of sugar-sweetened beverages among low-income Black adolescents after exposure to caloric information. Am J Public Health 2012;102:329-335. Abstract

Boston G. "Why running to burn off that ice cream is missing the point", Washington Post, July 14, 2017. www.WashingtonPost.com

Cramer S. Food should be labelled with the exercise needed to expend its calories. Br Med J 2016;353:i1856. Abstract

Downs JS, Wisdom J, Wansink B, et al. Supplementing menu labeling with calorie recommendations to test for facilitation effects. Am J Public Health 2013;103:1604-1609. Abstract

Dowray S, Swartz JJ, Braxton D, et al. Potential effect of physical activity based menu labels on the calorie content of selected fast food meals. Appetite 2013;62:173-181. Abstract

Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type-2 diabetes, and cardiovascular disease. Diabetes 2007;56:2655-2667. Abstract

James A, Adams-Huet B, Shah M. Menu labels displaying the kilocalorie content or the exercise equivalent: effects on energy ordered and consumed in young adults. Am J Health Promotion 2015;29:294-302. Abstract

Lee MS, Thompson JK. Exploring enhanced menu labels' influence on fast food selections and exercise-related attitudes, perceptions, and intentions. Appetite 2016;105:416-422. Abstract

Long MW, Tobias DK, Cradock AL, et al. Systematic review and meta-analysis of the impact of restaurant menu calorie labeling. Am J Public Health 2015;105:e11-e24. Abstract

Pang J, Hammond D. Efficacy and consumer preferences for different approaches to calorie labeling on menus. J Nutr Educ Behav 2013;45:669-675. Abstract

Shah M, Bouza B, Adams-Huet B, et al. Effect of calorie or exercise labels on menus on calories and macronutrients ordered and calories from specific foods in Hispanic participants: a randomized study. J Investig Med 2016;64:1261-1268. Abstract

Sinclair S, Hammond D, Goodman S. Sociodemographic differences in the comprehension of nutritional labels on food products. J Nutr Educ Behav 2013;45:767-772. Abstract

Swartz JJ, Braxton D, Viera AJ. Calorie menu labeling on quick-service restaurant menus: an updated systematic review of the literature. Int J Behav Nutr Phys Activity 2011;8:135. Abstract

van Kleef E, van Trijp H, Paeps F, et al. Consumer preferences for front-of-pack calories labelling. Public Health Nutrition 2008;11:203-213. Abstract

Viera AJ, Antonelli R. Potential effects of physical activity calorie equivalent labeling on parent fast food decisions. Pediatrics 2015;135:e376-e382. Abstract

Watson WL, Chapman K, King L, et al. How well do Australian shoppers understand energy terms on food labels? Public Health Nutr 2013;16:409-417. Abstract

Yamamoto JA, Yamamoto JB, Yamamoto BE, et al. Adolescent fast food and restaurant ordering behavior with and without calorie and fat content menu information. J Adolesc Health 2005;37:397-402. Abstract

ABOUT THE AUTHOR



Stan Reents, PharmD, is a former healthcare professional. He is a member of the American College of Lifestyle Medicine (ACLM) and a member of the American College of Sports Medicine (ACSM). In the past, he has been certified as a Health Fitness Specialist by ACSM, as a Certified Health Coach by ACE, as a Personal Trainer by ACE, and as a tennis coach by USTA. He is the author of Sport and Exercise Pharmacology (published by Human Kinetics) and has written for Runner's World magazine, Senior Softball USA, Training and Conditioning and other fitness publications.




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