The Keystone Forum's final report on away-from-home foods, described on the last few pages of this issue, provides more recommendations to curb obesity in our nation. This work was requested and funded by the FDA. And while the report says a conclusive body of evidence does not exist linking away-from-home foods to obesity, it states that preliminary research indicates that "the consumption of away-from-home foods can be a factor in determining calorie consumption and body weight, an important one for many individuals."1 Admittedly, it's goal was not to resolve this question but to offer solutions to the problem of obesity.

Most of the recommendations in this report relate, of course, to the restaurant industry. So, one might ask, "How did this industry respond?" According to a recent article in the Nation's Restaurant News, experts say the forum's recommendations "ignore consumer behavior and industry's health-focused efforts."2 It describes how "the National Restaurant Association's [NRA's] chief nutrition policy official, who was among the industry representatives who provided input for the report, said other contributors seemed oblivious to recent trends among restaurants to promote leaner items, offer more vegetarian options, and make available more information about nutrition." In fact, Sheila Cohn, NRA's director of nutrition policy, is quoted as saying that the report focused "too heavily on quick-service restaurants" and that "some of the recommendations made showed they were out of touch with what was going on in restaurants [horizontal ellipsis] and were not familiar with [revised] menus or the amount of nutritional information available."

Some interesting comments can be found in the NRA article. For example, it is pointed out that while chains such as McDonald's have added more healthy food items, "consumers haven't always bought them," and Wendy's took its fresh fruit bowl off the menu last November due to low consumer demand. "It's the restaurant's responsibility to have a range of menu items that satisfy a variety of nutrition needs," commented the executive VP for marketing at Hardees, Brad Haley. "Ultimately, I think it boils down to restaurants are in the business to sell what people like to buy," he says. "However, the public still seems to vote with their pocketbook when it comes to things like hamburgers and pizza." One marketing consultant, Jack Trout, said the Keystone Forum's report was "a voice crying in the fast-food wilderness." He feels the recommendations would not persuade more customers to stop ordering high-calorie foods even if embraced by restaurants; and he explains that "the hard-core fast food user is going to ignore all this and say 'I like this burger.' You're not going to change their habits." And Rick Hendrie, a food service consultant, explains that customers say "they don't want to be told how many calories they're eating." He feels consumers are reluctant to change their behaviors until they are forced into a life-and-death situation.

Only time will tell if positive results come from the new recommendations. In the meantime, the government is still footing the bill for certain types of bariatric surgery; and it as well as other third-party payers continue to cover the medical expenses for most obesity-related complications.

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