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Will They Eat It?

The mayor wants city restaurants to add healthier meals. Some have, and now we'll see if diners bite.

In August, Mayor Tom Menino announced the start of an ambitious program, Boston BestBites, part of the city's attempt to help folks who are overweight or, worse, obese. It's a noble cause, as at least half of our city and state residents carry too many pounds. The campaign encourages restaurants to add at least one healthy, lighter menu item, with fewer calories, healthier ingredients, and less fat and sodium. And nutritionists at Brigham and Women's Hospital will check that the dishes really are good for the waistline. At least 12 cafes and diners have signed up, including such quick-bite favorites as Victoria's Diner in Boston and Centre Street Cafe in Jamaica Plain, and the city plans to inundate some 600 other restaurants with information packets encouraging them to join the program.

As a food policy professor, I endorse the mayor's program and wish participating restaurants the greatest success. They have done their part, but now will restaurant goers choose these healthy items? Nationally, fast-food and casual-dining chains like McDonald's, Burger King, and TGI Friday's have tried the same approach, but in many cases, months after introducing good-for-you dishes, the businesses have had to scale back these offerings or drop them completely. Don't fault the restaurants. They tried - some are still trying - but their customers didn't buy enough of these healthy foods to make them economically feasible. Based on this national track record, I doubt that the BestBites program, no manner how well intentioned, will amount to much by itself.

Menino is right that the government should play a role in solving the problem. A staggering two-thirds of all American adults are overweight or obese (Massachusetts does fare better than other states). Restaurants certainly do affect the public's health - about half of our food dollars go to prepared and ready-to-eat foods - and it makes sense to nudge these businesses to sell healthy things to eat. But restaurants should never be strong-armed to offer menu items such as fresh-fruit plates and dinner salads - made from expensive, preparation costly, and easily perishable ingredients - if their particular clientele does not want to buy them and the owners would lose money. Restaurants are businesses that need to satisfy customers, not public health or educational organizations.

So where would our attention be best directed? At the federal level, the government should seek out and pay for scientific research looking at how the overweight public's appetite can be changed - both in restaurants and in the home - and then apply this understanding to programs that will get lasting results. There have been many government-funded studies on the best foods to eat for good health, yet little on how to successfully encourage Americans - who live in a hectic, food-abundant world - to learn how to choose good foods over bad. Today's textbooklike dietary guidelines and confusing food pyramid are hardly motivational.

Our national government also needs to tap a single agency to focus on obesity and empower that department with the necessary funding and mandate. Right now, responsibility for diet information, research, and regulation is scattered among several agencies: The US Department of Health and Human Services and the US Department of Agriculture share responsibility for telling us what to eat, the Food and Drug Administration has food labeling, the Federal Trade Commission has food advertising, and the Centers for Disease Control and Prevention is keeping score. This multiagency, mixed-agenda approach hasn't worked for our waistlines.

This needs to change if we want to slim down our overweight nation. Only Congress has the power and purse to solicit this research and create this agency. And this will only happen if we - realizing our weight predicament, its health dangers, and its spiraling medical costs - insist on change through our elected representatives and then conscientiously follow any national plan that gets results.

James E. Tillotson is a professor at Tufts University Friedman School of Nutrition Science and Policy. E-mail comments to

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