Public health is about protecting the whole public, not any subset, even if underserved and strongly affected subsets are of course its frequent focus. It's about making society safer and healthier. That's where it rubs plenty of people (like my libertarian colleague Megan) the wrong way. The nanny state is the cuddlier term for the fascist state, and activist health commissioners like Thomas Frieden, now the head of the CDC, and his successor, Thomas Farley, are pet targets of people who use the word "activist" as a smear.
New York City was ridiculed when it banned trans fats, as I pointed out in a piece asking what the fate of the doughnut would be after the ban. (It survived quite nicely--and, as calorie-labeling has made painfully clear, doughnuts frequently have many many fewer calories than healthful-seeming muffins, especially in the colossally caloric pastry cases at Starbucks). But, as Frieden, then the New York City health commissioner, pointed out when I talked to him about the ban, the real impact was on McDonalds and the other chains (yes, Dunkin Donuts) that, once they went to the expense of complying with New York's rules, would likely change production for the whole country or much of it.
Calorie labeling has already had remarkable impact on the foods that fast-food companies make and serve. Yuppie avatar Starbucks immediately changed its default milk from whole to 2 percent, so it wouldn't have to admit that a Frappuccino could amount to practically as many calories as you should eat in a whole day; it recently removed high-fructose corn syrup from its baked goods, though unfortunately didn't make them lower-calorie--that's said to be in the works--or better-tasting, which I hope is in the works too.
And the big players, the ones health departments hope will change, are in fact changing. Just this week, Nonas told me--the day after the Times story came out--Burger King began a new ad campaign telling how customers could eat a full meal for 650 calories or less. McDonalds took .7 ounces and 70 calories out of its standard portion of french fries. Dunkin Donuts introduced an egg-white breakfast. KFC put grilled skinless chicken on its menu--not something anyone expected to see at KFC.
"We still feel it's a restaurant's responsibility to make affordable healthy choices available to the public," Nonas told me, but added that calorie posting is "one important piece but not the whole piece." She mentioned new education programs the city is running and new ways to get fresh produce into poor neighborhoods and into schools--the current focus of every health and school official you talk to, and of our own Josh Viertel and Helene York.
Nonas and colleagues are now analyzing their own study. It has ten times the number of participants, is drawn from more neighborhoods than the NYU study, and was conducted over six weeks--like the NYU study, shortly after the regulations were made enforceable. She said she had no idea what the results would show, and emphasized the difficult of picking out and cleaning the data.