If you knew youd need to run 12 miles to burn the number of calories in a 10-inch pepperoni pizza, would you decide to eat only half the pie or order a salad instead? A review published in December 2019 in the Journal of Epidemiology & Community Health suggested that labeling food and drinks with the amount and kind of physical activity needed to burn off the calories in different foods could encourage people to make healthier choices or consume smaller portions.

The label, called a physical activity calorie equivalent label (PACE), informs consumers how much walking or running they would need to do to equal the calories contained in the food. For example, a soda containing 138 calories would take 13 minutes of running or 26 minutes of walking to burn off.

Many people dont understand the concept of calories or how they relate to the energy we use throughout the day, the study authors wrote. PACE labeling has the added benefit over other types of labeling by having the potential to both nudge us to think about what we eat and also encourage us to be more physically active, says lead author Amanda Daley, a professor at the University of Loughborough in England.

The U.K. Royal Society for Public Health has already recommendedthat PACE labeling replace the current food labeling system in that country, but to date theres been little strong evidence that this would make a meaningful difference in the obesity epidemic, the authors wrote.

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To determine if labeling could make a difference in how much food people order, purchase, or consume, researchers analyzed data from 14 randomized controlled trials that compared peoples behavior when the PACE labels were used versus no labels or a standard calorie label.

Eight trials queried participants on what foods they'd hypothetically order from a menu. Another trial assessed which foods participants would purchase. In these nine trials, researchers determined that when PACE labeling was present, participants selected or purchased foods that were 65 calories less, on average, compared with when PACE labeling was not present. Yet in these trials study authors did not follow participants to see how much they went on to consume.

Five additional trials did assess how many calories participants consumed when PACE labeling was used, when only calorie labeling was used, and when no labels were used. Researchers observed that PACE labeling resulted in participants consuming 80 to 100 fewer calories compared with when no labeling was used. Nonetheless, the PACE labeling didn't result in lower calorie consumption compared to the calorie-only labeling.

Given that the average person consumes three meals and two snacks per day, the authors believe that PACE labeling could potentially shrink peoples intake by as much as 200 calories a day.

This reduction could have health benefits, even if a person doesnt have obesity. A study published in July 2019 in The Lancet Diabetes & Endocrinology found that people who consumed 200 to 300 fewer calories per day lost weight and had significant drops in LDL bad cholesterol and improved their blood pressure.

Even for people who dont exercise, the PACE food labeling is an easy way to see and understand the energy costs of different foods, says Daley. This is one of the good things about PACE labeling it may prompt the public to do more physical activity, she adds.

According to the U.S. Department of Health and Human Services (HHS), less than 5 percent of adults in the United States participate in 30 minutes of physical activity each day, and only 1 in 3 people get the recommended amount of physical activity. Current guidelines suggest that adults do 150 to 300 minutes of moderate intensity exercise or 75 to 150 minutes of vigorous intensity physical activity every week.

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There could be potential benefits to PACE labeling, says Colleen Clarkin Schreyer, PhD, assistant professor of psychiatry and behavioral sciences at Johns Hopkins Medicine in Baltimore, who specializes in eating disorders. Obesity is a significant problem in our society, and it is associated with morbidity and mortality, says Dr. Schreyer. Ideally, it might help people make informed choices about what theyre about to eat, she says. Theres good evidence that the average person may underestimate calories in the food and beverages that theyre consuming, adds Schreyer.

There can also be a disconnect regarding how much activity might be required to use up all the calories that are found in some foods, says Fatima Cody Stanford, MD, MPH, assistant professor of medicine and pediatrics at Massachusetts General Hospital and Harvard Medical School in Boston, and an obesity expert. But I think that labeling the foods in this way presumes that all persons burn the same amount regardless of their gender, race or ethnicity, age, [and] genetics, which is not the case.

This labeling proposal would be one way to educate the general public that quite a bit of activity is sometimes necessary to burn calories acquired with food, says Dr. Stanford. However, this thought process presumes that the calories incalories out mantra is correct when it is indeed inaccurate. There are several factors that take place to regulate weight, she says. It might be beneficial to give a range and put a disclaimer about variability in persons due to other factors, adds Stanford.

According to a Calorie Burn Rate Calculator from the University of Rochester Medical Center, a 130-pound person burns about 600 calories an hour running at a 10-minute-per-mile pace, whereas a 200-pound person would burn 960 calories running at the same pace for one hour.

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Although proposals like PACE labeling that are meant to curb obesity are well-intentioned, there can be a downside to these efforts, says Schreyer. When an individual who has disordered eating sees these types of pictures or information, theyre often not able to view it in a healthy way, she says. Eating a variety of foods with various calorie densities can promote recovery, she adds. Yet if that person sees pictures like this on food that may be nutritious but has higher calorie content, the initial reaction can be avoid, avoid, avoid, because theyre frightened of the potential effect, she says.

Excessive exercise or compulsive exercise is another problem that people who have eating disorders may have, which could be triggered by this type of labeling, says Schreyer.

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This proposal fails to address the complexity of weight regulation, says Stanford. I can imagine a person going to burn off the calories that the labeling indicates and feeling as if they failed when the numbers don't add up, she says.

One challenge is that the public needs more nuanced information about nutrition, and thats harder to package succinctly, says Schreyer. Depending on the size of the person we need to consume somewhere between 1,800 and 2,200 calories per day, but thats just an average, and many other variables can impact that, she says. Ideally, the approach shouldnt be about a hard yes or no about certain foods, but rather trying to eat a healthy and balanced diet, says Schreyer. Its important to remember that you need to consume a sufficient number of calories every day thats what were meant to do, she says.

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A Food Label That Suggests Exercise Needed to Burn Calories May Aid Weight Loss - Everyday Health