The requirement, which went into effect in 2010, requires chain restaurants with 15 or more locations to provide the information.
No similar requirements are on the books in neighboring Snohomish County, although some chains like McDonalds, Taco Time, Jack in the Box and Ivar's seafood bars in Edmonds, Everett and Mukilteo are now providing the information.
The Snohomish Health District, which has undergone a series of budget cuts, hasn't had the resources to implement restaurant labeling requirements similar to those in King County, said Dr. Gary Goldbaum, health officer.
In Snohomish County, there have been questions about whether to extend those same type of regulations to small chains and independent restaurants, Goldbaum said.
"Personally I think this will be something that will be embraced ultimately by industry and the community," he said. "I think it's a valuable tool, but it's only one part of our efforts to address the obesity epidemic."
The health district's Food Advisory Council, made up of industry representatives, has discussed the issue in the past but has not supported a requirement to provide the information, said Rick Zahalka, the health district's food program manager.
Martha Peppones, a registered dietician at Senior Services of Snohomish County and a member of the Food Advisory Council, said that one of the reasons for the lack of support is the initial expense in having menu items analyzed.
Bob Donegan, president of Ivar's, said the cost to do the nutrition analysis in a laboratory was one of the concerns when King County's Board of Health approved its requirements.
"I'm going to say it was about $300 per item to be tested," he said. King County decided to allow restaurants to use approved software programs to do the analysis. The cost dropped significantly, he said.
The information is available to customers on reader boards inside its quick serve restaurants and in printed pamphlets, with offerings ranging from a 410-calorie Caesar salad to a 1,040- calorie crab cake sandwich with fries. Many restaurant chains also have the information on their websites.
Since King County's labeling requirements went into effect, "the vast majority of people look at it and don't change their eating behaviors at all," he said.
"When you're hungry for fish and chips, you won't change to salad with steamed cod on top of it," Donegan said.
Diane Symms, owner of Lombardi's, which has Italian restaurants in Everett, Mill Creek and Issaquah, said she also wonders how many people would pay attention if nutritional information was listed on menus.
"I don't believe that when people go out to a full service restaurant if they're really interested in the nutritional information," she said.
In recent years, more customers have been asking for information on salt content and gluten than in the past, Symms said.
"We have gluten-free pasta available," she said. The restaurant is conscientious about its use of salt, choosing canned tomatoes from Naples that have fresh flavor but less than 8 percent salt content, Symms said.
University of Washington researchers who looked at restaurant menus in King County six and 18 months after its restaurant labeling regulations went into effect. They found that the calories listed on the menu declined, particularly at sit-down restaurants, said Brian Saelens, a health psychologist at Seattle Children's Hospital.
"We don't know that it's directly related to just this regulations... but it is quite a coincidence that it was at the same time that the menu labeling went into effect," he said.
Wes Benson, franchise representative for Taco Time Northwest, said his organization has been tracking nutritional information as far back as the 1980s.
The information is posted on all its menu boards, both inside and outside for customers using the drive-through.
"Once we put up the menu labeling, we liked what we saw as far as calorie counts," Benson said. It also inspired his organization to consider whether there's a niche market for health-conscious consumers, he said.
Dick's Drive-In Restaurants, which has five restaurants in King County and one in Edmonds, isn't currently required to post its nutritional information, but plans to do so by the end of the year, said Carrie Shaw, Dick's marketing director.
A nationwide effort to require all chain restaurants with 20 or more locations to post nutritional information is included in the federal health care law, but it's on hold while details are being ironed out, said Leonard Winchester, who works in the food and facilities section of Public Health Seattle & King County.
The law requires calories to be posted next to each item on the menu, he said.
The Washington Restaurant Association favors a statewide approach to menu labeling. "With 39 counties across the state, the chances of a patchwork effect is pretty high," said Heather Donahoe, the group's spokeswoman.
Peppones said that even when food undergoes nutritional analysis, there can be issues with the results.
Unless portion sizes served in restaurants are exactly the same every time, the counts that are reported in the nutritional information could vary, sometimes significantly, from what consumers are served, she said.
Yet even with these and other issues, Peppones said she thinks it's good for consumers to have nutrition information.
"We dietitians say it's tough to say you should only have this many milligrams of salt when you can't find the information," she said.
Sharon Salyer: 425-339-3486; email@example.com.
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