On a recent trip to New York City, Sarah Kosmack was blown away by what she read on the menu at fast-food restaurant, Shake Shack.

She planned to order a milkshake — until she saw the damage.

New York City mandates that large chain restaurants post calorie counts on their menus. According to Shake Shack's menu, Kosmack's selected drink totalled around 800 calories, more than the amount in many of its burgers.

"I was shocked," Kosmack, who lives in Toronto, recalls. "It was so brutal. The calories were so high, I couldn't do it."

People in Ontario may soon be in for a similar shock. Starting in 2017, the province will require that food service establishments with 20 or more locations list the calorie amounts on the menu or menu display board.

Smaller eateries are exempt because of the costs of meeting the requirements.

Tell-all menus

With our growing obesity epidemic, some health advocates are pushing for all of Canada to adopt similar regulations and to add even more nutritional details.

Critics in the restaurant industry argue it's just too much information and could cause confusion.

But advocates point out that some U.S. states already require calories on chain restaurant menus, and that nationwide U.S. regulations are in the works. Many chain restaurants in the U.S. already post calorie counts on menus. (NYC Department of Health)

"It's a major public health issue," says Norman Campbell, professor of medicine at the University of Calgary.

"We've reached the situation where unhealthy diets are the leading risk for death and disability in Canada."

Prof. Campbell argues that, in an era when more people are dining out, nutritional information on menus is an easy way to help Canadians make healthier choices.

Indeed, it might make people think twice about ordering dishes like Boston Pizza's Smoky Mountain Spaghetti and Meatballs. It clocks in at 1,760 calories.

Or customers might reconsider the prime rib hash at Milestones. The brunch item totals a whopping 1,990 calories — and that excludes the accompanying bread.

For inactive adult women, that dish would exceed their government-recommended 1,800 to 1,900 daily calorie requirement.

According to Boston Pizza's own data, its Smoky Mountain Spaghetti with Meatballs contains 1,760 calories. (Boston Pizza)

The cry for 'menu truth'

Many national health organizations including the Heart and Stroke Foundation and the Canadian Diabetes Association want calories listed on chain restaurant menus across Canada.

The Fitness Industry Council of Canada is running a campaign called Menu Truth, asking Canadians who support the cause to contact their provincial health minister.

It's also on the agenda for Montreal city councillor Marvin Rotrand. He's lobbying Quebec to adopt regulations similar to Ontario's.

"Many of us in Quebec don't understand why people in Ontario should have better nutritional information available to them," says Rotrand. "It does, ultimately, make a difference in terms of calories consumed."

Following her New York experience, Kosmack agrees. "It's really hard to order a milkshake knowing it has 800 calories."

She believes posting the information on menus would, "dissuade you from a lot of things."

But not all restaurant-goers are on side.

Sitting with friends during a recent trip to a Keg Steakhouse in Toronto, Aldo Valente perused the menu, looking for, he said, "the biggest steak they have."

Valente watches what he eats at home. But when he dines out, he claims he couldn't care less about the calories.

"I go to restaurants to indulge myself," he said.

Restaurant-goer Aldo Valente says he doesn't care about the calories when dining out. (CBC)

And then there's salt

Valente may not care, but many who support the cause want to see even more information. Coun. Rotrand also wants sodium content posted on menus.

"Many foods offered in fast food restaurants have a lot of sodium, far more than your daily requirement," he says.

For example, a Reuben sandwich at the Keg contains 3,472 milligrams of sodium.

Jack Astor's Spicy Shrimp Fajita dish has slightly more: 3,481 milligrams.

Both contain more than 1,000 milligrams above Health Canada's recommended daily maximum sodium limit of 2,300 milligrams.

New York City requires restaurant chains to place this symbol next to menu items high in sodium. (NYC Department of Health) Prof. Campbell desires even more disclosure. He'd like to see a food wheel on menus that uses different colours indicating levels of sodium, sugar, and saturated fat in dishes.

"It's very easy to interpret," he says.

Prof. Campbell also recommends a cautionary label on menus for food items that exceed recommended amounts.

Since last month, New York City chain restaurants have also had to post a warning salt shaker icon next to menu items high in sodium.

Too much information?

The many ideas for menus are all too much for Restaurants Canada.

The industry association's Ontario vice president, James Rilett, says restaurant dishes often vary depending on factors like serving size or flavour option. He argues that makes it difficult to post even calories on menus, much less added nutritional content.

"It has been found that more information on the menu actually leads to confusion, which makes it less likely that customers will use the information," says Rilett.

He also points out that many restaurants already voluntarily provide detailed nutritional information either online or at their location by request.

"Chain restaurants support transparency," says Rilett.

But health advocates argue people need to be confronted with the details right when they order.

Kosmack agrees. She says she never checks nutritional information online but believes one can't ignore the calorie count on a menu.

"It will be a bit of a bummer but I think it will be quite useful for a lot of people," she says.