Starbucks calorie counts.

Seattle and King County director of public health Dr. David Fleming has enjoyed a few accomplishments in his career, including shepherding a terrified nation through the anthrax scare from his post as deputy director of the the Centers for Disease Control, and speeding vaccines into the hands of developing countries from his post at the Gates Foundation—saving some seven million kids’ lives in the process.

Currently one of his defining passions is preventive public health measures, like the menu labeling initiative he spearheaded for King County in 2009. You’ve seen calorie counts listed beside menu items in the bigger restaurant chains around here—that was Fleming’s doing. And although one study from 2011 found that Taco Time customers weren’t influenced at all by the calorie counts…Taco Time had already been highlighting its healthier options, which makes its record not the most accurate gauge of the law’s effectiveness.

Is it considered successful from a public health perspective? “Yes,” Fleming told me last week. “Of course the problem of nutrition is huge, and there’s no single answer. But menu labeling has resulted in a modest reduction in the number of calories consumed—interestingly, more in women than men.”

“It’s also caused a change in the way fast-food restaurants decide what’s on their menus. Menu labeling reminds us of nutritional content. Without menu labels, it’s easy to be attracted to food by its volume; that becomes your sense of its value. But we’ve seen restaurants decrease portion sizes because of the law.”

And, Fleming continues, we’ve seen it spread. “There’s a menu labeling law that’s part of the Affordable Care Act,” he reminds us. Yeah it’s been delayed—but some restaurants, including McDonald’s, are getting on board before it’s mandated, and rolling out healthier alternatives at the same time.