A Big Mac, a large Coke and large fries has 1,360 calories — more than three times the recommended 400 calories per meal.
Public health officials hope seeing calorie counts like these on restaurant menus and vending machines will lead consumers to make healthier food choices and help reduce obesity in America. But as Americans increasingly opt for meals outside the home, the battle's quickly becoming uphill.

'Healthy' options
The Patient Protection and Affordable Care Act of 2010 requires restaurants with 20 or more locations to post calorie counts on menus. According to the Food and Drug Administration, 280,000 of the United State's 600,000 restaurants will be subject to the new regulations.
In September, McDonald's was one of the first large fast food chains to roll out the new menus.
Starting in­­ 2013, the American Beverage Association is launching its Calories Count program with Coca-Cola and PepsiCo, where calorie information will be posted on vending machines. The program is first rolling out in a few cities, then going nation-wide.
Whether the up-front information will lead to healthier choices is still up for debate.
"I think maybe there are some people, whether it be students or adults, who will look at something like that and make a conscious and healthy decision. I also believe there will be plenty of people who will not be deterred by that as well," said Dana Ruhl, business manager of the Hannibal public school district.
At Monroe City High School, where only vending machines containing soft drinks are available, Principal Ryan Watson doubts the benefits.
"I do not believe it will make a difference," he said. "It's easy to target schools because that's the one place where all kids are in one spot at one time, but to pin childhood obesity on a school lunch program, soda machines or vending machines really is not factual. When kids can leave our school and go to any gas station or fast food restaurant and get all sorts of processed foods filled with calories… We're a small part of that."
In Hannibal, providing healthier food options is nothing new.
"There hasn't been a major change because we were already headed in that direction," said Ashley Gottman, food services coordinator. "We've always offered a lot of fresh fruit and vegetable choices. This year we are offering some different choices because of the sub-groups of vegetables we're required to serve. On our menus now you'll see more beans and sweet potatoes offered. And instead of just an iceberg lettuce we are incorporating romaine and spinach into our lettuces."
But it's not just youth that are seeing the bulge.
The percentage of calories Americans consume away from home has almost doubled since the late 1970s, according to the USDA Economic Research Service — and it's affecting our health and waist lines.
A study from the National Heart, Lung, and Blood Institute published in 2004 indicated young adults who eat frequently at fast food restaurants gain more weight and have a greater increase in insulin resistance in early middle age.
Insulin resistance is a risk factor for type 2 diabetes, and diabetes is a major risk factor for heart disease.

Expanding awareness, waistlines
As Americans' eating-out habits have increased, so has the nation's obesity rate.
The percentage of children in the United States who were obese increased from 7 percent in 1980 to almost 20 percent in 2008, according to the Centers for Disease Control. Adolescents saw a similar increase.
More than one-third of U.S. adults are obese, resulting in about $147 billion in health care costs in 2008, according to the CDC.
Jim White, registered dietitian and spokesperson for the Academy of Nutrition and Dietetics, said calorie awareness is important for addressing overeating in America.
"I don't think it is going to harm anything," he said of posting calorie counts on menus. "I think some people are going to be alarmed at the calories in some common restaurant items. A common restaurant meal can be 800 to 1,000 calories. I recommend a lot women have a 400-calorie-per-meal plan. They are getting 75 percent of their calories for a normal day in one meal."
Whether or not the calorie shock will truly dissuade consumers from ordering high-calorie, high-fat foods remains to be seen.
Two major university studies have shown conflicting results of posting calories counts on menus.
A Stanford study of Starbucks consumers showed a 6 percent decrease in calorie consumption when food calorie counts were posted on menus.
New York University researchers found about 28 percent of New York City customers indicated calorie labeling influenced their choices.
However, the participants' receipts showed they purchased about the same amount of calories before the labeling went into effect.

Teetering on the edge of health
Despite the calorie postings, some consumers will continue to opt for high-calorie, high-fat choices, with convenience and cost being large factors in those decisions, White said.
White noted many of the items on fast food dollar menus are the higher calorie foods, which may make it more difficult for consumers with fewer economic resources to make healthy choices.
"I think there are definitely certain people who will not opt for a healthy lifestyle, regardless," he said, "but I think there is a certain population that is teetering and might choose a healthier lifestyle if they had the information. It is that middle population we are looking at."
White said creating calories awareness at restaurants may lead to healthier eating at home.
"If you can eat healthy at a fast food restaurant, you can eat healthy anywhere," White said. "If you can face great-tasting things like cheeses and butter and tasty fried foods, you've dodged a bullet."

— Danny Henley contributed to this report.