How many calories did I just eat?' An experimental study examining the effect of changes to serving size information on nutrition labels (original) (raw)
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Consumer understanding of calorie amounts and serving size: implications for nutritional labelling
Canadian journal of public health = Revue canadienne de santé publique
Increased consumption of sugar-sweetened beverages has contributed to rising obesity levels. Under Canadian law, calories for pre-packaged foods and beverages are presented by serving size; however, serving sizes differ across products and even for the same product in different containers. This study examined consumer understanding of calorie amounts for government nutrition labels and industry labelling schemes. A national sample of 687 Canadian adults completed an online survey. Participants were randomized to view images of Coke® bottles that displayed different serving sizes and calorie amounts. Participants viewed either the regulated nutrition information on the "back" of containers, or the voluntary calorie symbols displayed on the "front" of Coke® products. Participants were asked to determine how many calories the bottle contained. Across all conditions, 54.2% of participants correctly identified the number of calories in the beverage. Participants who v...
Canadian journal of public health = Revue canadienne de sante publique, 2016
Several countries have proposed changes to calorie labelling on nutrition facts tables (NFTs) on pre-packaged foods. As most research to date has examined general use of NFTs, there is a lack of evidence to guide specific design changes to calorie information on labels. This study examined the efficacy of various calorie labelling formats on recall, comprehension, and consumer preferences for calorie information. Experiments were conducted as part of an online survey with a national sample of 2,008 Canadians aged 16-24. In Task 1, participants were shown one of six labelling formats (e.g., %DV, Traffic Light) with calories in either small or large font, and asked to recall the amount of calories. Task 2 examined comprehension of calories in the context of recommended daily intake (RDI), using the same NFT as in Task 1. Task 3 identified participants' preferences for labelling formats. NFTs with calories in large font enhanced calorie recall (p < 0.001). When small font was di...
Canadian Journal of Public Health
Objectives To test the efficacy of calorie labelling for alcoholic and non-alcoholic beverages on restaurant menus on noticing calorie information, calorie knowledge, and perceived and actual influence on hypothetical beverage orders. Methods Participants included upper-level university students of legal drinking age residing in Ontario, Canada (n = 283). Using a between-groups experiment, participants were randomized to view one of two menus: (1) No Calorie Information (control), and (2) Calorie Information adjacent to each beverage. Participants completed a hypothetical ordering task, and measures related to noticing calorie information, calorie knowledge, and actual and perceived influence of calorie information on beverages ordered were assessed. Linear, logistic, and multinomial logistic regression models were used to examine the four outcomes. Results The odds of noticing calorie information were significantly higher in the Calorie Information (72.6%) versus No Calorie Information condition (8.0%) (OR = 43.7, 95% CI: 16.8, 113.8). Compared to those in the No Calorie Information condition, participants in the Calorie Information condition had significantly lower odds of responding 'Don't know' (OR = 0.04, 95% CI: 0.02, 0.09), underestimating (OR = 0.06, 95% CI: 0.02, 0.2), and overestimating (OR = 0.05, 95% CI: 0.02, 0.2) versus accurately estimating calories in beverages ordered. No significant differences were observed between menu labelling conditions in the calories in beverages ordered or the perceived influence of calorie information on the number of beverages ordered. Conclusion Exposure to menus with calorie information increased consumers noticing the calorie information, and accurately estimating calories in alcoholic and non-alcoholic beverages ordered. These results have implications for policy-makers considering mandatory menu labelling policy inclusive of alcoholic beverages. Résumé Objectifs Évaluer l'effet de l'inscription de la valeur calorique des boissons alcoolisées et non alcoolisées sur les probabilités de remarquer cette information et la connaissance de la valeur calorique, et sur l'influence, réelle ou perçue, sur des commandes hypothétiques de boissons. Méthodologie Les participants étaient des étudiants universitaires avancés ayant l'âge légal pour consommer de l'alcool et vivant en Ontario, au Canada (n = 283). On les a répartis au hasard en deux groupes : 1) ceux du premier groupe ont consulté un menu sans valeurs caloriques (groupe témoin) et 2) ceux du second groupe ont consulté un menu indiquant les valeurs caloriques à côté de chaque boisson. Les participants ont ensuite fait des commandes hypothétiques et on a mesuré les données suivantes : probabilité de remarquer les valeurs caloriques, connaissance des valeurs caloriques et influence, réelle ou perçue, de cette information sur le choix des boissons. Des modèles de régression linéaire, logistique et logistique multinomiale ont été employés pour analyser les données recueillies. Résultats Les probabilités de remarquer les valeurs caloriques étaient beaucoup plus élevées dans le groupe valeurs caloriques (72,6 %) que dans le groupe sans valeurs caloriques (8,0 %) (RC = 43,7, IC à 95% : 16,8-113,8). Comparés à ceux du groupe sans valeurs caloriques, les participants du groupe valeurs caloriques avaient beaucoup moins de Extended author information available on the last page of the article Canadian Journal of Public Health 1 3 chances de répondre « Je ne sais pas » (RC = 0,04, IC à 95% : 0,02-0,09), de donner une réponse trop basse (RC = 0,06, IC à 95% : 0,02-0,2) ou trop haute (RC = 0,05, IC à 95% : 0,02-0,2) que d'estimer précisément le nombre de calories dans les boissons commandées. Aucune différence significative n'a été observée entre les deux groupes quant au nombre de calories contenues dans les boissons commandées ni dans l'influence perçue des valeurs caloriques sur le nombre de boissons commandées. Conclusion Le fait d'inscrire les valeurs caloriques sur le menu augmente les probabilités que les consommateurs remarquent les valeurs caloriques, et facilite l'estimation précise de la valeur calorique des boissons alcoolisées ou non alcoolisées commandées. Ces résultats ont une incidence pour les décideurs qui envisagent de rendre obligatoire l'inscription des valeurs caloriques sur les menus, y compris pour les boissons alcoolisées.
A randomized trial of calorie labeling on menus
Preventive Medicine, 2013
Background. Food consumed outside the home accounts for a growing proportion of the North American diet and has been associated with increased obesity. Purpose. To examine the effect of nutrition labeling on menus on awareness, use, and food consumption, including the impact of "traffic light" labeling and adding other nutrients. Methods. Blinded, randomized trial with 635 Canadian adults conducted in 2010-2011. Participants ordered a free meal from one of four experimental menus: 1) no nutritional information shown, 2) calorie amounts only, 3) calorie amounts in "traffic lights", and 4) calorie, fat, sodium, and sugar shown in "traffic lights". Recall of nutrition information, knowledge of calorie content and nutrient consumption were assessed. Results. Participants in the calorie conditions were more likely to recall the calorie content of meals and to report using nutrition information when ordering. The calorie content of meals was not significantly different across conditions; however, calorie consumption was significantly lower among participants in the Calorieonly condition compared to the No information condition (mean = −96 kcal, p = .048). Conclusions. Menu labeling increased awareness and use of nutrition information and reduced consumption. Adding "traffic lights", fat, sodium, and sugar amounts to menus had little impact compared to calorie-only labeling.
This scoping review investigated how consumers perceive and interpret serving size information on food packages. A search of seven databases (2010 to September 2017) was followed by title and abstract screening, with relevant articles assessed for eligibility in full-text. Fourteen studies met inclusion criteria, with relevant data extracted by one reviewer and checked for consistency by a second reviewer. Five studies reported poor understanding of nutrition facts labelling and portion size, with information to ‘benchmark’ serving size against reported as helpful in two studies. Consumer attitudes towards serving size labelling were measured in six studies and identified that serving size information was interpreted as indicative of nutrient intake regardless of portion size recommendations. Increased labelled serving sizes resulted in increased portion sizes in three studies, with three studies reporting the opposite or neutral effect for discretionary food portion siz...
The presentation of nutrition information on a serving size basis is a strategy that has been adopted by several countries to promote healthy eating. Variation in serving size, however, can alter the nutritional values reported on food labels and compromise the food choices made by the population. This narrative review aimed to discuss (1) current nutrition labelling legislation regarding serving size and (2) the implications of declared serving size for nutrition information available on packaged foods. Most countries with mandatory food labelling require that serving size be presented on food labels, but variation in this information is generally allowed. Studies have reported a lack of standardisation among serving sizes of similar products which may compromise the usability of nutrition information. Moreover, studies indicate that food companies may be varying serving sizes as a marketing strategy to stimulate sales by reporting lower values of certain nutrients or lower energy values on nutrition information labels. There is a need to define the best format for presenting serving size on food labels in order to provide clear and easily comprehensible nutrition information to the consumer.
The Impact of Nutrition Labeling on Menus: A Naturalistic Cohort Study
American Journal of Health Behavior, 2015
Objectives: To examine the impact of a calorie label intervention on cafeteria menus. Methods: Exit surveys were conducted in a university cafeteria. Participants were surveyed at baseline and one week after calorie labels were displayed. We assessed changes in noticing and use of nutrition information, the calorie content of food purchased, and estimated calorie consumption. Results: The intervention was associated with significant increases in noticing nutrition information (92.5% vs 39.6%; p < .001), and the use of nutrition information to guide food purchases (28.9% vs 8.8%; p < .001). The calorie content of foods purchased decreased after calorie labels were posted (B =-88.69, p = .013), as did the estimated amount of calories consumed (B =-95.20, p = .006). Conclusions: Findings suggest that displaying calorie amounts on menus can help reduce excess energy intake.
International Journal of Behavioral Nutrition and Physical Activity, 2013
Background: Recent legislation has required calorie labels on restaurant menus as a means of improving Americans' health. Despite the growing research in this area, no consensus has been reached on the effectiveness of menu labels. This suggests the possibility of heterogeneity in responses to caloric labels across people with different attitudes and demographics. The purpose of this study was to explore the potential relationships between caloric intake and diners' socio-economic characteristics and attitudes in a restaurant field experiment that systematically varied the caloric information printed on the menus. Methods: We conducted a field experiment in a full service restaurant where patrons were randomly assigned to one of three menu treatments which varied the amount of caloric information printed on the menus (none, numeric, or symbolic calorie label). At the conclusion of their meals, diners were asked to complete a brief survey regarding their socio-economic characteristics, attitudes, and meal selections. Using regression analysis, we estimated the number of entrée and extra calories ordered by diners as a function of demographic and attitudinal variables. Additionally, irrespective of the menu treatment to which a subject was assigned, our study identified which types of people are likely to be low-, medium-, and high-calorie diners. Results: Results showed that calorie labels have the greatest impact on those who are least health conscious. Additionally, using a symbolic calorie label can further reduce the caloric intake of even the most health conscious patrons. Finally, calorie labels were more likely to influence the selection of the main entrée as opposed to supplemental items such as drinks and desserts. Conclusions: If numeric calorie labels are implemented (as currently proposed), they are most likely to influence consumers who are less health consciousprobably one of the key targets of this legislation. Unfortunately, numeric labels did little for those consumers who were already more knowledgeable about health and nutrition. To reach a broader group of diners, a symbolic calorie label may be preferred as it reduced caloric intake across all levels of health consciousness.
Appetite, 2014
There is some evidence for paradoxical effects of nutritional labelling on energy intake particularly amongst restrained eaters and those with a higher body mass index (BMI) resulting in greater consumption of energy from foods with a positive health message (e.g. "low-fat") compared with the same foods, unlabelled. This study aimed to investigate, in a UK general population sample, the likelihood of paradoxical effects of nutritional labelling on energy intake. Participants (n = 287) attended a London cinema and were offered a large tub of salted or toffee popcorn. Participants were randomised to receive their selected flavour with one of three labels: a green low-fat label, a red high-fat label or no label. Participants watched two film clips while completing measures of demographic characteristics, emotional state and taste of the popcorn. Following the experiment, popcorn consumption was measured. There were no main effects of nutritional labelling on consumption. Cont...
Estimating food portions. Influence of unit number, meal type and energy density
Appetite, 2013
Estimating how much is appropriate to consume can be difficult, especially for foods presented in multiple units, those with ambiguous energy content and for snacks. This study tested the hypothesis that the number of units (single vs. multi-unit), meal type and food energy density disrupts accurate estimates of portion size. Thirty-two healthy weight men and women attended the laboratory on 3 separate occasions to assess the number of portions contained in 33 foods or beverages of varying energy density (1.7-26.8 kJ/g). Items included 12 multi-unit and 21 single unit foods; 13 were labelled ''meal'', 4 ''drink'' and 16 ''snack''. Departures in portion estimates from reference amounts were analysed with negative binomial regression. Overall participants tended to underestimate the number of portions displayed. Males showed greater errors in estimation than females (p = 0.01). Single unit foods and those labelled as 'meal' or 'beverage' were estimated with greater error than multi-unit and 'snack' foods (p = 0.02 and p < 0.001 respectively). The number of portions of high energy density foods was overestimated while the number of portions of beverages and medium energy density foods were underestimated by 30-46%. In conclusion, participants tended to underestimate the reference portion size for a range of food and beverages, especially single unit foods and foods of low energy density and, unexpectedly, overestimated the reference portion of high energy density items. There is a need for better consumer education of appropriate portion sizes to aid adherence to a healthy diet.