Looking at the label and beyond: the effects of calorie labels, health consciousness, and demographics on caloric intake in restaurants (original) (raw)

Understanding the Calorie Labeling Paradox in Chain Restaurants: Why Menu Calorie Labeling Alone May Not Affect Average Calories Ordered

Journal of Public Policy & Marketing, 2019

Menu calorie labeling is now required nationwide for chain restaurants in the United States; however, a number of studies have found that calorie labeling does not reduce average calories ordered. This research examines how different food-value orientations are associated with divergent consumer responses to the provision of calorie information on restaurant menus and menu boards. Results from two pilot studies and two experiments, including a restaurant field experiment, indicate that calorie labeling is effective in decreasing the number of calories ordered by health-value oriented consumers. However, for quantity-and taste-value oriented consumers, menu calorie labeling may result in an increase in calories ordered. These influences counterbalance one another, leading to an overall nonsignificant effect of calorie labeling on calories ordered in restaurant settings. These findings offer a compelling explanation for the many studies showing nonsignificant effects of menu calorie labeling and inform ongoing policy debates regarding the national implementation of menu calorie labeling for chain restaurants. The conceptual contributions and implications of these findings for public policy and consumer wellbeing are discussed.

Calorie-labelling in catering outlets: Acceptability and impacts on food sales

Preventive Medicine, 2014

Objective. Obesity is the biggest challenge facing preventive medicine. Calorie-labelling has been suggested as a way of changing the architecture of an 'obesogenic' environment without limiting consumer choice. This study examined the effect of calorie-labelling on sales of food items at catering outlets on a city-centre university campus. Methods. Sales data were collected for two consecutive months in 2013 on three UK university sites (two with calorie-labelling during second month, one control) and analysed with chi-square 'Goodness-of-Fit' tests. A questionnaire seeking consumers' views and use of the calorie-labelling was administered and analysed at grouplevel with chi-square tests. Results. In intervention vs control sites, total sales of all labelled items fell significantly (− 17% vs − 2%, p b 0.001) for the month with calorie-labelling. Calorie-labelling was associated with substantially reduced sales of high-calorie labelled items, without any compensatory changes in unlabelled alternative items. Among 1166 student-and 646 staff-respondents, 56% reported using the calorie-labels, 97% of them to make lower-calorie choices. More females (63%) than males (40%) reported being influenced by calorie-labels when choosing foods (p = 0.01). Conclusions. This study provides evidence, beyond that from single-meal exposures, for the acceptability of meal calorie-labelling and its potential as an effective low-cost anti-obesity measure.

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.

What types of nutrition menu labelling lead consumers to select less energy-dense fast food? An experimental study

Appetite, 2013

This study assessed whether the inclusion of kilojoule labelling alone or accompanied by further nutrition information on menus led adults to select less energy-dense fast food meals. A between-subjects experimental design was used with online menu boards systematically varied to test the following labelling conditions: none (control); kilojoule; kilojoule + percent daily intake; kilojoule + traffic light; and kilojoule + traffic light + percent daily intake. Respondents were 1294 adults aged 18-49 in Victoria, Australia who had purchased fast food in the last month and were randomly assigned to conditions. Respondents in the no labelling condition selected meals with the highest mean energy content and those viewing the kilojoule and kilojoule + traffic light information selected meals with a significantly lower mean energy content, that constituted a reduction of around 500 kJ (120 kcal). Respondents most commonly reported using the traffic light labels in making their selections. These findings provide support for the policy of disclosure of energy content on menus at restaurant chains. Given the magnitude of the reduction in energy density reported, and the prevalence of fast food consumption, this policy initiative has the potential to yield health benefits at the population level.

The Association Between Restaurant Menu Label Use and Caloric Intake

2018

This study uses survey data to analyze the association between restaurant menu label use and total and source-specific daily caloric intakes among U.S. adults age 20 and older who saw nutrition information on a menu the last time they visited a fast-food or sit-down restaurant. Findings show that survey respondents who report seeing and using restaurant menu labels consume significantly fewer total calories per day than do respondents who report seeing the labels but not using them. Fast-food and sit-down restaurant menu label uses are both significantly associated with lower total daily caloric intake, and the associations are estimated to be of similar magnitudes. Findings also suggest that the total daily calorie consumption difference between restaurant menu label users and nonusers may be partly attributable to restaurant menu label users' lower intake of calories from restaurants that post nutrition information on menus. Taken together, these results suggest that nutrition...

Consumers May Not Use or Understand Calorie Labeling in Restaurants

Journal of The American Dietetic Association, 2006

This study was an investigation of the possible utility of calorie labeling legislation in restaurants in community (n=649) and college student (n=316) samples. Only 48% to 66% of participants presently looked at food labels, and 64% to 73% were able to report accurate knowledge of daily caloric needs. Furthermore, 44% to 57% reported that they were not likely to use food label information in restaurants if it were available. Therefore, public education campaigns focused on calorie requirements may need to precede restaurant labeling, and perhaps other possibilities in labeling formats should be considered (eg, defining foods as “low,” “moderate,” and “high” calorie).

Menu Labeling as a Potential Strategy for Combating the Obesity Epidemic: A Health Impact Assessment

American Journal of Public Health, 2009

Objectives. We conducted a health impact assessment to quantify the potential impact of a state menu-labeling law on population weight gain in Los Angeles County, California. Methods. We utilized published and unpublished data to model consumer response to point-of-purchase calorie postings at large chain restaurants in Los Angeles County. We conducted sensitivity analyses to account for uncertainty in consumer response and in the total annual revenue, market share, and average meal price of large chain restaurants in the county. Results. Assuming that 10% of the restaurant patrons would order reduced-calorie meals in response to calorie postings, resulting in an average reduction of 100 calories per meal, we estimated that menu labeling would avert 40.6% of the 6.75 million pound average annual weight gain in the county population aged 5 years and older. Substantially larger impacts would be realized if higher percentages of patrons ordered reduced-calorie meals or if average per-m...

Efficacy of calorie labelling for alcoholic and non-alcoholic beverages on restaurant menus on noticing information, calorie knowledge, and perceived and actual influence on hypothetical beverage orders: a randomized trial

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.

Changes in Calorie Content of Menu Items at Large Chain Restaurants After Implementation of Calorie Labels

JAMA Network Open

IMPORTANCE Calorie labeling on menus is required in US chain food establishments with 20 or more locations. This policy may encourage retailers to offer lower-calorie items, which could lead to a public health benefit by reducing customers' calorie intake from prepared foods. However, potential reformulation of restaurant menu items has not been examined since nationwide enforcement of this policy in 2018. OBJECTIVE To examine the calorie content of menu items at large chain restaurants before and after implementation of federally mandated menu calorie labels. DESIGN, SETTING, AND PARTICIPANTS This pre-post cohort study used restaurant menu data from MenuStat, a database of nutrition information for menu items offered in the largest chain restaurants in the US, collected annually from 2012 to 2019. The study comprised 35 354 menu items sold at 59 large chain restaurants in the US. Statistical analysis was conducted from February 4 to October 8, 2021. INTERVENTION Nationwide implementation of menu calorie labeling. MAIN OUTCOMES AND MEASURES Changes in menu items' calorie content after restaurant chains implemented calorie labels were estimated, adjusting for prelabeling trends. All menu items, continuously available items, items newly introduced to menus, and items removed from menus were examined separately. RESULTS Among the 59 restaurant chains included in the study, after labeling, there were no changes in mean calorie content for all menu items (change = −2.0 calories; 95% CI, −8.5 to 4.4 calories) or continuously available items (change = −2.3 calories; 95% CI, −11.5 to 6.3 calories). Items that were newly introduced after labeling, however, had a lower mean calorie content than items introduced before labeling (change = −112.9 calories; 95% CI, −208.6 to −25.2 calories), although there was heterogeneity by restaurant type. Items removed from menus after labeling had similar calorie content as items removed before labeling (change = 0.5 calories; 95% CI, −79.4 to 84.0 calories). CONCLUSIONS AND RELEVANCE In this cohort study of large chain restaurants, implementing calorie labels on menus was associated with the introduction of lower-calorie items but no changes in continuously available or removed items.