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Menu labelling is effective in reducing energy ordered and consumed: a systematic review and meta-analysis of recent studies

  • Jodie Anne Littlewood (a1), Sofia Lourenço (a1), Cecilie Lauberg Iversen (a1) and Gitte Laub Hansen (a1)
Abstract
Objective

Menu labelling is a practical tool to inform consumers of the energy content of menu items and help consumers make informed decisions in the eating-out environment, and the volume of studies published recently regarding its effects is expanding, both quantitatively and geographically. The aim of the present review and meta-analysis is to consider the most recent evidence which assesses the effect of menu labelling regarding changes in energy consumed, ordered or selected in both real-world and experimental settings.

Design

The review included fifteen peer-reviewed, full-text articles published between 2012 and 2014. Pertinent methodological information was extracted from each of the included studies and a quality assessment scheme was applied to classify the studies, after which systematic across-study comparisons were conducted. A meta-analysis was conducted including twelve of the fifteen studies, and stratified according to type of research setting and outcome: energy consumed, ordered or selected.

Results

The rating yielded studies categorized by study quality: good (n 3), fair (n 9) and weak (n 3). Overall nine studies showed statistically significant reductions in energy consumed, ordered or selected. Three articles reported no effect of menu labelling. The meta-analysis showed statistically significant effects of menu labelling: overall energy consumed was reduced by a mean of 419·5 kJ (100·2 kcal) and energy ordered in real-world settings decreased by a mean of 325·7 kJ (77·8 kcal).

Conclusions

The review supports that menu labelling can effectively reduce energy ordered and consumed in the away-from-home food environment.

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Corresponding author
* Corresponding author: Email soflou@cancer.dk
References
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1. New South Wales Food Authority (2010) Better Regulation Statement: Provision of Nutritional Information at Point of Sale in Standard Retail Food Outlets. Newington, NSW: NSW Food Authority.
2. Nikolaou, CK, Lean, ME & Hankey, CR (2014) Calorie-labelling in catering outlets: acceptability and impacts on food sales. Prev Med 67, 160165.
3. Mah, CL, Vanderlinden, L, Mamatis, D et al. (2013) Ready for policy? Stakeholder attitudes toward menu labelling in Toronto, Canada. Can J Public Health 104, e229234.
4. Pang, J & Hammond, D (2013) Efficacy and consumer preferences for different approaches to calorie labeling on menus. J Nutr Educ Behav 45, 669675.
5. Andersen, V (2014) Folkesundhed: Fastfood er da fedt – eller er det? Copenhagen: Mandag Morgen.
6. National Restaurant Association (2014) Facts at a Glance. Restaurant Industry Sales. http://www.restaurant.org/News-Research/Research/Facts-at-a-Glance (accessed November 2014).
7. Block, JP, Condon, SK, Kleinman, K et al. (2013) Consumers’ estimation of calorie content at fast food restaurants: cross sectional observational study. BMJ 346, f2907f2916.
8. Rosenheck, R (2008) Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk. Obes Rev 9, 535547.
9. Bezerra, IN, Curioni, C & Sichieri, R (2012) Association between eating out of home and body weight. Nutr Rev 70, 6579.
10. Lachat, C, Nago, E, Verstraeten, R et al. (2012) Eating out of home and its association with dietary intake: a systematic review of the evidence. Obes Rev 13, 329346.
11. Pereira, MA, Kartashov, AI, Ebbeling, CB et al. (2005) Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet 365, 3642.
12. World Health Organization (2014) Overweight and obesity, Fact sheet no. 311. http://www.who.int/mediacentre/factsheets/fs311/en/ (accessed November 2014).
13. Public Health England (2014) Obesity and Health. http://www.noo.org.uk/NOO_about_obesity/obesity_and_health (accessed November 2014).
14. Danish National Board of Health (2003) National Action Plan Against Obesity. Recommendations and Perspectives, Short version. Copenhagen: Danish National Board of Health.
15. Hammond, RA & Levine, R (2010) The economic impact of obesity in the United States. Diabetes Metab Syndr Obes 3, 285295.
16. Liu, PJ, Roberto, CA, Liu, LJ et al. (2012) A test of different menu labeling presentations. Appetite 59, 770777.
17. Krieger, J & Saelens, BE (2013) Impact of Menu Labeling on Consumer Behavior: A 20082012 Update . Princeton, NJ: Robert Wood Johnson Foundation.
18. New South Wales Food Authority (2013) Evaluation of Kilojoule Menu Labelling. Newington. NSW: NSW Food Authority.
19. Food Safety Authority of Ireland (2012) Calories on Menus in Ireland. Report on a National Consultation June 2102. Dublin: FSAI.
20. Roberto, CA, Agnew, H & Brownell, KD (2009) An observational study of consumers’ accessing of nutrition information in chain restaurants. Am J Public Health 99, 820821.
21. Vanderlee, L & Hammond, D (2014) Does nutrition information on menus impact food choice? Comparisons across two hospital cafeterias. Public Health Nutr 17, 13931402.
22. Auchincloss, AH, Mallya, GG, Leonberg, BL et al. (2013) Customer responses to mandatory menu labeling at full-service restaurants. Am J Prev Med 45, 710719.
23. Campos, S, Doxey, J & Hammond, D (2011) Nutrition labels on pre-packaged foods: a systematic review. Public Health Nutr 14, 14961506.
24. Storcksdieck, GBS & Wills, JM (2012) Nutrition labeling to prevent obesity: reviewing the evidence from Europe. Curr Obes Rep 1, 134140.
25. Sassi, F, Cecchini, M, Lauer, J et al. (2009) Improving Lifestyles, Tackling Obesity: The Health and Economic Impact of Prevention Strategies. Paris: OECD.
26. The Nielsen Company (2012) Battle of the Bulge & Nutrition Labels. Healthy Eating Trends Around the World. New York: The Nielsen Company.
27. Department of Health, England (2011) The Public Health Responsibility Deal, March 2011. London: Department of Health, England.
28. Food Standards Agency, Northern Ireland (n.d.) Caloriewise scheme. http://www.food.gov.uk/northern-ireland/nutritionni/caloriewise (accessed October 2014).
29. US Food and Drug Administration (2015) Menu and Vending Machines Labeling Requirements. http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm217762.htm (accessed October 2015).
30. New South Wales Food Authority (2014) kJ labelling: fast & snack food menu initiative. http://www.foodauthority.nsw.gov.au/industry/legislation/proposals-policy/fast-choices.VHWIouG_Tp (accessed November 2014).
31. Government of South Australia (n.d.) User Guide. Display of Kilojoules at Multiple-Site Food Businesses. Adelaide, SA: Government of South Australia.
32. Australian Capital Territory Legislative Assembly (2011) Food (Nutritional Information) Amendment Bill 2011. Explanatory Statement. Canberra, ACT: ACT Legislative Assembly.
33. Legislative Assembly of Ontario (2015) Bill 45, Making Healthier Choices Act, 2015. Toronto, ON: Legislative Assembly of Ontario.
34. European Food Information Council (2015) EUFIC’s Global Update on Nutrition Labelling. Brussels: EUFIC.
35. US Food and Drug Administration (2014) Food Labeling; Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Food Establishments. https://www.federalregister.gov/articles/2014/12/01/2014-27833/food-labeling-nutrition-labeling-of-standard-menu-items-in-restaurants-and-similar-retail-food (accessed December 2014).
36. Sinclair, SE, Cooper, M & Mansfield, ED (2014) The influence of menu labeling on calories selected or consumed: a systematic review and meta-analysis. J Acad Nutr Diet 114, 13751388.
37. Swartz, JJ, Braxton, D & Viera, AJ (2011) Calorie menu labeling on quick-service restaurant menus: an updated systematic review of the literature. Int J Behav Nutr Phys Act 8, 135142.
38. Holmes, AS, Serrano, EL, Machin, JE et al. (2013) Effect of different children’s menu labeling designs on family purchases. Appetite 62, 198202.
39. Ellison, B, Lusk, JL & Davis, D (2013) Looking at the label and beyond: the effects of calorie labels, health consciousness, and demographics on caloric intake in restaurants. Int J Behav Nutr Phys Act 10, 2129.
40. Roseman, MG, Mathe-Soulek, K & Higgins, JA (2013) Relationships among grocery nutrition label users and consumers’ attitudes and behavior toward restaurant menu labeling. Appetite 71, 274278.
41. R Core Team (2014) R: A Language and Environment for Statistical Computing, 3.03 ed. Vienna: R Foundation for Statistical Computing.
42. Higgins, JPT, Thompson, SG, Deeks, JJ et al. (2003) Measuring inconsistency in meta-analyses. BMJ 327, 557560.
43. James, A, Adams-Huet, B & Shah, M (2014) Menu labels displaying the kilocalorie content or the exercise equivalent: effects on energy ordered and consumed in young adults. Am J Health Promot 29, 294302.
44. Hammond, D, Goodman, S, Hanning, R et al. (2013) A randomized trial of calorie labeling on menus. Prev Med 57, 860866.
45. Krieger, JW, Chan, NL, Saelens, BE et al. (2013) Menu labeling regulations and calories purchased at chain restaurants. Am J Prev Med 44, 595604.
46. Elbel, B, Mijanovich, T, Dixon, LB et al. (2013) Calorie labeling, fast food purchasing and restaurant visits. Obesity (Silver Spring) 21, 21722179.
47. Brissette, I, Lowenfels, A, Noble, C et al. (2013) Predictors of total calories purchased at fast-food restaurants: restaurant characteristics, calorie awareness, and use of calorie information. J Nutr Educ Behav 45, 404411.
48. Dodds, P, Wolfenden, L, Chapman, K et al. (2014) The effect of energy and traffic light labelling on parent and child fast food selection: a randomised controlled trial. Appetite 73, 2330.
49. Morley, B, Scully, M, Martin, J et al. (2013) What types of nutrition menu labelling lead consumers to select less energy-dense fast food? An experimental study. Appetite 67, 815.
50. Dowray, S, Swartz, JJ, Braxton, D et al. (2013) Potential effect of physical activity based menu labels on the calorie content of selected fast food meals. Appetite 62, 173181.
51. Harnack, LJ & French, SA (2008) Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices: a review of the literature. Int J Behav Nutr Phys Act 5, 51.
52. Kiszko, KM, Martinez, OD, Abrams, C et al. (2014) The influence of calorie labeling on food orders and consumption: a review of the literature. J Community Health 39, 12481269.
53. Long, MW, Tobias, DK, Cradock, AL et al. (2015) Systematic review and meta-analysis of the impact of restaurant menu calorie labeling. Am J Public Health 105, e11e24.
54. Dumanovsky, T, Huang, CY, Bassett, MT et al. (2010) Consumer awareness of fast-food calorie information in New York City after implementation of a menu labeling regulation. Am J Public Health 100, 25202525.
55. Berman, M & Lavizzo-Mourey, R (2008) Obesity prevention in the information age. Caloric information at the point of purchase. JAMA 300, 433435.
56. Ludwig, DS & Brownell, KD (2009) Public health action amid scientific uncertainty. The case of restaurant calorie labeling regulations. JAMA 302, 434435.
57. Larson, N & Story, M (2009) Menu Labeling: Does Providing Nutrition Information at the Point of Purchase Affect Consumer Behavior? Princeton. NJ: Robert Wood Johnson Foundation.
58. Roberto, CA, Schwartz, MB & Brownell, KD (2009) Rationale and evidence for menu-labeling legislation. Am J Prev Med 37, 546551.
59. Nestle, M (2013) Menu labelling: What's new? http://www.foodpolitics.com/2013/04/menu-labeling-whats-new/ (accessed July 2014).
60. Hartocollis, A (2009) Calorie postings don’t change habits, study finds. New York Times, 6 October; available at http://www.nytimes.com/2009/10/06/nyregion/06calories.html?_r=0
61. Public Health Law Center, William Mitchell College of Law (2010) Menu Labelling. http://publichealthlawcenter.org/topics/healthy-eating/menu-labeling (accessed November 2014).
62. Farley, TA, Caffarelli, A, Bassett, MT et al. (2009) New York City’s fight over calorie labeling. Health Aff (Millwood) 28, w1098w1109.
63. Center for Science in the Public Interest (2011) State and Local Menu Labeling Policies. http://cspinet.org/new/pdf/ml_map.pdf (accessed June 2014).
64. Cohn, EG, Larson, EL, Araujo, C et al. (2012) Calorie postings in chain restaurants in a low-income urban neighborhood: measuring practical utility and policy compliance. J Urban Health 89, 587597.
65. Nikolaou, CK, Hankey, CR & Lean, MEJ (2014) Preventing weight gain with calorie-labeling. Obesity (Sliver Spring) 22, 22772283.
66. Bruemmer, B, Krieger, J, Saelens, BE et al. (2012) Energy, saturated fat, and sodium were lower in entrees at chain restaurants at 18 months compared with 6 months following the implementation of mandatory menu labeling regulation in King County, Washington. J Acad Nutr Diet 112, 11691176.
67. Namba, A, Auchincloss, A, Leonberg, BL et al. (2013) Exploratory analysis of fast-food chain restaurant menus before and after implementation of local calorie-labeling policies, 2005–2011. Prev Chronic Dis 10, e101e108.
68. Bauer, KW, Hearst, MO, Earnest, AA et al. (2012) Energy content of US fast-food restaurant offerings: 14-year trends. Am J Prev Med 43, 490497.
69. Booth, SL, Sallis, JF, Ritenbaugh, C et al. (2001) Environmental and societal factors affect food choice and physical activity: rationale, influences, and leverage points. Nutr Rev 59, 3 Pt 2, S21S39.
70. Eertmans, A, Baeyens, F & Van den Bergh, O (2001) Food likes and their relative importance in human eating behavior: review and preliminary suggestions for health promotion. Health Educ Res 16, 443456.
71. Rydell, SA, Harnack, LJ, Oakes, JM et al. (2008) Why eat at fast-food restaurants: reported reasons among frequent consumers. J Am Diet Assoc 108, 20662070.
72. Schindler, J, Kiszko, K, Abrams, C et al. (2013) Environmental and individual factors affecting menu labeling utilization: a qualitative research study. J Acad Nutr Diet 113, 667672.
73. Swartz, JJ, Dowray, S, Braxton, D et al. (2013) Simplifying healthful choices: a qualitative study of a physical activity based nutrition label format. Nutr J 12, 7281.
74. Ray, K, Clegg, S, Davidson, R et al. (2013) Evaluation of Caloriewise: a Northern Ireland Pilot of the Display of Calorie Information in Food Catering Businesses. London: Policy Studies Institute, University of Westminster.
75. Powell, LM & Nguyen, BT (2013) Fast-food and full-service restaurant consumption among children and adolescents: effect on energy, beverage, and nutrient intake. JAMA Pediatr 167, 1420.
76. Auchincloss, AH, Leonberg, BL, Glanz, K et al. (2014) Nutritional value of meals at full-service restaurant chains. J Nutr Educ Behav 46, 7581.
77. Urban, LE, Lichtenstein, AH, Gary, CE et al. (2013) The energy content of restaurant foods without stated calorie information. JAMA Intern Med 173, 12921299.
78. Scourboutakos, MJ & L’Abbe, MR (2012) Restaurant menus: calories, caloric density, and serving size. Am J Prev Med 43, 249255.
79. Schwartz, J, Riis, J, Elbel, B et al. (2012) Inviting consumers to downsize fast-food portions significantly reduces calorie consumption. Health Aff (Millwood) 31, 399407.
80. Elbel, B, Kersh, R, Brescoll, VL et al. (2009) Calorie labeling and food choices: a first look at the effects on low-income people in New York City. Health Aff (Millwood) 28, w1110w1121.
81. Bassett, MT, Dumanovsky, T, Huang, C et al. (2008) Purchasing behavior and calorie information at fast-food chains in New York City, 2007. Am J Public Health 98, 14571459.
82. Food and Drug Administration (2011) Food labeling: nutrition labeling of standard menu items in restaurants and similar retail food establishments notice of proposed rulemaking. http://www.fda.gov/downloads/Food/LabelingNutrition/UCM249276.pdf (accessed November 2014).
83. Harnack, LJ, French, SA, Oakes, JM et al. (2008) Effects of calorie labeling and value size pricing on fast food meal choices: results from an experimental trial. Int J Behav Nutr Phys Act 5, 63.
84. Bollinger, B, Leslie, P & Sorensen, A (2010) Calorie Posting in Chain Restaurants. Cambridge, MA: National Bureau of Economic Research.
85. Feldman, C, Harwell, H & Brusca, J (2013) Using student opinion and design inputs to develop an informed university foodservice menu. Appetite 69, 8088.
86. Sonnenberg, L, Gelsomin, E, Levy, DE et al. (2013) A traffic light food labeling intervention increases consumer awareness of health and healthy choices sat the point-of-purchase. Prev Med 57, 253257.
87. Thorndike, AN, Sonnenberg, L, Riis, J et al. (2012) A 2-phase labeling and choice architecture intervention to improve healthy food and beverage choices. Am J Public Health 102, 527533.
88. Grunert, K & Wills, J (2007) A review of European research on consumer response to nutrition information on food labels. J Public Health 15, 385399.
89. Fitch, RC, Harnack, LJ, Neumark-Sztainer, DR et al. (2009) Providing calorie information on fast-food restaurant menu boards: consumer views. Am J Health Promot 24, 129132.
90. Blumenthal, K & Volpp, KG (2010) Enhancing the effectiveness of food labeling in restaurants. JAMA 303, 553554.
91. Sarink, D, Peeters, A, Freak-Poli, R et al. (2014) The impact of mandatory menu energy labelling on socio-economic disparities in overweight and obesity. Obes Res Clin Pract 7, Suppl. 2, e123.
92. Yoon, HJ & George, T (2012) Nutritional information disclosure on the menu: Focusing on the roles of menu context, nutritional knowledge and motivation. Int J Hospital Manage 31, 11871194.
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