Effects of calorie labeling and value size pricing on fast food meal choices: Results from an experimental trial

BackgroundAlthough point-of-purchase calorie labeling at restaurants has been proposed as a strategy for improving consumer food choices, a limited number of studies have evaluated this approach. Likewise, little research has been conducted to evaluate the influence of value size pricing on restaurant meal choices.MethodsTo examine the effect of point-of-purchase calorie information and value size pricing on fast food meal choices a randomized 2 × 2 factorial experiment was conducted in which participants ordered a fast food meal from one of four menus that varied with respect to whether calorie information was provided and whether value size pricing was used. Study participants included 594 adolescents and adults who regularly ate at fast food restaurants. Study staff recorded the foods ordered and consumed by each participant. Participants also completed surveys to assess attitudes, beliefs and practices related to fast food and nutrition.ResultsNo significant differences in the energy composition of meals ordered or eaten were found between menu conditions. The average energy content of meals ordered by those randomized to a menu that included calorie information and did not include value size pricing was 842 kcals compared with 827 kcals for those who ordered their meal from a menu that did not include calorie information but had value size pricing (control menu). Results were similar in most analyses conducted stratified by factors such as age, race and education level.ConclusionAdditional research is needed to better evaluate the effects of calorie labeling and value size pricing on fast food meal choices. Studies in which participants are repeatedly exposed to these factors are needed since long term exposure may be required for behavior change.

[1]  S. Hoerr,et al.  Can nutrition information increase sales of healthful vended snacks? , 1993, The Journal of school health.

[2]  D. Jolliffe,et al.  Let's Eat Out: Americans Weigh Taste, Convenience, and Nutrition , 2006 .

[3]  Mark Von Tress,et al.  Generalized, Linear, and Mixed Models , 2003, Technometrics.

[4]  C. Achterberg,et al.  Food shopping and label use behavior among high school-aged adolescents. , 1997, Adolescence.

[5]  A. Kristal,et al.  Trends in food label use associated with new nutrition labeling regulations. , 1998, American journal of public health.

[6]  K. Flegal,et al.  Prevalence of overweight and obesity in the United States, 1999-2004. , 2006, JAMA.

[7]  R. Jeffery,et al.  An environmental intervention to increase fruit and salad purchases in a cafeteria. , 1994, Preventive medicine.

[8]  Allen D. Sproul,et al.  Does point-of-purchase nutrition labeling influence meal selections? A test in an Army cafeteria. , 2003, Military medicine.

[9]  Susan N. Lukwago,et al.  Do nutrition label readers eat healthier diets? Behavioral correlates of adults' use of food labels. , 1997, American journal of preventive medicine.

[10]  J. Mayer,et al.  Promoting low-fat entree choices in a public cafeteria. , 1986, Journal of applied behavior analysis.

[11]  A. Fiske,et al.  Effects of promotional materials on vending sales of low-fat items in teachers' lounges. , 2004, Journal of the American Dietetic Association.

[12]  S. Fortmann,et al.  Restaurant Menu Labeling: Impact of Nutrition Information on Entree Sales and Patron Attitudes , 1990, Health education quarterly.

[13]  Marion Nestle,et al.  Expanding portion sizes in the US marketplace: implications for nutrition counseling. , 2003, Journal of the American Dietetic Association.

[14]  T. Rogers,et al.  Influencing food selection with point-of-choice nutrition information , 1985 .

[15]  Jean Harvey-Berino,et al.  Consumers may not use or understand calorie labeling in restaurants. , 2006, Journal of the American Dietetic Association.

[16]  B. Lin,et al.  Away-From-Home Foods Increasingly Important to Quality of American Diet , 1999 .

[17]  M Nestle,et al.  Halting the obesity epidemic: a public health policy approach. , 2000, Public health reports.

[18]  W. G. Johnson,et al.  The influence of caloric information on cafeteria food choices. , 1984, Journal of applied behavior analysis.

[19]  B. Lin,et al.  Nutritional Quality of Foods At and Away From Home , 1997 .

[20]  Joni A. Mayer,et al.  A multi-component intervention for modifying food selections in a worksite cafeteria , 1987 .

[21]  Jonathan J. Fox,et al.  Who uses nutrition labeling, and what effects does label use have on diet quality? , 1995 .

[22]  Judith S. Baxter,et al.  Pricing and promotion effects on low-fat vending snack purchases: the CHIPS Study. , 2001, American journal of public health.

[23]  S. Abrams,et al.  An educational program enhances food label understanding of young adolescents. , 2006, Journal of the American Dietetic Association.

[24]  J. Fielding,et al.  Point-of-choice nutritional labeling: evaluation in a worksite cafeteria , 1986 .

[25]  R. Jeffery,et al.  Pricing strategy to promote fruit and vegetable purchase in high school cafeterias. , 1997, Journal of the American Dietetic Association.

[26]  Ming-chin Yeh,et al.  Effects of energy-content labels and motivational posters on sales of sugar-sweetened beverages: stimulating sales of diet drinks among adults study. , 2006, Journal of the American Dietetic Association.

[27]  B. Derby,et al.  Prevalence of reading nutrition and ingredient information on food labels among adult Americans: 1982-1988 , 1992 .

[28]  A. Wise,et al.  Food choice in response to computer-generated nutrition information provided about meal selections in workplace restaurants , 1996 .

[29]  S. Zifferblatt,et al.  Healthy vending: a cooperative pilot research program to stimulate good health in the marketplace. , 1981, Preventive medicine.

[30]  Scot Burton,et al.  Making Healthful Food Choices: The Influence of Health Claims and Nutrition Information on Consumers’ Evaluations of Packaged Food Products and Restaurant Menu Items , 2003 .

[31]  D. Mela,et al.  The influence of recipe modification and nutritional information on restaurant food acceptance and macronutrient intakes , 2000, Public Health Nutrition.

[32]  Scot Burton,et al.  Attacking the obesity epidemic: the potential health benefits of providing nutrition information in restaurants. , 2006, American journal of public health.

[33]  P. Cinciripini Changing Food Selections in a Public Cafeteria , 1984 .

[34]  Loren G Yamamoto,et al.  Adolescent fast food and restaurant ordering behavior with and without calorie and fat content menu information. , 2005, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[35]  R. Milich,et al.  Effects of Visual Presentation of Caloric Values on Food Buying by Normal and Obese Persons , 1976, Perceptual and motor skills.

[36]  P Hannan,et al.  A pricing strategy to promote low-fat snack choices through vending machines. , 1997, American journal of public health.

[37]  M L Neuhouser,et al.  Use of food nutrition labels is associated with lower fat intake. , 1999, Journal of the American Dietetic Association.

[38]  D. Cranage,et al.  College Students' Use of Point of Selection Nutrition Information , 2005 .

[39]  K. Brownell,et al.  Comparison of price change and health message interventions in promoting healthy food choices. , 2002, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[40]  B. Rolls The Supersizing of America: Portion Size and the Obesity Epidemic. , 2003, Nutrition today.

[41]  M. Nestle,et al.  The contribution of expanding portion sizes to the US obesity epidemic. , 2002, American journal of public health.

[42]  L. B. Larson-Brown Point-of-purchase information on vended foods , 1978 .