The Influence of Calorie Labeling on Food Orders and Consumption: A Review of the Literature

Abstract Obesity is a challenging public health problem that affects millions of Americans. Increasingly policy makers are seeking environmental and policy-based solutions to combat and prevent its serious health effects. Calorie labeling mandates, including the provision in the 2010 Patient Protection and Affordable Care Act that is set to begin in 2014, have been one of the most popular and most studied approaches. This review examines 31 studies published from January 1, 2007 through July 19, 2013. It builds on Harnack and French’s 2008 review and assesses the evidence on the effectiveness of calorie labeling at the point of purchase. We find that, while there are some positive results reported from studies examining the effects of calorie labeling, overall the best designed studies (real world studies, with a comparison group) show that calorie labels do not have the desired effect in reducing total calories ordered at the population level. Moving forward, researchers should consider novel, more effective ways of presenting nutrition information, while keeping a focus on particular subgroups that may be differentially affected by nutrition policies.

[1]  Panagiotis Kasteridis,et al.  Who are consuming food away from home and where? Results from the Consumer Expenditure Surveys , 2013 .

[2]  J. Lusk,et al.  Looking at the label and beyond: the effects of calorie labels, health consciousness, and demographics on caloric intake in restaurants , 2013, International Journal of Behavioral Nutrition and Physical Activity.

[3]  V. Brescoll,et al.  Calorie labeling and food choices: a first look at the effects on low-income people in New York City. , 2009, Health affairs.

[4]  Alan T. Sorensen,et al.  Calorie Posting in Chain Restaurants , 2010 .

[5]  A. Auchincloss,et al.  Barriers and facilitators of consumer use of nutrition labels at sit-down restaurant chains , 2013, Public Health Nutrition.

[6]  Karen H. Smith,et al.  Nutrition Information and Children's Fast Food Menu Choices , 2011 .

[7]  Peggy J. Liu,et al.  A test of different menu labeling presentations , 2012, Appetite.

[8]  Dimitri A. Christakis,et al.  Nutrition Menu Labeling May Lead to Lower-Calorie Restaurant Meal Choices for Children , 2010, Pediatrics.

[9]  Ken Kleinman,et al.  Consumers’ estimation of calorie content at fast food restaurants: cross sectional observational study , 2013, BMJ.

[10]  K. Glanz,et al.  The impact of menu labeling on fast-food purchases for children and parents. , 2011, American journal of preventive medicine.

[11]  R. Hakkak,et al.  Impact of Menu Labeling on Food Choices of Southern Undergraduate Students , 2013 .

[12]  Ross A Hammond,et al.  The economic impact of obesity in the United States , 2010, Diabetes, metabolic syndrome and obesity : targets and therapy.

[13]  D. Fleming,et al.  Menu labeling regulations and calories purchased at chain restaurants. , 2013, American journal of preventive medicine.

[14]  Elena L. Serrano,et al.  Effect of different children’s menu labeling designs on family purchases , 2013, Appetite.

[15]  S. Bleich,et al.  Reduction in purchases of sugar-sweetened beverages among low-income Black adolescents after exposure to caloric information. , 2012, American journal of public health.

[16]  D. Blumenthal,et al.  Patient Protection and Affordable Care Act , 2010 .

[17]  Candace Young,et al.  Purchasing behavior and calorie information at fast-food chains in New York City, 2007. , 2008, American journal of public health.

[18]  J Michael Oakes,et al.  Effects of calorie labeling and value size pricing on fast food meal choices: Results from an experimental trial , 2008, The international journal of behavioral nutrition and physical activity.

[19]  D. Hammond,et al.  Does nutrition information on menus impact food choice? Comparisons across two hospital cafeterias , 2013, Public Health Nutrition.

[20]  Scot Burton,et al.  The roles of gender and motivation as moderators of the effects of calorie and nutrient information provision on away-from-home foods. , 2009 .

[21]  K. Flegal,et al.  Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. , 2012, JAMA.

[22]  K. Brownell,et al.  An observational study of consumers' accessing of nutrition information in chain restaurants. , 2009, American journal of public health.

[23]  K. Brownell,et al.  A Survey of undergraduate student perceptions and use of nutrition information labels in a university dining hall , 2013 .

[24]  Anita Jansen,et al.  Exploring how calorie information and taxes on high-calorie foods influence lunch decisions. , 2011, The American journal of clinical nutrition.

[25]  M. Wakefield,et al.  What types of nutrition menu labelling lead consumers to select less energy-dense fast food? An experimental study , 2013, Appetite.

[26]  Wei Wei,et al.  Effects of calorie information disclosure on consumers’ food choices at restaurants , 2013 .

[27]  R. Annunziato,et al.  An intervention study targeting energy and nutrient intake in worksite cafeterias. , 2010, Eating behaviors.

[28]  G. Loewenstein,et al.  Supplementing menu labeling with calorie recommendations to test for facilitation effects. , 2013, American journal of public health.

[29]  Battling the bulge: menu board calorie legislation and its potential impact on meal repurchase intentions , 2011 .

[30]  Anthony J Viera,et al.  Calorie menu labeling on quick-service restaurant menus: an updated systematic review of the literature , 2011, The international journal of behavioral nutrition and physical activity.

[31]  O. Williams,et al.  Calorie Postings in Chain Restaurants in a Low-Income Urban Neighborhood: Measuring Practical Utility and Policy Compliance , 2012, Journal of Urban Health.

[32]  S. McGuire.  Todd J.E., Mancino L., Lin B-H. The impact of food away from home on adult diet quality. ERR-90, U.S. Department of Agriculture, Econ. Res. Serv., February 2010. , 2011, Advances in nutrition.

[33]  Tod Mijanovich,et al.  Calorie Labeling, Fast Food Purchasing and Restaurant Visits , 2013, Obesity.

[34]  J. Polivy,et al.  The effects of calorie information on food selection and intake , 2012, International Journal of Obesity.

[35]  L. Lloyd,et al.  Childhood obesity and risk of the adult metabolic syndrome: a systematic review , 2011, International Journal of Obesity.

[36]  Elizabeth Pulos,et al.  Evaluation of a voluntary menu-labeling program in full-service restaurants. , 2010, American journal of public health.

[37]  Biing-Hwan Lin,et al.  The Impact of Food Away from Home on Adult Diet Quality , 2010 .

[38]  M. Freedman.  Point-of-Selection Nutrition Information Influences Choice of Portion Size in an All-You-Can-Eat University Dining Hall , 2011 .

[39]  B. Lin,et al.  How Food Away From Home Affects Children's Diet Quality , 2012 .

[40]  E. Frongillo,et al.  Improving patrons' meal selections through the use of point-of-selection nutrition labels. , 2009, American journal of public health.

[41]  S. French,et al.  Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices: A review of the literature , 2008, The international journal of behavioral nutrition and physical activity.

[42]  George Loewenstein,et al.  Promoting Healthy Choices: Information versus Convenience , 2010 .

[43]  B. Elbel,et al.  Consumer purchasing patterns in response to calorie labeling legislation in New York City , 2011, The international journal of behavioral nutrition and physical activity.

[44]  P. Crawford,et al.  Menu Labeling Responsive to Consumer Concerns and Shows Promise for Changing Patron Purchases , 2011 .

[45]  B. Elbel,et al.  Environmental and individual factors affecting menu labeling utilization: a qualitative research study. , 2013, Journal of the Academy of Nutrition and Dietetics.

[46]  B. Elbel,et al.  Consumer Estimation of Recommended and Actual Calories at Fast Food Restaurants , 2011, Obesity.

[47]  Anthony J. Viera,et al.  Potential effect of physical activity based menu labels on the calorie content of selected fast food meals , 2013, Appetite.

[48]  J. Stockman.  Changes in energy content of lunchtime purchases from fast food restaurants after introduction of calorie labelling: cross sectional customer surveys , 2013 .

[49]  Katherine M Flegal,et al.  Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. , 2012, JAMA.

[50]  M. A. Gerend,et al.  Does calorie information promote lower calorie fast food choices among college students? , 2009, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[51]  James Krieger,et al.  Mandatory menu labeling in one fast-food chain in King County, Washington. , 2011, American journal of preventive medicine.

[52]  S. Rydell,et al.  Results from an experimental trial at a Head Start center to evaluate two meal service approaches to increase fruit and vegetable intake of preschool aged children , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[53]  Calorie labeling and fast food choices in surveys and actual markets: some new behavioral results , 2013 .

[54]  B. Elbel,et al.  Child and adolescent fast-food choice and the influence of calorie labeling: a natural experiment , 2011, International Journal of Obesity.

[55]  S. Malnick,et al.  The medical complications of obesity. , 2006, QJM : monthly journal of the Association of Physicians.

[56]  D. Levy,et al.  Food choices of minority and low-income employees: a cafeteria intervention. , 2012, American journal of preventive medicine.

[57]  Henry Agnew,et al.  Evaluating the Impact of Menu Labeling on Food Choices and Intake , 2022 .

[58]  S. Bowman,et al.  Fast Food Consumption of U.S. Adults: Impact on Energy and Nutrient Intakes and Overweight Status , 2004, Journal of the American College of Nutrition.