Interpretive labelling on restaurant menus decreases calories ordered and consumed

Sinclair SE, Cooper M and Mansfield ED. The influence of menu labeling on calories selected or consumed: a systematic review and meta-analysis J Acad Nutr Diet. 2014;114:1375-1388.e15.

Review question

Are people more likely to order and eat items with fewer calories if restaurant menus include nutrition information? Are certain formats of menu labelling more effective than others?

Background

In recent years, rates of obesity and other diseases related to poor diet have increased across North America. Restaurants often serve large portions that are high in unhealthy nutrients like fats, salt and sugars. Currently, few restaurants include menu labels listing nutrition information about menu items to help guide decisions about heathy choices. The aim of this review was to measure whether menu labelling reduces the calories people order and consume, and whether certain labelling formats have a greater impact on decision-making.

How the review was done

This is a review of 17 studies conducted from 1996 to 2013, including 10 randomized controlled trials which were combined in a meta-analysis. Three of the studies were considered high quality.

• All participants were healthy adolescents or adults.
• In seven studies, researchers measured the calories in restaurant food purchases, comparing purchases made with and without nutrition information on the menus.
• In the 10 randomized controlled trials, participants were given menus with some form of nutrition information (nutrition information alone; nutrition information plus contextual information and/or interpretive information). Researchers measured the calories in the food people then purchased or ate. Results were compared to control groups who did not receive menus with nutrition information.
• Examples of interpretive menu labels included traffic light (red, yellow, green) labels corresponding with nutritional values, and an estimate of the equivalent minutes or miles of walking required to expend the calories.

What the researchers found

Menus with contextual or interpretive nutrition information decreased the number of calories people selected and consumed. Menus labelled with calorie values alone did not improve people’s eating habits. Menu labelling appeared to be more effective in women, as their ordering and eating habits were more likely to be influenced by nutrition information. More research is needed to measure whether menu labelling changes people’s eating habits in the long-term and if literacy levels, dietary goals and levels of hunger affect the effectiveness of menu labels.

Conclusion

Menu labels that interpret and/or provide context for nutrition values of menu items decrease calories that people, especially women, order and consume at restaurants.