Nutrition labels are one strategy being used to combat the increasing prevalence of overweight and obesity in the United States. The Patient Protection and Affordable Care Act of 2010 mandates that calorie labels be added to menu boards of chain restaurants with 20 or more locations. This systematic review includes seven studies published since the last review on the topic in 2008. Authors searched for peer-reviewed studies using PUBMED and Google Scholar. Included studies used an experimental or quasi-experimental design comparing a calorie-labeled menu with a no-calorie menu and were conducted in laboratories, college cafeterias, and fast food restaurants. Two of the included studies were judged to be of good quality, and five of were judged to be of fair quality. Observational studies conducted in cities after implementation of calorie labeling were imprecise in their measure of the isolated effects of calorie labels. Experimental studies conducted in laboratory settings were difficult to generalize to real world behavior. Only two of the seven studies reported a statistically significant reduction in calories purchased among consumers using calorie-labeled menus. The current evidence suggests that calorie labeling does not have the intended effect of decreasing calorie purchasing or consumption.

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SummaryThe Diabetes Prevention Program (DPP) demonstrated risk reduction for incident diabetes through weight loss among all participants, including African Americans. Several DPP translations have been conducted in less controlled settings, including primary care practices and communities; however, there is no detailed compilation of how effective these translations have been for African Americans. This systematic literature review evaluated DPP translations from 2003 to 2012. Eligible records were retrieved using a search strategy of relevant databases and gray literature. Retrieved records (n = 1,272) were screened using a priori criteria, which resulted in 21 full-text studies for review. Seventeen studies were included in the full-text qualitative synthesis. Seven studies had 100% African American samples and 10 studies had mixed samples with African American subgroups. African American participants' average weight loss was roughly half of that achieved in the DPP intervention. However, with few higher-quality studies, small sample sizes and differences in intervention designs and implementation, comparisons across interventions were difficult. The suboptimal effectiveness of DPP translations among African American adults, particularly women, signals the need for enhancements to existing evidence-based interventions and more high-quality research that includes other at-risk African American subgroups such as men and younger adults of lower socioeconomic status.

BackgroundBecause residents of the southeastern United States experience disproportionally high rates of cardiovascular disease (CVD), it is important to develop effective lifestyle interventions for this population.MethodsThe primary objective was to develop and evaluate a dietary, physical activity (PA) and weight loss intervention for residents of the southeastern US. The intervention, given in eastern North Carolina, was evaluated in a 2 year prospective cohort study with an embedded randomized controlled trial (RCT) of a weight loss maintenance intervention. The intervention included: Phase I (months 1–6), individually-tailored intervention promoting a Mediterranean-style dietary pattern and increased walking; Phase II (months 7–12), option of a 16-week weight loss intervention for those with BMI ≥ 25 kg/m2 offered in 2 formats (16 weekly group sessions or 5 group sessions and 10 phone calls) or a lifestyle maintenance intervention; and Phase III (months 13–24), weight loss maintenance RCT for those losing ≥ 8 lb with all other participants receiving a lifestyle maintenance intervention. Change in diet and PA behaviors, CVD risk factors, and weight were assessed at 6, 12, and 24 month follow-up.ResultsBaseline characteristics (N = 339) were: 260 (77 %) females, 219 (65 %) African Americans, mean age 56 years, and mean body mass index 36 kg/m2. In Phase I, among 251 (74 %) that returned for 6 month follow-up, there were substantial improvements in diet score (4.3 units [95 % CI 3.7 to 5.0]), walking (64 min/week [19 to 109]), and systolic blood pressure (−6.4 mmHg [−8.7 to −4.1]) that were generally maintained through 24 month follow-up. In Phase II, 138 (57 group only, 81 group/phone) chose the weight loss intervention and at 12 months, weight change was: −3.1 kg (−4.9 to −1.3) for group (N = 50) and −2.1 kg (−3.2 to −1.0) for group/phone combination (N = 75). In Phase III, 27 participants took part in the RCT. At 24 months, weight loss was −2.1 kg (−4.3 to 0.0) for group (N = 51) and −1.1 kg (−2.7 to 0.4) for combination (N = 72). Outcomes for African American and whites were similar.ConclusionsThe intervention yielded substantial improvement in diet, PA, and blood pressure, but weight loss was modest.Trial registrationclinicaltrials.gov Identifier: NCT01433484Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3370-9) contains supplementary material, which is available to authorized users.