Assessment of Calories Purchased After Calorie Labeling of Prepared Foods in a Large Supermarket Chain

Abstract

IMPORTANCE Calorie labels for prepared (ie, ready-to-eat) foods are required in large chain food establishments in the US. Large evaluations in restaurants suggest small declines in purchases of prepared foods after labeling, but to the authors' knowledge, no studies have examined how this policy influences supermarket purchases.OBJECTIVE To estimate changes in calories purchased from prepared foods and potential packaged substitutes compared with control foods after calorie labeling of prepared foods in supermarkets. DESIGN, SETTING, AND PARTICIPANTSThis controlled interrupted time series compared sales 2 years before labeling implementation (April 2015-April 2017) with sales 7 months after labeling implementation (May 2017-December 2017). Data from 173 supermarkets from a supermarket chain with locations in Maine, Massachusetts, New Hampshire, New York, and Vermont were analyzed from March 2020 to May 2022. INTERVENTION Implementation of calorie labeling of prepared foods in April 2017.MAIN OUTCOMES AND MEASURES Purchased items were classified as prepared foods, potential packaged substitutes for prepared foods, or all other (ie, control) foods. The primary outcome was mean weekly calories per transaction purchased from prepared foods, and the secondary outcome was mean weekly calories per transaction purchased from similar packaged items (for substitution analyses). Analyses of prepared and packaged foods were stratified by food category (bakery, entrées and sides, or deli meats and cheeses). RESULTS Among the included 173 supermarkets, calorie labeling was associated with a mean 5.1% decrease (95% CI, −5.8% to −4.4%) in calories per transaction purchased from prepared bakery items and an 11.0% decrease (95% CI, −11.9% to −10.1%) from prepared deli items, adjusted for changes in control foods; no changes were observed for prepared entrées and sides (change = 0.3%; 95% CI, −2.5% to 3.0%). Labeling was also associated with decreased calories per transaction purchased from packaged bakery items (change = −3.9%; 95% CI, −4.3% to −3.6%), packaged entrées and sides (change = −1.2%; 95% CI, −1.4% to −0.9%), and packaged deli items (change = −2.1%; 95% CI, −2.4% to −1.7%). CONCLUSIONS AND RELEVANCEIn this longitudinal study of supermarkets, calorie labeling of prepared foods was associated with small to moderate decreases in calories purchased from prepared bakery and deli items without evidence of substitution to similar packaged foods.

Preventing Obesity—It Is Time for Multiple Policy Strategies

“…The investigators focused specifically on sales of calories from baked goods (eg, muffins, donuts), deli items (eg, meats, cheeses), and prepared meals (eg, sandwiches). 4 They observed a 5.1% decrease in calories from bakery items, an 11% decrease in calories from prepared deli items, but no change in calories from meals or side dishes. The observed decreases in percentages are larger than results seen in most other calorielabeling studies, but translate to a decrease of 10 calories per bakery item and 18 calories per prepared deli item-hardly enough to seem capable of having any influence on body weight.…”

“…guidingstars.com). Petimar et al 4 used these and other sales data to examine purchases before the chain introduced calorie labeling in April 2017 and for 7 months after.…”

“…Would calorie labeling at supermarkets produce more impressive effects? In the study by Petimar et al in this issue of JAMA Internal Medicine , the authors reported using more than 4 billion sales records from 173 supermarkets to evaluate calorie purchases before and after institution of labeling. Since 2006, a supermarket chain in several Northeastern states has been collecting data on the effectiveness of its Guiding Stars system to promote sales of healthier products (www.guidingstars.com).…”

“…Since 2006, a supermarket chain in several Northeastern states has been collecting data on the effectiveness of its Guiding Stars system to promote sales of healthier products (www.guidingstars.com). Petimar et al used these and other sales data to examine purchases before the chain introduced calorie labeling in April 2017 and for 7 months after.…”

“…The investigators focused specifically on sales of calories from baked goods (eg, muffins, donuts), deli items (eg, meats, cheeses), and prepared meals (eg, sandwiches) . They observed a 5.1% decrease in calories from bakery items, an 11% decrease in calories from prepared deli items, but no change in calories from meals or side dishes.…”