Effects of physical activity calorie equivalent food labelling to reduce food selection and consumption: systematic review and meta-analysis of randomised controlled studies

Abstract

BackgroundThere is limited evidence that nutritional labelling on food/drinks is changing eating behaviours. Physical activity calorie equivalent (PACE) food labelling aims to provide the public with information about the amount of physical activity required to expend the number of kilocalories in food/drinks (eg, calories in this pizza requires 45 min of running to burn), to encourage healthier food choices and reduce disease.ObjectiveWe aimed to systematically search for randomised controlled trials and experimental studies of the effects of PACE food labelling on the selection, purchase or consumption of food/drinks.MethodsPACE food labelling was compared with any other type of food labelling or no labelling (comparator). Reports were identified by searching electronic databases, websites and social media platforms. Inverse variance meta-analysis was used to summarise evidence. Weighted mean differences (WMD) and 95% CIs were used to describe between-group differences using a random effects model.Results15 studies were eligible for inclusion. When PACE labelling was displayed on food/drinks and menus, significantly fewer calories were selected, relative to comparator labelling (WMD=−64.9 kcal, 95% CI −103.2 to −26.6, p=0.009, n=4606). Presenting participants with PACE food labelling results in the consumption of significantly fewer calories (WMD=−80.4 kcal, 95% CI−136.7 to −24.2, p=0.005, n=486) relative to comparator food labelling.ConclusionBased on current evidence PACE food labelling may reduce the number of kilocalories selected from menus and decrease the number of kilocalories/grams of food consumed by the public, compared with other types of food labelling/no labelling.Trial registration numberCRD42018088567.

Alcohol, calories, and obesity: A rapid systematic review and meta‐analysis of consumer knowledge, support, and behavioral effects of energy labeling on alcoholic drinks

“…Studies tended to examine the potential effects of numeric energy information (i.e., number of calories), and therefore, the conclusions of this review are limited to this type of energy labeling. However, other display formats such as PACE (e.g., “it takes x minutes to burn off the calories in this drink”) may be more meaningful to consumers and therefore more likely to motivate behavior change 17 …”

“…Systematic reviews have also attempted to compare the effect of different types of energy labeling on food choice. For example, physical activity equivalence (PACE) information (e.g., “it takes x minutes to burn off the calories in this menu item”) may be more meaningful to consumers than standard energy labeling (e.g., number of calories), but current evidence is equivocal in part because there are few direct comparisons of standard energy labeling (number of calories) and PACE labeling in the real world 17 . To date, there has been no systematic review of research on energy labeling of alcoholic drinks, and it is unclear the extent to which consumers are aware of the number of calories in alcoholic beverages, whether mandatory energy labeling of alcoholic drinks is acceptable (policy support), and whether energy labeling of alcoholic drinks affects consumer behavior (e.g., reduces energy intake).…”

The Differential Effects of Physical Activity Calorie Equivalent Labeling on Consumer Preferences for Healthy and Unhealthy Food Products: Evidence from a Choice Experiment

“…In this study, we chose three labels (standard kcal label, a label showing the minutes of walking needed to burn off the calories, and a label showing the minutes of running needed to burn off the calories) and a condition without a label (see Figure 1). The forms of PACE labels were referred to prior literature [52,53]. The total calories of the two products were calculated based on the original calorie information printed on the backs of their respective packages, and the calories of walking and running burn off per hour were refer to Keep App, which is a professional health app that contains data collected about calories of different sports burn off per hour.…”

Affordability of current diets and healthy, more equitable, sustainable diets, by area of socioeconomic disadvantage and remoteness in Queensland: Insights into the drivers of food choice

“…There is surprisingly little comprehensive research on the most in uential drivers of consumer food choices. Multiple studies have cited the importance of particular determinants, such as taste (53,54), healthiness/nutrition (55), time and convenience (Zorbas et al, 2018), gender (Vukmirovic, 2015), psychological or behavioural factors (56), societal in uence (53), accessibility (6), packaging and labelling (57,58), advertising, marketing, and promotion (59,60), availability (6,56,61), and sociocultural acceptability (56). Food store practices, including placement of healthy and unhealthy products, the amount of shelf-space allocated to these (62), and promotions and pricing policies, such as subsidising fresh foods (Ferguson et al, 2018; Lee and Ride, 2018) have been cited as important factors in consumer food choice too.…”