Providing Nutrition Information on US Restaurant Menus: A Systematic Review Since the Affordable Care Act (2010)

Abstract

One noteworthy provision in the Affordable Care Act (ACA) of 2010 in the USA was the mandate for restaurants with more than 20 locations to provide nutrition information on their printed restaurant menus and menu boards. This provision has received a wide variety of scrutiny in the literature and in popular press. This systematic review attempts to summarize the current state of research exploring the consumer behavior effects of providing nutrition information, identify gaps in the literature, and suggest future areas for research into the provision of such nutrition information. PRISMA guidelines were followed, and study quality was assessed using the Effective Public Health Practice Project’s (EPHPP) Quality Assessment Tool. Due to stringent inclusion criteria, focusing on research from ACA 2010 onwards in the USA, published in English, and assessed using EPHPP for high quality, 24 papers were ultimately included. The studies included dependent variables such as the calories or nutritional values of the meal choices made following menu exposure, the perceptions of the restaurant, the sales of the menu items, and evaluations or perceptions of the menu itself. The final discussion in this paper identifies a multitude of gaps in the current literature and avenues for further research into the effects of providing nutrition information on different socio-demographic segments, in different food and restaurant categories, in different health contexts and individual health situations, and groups with pre-existing eating disorders.