Systematic Review and Meta-analysis of the Impact of Restaurant Menu Calorie Labeling

Abstract

We conducted a systematic review and meta-analysis evaluating the relationship between menu calorie labeling and calories ordered or purchased in the PubMed, Web of Science, PolicyFile, and PAIS International databases through October 2013. Among 19 studies, menu calorie labeling was associated with a -18.13 kilocalorie reduction ordered per meal with significant heterogeneity across studies (95% confidence interval = -33.56, -2.70; P = .021; I(2) = 61.0%). However, among 6 controlled studies in restaurant settings, labeling was associated with a nonsignificant -7.63 kilocalorie reduction (95% confidence interval = -21.02, 5.76; P = .264; I(2) = 9.8%). Although current evidence does not support a significant impact on calories ordered, menu calorie labeling is a relatively low-cost education strategy that may lead consumers to purchase slightly fewer calories. These findings are limited by significant heterogeneity among nonrestaurant studies and few studies conducted in restaurant settings.

Menu labelling is effective in reducing energy ordered and consumed: a systematic review and meta-analysis of recent studies

“…Another two real-world studies resulted in statistically significant reductions in energy ordered for energy-labelled main meals (39) and for coffee chains (45) . This is a progressive and positive step compared with the reviews by Krieger and Saelens (2013) and Long et al (2015), which found that only those studies conducted in experimental settings resulted in statistically significant energy reductions (17,53) . The positive impact of ML on consumer behaviour in realworld settings is further highlighted by the results of an outcome evaluation of ML implementation in New South Wales, Australia, where the median energy purchased decreased significantly by 15 % from May 2011 to January 2013 (18) , and by the results of the current meta-analysis which found a statistically significant reduction in energy ordered in real-world settings.…”

“…The study-specific mean difference (MD) and 95 % CI are represented by the black dot square and horizontal line, respectively; the area of the grey square is proportional to the specific-study weight to the overall meta-analysis. The centre of the diamond represents the pooled MD and its width represents the pooled 95 % CI meta-analysis by Long et al, including nineteen studies spanning from 2008 to 2013, found a small but statistically significant energy reduction in energy ordered per meal, but this was associated with statistically significant heterogeneity across studies (53) . Despite no restrictions on the published date of the studies included, only those published since 2008 were deemed acceptable, due to the eligibility criteria applied, which excluded studies with ML formats not consistent with the US federal ML laws.…”

Examining Consumer Responses to Calorie Information on Restaurant Menus in a Discrete Choice Experiment

“…Numerous studies (and several systematic reviews) have tried to assess the effects of local menu labeling rules, but the results of the reviews have been mixed and sometimes contradictory (VanEpps et al, 2016;Sarink et al, 2016;Long et al, 2015;Sinclair, Cooper, and Mansfield, 2014;Swartz, Braxton, and Viera, 2011). There are plausible reasons for this heterogeneity, such as differences in label styles and information provided, differences in the types of restaurants in the study, and variance in groups of participants.…”

Policy recommendations for front-of-package, shelf, and menu labelling in Canada: Moving towards consensus

“…22,24,25 With that said, a recent metaanalysis, including real-world and experimental studies, found that menu labelling can reduce calories purchased in some contexts and for some food types. 26 In other words, it works in some restaurants, for some people, some of the time.…”