Need for and Effectiveness of Menu Labeling

Abstract

In the article, “Consumers May Not Use or Understand Calorie Labeling in Restaurants,” in the June 2006 issue of the Journal by Krukowski and colleagues, the authors came to conclusions that extend beyond their data. Most importantly, the authors did not actually measure the use of calorie labeling in restaurants. In addition, the authors interpret their data in a surprisingly negative manner, and do not reference other studies on this subject that contradict their conclusions.Even if we disregard the low response rate for their survey (only 40% of those surveyed responded), the authors’ conclusions are surprisingly negative given their data. The authors stress that one third of the community sample reported that they do not generally look at nutrition labels on packaged foods. Rather, two thirds of the community using food labels when deciding what to eat could have an important public health effect.National studies have found that three quarters of American adults report using food labels, and studies link using food labels with eating more healthful diets (1US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Healthy People 2000 Final Review. Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2001.Google Scholar, 2Kim S.Y. Nayga R.M. Capps O. The effect of food label use on nutrient intakes: An endogenous switching regression analysis.J Agricultural Resource Econ. 2000; 25: 215-231Google Scholar, 3Kreuter M.W. Brennan L.K. Scharff D.P. Lukwago S.N. Do nutrition label readers eat healthier diets? Behavioral correlates of adults’ use of food labels.Am J Prev Med. 1997; 13: 277-283Google Scholar, 4Neuhouser M.L. Krital A.R. Patterson R.E. Use of food nutrition labels is associated with lower fat intake.J Am Diet Assoc. 1999; 99: 45-53Google Scholar). About half (48%) report that the nutrition information on food labels has caused them to change their minds about buying a food product (5Levy A.S. Derby B.M. The impact of NLEA on consumers: Recent findings from FDA’s Food Label and Nutrition Tracking System. FDA Office of the Commissioner, Washington, DC1996Google Scholar). Studies show that nutrition information in restaurants also helps people make lower-calorie choices (6Burton S. Creyer E.H. What consumers don’t know can hurt them: Consumer evaluations and disease risk perceptions of restaurant menu items.J Consumer Aff. 2004; 38: 121-145Google Scholar, 7Burton S. Creyer E.H. Kees J. Huggins K. Attacking the obesity epidemic: An examination of the potential health benefits of nutrition information provision in restaurants.Am J Public Health. 2006; 96: 1669-1675Google Scholar, 8Conklin M.T. Lambert C.U. Cranage D.A. Nutrition information at point of selection could benefit college students.Top Clin Nutr. 2005; 20: 90-96Google Scholar, 9Kozup K.C. Creyer E.H. Burton S. Making healthful food choices: The influence of health claims and nutrition information on consumers’ evaluations of packaged food products and restaurant menu items.J Mark. 2003; 67: 19-34Google Scholar, 10Kral T.V.E. Roe L.S. Rolls B.J. Does nutrition information about the energy density of meals affect food intake in normal-weight women?.Appetite. 2002; 39: 137-145Google Scholar, 11Milich R. Anderson J. Mills M. Effects of visual presentation of caloric values on food buying by normal and obese persons.Percept Mot Skills. 1976; 42: 155-162Google Scholar).Krukowski’s survey found that about half of the respondents said they would use information at restaurants to choose their food. However, national surveys, with better response rates, find that as many as 80% of Americans want restaurants to provide nutrition information for all their menu items (12Mallone C. Bland-Campbell J. New Insights on the Away-From-Home Eating Patterns and Nutritional Preferences of Americans. 2005Google Scholar).Finally, the authors overlook one of the most significant effects that packaged food labeling has had on food choices: product reformulation and the introduction of new, nutritionally improved products. Between 1991 (before the implementation of packaged food labeling requirements) and 1995 (after implementation), the number of available fat-modified cheese products tripled, and the market share for fat-modified cookies increased from 0% of the market to 15% (5Levy A.S. Derby B.M. The impact of NLEA on consumers: Recent findings from FDA’s Food Label and Nutrition Tracking System. FDA Office of the Commissioner, Washington, DC1996Google Scholar, 13Silverglade B.A. Food labeling: Rules you can live by.Legal Times. 1995; (July 17): 21-24Google Scholar). In a similar fashion, nutrition labeling on menus and menu boards is likely to spur nutritional improvements in restaurant foods.Given the growing role of restaurant foods in Americans’ diets and the link between eating out and obesity, people have a right to basic nutritional information at restaurants. The recently published report by the Food and Drug Administration, The Keystone Forum on Away-From-Home Foods: Opportunities for Preventing Weight Gain and Obesity, recommends that nutrition information be provided at restaurants in a standard format that is easy to use and available at the point of decision making (14US Department of Health and Human Services, Food and Drug AdministrationThe Keystone Forum on Away-From-Home Foods: Opportunities for Preventing Weight Gain and Obesity, Final Report. US Department of Health and Human Services, Food and Drug Administration, Washington, DC2006Google Scholar).It is hard for food and nutrition professionals to educate people about nutrition and for people to make informed choices without nutrition information. We encourage the readers of the Journal to look beyond this one limited study in formulating their opinion on the need for and effectiveness of menu labeling. In the article, “Consumers May Not Use or Understand Calorie Labeling in Restaurants,” in the June 2006 issue of the Journal by Krukowski and colleagues, the authors came to conclusions that extend beyond their data. Most importantly, the authors did not actually measure the use of calorie labeling in restaurants. In addition, the authors interpret their data in a surprisingly negative manner, and do not reference other studies on this subject that contradict their conclusions. Even if we disregard the low response rate for their survey (only 40% of those surveyed responded), the authors’ conclusions are surprisingly negative given their data. The authors stress that one third of the community sample reported that they do not generally look at nutrition labels on packaged foods. Rather, two thirds of the community using food labels when deciding what to eat could have an important public health effect. National studies have found that three quarters of American adults report using food labels, and studies link using food labels with eating more healthful diets (1US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Healthy People 2000 Final Review. Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2001.Google Scholar, 2Kim S.Y. Nayga R.M. Capps O. The effect of food label use on nutrient intakes: An endogenous switching regression analysis.J Agricultural Resource Econ. 2000; 25: 215-231Google Scholar, 3Kreuter M.W. Brennan L.K. Scharff D.P. Lukwago S.N. Do nutrition label readers eat healthier diets? Behavioral correlates of adults’ use of food labels.Am J Prev Med. 1997; 13: 277-283Google Scholar, 4Neuhouser M.L. Krital A.R. Patterson R.E. Use of food nutrition labels is associated with lower fat intake.J Am Diet Assoc. 1999; 99: 45-53Google Scholar). About half (48%) report that the nutrition information on food labels has caused them to change their minds about buying a food product (5Levy A.S. Derby B.M. The impact of NLEA on consumers: Recent findings from FDA’s Food Label and Nutrition Tracking System. FDA Office of the Commissioner, Washington, DC1996Google Scholar). Studies show that nutrition information in restaurants also helps people make lower-calorie choices (6Burton S. Creyer E.H. What consumers don’t know can hurt them: Consumer evaluations and disease risk perceptions of restaurant menu items.J Consumer Aff. 2004; 38: 121-145Google Scholar, 7Burton S. Creyer E.H. Kees J. Huggins K. Attacking the obesity epidemic: An examination of the potential health benefits of nutrition information provision in restaurants.Am J Public Health. 2006; 96: 1669-1675Google Scholar, 8Conklin M.T. Lambert C.U. Cranage D.A. Nutrition information at point of selection could benefit college students.Top Clin Nutr. 2005; 20: 90-96Google Scholar, 9Kozup K.C. Creyer E.H. Burton S. Making healthful food choices: The influence of health claims and nutrition information on consumers’ evaluations of packaged food products and restaurant menu items.J Mark. 2003; 67: 19-34Google Scholar, 10Kral T.V.E. Roe L.S. Rolls B.J. Does nutrition information about the energy density of meals affect food intake in normal-weight women?.Appetite. 2002; 39: 137-145Google Scholar, 11Milich R. Anderson J. Mills M. Effects of visual presentation of caloric values on food buying by normal and obese persons.Percept Mot Skills. 1976; 42: 155-162Google Scholar). Krukowski’s survey found that about half of the respondents said they would use information at restaurants to choose their food. However, national surveys, with better response rates, find that as many as 80% of Americans want restaurants to provide nutrition information for all their menu items (12Mallone C. Bland-Campbell J. New Insights on the Away-From-Home Eating Patterns and Nutritional Preferences of Americans. 2005Google Scholar). Finally, the authors overlook one of the most significant effects that packaged food labeling has had on food choices: product reformulation and the introduction of new, nutritionally improved products. Between 1991 (before the implementation of packaged food labeling requirements) and 1995 (after implementation), the number of available fat-modified cheese products tripled, and the market share for fat-modified cookies increased from 0% of the market to 15% (5Levy A.S. Derby B.M. The impact of NLEA on consumers: Recent findings from FDA’s Food Label and Nutrition Tracking System. FDA Office of the Commissioner, Washington, DC1996Google Scholar, 13Silverglade B.A. Food labeling: Rules you can live by.Legal Times. 1995; (July 17): 21-24Google Scholar). In a similar fashion, nutrition labeling on menus and menu boards is likely to spur nutritional improvements in restaurant foods. Given the growing role of restaurant foods in Americans’ diets and the link between eating out and obesity, people have a right to basic nutritional information at restaurants. The recently published report by the Food and Drug Administration, The Keystone Forum on Away-From-Home Foods: Opportunities for Preventing Weight Gain and Obesity, recommends that nutrition information be provided at restaurants in a standard format that is easy to use and available at the point of decision making (14US Department of Health and Human Services, Food and Drug AdministrationThe Keystone Forum on Away-From-Home Foods: Opportunities for Preventing Weight Gain and Obesity, Final Report. US Department of Health and Human Services, Food and Drug Administration, Washington, DC2006Google Scholar). It is hard for food and nutrition professionals to educate people about nutrition and for people to make informed choices without nutrition information. We encourage the readers of the Journal to look beyond this one limited study in formulating their opinion on the need for and effectiveness of menu labeling. Consumers May Not Use or Understand Calorie Labeling in RestaurantsJournal of the American Dietetic AssociationVol. 106Issue 6PreviewThis study was an investigation of the possible utility of calorie labeling legislation in restaurants in community (n=649) and college student (n=316) samples. Only 48% to 66% of participants presently looked at food labels, and 64% to 73% were able to report accurate knowledge of daily caloric needs. Furthermore, 44% to 57% reported that they were not likely to use food label information in restaurants if it were available. Therefore, public education campaigns focused on calorie requirements may need to precede restaurant labeling, and perhaps other possibilities in labeling formats should be considered (eg, defining foods as “low,” “moderate,” and “high” calorie). Full-Text PDF Response to Wootan LetterJournal of the American Dietetic AssociationVol. 107Issue 1PreviewWe wholeheartedly agree with Dr Wootan that the public should not use the findings from our study as the definitive word on food labeling in restaurants. Our study was, as we defined it in the article, a pilot study; clearly, larger studies should be relied upon for drawing conclusions about this matter. It is also important to note that the response rate was 40% in one of our samples and 60% in the other sample; these are not unreasonable response rates for telephone surveys, particularly in comparison to a large national phone survey (1). Full-Text PDF