Calorie Labeling Research Articles

The Federal Menu Labeling Law and Twitter Discussions about Calories in the United States: An Interrupted Time-Series Analysis.

Public awareness of calories in food sold in retail establishments is a primary objective of the menu labeling law. This study explores the extent to which we can use social media and internet search queries to understand whether the federal calorie labeling law increased awareness of calories. To evaluate the association of the federal menu labeling law with tweeting about calories we retrieved tweets that contained the term “calorie(s)” from the CompEpi Geo Twitter Database from 1 January through 31 December in 2016 and 2018. Within the same time period, we also retrieved time-series data for search queries related to calories via Google Trends (GT). Interrupted time-series analysis was used to test whether the federal menu labeling law was associated with a change in mentions of “calorie(s)” on Twitter and relative search queries to calories on GT. Before the implementation of the federal calorie labeling law on 7 May 2018, there was a significant decrease in the baseline trend of 4.37 × 10−8 (SE = 1.25 × 10−8, p < 0.001) mean daily ratio of calorie(s) tweets. A significant increase in post-implementation slope of 3.19 × 10−8 (SE = 1.34 × 10−8 , p < 0.018) mean daily ratio of calorie(s) tweets was seen compared to the pre-implementation slope. An interrupted time-series (ITS) analysis showed a small, statistically significant upward trend of 0.0043 (SE = 0.036, p < 0.001) weekly search queries for calories pre-implementation, with no significant level change post-implementation. There was a decrease in trend of 1.22 (SE = 0.27, p < 0.001) in search queries for calories post-implementation. The federal calorie labeling law was associated with a 173% relative increase in the trend of mean daily ratio of tweets and a -28381% relative change in trend for search queries for calories. Twitter results demonstrate an increase in awareness of calories because of the addition of menu labels. Google Trends results imply that fewer people are searching for the calorie content of their meal, which may no longer be needed since calorie information is provided at point of purchase. Given our findings, discussions online about calories may provide a signal of an increased awareness in the implementation of calorie labels.

Does Information Disclosure Improve Consumer Knowledge?

We estimate the impact of information disclosure on consumer knowledge in an important context: the calorie content of restaurant food. We conduct a randomized controlled experiment of calorie labels on restaurant menus, and find that information disclosure improves consumer knowledge but does not eliminate the problem of imperfect information. Calorie labels improve consumers’ post-meal estimates of the number of calories they ordered by 4.0 percent and reduce by 28.9 percent the probability that consumers underestimate the calories in their meal by half or more. However, even after information disclosure, the absolute value of percent error averages 34.2 percent.

Attention mediates restrained eaters’ food consumption intentions

Restrained eaters are chronic dieters who pay attention to their food choices, intend to eat healthier foods, but commonly suffer from obesity. With obesity rates continuing to rise, public policy makers are attempting to help consumers battle this disease. Accordingly, the Affordable Care Act menu labeling provision was passed in the United States, and requires restaurants to include calorie labeling on their menus. The literature on the effectiveness of menu calorie labeling has yielded mixed results thus far. We propose that is because the initiative helps certain individuals, but not others. Since individuals do not often accurately self-report their attention to menu calorie labeling due to social desirability bias, we utilize an eye-tracking methodology that focuses on the time consumers spent looking at menu calorie information. This (attention) measure is seen as a mediating process by which restrained eating reduces caloric intake intentions. Our results point to menu calorie labeling being effective for restrained eaters, a group in need of assistance.

Is Calorie Labeling on Menus Related to Weight Disturbances among Females in Saudi Arabia?

Calorie labeling is a recent initiative from the Saudi Food and Drug Authority (SFDA) aimed to reduce the prevalence of noncommunicable diseases (NCDs) by influencing people to make healthier food choices when they eat out and can also help people with weight disturbances to be more aware of their calorie intake. The present study aimed to investigate the association between the use of calorie labeling on restaurant menus, calorie intake, weight concern, body weight perception, and weight-control behaviors among young women. A quasi-experimental study was conducted among female students at a university restaurant. Participants were assigned to two groups: food menus with (experimental group) and without (control group) calorie labeling. The logistic regression model assessed the predictors of using calorie information separately for the experimental and control groups. Calorie labeling had a significant effect on reducing calorie consumption in the experimental group by 59 calories compared to the control group. The higher weight concern in the control group (OR = 0.410; 95% CI 0.230–0.730; P ≤ 0.002) was a predictor for using calorie information. The experimental group had higher weight concern (OR = 1.530; 95% CI 1.107–2.115; P ≤ 0.01) and body weight perception (OR = 4.230; 95% CI 1.084–6.517; P ≤ 0.038) and lower calorie intake (OR = 1.005; 95% CI 1.001–6.517; P ≤ 0.008) predictors for using calorie information. Weight-control behaviors did not significantly predict the use of calorie information in the groups. Calorie labeling might increase the weight disturbances among young females. More investigation is needed across various populations to gain a better understanding of calorie labeling as an effective food choice among people who are vulnerable to weight disturbances or already have weight disorders.

Measuring the impact of calorie labeling: The mechanisms behind changes in obesity.

Learning the true calorie content of fast food may induce consumers to change behavior, yet recent evidence is mixed on whether calorie labels cause consumers to order healthier meals. Especially for individuals for whom consumption of highly caloric fast-food is habitual, a rational response to calorie labeling may instead be to maintain consumption levels but increase physical activity. Using American Time Use Survey data from 2004 to 2012, we show that the 2008 New York City Calorie Labeling Mandate significantly improved several measures of physical activity, including overall metabolic equivalents of task units and minutes of sedentary activity. Our results translate to an average extra 28 calories burned per day or a 0.6kg weight decrease for the average person over one year. These results provide a plausible mechanism for calorie labeling mandates to lower obesity rates, which we demonstrate in the New York City context.

Changes in the calorie and nutrient content of purchased fast food meals after calorie menu labeling: A natural experiment.

BackgroundCalorie menu labeling is a policy that requires food establishments to post the calories on menu offerings to encourage healthy food choice. Calorie labeling has been implemented in the United States since May 2018 per the Affordable Care Act, but to the best of our knowledge, no studies have evaluated the relationship between calorie labeling and meal purchases since nationwide implementation of this policy. Our objective was to investigate the relationship between calorie labeling and the calorie and nutrient content of purchased meals after a fast food franchise began labeling in April 2017, prior to the required nationwide implementation, and after nationwide implementation of labeling in May 2018, when all large US chain restaurants were required to label their menus.Methods and findingsWe obtained weekly aggregated sales data from 104 restaurants that are part of a fast food franchise for 3 national chains in 3 US states: Louisiana, Mississippi, and Texas. The franchise provided all sales data from April 2015 until April 2019. The franchise labeled menus in April 2017, 1 year prior to the required nationwide implementation date of May 2018 set by the US Food and Drug Administration. We obtained nutrition information for items sold (calories, fat, carbohydrates, protein, saturated fat, sugar, dietary fiber, and sodium) from Menustat, a publicly available database with nutrition information for items offered at the top revenue-generating US restaurant chains. We used an interrupted time series to find level and trend changes in mean weekly calorie and nutrient content per transaction after franchise and nationwide labeling. The analytic sample represented 331,776,445 items purchased across 67,112,342 transactions. Franchise labeling was associated with a level change of −54 calories/transaction (95% confidence interval [CI]: −67, −42, p < 0.0001) and a subsequent 3.3 calories/transaction increase per 4-week period (95% CI: 2.5, 4.1, p < 0.0001). Nationwide implementation was associated with a level decrease of −82 calories/transaction (95% CI: −88, −76, p < 0.0001) and a subsequent −2.1 calories/transaction decrease per 4-week period (95% CI: −2.9, −1.3, p < 0.0001). At the end of the study, the model-based predicted mean calories/transaction was 4.7% lower (change = −73 calories/transaction, 95% CI: −81, −65), and nutrients/transaction ranged from 1.8% lower (saturated fat) to 7.0% lower (sugar) than what we would expect had labeling not been implemented. The main limitations were potential residual time-varying confounding and lack of individual-level transaction data.ConclusionsIn this study, we observed that calorie labeling was associated with small decreases in mean calorie and nutrient content of fast food meals 2 years after franchise labeling and nearly 1 year after implementation of labeling nationwide. These changes imply that calorie labeling was associated with small improvements in purchased meal quality in US chain restaurants.

Energy (calorie) labelling for healthier selection and consumption of food or alcohol.

Energy (calorie) labelling for healthier selection and consumption of food or alcohol.

Calorie Labeling and Product Reformulation: A Longitudinal Analysis of Supermarket-Prepared Foods

The 2010 Affordable Care Act required chain retail food establishments, including supermarkets, to post calorie information for prepared (i.e., ready to eat) foods. Implementation of calorie labeling could spur companies to reduce the calorie content of prepared foods, but few studies have explored this. This study evaluates the changes in the calorie content of prepared foods at 2 large U.S. supermarket chains after they implemented calorie labels in April 2017. The chains (≈1,200 stores) provided data on the calorie content and labeling status of all items sold between July 2015 and January 2019. In 2021, analyses used a difference-in-differences approach to examine the changes in the calorie content of prepared bakery, entree, and deli items introduced before calorie labeling to those introduced after the labeling compared with changes in similar foods not subject to the new labeling requirement. Primary analyses examined continuously available items; exploratory analyses examined items newly introduced to the marketplace. Relative to changes in comparison foods not subject to the labeling requirement, continuously available prepared bakery items decreased by 7.7 calories per item after calorie labels were implemented (95% CI= -12.9, -2.5, p=0.004, ≈0.5% reduction). In exploratory analyses, prepared bakery items introduced after calorie labeling contained 440 fewer calories per item than those introduced before calorie labeling (95% CI= -773.9, -106.1, p=0.01, ≈27% reduction), driven by reductions in product size. No changes were observed in the calorie content of continuously available or newly introduced prepared entrees or deli items. Implementing calorie labels could encourage product reformulation among some types of prepared supermarket foods. These supply-side changes could lead to reductions in caloric intake.

The effect of calorie and physical activity equivalent labelling of alcoholic drinks on drinking intentions in participants of higher and lower socioeconomic position: An experimental study.

The primary objective of the study was to examine the effect of calorie labelling and physical activity equivalence labelling of alcoholic drinks on drinking intentions in participants of lower and higher socioeconomic position (SEP). Participants (N = 1,084) of higher and lower SEP were recruited into an online study and randomized into one of three drink label conditions; Control (standard alcohol labelling), kcal labelling (standard labelling plus drink kilocalorie information), or kcal + PACE labelling (standard labelling and kilocalorie information, plus information on physical activity needed to compensate for drink calories). After viewing drink labels, participants reported alcohol drinking intentions. Participants also completed measures of alcoholic drink energy content estimation, beliefs about how calorie labelling would affect health behaviour and support for calorie labelling of alcoholic drinks. kcal labelling (d = 0.31) and kcal + PACE labelling (d = 0.38) conditions had significantly lower drinking intentions compared to the control condition (ps < .001). There was no evidence that effect of labelling condition on drinking intentions was moderated by SEP. A subset of participants also reported that they believed calorie labelling would be likely to positively change their eating and exercise behaviour. Estimates of the energy content of alcoholic drinks tended to be inaccurate and the majority of participants supported the introduction of calorie labelling on alcoholic drinks. Calorie labelling of alcoholic drinks resulted in small reductions to intended drinking and testing of the effect calorie labelling has on behaviour in real-world settings is now warranted.

Messages Promoting Healthy Kids’ Meals: An Online RCT

Calorie labeling is now required on all large U.S. chain restaurant menus, but its influence on consumer behavior is mixed. This study examines whether different parent-targeted messages encourage parents to order lower-calorie meals for their children in a hypothetical online setting. An online RCT was conducted with sociodemographically diverse primary caregivers of children aged 6-12 years (data collected and analyzed in 2017-2019). Participants (N=2,373) were randomized to see 1 of 4 messages: (1) nonfood control, (2) kids' meals are the right size for children, (3) doctors recommend a 600 kcal per meal limit for kids, or (4) 600 kcal per meal is a generally recommended limit for kids. Participants ordered hypothetical meals for their children and themselves and rated meal and message perceptions. There were no significant differences between conditions in calories ordered for children at either restaurant, although all 3 food message conditions ordered fewer calories for their children than the control (full service: 27-68 fewer kcal, fast food: 18-64 fewer kcal). The general 600 kcal/meal limit message consistently performed best across outcomes, encouraging parents to order the fewest calories for their children at both restaurants (5%-7% fewer) and significantly increasing their understanding of calorie recommendations for kids' meals. It also significantly reduced fast-food calories parents ordered for themselves compared with the control (-106 kcal, p=0.042). Although no statistically significant differences were detected, messages with specific calorie recommendations for kids led parents to order lower-calorie restaurant meals for their children, suggesting that additional real-world studies with larger sample sizes are warranted.

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

Mandatory energy (calorie) labeling of alcoholic drinks is a public health measure that could be used to address both alcohol consumption and obesity. We systematically reviewed studies examining consumer knowledge of the energy content of alcoholic drinks, public support for energy labeling, and the effect of energy labeling of alcoholic drinks on consumption behavior. Eighteen studies were included. Among studies examining consumer knowledge of the energy content of alcoholic drinks (N = 8) and support for energy labeling (N = 9), there was moderate evidence that people are unaware of the energy content of alcoholic drinks (pooled estimate: 74% [95% CI: 64%-82%] of participants inaccurate) and support energy labeling (pooled estimate: 64% [95% CI: 53%-73%] of participants support policy). Six studies examined the effect of energy labeling on consumption behavior. In these studies, there was no evidence of a beneficial effect of labeling on alcohol drinking-related outcome measures. However, the majority of studies were of low methodological quality and used proxy outcome measures, and none of the studies were conducted in real-world settings, resulting in a very low level of evidence and high degree of uncertainty. Further research is required to determine whether energy labeling of alcoholic drinks is likely to be an effective public health policy.

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

Background: Since numerical calorie labels have limited effects on less-calorie food ordering, an alternative called physical activity calorie equivalent (PACE) labels, which exhibit calories using visible symbols and the minutes of exercise to burn off the calories, may be more effective in reducing calories ordered. Methods: By using a choice experiment (CE) approach, the aims of this study were to estimate the effects of PACE labels on consumer preferences for healthy and unhealth food. Red date walnuts and potato chips were used as the representatives of healthy and unhealthy foods respectively in this study. Moreover, future time perspective (FTP) is an individual trait variable of consumers, which has been recognized as a significant driver of healthy behaviors. We also included FTP into the interaction with PACE labels. Results: Firstly, the results were opposite between the healthy and unhealthy food groups. Respondents showed significantly more positive attitudes toward red date walnuts (i.e., healthy food) with PACE labels, while they showed significantly more negative preferences for chips (i.e., unhealthy food) with PACE labels. Secondly, people with higher FTP are preferred red date walnuts with PACE labels, while PACE labels on chips could undermine the preferences of respondents with higher FTP. Thirdly, we found that women (vs. men) were less inclined to choose healthy food with standard calorie labels and labels showing the minutes of running to burn off the calories, as well as that the elderly (vs. younger) people in the healthy food group preferred the labels showing the minutes of running to burn off the calories. People with a higher body mass index (BMI) were reluctant to purchase walnuts with the information about the minutes of walking. Conclusions: Results from this study showed that PACE labels have significant effects on consumers’ preferences for food products.

Consumer Responses to Firms’ Voluntary Disclosure of Information: Evidence from Calorie Labeling by Starbucks

This paper estimates the impact on consumer behavior of a firm’s voluntary disclosure of information. Specifically, we study the impact of Starbucks’ disclosure of calorie information on its menu boards in June 2013. Using data on over 250,000 consumers’ visits to specific restaurant chains, we estimate difference-in-difference models that compare the change in the probability that consumers recently visited Starbucks to the change in the probability that they recently visited a similar chain that did not voluntarily disclose: Dunkin Donuts. Estimates from difference-in-differences models indicate that we cannot reject the null hypothesis that Starbucks’ disclosure of calorie information had no impact on the probability that consumers patronized Starbucks in the past month. However, we find evidence of a transitory negative impact on the probability of visits the first year after disclosure, and evidence that disclosure reduced the probability of visits by men. These results are useful for understanding how consumers respond to the voluntary disclosure of information, a decision faced by many firms.

Factors Influencing Customers' Behavior toward Eating Healthy Food in Restaurants at Minia Governorate in Egypt

The research aimed to examine the factors influencing customers' behavior towards eating healthy food at Minia district restaurants in Minia governorate in Egypt. The research used a quantitative approach and conducted descriptive-analytical methodology by using a questionnaire. The inhabitants of Minia district were the population of the research who visit 52 main restaurants in Minia. Five hundred questionnaires were distributed to restaurants' customers as a sample of the research, 385 returned questionnaires were valid to analyze with a response rate of 77 % of distributed questionnaires. The data were analyzed using descriptive statistics, regression, T-Test, and Anova by using SPSS 22. The results showed that the averages of restaurant customers' affective attitude; injunctive and descriptive norms; perceived behavioral control; behavioral intentions; behavior were moderate, which might cause obesity and its diseases to customers. Moreover, perceived health problems of eating high-calorie foods; positive outcomes of eating healthy food; affective and cognitive attitudes; injunctive and descriptive norms; perceived behavior control had a significant influence on customers' behavioral intentions towards eating healthful food in restaurants. Customers' behavioral intention also had a significant influence on their eating healthy food behavior. There were only significant differences between customers' educational levels, where customers who got secondary school were better than those who got bachelor degree towards eating healthy behavior. Menu calorie labeling; Healthy food; Theory of planned behavior, Behavioral intentions, Customer behavior.

The effect of calorie labelling, motivation and habits on the calorie content of items selected from a coffee shop menu

The effect of calorie labelling, motivation and habits on the calorie content of items selected from a coffee shop menu

A Qualitative Study of Parents With Children 6 to 12 Years Old: Use of Restaurant Calorie Labels to Inform the Development of a Messaging Campaign

BackgroundUS law mandates that chain restaurants with 20 or more locations post calorie information on their menus to inform consumers and encourage healthy choices. Few qualitative studies have assessed how parents perceive and use this information when ordering for their children and what types of accompanying messages might increase use of calorie labels when ordering food. ObjectiveWe aimed to better understand parents’ perceptions and use of calorie labeling and the types of messages that might increase use. DesignWe conducted 10 focus groups (n = 58) and 20 shop-along interviews (n = 20). Focus group participants discussed their hypothetical orders and restaurant experiences when dining with their children, and shop-along participants verbalized their decision processes while ordering at a restaurant. Both groups gave feedback on 4 public service messages aimed to increase healthier ordering for children. All interviews were voice-recorded and transcribed. Participants/SettingParticipants were primary caregivers of at least 1 child between 6 and 12 years who reported having less than a college education at the time of screening and who commonly ate at chain restaurants. Focus groups were conducted in a conference room, and shop-alongs were conducted in quick-serve and full-service chain restaurants around Philadelphia between August 2016 and May 2017. AnalysesA modified grounded theory approach was used to extract themes from transcripts. ResultsThematic analysis of transcripts revealed 5 key themes: (1) parents’ use of calorie labels; (2) differences across restaurant settings; (3) nonjudgmental information; (4) financial value and enjoyment of food; and (5) message preferences. These themes suggested that nonjudgmental, fact-based messages that highlight financial value, feelings of fullness, and easy meal component swaps without giving up the treatlike aspect of eating out may be particularly helpful for consumers. ConclusionsThese findings can inform current US Food and Drug Administration campaign efforts to support consumer use of calorie labels on menus.

Associations between Governmental Policies to Improve the Nutritional Quality of Supermarket Purchases and Individual, Retailer, and Community Health Outcomes: An Integrative Review.

Supermarkets are natural and important settings for implementing environmental interventions to improve healthy eating, and governmental policies could help improve the nutritional quality of purchases in this setting. This review aimed to: (1) identify governmental policies in the United States (U.S.), including regulatory and legislative actions of federal, tribal, state, and local governments, designed to promote healthy choices in supermarkets; and (2) synthesize evidence of these policies’ effects on retailers, consumers, and community health. We searched five policy databases and developed a list of seven policy actions that meet our inclusion criteria: calorie labeling of prepared foods in supermarkets; increasing U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) benefits; financial incentives for the purchase of fruit and vegetables; sweetened beverage taxes; revisions to the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package; financial assistance for supermarkets to open in underserved areas; and allowing online purchases with SNAP. We searched PubMed, Econlit, PsycINFO, Web of Science, and Business Source Ultimate to identify peer-reviewed, academic, English-language literature published at any time until January 2020; 147 studies were included in the review. Sweetened beverage taxes, revisions to the WIC food package, and financial incentives for fruits and vegetables were associated with improvements in dietary behaviors (food purchases and/or consumption). Providing financial incentives to supermarkets to open in underserved areas and increases in SNAP benefits were not associated with changes in food purchasing or diet quality but may improve food security. More research is needed to understand the effects of calorie labeling in supermarkets and online SNAP purchasing.

S1205 Nutritional Calorie Labeling and Menu Ordering Practices Among U.S. Adults With Chronic Illnesses

INTRODUCTION: The relationship between diet and the management of chronic illnesses is well established. However, it is unknown the extent to which people with chronic illnesses pay attention to nutritional information and act upon the information obtained. Aim: To evaluate the menu ordering practices of adults with chronic illnesses. METHODS: We analyzed the 2018 Health Information National Trends Survey (HINTS 5 Cycle 2). Our analytic cohort included 3,118 respondents (weighted population size = 227,008,103). Respondents answered questions regarding a personal history of these chronic illnesses: (1) Diabetes, (2) Hypertension, (3) Heart disease (including heart attack, angina or congestive heart failure) and (4) Obesity. They also answered questions about their nutritional habits regarding whether they noticed caloric information at fast-food or sit-down restaurants and how that information influenced their dietary choices. We used logistic regression analyses to examine the association between chronic illnesses and the likelihood to notice caloric information and modify their dietary behavior by ordering less calories. We used survey weights in all analyses. We calculated odds ratios (OR) and 95% confidence interval (CI). RESULTS: The mean age of the cohort was 48.6 years, 51.2% female, 65.2% White, 10.7% Black, 15.9% Hispanic, 15.8% current smokers, 28.3% with a yearly household income less than $35,000 and 30.4% had a high school education or less. Among respondents with chronic illnesses, only obese patients were more likely to pay attention to caloric information. Among the respondents with chronic illnesses who noticed caloric information, none of them ordered fewer calories when compared to those without the specific chronic illness (Table 1). CONCLUSION: US adults with chronic illnesses do not pay sufficient attention to calorie information of their diet. Furthermore, awareness of the calorie information did not influence their dietary choices. Healthcare professionals should incorporate dietary counseling into the management of chronic illnesses of their patients.Table 1.: Multivariate adjusted for age, sex, smoking, income, race, and education

A Natural Experiment to Evaluate the Nutritional Content of Restaurant Meal Purchases After Calorie Labeling

BackgroundCalorie labeling is mandated in restaurant chains with ≥20 locations nationwide, but the effect of labeling on the nutritional quality of purchased meals in fast-food settings is unclear, especially for adolescents and children. ObjectiveTo estimate the effect of calorie menu labeling on the nutrient content and composition of fast-food meal purchases in McDonald’s restaurants vs control restaurants. DesignFrom 2010 to 2014, customers were sampled during repeated visits to McDonald’s restaurants, which voluntarily labeled menus with calorie information in 2012, and 5 control fast-food restaurant chains that had not labeled their menus over the study period. Participants/settingRestaurant receipts and questionnaires were collected from 2883 adults, 2131 adolescents, and 433 children in 4 New England cities. Main outcome measuresSaturated fat, sugar, sodium, and fiber content of purchased meals, as well as nutrient densities (ie, nutrient content adjusted for total calories), were calculated after linking purchases to nutrition data from restaurant websites. Statistical analysesDifference-in-differences analyses and linear mixed models were used to examine whether calorie labeling in McDonald’s was associated with changes in nutrient content and nutrient density of purchased meals separately in adults, adolescents, and children. ResultsAfter implementation of calorie labeling at McDonald’s, adult meals contained on average 4.0% fewer calories from sugar (95% confidence interval: −7.5 to −0.5), but 1.8% more calories from saturated fat (95% confidence interval: 0.7 to 2.9) compared with control chains. The fiber content of children’s purchased meals was lower at McDonald’s after calorie labeling (change = −1.4 g, 95% confidence interval: −2.5 to −0.3). Calorie labeling was not associated with changes in nutrient quality of adolescent meals. ConclusionsCalorie labeling at McDonald’s was associated with a possibly small positive change in the nutritional quality of meals in adults but not in adolescents or children. Efforts are needed to improve the nutritional quality of restaurant meals.

Excess success in “Don’t count calorie labeling out: Calorie counts on the left side of menu items lead to lower calorie food choices”

Based on findings from six experiments, Dallas, Liu, and Ubel (2019) conclude that placing calorie labels to the left of menu items influences consumers to choose lower calorie food options. Contrary to previously reported findings, they suggest that calorie labels can influence food choices, but only when placed to the left because they are in this case read first. If true, these findings have important implications for the design of menus and may help address the obesity pandemic. However, an analysis of the reported results indicates that they seem too good to be true. We show that if the effect sizes in Dallas et al. (2019) are representative of the populations, a replication of the six studies (with the same sample sizes) has a probability of only 0.014 of producing uniformly significant outcomes. Such a low success rate suggests that the original findings might be the result of questionable research practices or publication bias. We therefore caution readers and policy makers to be skeptical about the results and conclusions reported by Dallas et al. (2019).