How useful is calorie labeling on restaurant menus?

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People line up to buy food at a fast food restaurant in Harlem in New YorkFour years ago, a federal law specified that chain restaurants with more than 20 outlets be required to post the calorie contents of their foods (menu labeling, or ML). The rationale for the law was that if consumers could get a realistic idea of the energy content of their foods, it might encourage them to choose foods with fewer calories and thus help reduce the burden of obesity. But the extent to which restaurant patrons actually use ML to decrease calorie consumption hasn t yet been determined.

Therefore, as reported in the CDC s Morbidity and Mortality Weekly Report (MMWR), a group of CDC researchers, led by Dr. Seun Hee Lee-Kwan, undertook the task of evaluating data on the extent of ML use by consumers. They used data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) survey to query over 100,000 adults who said they ate at chain restaurants. This is an annual, state-based telephone survey of non-institutionalized adult US citizens.

The investigators used data from 17 states that had used a particular questionnaire the Sugar-Sweetened Beverages and Menu Labeling module to obtain information on ML use. They found that overall, the estimated proportion of ML users ranged from 49 percent in Montana to 61 percent in New York, with an average of 57 percent. More women (67 percent) than men (47 percent) reported using ML information. Use by various age and ethnic groups varied considerably by state; the reasons for these differences were not clear.

In their discussion, the authors noted that there were some limitations to their study: the ML data were self-reported and the validity of the reports is unknown; since only 17 states provided usable data, the results are not generalizable to the whole country; finally, ML users food choices were not recorded so it was impossible to determine if frequent or moderate ML users made more or less healthful choices than non-users. They also suggested that engaging public health practitioners, restaurants and other stakeholders to assist in raising awareness of ML might help patrons make more healthful foods choices.

ACSH s Dr. Ruth Kavahad this thought: It definitely would have been more useful to expand the questionnaire to include food selections, since the main reason for having ML in the first place was to influence food choices. Lacking that information makes this study less compelling.