Mandatory calorie postings at fast-food chains does not influence food choice, study
Posting the calorie content of menu items at major fast-food chains did not change the purchasing habits or decrease the number of calories that customers in Philadelphia in the US consumed, according to research from the New York University (NYU) School of Medicine and the NYU Langone Medical Centre.
The findings, reported on 15 November 2013 at the Obesity Society’s annual scientific meeting in Atlanta, Georgia, echoed those conducted by the same researchers among low-income neighbourhoods in New York City before and after calorie-labels were mandated in New York in July 2008.
“What we’re seeing is that many consumers, particularly vulnerable groups, do not report noticing calorie labelling information and even fewer report using labelling to purchase fewer calories,” said Dr Brian Elbel, lead study author and Assistant Professor of Population Health and Health Policy at NYU School of Medicine. “After labelling began in Philadelphia, about 10 per cent of the respondents in our study said that calorie labels at fast-food chains resulted in them choosing fewer calories,” he said.
As part of an effort to encourage people to make healthier food choices, the Patient Protection and Affordable Care Act mandates that restaurant chains in the US with 20 or more locations nationally must post the calorie content of all regular food and drink items on their menu board or printed menus.
But the researchers said there is “limited scientific evidence from real-world studies” to support calorie labelling. Moreover, little is understood about how calorie labels will impact different populations, according to the researchers. Obesity affects more than one third of Americans, with low-income, urban neighbourhoods hardest hit.
“Studies have not generally examined whether labelling is more or less effective for particular subgroups,” Dr Elbel said.
The researchers said they set out to assess the impact of calorie labels at fast-food chains in the wake of the new legislation. In this latest study, conducted in Philadelphia, researchers collected receipts from more than 2,000 customers, aged 18 to 64 years, who visited McDonald’s and Burger King restaurants during lunch or dinner before and after February 2010, when the calorie-label law went into effect in Philadelphia.
Each customer was asked a short series of questions, including how often they had visited “big chain” fast food restaurants in the last week, whether they noticed calorie information in the restaurant, and if so, whether they used the information to purchase more or less food than they otherwise would have the restaurant.
The research team also commissioned a professional survey firm to simultaneously conduct a random phone survey of residents within the city limits of Philadelphia. Respondents aged 18 to 64 were asked a series of questions, including whether they had consumed any “big chain” fast-food within the last three months. If they had, they were asked a series of additional questions about how often they eat fast food, along with demographic questions and their height and weight.
The researchers found that only 34 per cent of McDonald’s customers noticed the labels posted to menu boards, compared to 49 per cent of Burger King customers. Respondents with less education (high school or lower) were less likely to notice the labels. Moreover, respondents reported eating fast-food more than 5 times a week, both before and after the labels were posted. There was no decrease in visiting fast-food chains reported after calorie labelling began in Philadelphia.
As a control, the researchers also surveyed customers of both chains in Baltimore, where calorie-labels are not mandated. About 70 per cent of the customers surveyed in both cities were African American.
“We found no difference in calories purchased or fast-food visits after the introduction of the policy,” Dr Elbel said. “Given the limits of labelling reported here and in other studies, it’s clear that just posting calories is not enough to change behaviour among all populations. We need to consider other, more robust interventional policies in places where obesity is most prevalent,” he said.
Investigators on the study included, Brian D. Elbel, PhD,DPhil, Department of Population Health, NYU School of Medicine, and the Wagner School of Public Service, New York University, New York City; Tod Mijanovich,PhD, L. Beth Dixon,PhD, MPH, and Beth Weitzman, PhD, MPA, of the Steinhardt School, New York University; Rogan Kersh, MA, Department of Politics and International Affairs, Wake Forest University, Winston-Salem, North Carolina; Amy H. Auchincloss, PhD, MPH, Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania and Gbenga Ogedegbe , MD,MS, MPH, NYU School of Medicine.
This study was funded by National Institutes of Health (R01HL095935). The study sponsor had no role in study design.