Obesity is a challenging public health problem that affects millions of Americans. Increasingly policy makers are seeking environmental and policy-based solutions to combat and prevent its serious health effects. Calorie labeling mandates, including the provision in the 2010 Patient Protection and Affordable Care Act that is set to begin in 2014, have been one of the most popular and most studied approaches. This review examines 31 studies published from January 1, 2007 through July 19, 2013. It builds on Harnack and French's 2008 review and assesses the evidence on the effectiveness of calorie labeling at the point of purchase. We find that, while there are some positive results reported from studies examining the effects of calorie labeling, overall the best designed studies (real world studies, with a comparison group) show that calorie labels do not have the desired effect in reducing total calories ordered at the population level. Moving forward, researchers should consider novel, more effective ways of presenting nutrition information, while keeping a focus on particular subgroups that may be differentially affected by nutrition policies.

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Objectives Identify consumer characteristics that predict seeing and using calorie information on fast food menu boards. Methods Two separate data collection methods were used in Philadelphia during June 2010, several weeks after calorie labeling legislation went into effect: 1) point-of-purchase survey and receipt collection conducted outside fast food restaurants (N=669) and 2) a random digit dial telephone survey (N=702). Logistic regressions were used to predict the odds of reporting seeing, and of reporting seeing and being influenced by posted calorie information. Results Of the 35.1% of point-of-purchase and 65.7% of telephone survey respondents who reported seeing posted calorie information, 11.8% and 41.7%, respectively, reported that the labels influenced their purchasing decisions; of those influenced, 8.4% and 17% reported they were influenced in a healthful direction. BMI, education, income, gender, consumer preferences, restaurant chain, and frequency of visiting fast food restaurants were associated with heterogeneity in the likelihood of reporting seeing and reporting seeing and using calorie labels. Conclusions Demographic characteristics and consumer preferences are important determinants in the use of posted calorie information. Future work should consider the types of consumers this information is intended for, and how to effectively reach them.

Objective: To examine undergraduate student perceptions and reported use of nutrition information labels in campus dining halls. Design: Paper surveys were administered to a convenience sample of undergraduates. Setting: This study was conducted at an urban United States university. Method: A survey about perceptions and use of nutrition information labels in the dining halls was distributed to 487 students over a three-month period during the 2009-2010 academic year. Results: Of survey respondents, 98% were in favour of making nutrition information available to students, while 96% preferred the information to appear in the dining halls or both in the dining halls and online, rather than online only. Some 88% of survey respondents indicated that the labels affect their food choices at least sometimes. Conclusion:The results suggest that college and university dining halls should consider student opinion when deciding whether to provide nutrition information labels in the dining halls.