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

Abstract

Summary 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.

‘Joining the Dots’: Individual, Sociocultural and Environmental Links between Alcohol Consumption, Dietary Intake and Body Weight—A Narrative Review

“…A recent study found that low-alcohol products are perceived to target non-traditional consumers (pregnant women) and occasions (weekday lunchtimes), suggesting potential challenges to their uptake [ 159 ]. In a recent systematic review and meta-analysis, Robinson et al [ 153 ] found moderate evidence that consumers are unaware of the energy content of alcoholic drinks, and that consumers support energy labelling. However, most studies found no effect of energy-labelling on actual or intended alcohol consumption; studies were generally of poor methodological quality and none were conducted in a real-life setting.…”

Energy labelling of alcoholic drinks as a public health policy to reduce obesity: An integrative review

“…A subsequent UK study produced similar results; most participants were inaccurate when estimating energy content of common alcoholic drinks with between 76-87% of participants making incorrect estimates, dependent on drink type [48]. In the same systematic review [47], studies examining consumer support for energy labelling of alcoholic drinks were examined [49,50].…”

“…A number of studies have examined whether or not people are accurate when asked how many calories there are in common alcoholic drinks [45,46]. A recent systematic review and meta-analysis of eight studies that sampled participants from across Europe, North American and Australasia found that approximately 74% of sampled participants were unable to identify the number of calories in common alcoholic drinks accurately [47]. The review concluded there was only moderate (as opposed to strong) evidence that most people are unaware of the energy content of common alcoholic drinks, due to there being a relatively small number of included studies with some methodological limitations.…”

“…An alternative but not mutually exclusive possibility is that alcoholic drink labelling may serve to correct inaccurate misperceptions of drink energy content. Because a substantial proportion of people tend to underestimate the number of calories in alcoholic drinks [47,48], labelling may correct this misperception ('there are far more calories in this drink than I thought') and result in those individuals choosing a lower energy option. However, a significant number of participants in studies examining knowledge of drink energy content also overestimate and believe there are more calories in drinks than in reality [47,48].…”

“…Because a substantial proportion of people tend to underestimate the number of calories in alcoholic drinks [47,48], labelling may correct this misperception ('there are far more calories in this drink than I thought') and result in those individuals choosing a lower energy option. However, a significant number of participants in studies examining knowledge of drink energy content also overestimate and believe there are more calories in drinks than in reality [47,48]. In such instances labelling could result in consumers becoming aware there are fewer calories in drinks that what they previously believed, which based on the same reasoning could result in a form of licensing effect whereby consumers feel vindicated to drink more or select a higher energy option [53,54].…”