Attacking the Obesity Epidemic: The Potential Health Benefits of Providing Nutrition Information in Restaurants

Burton, Scot; Creyer, Elizabeth H.; Kees, Jeremy; Huggins, Kyle

doi:10.2105/ajph.2004.054973

Cited by 330 publications

(300 citation statements)

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“…[12][13][14][15] Furthermore, restaurant patrons have little understanding of the nutrition content of food consumed outside the home. For example, Burton et al 16 reported that consumers significantly underestimate the caloric content of menu items, with actual calorie counts approximately double the estimated number of calories.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Consumer Preferences for Different Approaches to Calorie Labeling on Menus

Pang

Hammond

2013

Journal of Nutrition Education and Behavior

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Objective: To evaluate the efficacy and consumer preferences of calorie labeling on menus. Design: Between-group experiment. Participants were randomized to view menu items according to 1 of 4 experimental conditions: no calorie information, calorie-only information, calorie plus health statement (HS), and calorie plus the Physical Activity Scale. Participants selected a snack and then rated menus from all conditions on the level of understanding and perceived effectiveness. Setting: University of Waterloo, Canada. Participants: A total of 213 undergraduate university students recruited from classrooms. Main Outcome Measures: The calorie amount of menu selection and ratings of understandability and perceived effectiveness. Analysis: Linear regression models and chi-square tests. Results: Participants who selected items from menus without calorie information selected snacks with higher calorie amounts than participants in the calorie-only condition (P ¼ .002) and the calorie plus HS condition (P ¼ .001). The calorie plus HS menu was perceived as most understandable and the calorie plus calorie plus Physical Activity Scale menu was perceived as most effective in helping to promote healthy eating. Conclusions and Implications: Calorie labeling on menus may assist consumers in making healthier choices, with consumer preference for menus that include contextual health statements.

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Section: Introductionmentioning

confidence: 99%

Efficacy and Consumer Preferences for Different Approaches to Calorie Labeling on Menus

Pang

Hammond

2013

Journal of Nutrition Education and Behavior

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“…Many menu-labelling proponents assume that menu labelling enables consumers to more accurately estimate the energy content of restaurant meals (2)(3)(4) . Indeed, a field study conducted outside fast-food restaurants in New York City, where menu-labelling legislation has already been implemented, found that menu labelling increased the percentage of consumers who could accurately estimate the energy in their meals (within 418 kJ (100 kcal)) from 15 % to 24 % (4) .…”

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confidence: 99%

‘How many calories are in my burrito?’ Improving consumers’ understanding of energy (calorie) range information

Liu

Bettman

Uhalde

et al. 2014

Public Health Nutr.

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Objective: Energy (calorie) ranges currently appear on menu boards for customized menu items and will likely appear throughout the USA when menu-labelling legislation is implemented. Consumer welfare advocates have questioned whether energy ranges enable accurate energy estimates. In four studies, we examined: (i) whether energy range information improves energy estimation accuracy; (ii) whether misestimates persist because consumers misinterpret the meaning of the energy range end points; and (iii) whether energy estimates can be made more accurate by providing explicit information about the contents of items at the end points. Design: Four studies were conducted, all randomized experiments. Setting: Study 1 took place outside a Chipotle restaurant. Studies 2 to 4 took place online. Subjects: Participants in study 1 were customers exiting a Chipotle restaurant (n 306). Participants in studies 2 (n 205), 3 (n 290) and 4 (n 874) were from an online panel. Results: Energy ranges reduced energy misestimation across different menu items (studies 1-4). One cause of remaining misestimation was misinterpretation of the low end point's meaning (study 2). Providing explicit information about the contents of menu items associated with energy range end points further reduced energy misestimation (study 3) across different menu items (study 4). Conclusions: Energy range information improved energy estimation accuracy and defining the meaning of the end points further improved accuracy. We suggest that when restaurants present energy range information to consumers, they should explicitly define the meaning of the end points.

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“…Studies demonstrate that the lay consumer significantly underestimates calories, fat, and saturated fat in restaurant meals [12][13][14][15][16][17]. Only 15% of consumers in New York City were correctly able to estimate (within 100 calories) the number of calories in their fast-food meal.…”

Section: Introductionmentioning

confidence: 99%

“…One study pointed out that the result of a consumer underestimating a meal by 600 calories only once per week leads to an added intake of approximately 30,000 calories in one year, which equals approximately 9 pounds of body fat if all other factors (i.e. physical activity) remain the same [16].…”

Section: Introductionmentioning

confidence: 99%

Impact of Menu Labeling on Food Choices of Southern Undergraduate Students

Gonzales¹

2014

J Obes Weight Loss Ther

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IntroductionThe rate of overweight and obesity has drastically increased over the past two decades. Recent obesity statistics from the National Health and Nutrition Examination Survey (NHANES) captured by the Centers for Disease Control and Prevention (CDC) in [2009][2010] indicate that approximately 68.8% of American adults are either overweight or obese, with 35.7% of them being obese [1]. As the rate of overweight and obesity continues to rise steadily with no end in sight, the government is charged with the task of devising strategies to hamper the epidemic. With the passage of the Nutrition Labeling and Education Act (NLEA) in 1990, all foods purchased in stores were required to list nutrition information on the packages in a standard format-a law implemented for the purpose of creating informed consumers who make healthier choices based on their knowledge of the nutritional content of the foods on store shelves [2]. This law, however, did not have the anticipated impact on overweight and obesity rates-partially because Americans are consuming more and more meals away from home at fast-food and dine-in restaurants [3].The term "menu labeling" refers to the listing of nutrition information next to each food item on restaurant menus, menu boards, and drive-through menu boards so it can be viewed and considered by customers when making their food selections [4]. According to the Patient Protection and Affordable Care Act of 2010, Section 4205, restaurant chains with 20 or more establishments of the same name will be required to disclose nutrition information for their menu items on the menu or menu board [5]. This nutrition information, at minimum, must include calories [5] but can list further information including, but not limited to, total fat, saturated fat, carbohydrates, sodium, protein, and fiber. If not disclosed on the menu, the additional nutrition information beyond calories must be made available to customers in written form upon request [6]. In addition to the calorie labels, menus must also contain a statement specifying the recommended daily caloric intake for one day for the average American-2000 caloriesenabling customers to put the calorie labels of individual food items into context of a total daily caloric intake [5].Restaurant foods are notorious for their energy density and large portion sizes-undoubtedly contributing to the undesirable weight status of a majority of Americans. Studies show that on average, foods prepared and eaten outside the home consist of large portion sizes and have high energy density with little nutritional value and low satiating power [7,8].Some chain restaurants currently offer nutrition information in the form of tray liners, pamphlets, posters, charts, on-site computers [9,10] or on food containers or napkins, depending on the restaurant. Most restaurants offer the information online, but not necessarily at the point-of-service [11].Research has shown the difficulty of estimating the number of calories and other determinants of nutritional quality in restauran...

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Attacking the Obesity Epidemic: The Potential Health Benefits of Providing Nutrition Information in Restaurants

Abstract: Most consumers are unaware of the high levels of calories, fat, saturated fat, and sodium found in many menu items. Provision of nutrition information on restaurant menus could potentially have a positive impact on public health by reducing the consumption of less-healthful foods.

Cited by 330 publications

References 7 publications

Efficacy and Consumer Preferences for Different Approaches to Calorie Labeling on Menus

Efficacy and Consumer Preferences for Different Approaches to Calorie Labeling on Menus

‘How many calories are in my burrito?’ Improving consumers’ understanding of energy (calorie) range information

Impact of Menu Labeling on Food Choices of Southern Undergraduate Students

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