Impact of Menu Labeling on Food Choices of Southern Undergraduate Students

Abstract

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...