Menu-Labeling Usage and Its Association with Diet and Exercise: 2011 BRFSS Sugar Sweetened Beverage and Menu Labeling Module

Abstract

IntroductionThe primary objective of our study was to investigate the association between menu-labeling usage and healthy behaviors pertaining to diet (consumption of fruits, vegetables, sodas, and sugar-sweetened beverages) and exercise.MethodsData from the 2011 Behavioral Risk Factor Surveillance System, Sugar Sweetened Beverage and Menu-Labeling module, were used. Logistic regression was used to determine the association between menu-labeling usage and explanatory variables that included fruit, vegetable, soda, and sugar-sweetened beverage consumption as well as exercise.ResultsNearly half (52%) of the sample indicated that they used menu labeling. People who used menu labeling were more likely to be female (odds ratio [OR], 2.29; 95% confidence interval [CI], 2.04–2.58), overweight (OR, 1.13; 95% CI, 1.00–1.29) or obese (OR, 1.29; 95% CI, 1.12–1.50), obtain adequate weekly aerobic exercise (OR, 1.18; 95% CI, 1.06–1.32), eat fruits (OR, 1.20; 95% CI, 1.12–1.29) and vegetables (OR, 1.12; 95% CI, 1.05–1.20), and drink less soda (OR, 0.76; 95% CI, 0.69–0.83).ConclusionAlthough obese and overweight people were more likely to use menu labeling, they were also adequately exercising, eating more fruits and vegetables, and drinking less soda. Menu labeling is intended to combat the obesity epidemic; however the results indicate an association between menu-labeling usage and certain healthy behaviors. Thus, efforts may be necessary to increase menu-labeling usage among people who are not partaking in such behaviors.

Factors Associated with Self-Reported Menu-Labeling Usage among US Adults

“…The findings showed a somewhat higher prevalence of menu labeling use than previous studies in single jurisdictions 14,23 and multiple jusrisdictions. 11,15 A 2010 study among 1,083 customers from King County, Washington, showed that while 60% of customers reported seeing menu labeling, only about 25% reported using it. 14 Another study with 8,489 adult customers from New York City in 2009 showed that only 15% of customers reported using calorie information after 9 months of full enforcement of menu labeling, though the researchers did not specify whether or not customers noticed or saw menu labeling.…”

“…11 Weight status was classified into three categories based on participants’ body mass index (BMI) using self-reported height and weight data: underweight/normal weight (BMI <25.0 kg/m 2 ); overweight (BMI 25.0–29.9 kg/m 2 ); and obese (BMI ≥30.0 kg/m 2 ). 21 The weight status categories of underweight and normal weight were combined as a single category because <2% of participants were classified as underweight.…”

“…Most menu labeling research has focused on awareness 12,13 and use 14 of calorie information and has been restricted to a single jurisdiction (e.g., New York City, King County, Washington). Although few previous studies 11,15 examined the possible associations between menu labeling use and certain sociodemographic and behavioral factors adjusting for confounders, one study used data from 2009 before the federal law was passed using sociodemographic variables and reading calorie information when available 15 and the other study using 2011 Behavioral Risk Factor Surveillance System (BRFSS) included food consumption variables, body mass index, self-perception of general health, and sociodemographic variables, but did not include race/ethnicity as a covariate because the sample consisted of adults from only 3 states (Wisconsin, Hawaii, and Minnesota), limiting subgroup analyses by race/ethnicity. 11 A recent surveillance study using 2012 BRFSS data focused on the state-specific prevalence of menu labeling use and bivariate relationship between menu labeling use with age, sex, and race/ethnicity without adjusting for other sociodemographic and behavioral factors.…”

“…9,10 Menu labeling use may be associated with other healthy behaviors such as low consumption of sugar-sweetened beverages (SSB). 11 Moreover, environmental factors such as enacted state and local menu labeling legislation could influence menu labeling use. Most menu labeling research has focused on awareness 12,13 and use 14 of calorie information and has been restricted to a single jurisdiction (e.g., New York City, King County, Washington).…”

Menu label accuracy at a university's foodservices. An exploratory recipe nutrition analysis

“…Menu labeling, the practice of providing nutritional information of calories, carbohydrates, fat, sodium, and other selected nutrients in menu items at points of purchase, has recently been regarded as an important strategy in the effort to reduce the prevalence of obesity in the United States (Krieger & Saelens, 2013). Several states and cities in the United States have passed regulations requiring restaurants to post nutrition labeling (Bowers & Suzuki, 2014). In 2010, U.S. federal legislation was enacted to encourage healthy menu selections through the Patient Protection and Affordable Care Act (PPACA), which requires restaurant chains to post caloric content and other nutritional facts of menu items (Patient Protection and Affordable Care Act, 2010;Peregrin, 2010).…”