• Does menu labelling work?

    I’ve covered individual studies before, but now it appears there’s a systematic review! “Systematic Review and Meta-analysis of the Impact of Restaurant Menu Calorie Labeling“:

    We conducted a systematic review and meta-analysis evaluating the relationship between menu calorie labeling and calories ordered or purchased in the PubMed, Web of Science, PolicyFile, and PAIS International databases through October 2013.

    If they included all 19 studies, then there was an 18 calorie reduction per meal offered. But there was a lot of variation in the studies. But 10 of these studies were in a non-restaurant setting. Four were in the Internet, 3 three in labs, 2 were on sidewalks, and 1 was in a hospital waiting room. Only three of them randomized people to order food that they’d eat from an actual menu. Seven of them, in other words, involved ordering from a hypothetical menu and a pretend meal. All if this is to say that their generalizability should be viewed with a little skepticism.

    If they included only controlled studies, however – and there were six of them – then there was no significant effect of menu labeling:

    CI = confidence interval. Horizontal lines represent the study 95% confidence intervals. Solid diamonds represent the point estimate study (change in kcal ordered or purchased per meal) from each study. The open diamond represents the pooled estimate of the effect of menu labeling and the 95% confidence interval around the estimate. The dashed line represents the point estimate of the pooled estimate.

    CI = confidence interval. Horizontal lines represent the study 95% confidence intervals. Solid diamonds represent the point estimate study (change in kcal ordered or purchased per meal) from each study. The open diamond represents the pooled estimate of the effect of menu labeling and the 95% confidence interval around the estimate. The dashed line represents the point estimate of the pooled estimate.

    That’s disappointing. But here’s the conclusion of the authors:

    Although current evidence does not support a significant impact on calories ordered, menu calorie labeling is a relatively low-cost education strategy that may lead consumers to purchase slightly fewer calories. These findings are limited by significant heterogeneity among nonrestaurant studies and few studies conducted in restaurant settings.

    I just have to disagree here. I’m not sure that menu-labeling regulations are low cost. Do they give any evidence for that? And without evidence, why would we continue to head down this path? I’m fine with further experiments and research, but it seems odd to do studies, note they don’t really seem to work, and say we should keep doing the policy. It sometimes feels like that’s the theme of too much nutrition policy in the US these days.

    @aaronecarroll

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