Menu Calorie Label Use and Diet Quality: a Cross-Sectional Study
Menu calorie labeling has been implemented in food service businesses to promote healthy food choices; however, evidence is limited on whether label use is associated with healthier dietary intake. This study examined the association between menu calorie label use and diet quality and whether it var...
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| Published in | American journal of preventive medicine Vol. 65; no. 6; pp. 1069 - 1077 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Netherlands
Elsevier Inc
01.12.2023
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0749-3797 1873-2607 1873-2607 |
| DOI | 10.1016/j.amepre.2023.07.003 |
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| Abstract | Menu calorie labeling has been implemented in food service businesses to promote healthy food choices; however, evidence is limited on whether label use is associated with healthier dietary intake. This study examined the association between menu calorie label use and diet quality and whether it varied by weight status.
Adults in the National Health and Nutrition Examination Survey 2017–2018 who visited restaurants were included. Menu calorie label use was categorized as did not notice labels, noticed labels, and used labels. Diet quality was measured using the Healthy Eating Index 2015 (maximum score 100) by two 24-hour diet recalls. The association between menu calorie label use and diet quality was examined using multiple linear regression and tested for effect modification by weight status. Data were collected during 2017–2018 and analyzed during 2022–2023.
Of 3,312 participants (representing 195,167,928 U.S. adults), 43% did not notice labels, 30% noticed labels, and 27% used labels. Using labels was associated with 4.0 points (95% CI 2.2, 5.8) higher Healthy Eating Index 2015 scores than not noticing labels. Healthy Eating Index 2015 scores in those using labels were higher for adults with normal BMI (3.4 points; 95% CI=0.2, 6.7), overweight (6.5 points; 95% CI=3.6, 9.5), and obesity (3.0 points; 95% CI=1.0, 5.1) (p-interaction=0.0004) than those who did not notice labels.
Using menu calorie labels was associated with modestly healthier diet quality than not noticing labels, regardless of weight status. This suggests that providing caloric information may help some adults with food decisions. |
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| AbstractList | Menu calorie labeling has been implemented in food service businesses to promote healthy food choices, but evidence is limited on whether label use is associated with healthier dietary intake. This study examined the association between menu calorie label use and diet quality and whether it varied by weight status.
Adults in the National Health and Nutrition Examination Survey 2017-2018 who visited restaurants were included. Menu calorie label use was categorized as did not notice labels, noticed labels, and used labels. Diet quality was measured using the Healthy Eating Index 2015 (HEI-2015; maximum score 100) by two 24-hour diet recalls. The association between menu calorie label use and diet quality was examined using multiple linear regression and tested for effect modification by weight status. Data were collected 2017–2018 and analyzed in 2022–2023.
Of 3,312 participants (representing 195,167,928 US adults), 43% did not notice labels, 30% noticed labels, and 27% used labels. Using labels was associated with HEI-2015 scores 4.0 points (95% CI 2.2, 5.8) higher than not noticing labels. HEI-2015 in those using labels were higher for adults with normal BMI (3.4 points; 95% CI 0.2, 6.7), overweight (6.5 points; 95% CI 3.6, 9.5), and obesity (3.0 points; 95% CI 1.0, 5.1)(p-interaction=0.0004), compared to those who did not notice labels.
Using menu calorie labels was associated with modestly healthier diet quality compared to not noticing labels, regardless of weight status, suggesting that providing caloric information may help some adults with food decisions. Menu calorie labeling has been implemented in food service businesses to promote healthy food choices; however, evidence is limited on whether label use is associated with healthier dietary intake. This study examined the association between menu calorie label use and diet quality and whether it varied by weight status. Adults in the National Health and Nutrition Examination Survey 2017-2018 who visited restaurants were included. Menu calorie label use was categorized as did not notice labels, noticed labels, and used labels. Diet quality was measured using the Healthy Eating Index 2015 (maximum score 100) by two 24-hour diet recalls. The association between menu calorie label use and diet quality was examined using multiple linear regression and tested for effect modification by weight status. Data were collected during 2017-2018 and analyzed during 2022-2023. Of 3,312 participants (representing 195,167,928 U.S. adults), 43% did not notice labels, 30% noticed labels, and 27% used labels. Using labels was associated with 4.0 points (95% CI 2.2, 5.8) higher Healthy Eating Index 2015 scores than not noticing labels. Healthy Eating Index 2015 scores in those using labels were higher for adults with normal BMI (3.4 points; 95% CI=0.2, 6.7), overweight (6.5 points; 95% CI=3.6, 9.5), and obesity (3.0 points; 95% CI=1.0, 5.1) (p-interaction=0.0004) than those who did not notice labels. Using menu calorie labels was associated with modestly healthier diet quality than not noticing labels, regardless of weight status. This suggests that providing caloric information may help some adults with food decisions. Menu calorie labeling has been implemented in food service businesses to promote healthy food choices; however, evidence is limited on whether label use is associated with healthier dietary intake. This study examined the association between menu calorie label use and diet quality and whether it varied by weight status.INTRODUCTIONMenu calorie labeling has been implemented in food service businesses to promote healthy food choices; however, evidence is limited on whether label use is associated with healthier dietary intake. This study examined the association between menu calorie label use and diet quality and whether it varied by weight status.Adults in the National Health and Nutrition Examination Survey 2017-2018 who visited restaurants were included. Menu calorie label use was categorized as did not notice labels, noticed labels, and used labels. Diet quality was measured using the Healthy Eating Index 2015 (maximum score 100) by two 24-hour diet recalls. The association between menu calorie label use and diet quality was examined using multiple linear regression and tested for effect modification by weight status. Data were collected during 2017-2018 and analyzed during 2022-2023.METHODSAdults in the National Health and Nutrition Examination Survey 2017-2018 who visited restaurants were included. Menu calorie label use was categorized as did not notice labels, noticed labels, and used labels. Diet quality was measured using the Healthy Eating Index 2015 (maximum score 100) by two 24-hour diet recalls. The association between menu calorie label use and diet quality was examined using multiple linear regression and tested for effect modification by weight status. Data were collected during 2017-2018 and analyzed during 2022-2023.Of 3,312 participants (representing 195,167,928 U.S. adults), 43% did not notice labels, 30% noticed labels, and 27% used labels. Using labels was associated with 4.0 points (95% CI 2.2, 5.8) higher Healthy Eating Index 2015 scores than not noticing labels. Healthy Eating Index 2015 scores in those using labels were higher for adults with normal BMI (3.4 points; 95% CI=0.2, 6.7), overweight (6.5 points; 95% CI=3.6, 9.5), and obesity (3.0 points; 95% CI=1.0, 5.1) (p-interaction=0.0004) than those who did not notice labels.RESULTSOf 3,312 participants (representing 195,167,928 U.S. adults), 43% did not notice labels, 30% noticed labels, and 27% used labels. Using labels was associated with 4.0 points (95% CI 2.2, 5.8) higher Healthy Eating Index 2015 scores than not noticing labels. Healthy Eating Index 2015 scores in those using labels were higher for adults with normal BMI (3.4 points; 95% CI=0.2, 6.7), overweight (6.5 points; 95% CI=3.6, 9.5), and obesity (3.0 points; 95% CI=1.0, 5.1) (p-interaction=0.0004) than those who did not notice labels.Using menu calorie labels was associated with modestly healthier diet quality than not noticing labels, regardless of weight status. This suggests that providing caloric information may help some adults with food decisions.CONCLUSIONSUsing menu calorie labels was associated with modestly healthier diet quality than not noticing labels, regardless of weight status. This suggests that providing caloric information may help some adults with food decisions. |
| Author | Van Horn, Linda O'Brien, Matthew J. Jia, Jenny Linder, Jeffrey A. Ackermann, Ronald T. Kandula, Namratha R. |
| AuthorAffiliation | 3 Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 1 Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 2 Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois |
| AuthorAffiliation_xml | – name: 1 Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois – name: 3 Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois – name: 2 Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois |
| Author_xml | – sequence: 1 givenname: Jenny orcidid: 0000-0001-6749-6918 surname: Jia fullname: Jia, Jenny email: Jenny.jia@northwestern.edu organization: Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois – sequence: 2 givenname: Linda surname: Van Horn fullname: Van Horn, Linda organization: Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois – sequence: 3 givenname: Jeffrey A. surname: Linder fullname: Linder, Jeffrey A. organization: Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois – sequence: 4 givenname: Ronald T. orcidid: 0000-0002-4006-0070 surname: Ackermann fullname: Ackermann, Ronald T. organization: Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois – sequence: 5 givenname: Namratha R. surname: Kandula fullname: Kandula, Namratha R. organization: Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois – sequence: 6 givenname: Matthew J. surname: O'Brien fullname: O'Brien, Matthew J. organization: Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois |
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