Changes in Calorie Content of Menu Items at Large Chain Restaurants After Implementation of Calorie Labels

Overview

Journal JAMA Netw Open

Publisher American Medical Association

Specialty General Medicine

Date 2021 Dec 30

PMID 34967879

Citations 14

Authors

Anna H Grummon

Joshua Petimar

Mark J Soto

Sara N Bleich

Denise Simon

Lauren P Cleveland

Anjali Rao

Jason P Block

Affiliations

Soon will be listed here.

Abstract

Importance: Calorie labeling on menus is required in US chain food establishments with 20 or more locations. This policy may encourage retailers to offer lower-calorie items, which could lead to a public health benefit by reducing customers' calorie intake from prepared foods. However, potential reformulation of restaurant menu items has not been examined since nationwide enforcement of this policy in 2018.

Objective: To examine the calorie content of menu items at large chain restaurants before and after implementation of federally mandated menu calorie labels.

Design, Setting, And Participants: This pre-post cohort study used restaurant menu data from MenuStat, a database of nutrition information for menu items offered in the largest chain restaurants in the US, collected annually from 2012 to 2019. The study comprised 35 354 menu items sold at 59 large chain restaurants in the US. Statistical analysis was conducted from February 4 to October 8, 2021.

Intervention: Nationwide implementation of menu calorie labeling.

Main Outcomes And Measures: Changes in menu items' calorie content after restaurant chains implemented calorie labels were estimated, adjusting for prelabeling trends. All menu items, continuously available items, items newly introduced to menus, and items removed from menus were examined separately.

Results: Among the 59 restaurant chains included in the study, after labeling, there were no changes in mean calorie content for all menu items (change = -2.0 calories; 95% CI, -8.5 to 4.4 calories) or continuously available items (change = -2.3 calories; 95% CI, -11.5 to 6.3 calories). Items that were newly introduced after labeling, however, had a lower mean calorie content than items introduced before labeling (change = -112.9 calories; 95% CI, -208.6 to -25.2 calories), although there was heterogeneity by restaurant type. Items removed from menus after labeling had similar calorie content as items removed before labeling (change = 0.5 calories; 95% CI, -79.4 to 84.0 calories).

Conclusions And Relevance: In this cohort study of large chain restaurants, implementing calorie labels on menus was associated with the introduction of lower-calorie items but no changes in continuously available or removed items.

Citing Articles

Estimating the impacts of calorie labels in fast-food settings using a novel comparison: Comparing California drive-through and in-store purchases.

Weitzman B, Heng L, Mijanovich T, Abrams C, Rummo P, Bragg M Appetite. 2025; 207:107864.

PMID: 39824223 PMC: 11884985. DOI: 10.1016/j.appet.2025.107864.

Introducing calorie labels in restaurants in England did not change customer behaviour.

Nat Hum Behav. 2025; 9(2):252-253.

PMID: 39747407 DOI: 10.1038/s41562-024-02069-2.

Evaluating the association between the introduction of mandatory calorie labelling and energy consumed using observational data from the out-of-home food sector in England.

Polden M, Jones A, Essman M, Adams J, Bishop T, Burgoine T Nat Hum Behav. 2024; 9(2):277-286.

PMID: 39587333 PMC: 11860223. DOI: 10.1038/s41562-024-02032-1.

The Impact of Non-Fiscal Mandatory and Voluntary Policies and Interventions on the Reformulation of Food and Beverage Products: A Systematic Review.

Packer J, Michalopoulou S, Cruz J, Dhar D, Stansfield C, Kaczmarska H Nutrients. 2024; 16(20).

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Navigating the online food environment: policy pathways for promoting food access, transparency, and healthy food choices online.

Greenthal E, Marx K, Friedman E, John S, Johnson J, LiPuma C Front Nutr. 2024; 11:1473303.

PMID: 39439521 PMC: 11494956. DOI: 10.3389/fnut.2024.1473303.

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