Evaluating the Application of Front-of-package Labelling Regulations to Menu Labelling in the Canadian Restaurant Sector Using Menu Food Label Information and Price (Menu-FLIP) 2020 Data

Overview

Journal Public Health Nutr

Publisher Cambridge University Press

Date 2024 Oct 31

PMID 39478431

Authors

Hayun Jeong

Yahan Yang

Christine Mulligan

Mary R LAbbe

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the application of front-of-package (FOP) labelling regulations to menu labelling in the Canadian restaurant sector by assessing the proportion of menu items that would be required to display the 'high-in' FOP symbol if the policy were extended to the restaurant sector.

Design: Nutrition information of 18 760 menu items was collected from 141 chain restaurants in Canada. Menu items were evaluated using the mandatory FOP labelling regulations promulgated in Canada Gazette II by Health Canada in July of 2022.

Setting: Chain restaurants with ≥20 establishments in Canada.

Participants: Canadian chain restaurant menu items including beverages, desserts, entrées, sides and starters.

Results: Overall, 77 % of menu items in the Canadian restaurant sector would display a 'high-in' FOP symbol. Among these menu items, 43 % would display 'high-in' one nutrient, 54 % would display 'high-in' two and 3 % would display 'high-in' all three nutrients-of-concern. By nutrient, 52 % were 'high-in' sodium, and 24 and 47 % were 'high-in' total sugars and saturated fat, respectively.

Conclusions: Given the poor nutritional quality of restaurant foods, the current regulations, if applied to restaurant foods, would result in most menu items displaying a FOP symbol. Therefore, expanding the Canadian FOP labelling regulations to the restaurant sector can be key to ensuring a healthy food environment for Canadians. Furthermore, menu labelling along with other multi-faceted approaches such as reformulation targets are necessary to improve the dietary intake of Canadians from restaurant foods.

References

Scourboutakos M, LAbbe M . Sodium levels in Canadian fast-food and sit-down restaurants. Can J Public Health. 2013; 104(1):e2-8. PMC: 6974083. View

Ahmed M, Schermel A, Lee J, Weippert M, Franco-Arellano B, LAbbe M . Development of the Food Label Information Program: A Comprehensive Canadian Branded Food Composition Database. Front Nutr. 2022; 8:825050. PMC: 8852278. DOI: 10.3389/fnut.2021.825050. View

Flexner N, Ng A, Ahmed M, Khandpur N, Acton R, Lee J . Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study. Front Nutr. 2023; 10:1098231. PMC: 10065472. DOI: 10.3389/fnut.2023.1098231. View

Ma Y, Gong W, Ding C, Song C, Yuan F, Fan J . The association between frequency of eating out with overweight and obesity among children aged 6-17 in China: a National Cross-sectional Study. BMC Public Health. 2021; 21(1):1005. PMC: 8161942. DOI: 10.1186/s12889-021-11104-0. View

Andreeva V, Egnell M, Touvier M, Galan P, Julia C, Hercberg S . International evidence for the effectiveness of the front-of-package nutrition label called Nutri-Score. Cent Eur J Public Health. 2021; 29(1):76-79. DOI: 10.21101/cejph.a6239. View

Petimar J, Ramirez M, Rifas-Shiman S, Linakis S, Mullen J, Roberto C . Evaluation of the impact of calorie labeling on McDonald's restaurant menus: a natural experiment. Int J Behav Nutr Phys Act. 2019; 16(1):99. PMC: 6829981. DOI: 10.1186/s12966-019-0865-7. View

English L, Ard J, Bailey R, Bates M, Bazzano L, Boushey C . Evaluation of Dietary Patterns and All-Cause Mortality: A Systematic Review. JAMA Netw Open. 2021; 4(8):e2122277. PMC: 8408672. DOI: 10.1001/jamanetworkopen.2021.22277. View

Dunford E, Wu J, Wellard-Cole L, Watson W, Crino M, Petersen K . A comparison of the Health Star Rating system when used for restaurant fast foods and packaged foods. Appetite. 2017; 117:1-8. DOI: 10.1016/j.appet.2017.06.005. View

Sarda B, Julia C, Serry A, Ducrot P . Appropriation of the Front-of-Pack Nutrition Label Nutri-Score across the French Population: Evolution of Awareness, Support, and Purchasing Behaviors between 2018 and 2019. Nutrients. 2020; 12(9). PMC: 7551644. DOI: 10.3390/nu12092887. View

10.

. Food labeling; nutrition labeling of standard menu items in restaurants and similar retail food establishments. Final rule. Fed Regist. 2014; 79(230):71155-259. View

11.

Croker H, Packer J, Russell S, Stansfield C, Viner R . Front of pack nutritional labelling schemes: a systematic review and meta-analysis of recent evidence relating to objectively measured consumption and purchasing. J Hum Nutr Diet. 2020; 33(4):518-537. DOI: 10.1111/jhn.12758. View

12.

Crockett R, King S, Marteau T, Prevost A, Bignardi G, Roberts N . Nutritional labelling for healthier food or non-alcoholic drink purchasing and consumption. Cochrane Database Syst Rev. 2018; 2:CD009315. PMC: 5846184. DOI: 10.1002/14651858.CD009315.pub2. View

13.

Bleich S, Soto M, Dunn C, Moran A, Block J . Calorie and nutrient trends in large U.S. chain restaurants, 2012-2018. PLoS One. 2020; 15(2):e0228891. PMC: 7010289. DOI: 10.1371/journal.pone.0228891. View

14.

Fogolari N, Souza A, Bernardo G, Uggioni P, Oliveira R, Rodrigues V . Qualitative menu labelling in university restaurants and its influence on food choices: A systematic review and synthesis without meta-analysis. Nutr Bull. 2023; 48(2):160-178. DOI: 10.1111/nbu.12612. View

15.

Scourboutakos M, LAbbe M . Restaurant menus: calories, caloric density, and serving size. Am J Prev Med. 2012; 43(3):249-55. DOI: 10.1016/j.amepre.2012.05.018. View

16.

Rincon-Gallardo P S, Zhou M, Da Silva Gomes F, Lemaire R, Hedrick V, Serrano E . Effects of Menu Labeling Policies on Transnational Restaurant Chains to Promote a Healthy Diet: A Scoping Review to Inform Policy and Research. Nutrients. 2020; 12(6). PMC: 7352298. DOI: 10.3390/nu12061544. View

17.

Kerins C, McHugh S, McSharry J, Reardon C, Hayes C, Perry I . Barriers and facilitators to implementation of menu labelling interventions from a food service industry perspective: a mixed methods systematic review. Int J Behav Nutr Phys Act. 2020; 17(1):48. PMC: 7161210. DOI: 10.1186/s12966-020-00948-1. View

18.

Hooper L, Martin N, Jimoh O, Kirk C, Foster E, Abdelhamid A . Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 2020; 8:CD011737. PMC: 8092457. DOI: 10.1002/14651858.CD011737.pub3. View

19.

Yang Y, Weippert M, Ahmed M, LAbbe M . Cross-Sectional Nutritional Information and Quality of Canadian Chain Restaurant Menu Items in 2020. Am J Prev Med. 2022; 64(1):42-50. DOI: 10.1016/j.amepre.2022.07.015. View

20.

Lachat C, Nago E, Verstraeten R, Roberfroid D, Van Camp J, Kolsteren P . Eating out of home and its association with dietary intake: a systematic review of the evidence. Obes Rev. 2011; 13(4):329-46. DOI: 10.1111/j.1467-789X.2011.00953.x. View