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Supplementing Menu Labeling With Calorie Recommendations to Test for Facilitation Effects

Downs, Julie S., Jessica Wisdom, Brian Wansink, and George Loewenstein. (2013).  Supplementing Menu Labeling With Calorie Recommendations to Test for Facilitation Effects. American Journal of Public Health, 103(9), 1604-1609. doi: 10.2105/AJPH.2013.301218.

In 2008 New York City began requiring chain restaurants to post calorie information on menus in an attempt to combat the obesity epidemic. Despite this law, research has found that most individuals do not utilize the listed calorie information when making meal selections. NYC added the requirement that daily calorie recommendations be added to menus in addition to the total calorie listing. However, this amendment has not proven to make the calorie information more useful and has been shown to have no impact on selections of overweight chain restaurant patrons.  We hypothesized that including on menus calorie recommendations per meal, rather than per day in addition to the calorie information would be more impactful in guiding costumers’ meal decisions.

To test the impact of daily calorie recommendations and per-meal calorie recommendations when added to menus, we conducted a survey of 1094 McDonald’s patrons in two locations, one in Brooklyn, NY and one in Manhattan, NY during lunchtime. Each patron was handed a slip that either gave daily or per-meal calorie recommendations, or no recommendation (control group). These recommendations were in addition to the already posted calorie information on the restaurant menus. The conditions were assigned randomly. Upon exiting the restaurant, participants returned their slip to the researchers and provided their receipt. In turn, participants were given $5 and asked to complete a survey. The survey asked them to estimate the calorie content of the meal they had just purchased, to estimate how many calories a doctor or nutritionist would recommend for them to eat in a day, and to report whether or not they had referred to the calorie information on the menu.  The survey also asked demographic information, including height and weight (to calculate BMI) and whether the individual was dieting (to adjust for recommended calorie intake).  The information reported was analyzed to determine whether any demographic and environmental information correlated with total meal calories. Next we analyzed the interaction between calorie postings and calorie recommendations. Finally researchers used a series of linear and logistic regressions to explore if any of the conditions in the study had an impact on food selection and accuracy when estimating calorie totals and whether there was any change in impact based on customer’s weight.

Results showed no significant interaction between calorie postings and calorie recommendations per day or per meal, indicating that individuals are not more likely to consume fewer calories when given calorie information combined with calorie recommendation. There was also no statistically significant relationship between calorie recommendations and the amount of food selected by overweight individuals. On average, patrons underestimated how many calories were in their meal. However, those who received the information on calorie recommendations did give relatively higher calorie estimates indicating that they were more aware of calorie count. This finding suggests that the calorie recommendations alone had an impact on consumers awareness of what they are buying but did not influence consumers to purchase fewer calories. We concluded that proving consumers with more information does not necessarily guide purchasing behavior. Instead, policy makers may have more success making it more convenient and easy for consumers to make healthy decisions through strategies such as promoting high-margin healthier items.