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April 23, 2013 10:00 AM How to Make Menu Labeling Work

By Aaron Carroll

I’ve been skeptical about menu labeling, not because I think the idea is bad, but because I‘m unconvinced that it will work in practice. That said, I’m always happy to be proven wrong. I’ve personally found it can help guide my choices, but I’ve not yet seen that it will work on a public health scale.

Researchers are savvy, though, and they’ve come up with a new idea that might work better:

In this study we examined the effect of physical activity based labels on the calorie content of meals selected from a sample fast food menu. Using a web-based survey, participants were randomly assigned to one of four menus which differed only in their labeling schemes (n = 802): (1) a menu with no nutritional information, (2) a menu with calorie information, (3) a menu with calorie information and minutes to walk to burn those calories, or (4) a menu with calorie information and miles to walk to burn those calories. There was a significant difference in the mean number of calories ordered based on menu type (p = 0.02), with an average of 1020 calories ordered from a menu with no nutritional information, 927 calories ordered from a menu with only calorie information, 916 calories ordered from a menu with both calorie information and minutes to walk to burn those calories, and 826 calories ordered from the menu with calorie information and the number of miles to walk to burn those calories. The menu with calories and the number of miles to walk to burn those calories appeared the most effective in influencing the selection of lower calorie meals (p = 0.0007) when compared to the menu with no nutritional information provided. The majority of participants (82%) reported a preference for physical activity based menu labels over labels with calorie information alone and no nutritional information. Whether these labels are effective in real-life scenarios remains to be tested.

It’s old school now to put calories up on the menus. But these researchers tried putting up how much you’d need to walk (exercise) in order to burn off those calories. It wasn’t surprising that people ordered the most calories from when they had a menu with no information at all. They ordered about 90 calories less if you put calorie information on the menu, and about 100 calories less if you put both calorie information and the minutes you’d need to walk to burn them off on the menu. Here’s the kicker, though. They ordered almost 200 calories less if you put both the calorie information and the distance they’d need to walk to burn off the calories.

Why? I have no idea. Maybe people really don’t like the idea of walking far. But telling them how much they’d need to walk seemed to be more of a deterrent to eating high calorie foods than anything else. This deserves further thought.

[Originally posted at The Incidental Economist]

Aaron Carroll ,MD, is an associate professor of Pediatrics and the associate director of Children’s Health Services Research at Indiana University School of Medicine.
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