Restaurant calorie labels less likely to influence poor, uneducated

By Madeline Kennedy (Reuters Health) - People with higher income and education levels are more likely to make food choices based on calorie information in restaurant menus, according to a recent study that calls for new ways of displaying the information to make a wider impact. More than half of participants in the study of McDonald’s diners noticed menu calorie labels, but only 16 percent used the information to alter their eating habits. The calorie labels, which will become mandatory at the end of 2015 for large U.S. restaurant chains, are intended to help consumers make healthier choices. But past studies have produced mixed results on their effectiveness. “We think that this inconsistency is partly because calorie menu labels do not influence all segments of the population in the same manner,” said Punam Ohri-Vachaspati, associate professor of nutrition at Arizona State University and the study’s senior author. Ohri-Vachaspati and colleagues collected customer receipts and surveyed 329 people at 29 McDonald’s locations in and around Phoenix. Half of the restaurants were in high-income neighborhoods and half were in low-income neighborhoods. McDonald’s has been posting calorie labels on its menus since 2012. The research team analyzed the purchases and responses to determine the total number of calories in each customer’s order and how likely customers were to notice or use the menu labels. Customers also gave information about their education level and socioeconomic status. About 60 percent of participants said that they noticed the menus’ calorie labels, but only 16 percent reported actually using the information when choosing a food or drink order. People who did use the labels ate about 150 fewer calories than those who did not. Only about 8 percent of people earning less than $50,000 per year used the calorie labels to choose their food. A much larger proportion of higher income people - about 1 in 4 people earning between $50,000 and $100,000 and 1 in 5 people earning over $100,000 - used the labels. About a third of customers with a bachelor’s degree or more education used menu labels in their decisions, while only 1 in 10 people with a high school degree or less did the same. Factors including age, sex, race and frequency of eating fast food did not significantly affect whether people noticed or used the calorie labels. Noticing menu labels was not enough to influence the number of calories customers took in, and only people who reported using the nutrition information actually ate fewer calories, the authors note in the Journal of the Academy of Nutrition and Dietetics. James Krieger, founding executive director of Action for Healthy Food, told Reuters Health in an email that previous studies have shown people underestimate the caloric content of their food by as much as half. “The hope is that people will become more aware of the nutritional value and caloric content of foods available in chain restaurants and use that information to make healthier choices,” said Krieger, who was not involved in the study. Krieger agrees with the study team that there are more and potentially better ways to present caloric information than just a number. “There needs to be some work to figure out the best way to present this information so people can really understand it and use it,” Krieger said. One way he proposes is a simple graphic representation, which could engage people with lower literacy and numeracy skills. He also suggested placing the information in context by indicating how many hours of exercise it would take to burn the calories. Ohri-Vachaspati added that nutrition education needs to start early and that school-age children should be learning how to read labels. She called for efforts by the fast-food industry and public health community to “make it easier for consumers from all income and education backgrounds to understand and use calorie menu labels.” Under the Patient Protection and Affordable Care Act, the U.S. Food and Drug Administration will require all restaurants and food vendors with 20 or more locations to post calorie counts on their menus by December of this year, Ohri-Vachaspati pointed out. “People have the right to understand what food they’re buying and be able to make informed choices for their health,” Krieger said. SOURCE: bit.ly/1IQgKmd Journal of the Academy of Nutrition and Dietetics, online February 2, 2015.