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. 2011 Jul 26:343:d4464.
doi: 10.1136/bmj.d4464.

Changes in energy content of lunchtime purchases from fast food restaurants after introduction of calorie labelling: cross sectional customer surveys

Tamara Dumanovsky  1 , Christina Y Huang, Cathy A Nonas, Thomas D Matte, Mary T Bassett, Lynn D Silver
Affiliations

Changes in energy content of lunchtime purchases from fast food restaurants after introduction of calorie labelling: cross sectional customer surveys

Tamara Dumanovsky et al. BMJ. .

Abstract

Objective: To assess the impact of fast food restaurants adding calorie labelling to menu items on the energy content of individual purchases.

Design: Cross sectional surveys in spring 2007 and spring 2009 (one year before and nine months after full implementation of regulation requiring chain restaurants' menus to contain details of the energy content of all menu items). Setting 168 randomly selected locations of the top 11 fast food chains in New York City during lunchtime hours.

Participants: 7309 adult customers interviewed in 2007 and 8489 in 2009.

Main outcome measures: Energy content of individual purchases, based on customers' register receipts and on calorie information provided for all items in menus.

Results: For the full sample, mean calories purchased did not change from before to after regulation (828 v 846 kcal, P = 0.22), though a modest decrease was shown in a regression model adjusted for restaurant chain, poverty level for the store location, sex of customers, type of purchase, and inflation adjusted cost (847 v 827 kcal, P = 0.01). Three major chains, which accounted for 42% of customers surveyed, showed significant reductions in mean energy per purchase (McDonald's 829 v 785 kcal, P = 0.02; Au Bon Pain 555 v 475 kcal, P<0.001; KFC 927 v 868 kcal, P<0.01), while mean energy content increased for one chain (Subway 749 v 882 kcal, P<0.001). In the 2009 survey, 15% (1288/8489) of customers reported using the calorie information, and these customers purchased 106 fewer kilocalories than customers who did not see or use the calorie information (757 v 863 kcal, P<0.001).

Conclusion: Although no overall decline in calories purchased was observed for the full sample, several major chains saw significant reductions. After regulation, one in six lunchtime customers used the calorie information provided, and these customers made lower calorie choices.

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Conflict of interest statement

Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare that (1) TD, CYH, CAN, and LDS had outside support for the submitted work through a grant from the Robert Wood Johnson Foundation awarded to the New York City Department of Health and Mental Hygiene; (2) no authors have relationships that might have an interest in the submitted work in the previous 3 years; (3) their spouses, partners, or children have no financial relationships that may be relevant to the submitted work; and (4) no authors have non-financial interests that may be relevant to the submitted work.

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