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Meta-Analysis
. 2015 May;105(5):e11-24.
doi: 10.2105/AJPH.2015.302570. Epub 2015 Mar 19.

Systematic review and meta-analysis of the impact of restaurant menu calorie labeling

Michael W Long  1 , Deirdre K Tobias, Angie L Cradock, Holly Batchelder, Steven L Gortmaker
Affiliations
Meta-Analysis

Systematic review and meta-analysis of the impact of restaurant menu calorie labeling

Michael W Long et al. Am J Public Health. 2015 May.

Abstract

We conducted a systematic review and meta-analysis evaluating the relationship between menu calorie labeling and calories ordered or purchased in the PubMed, Web of Science, PolicyFile, and PAIS International databases through October 2013. Among 19 studies, menu calorie labeling was associated with a -18.13 kilocalorie reduction ordered per meal with significant heterogeneity across studies (95% confidence interval = -33.56, -2.70; P = .021; I(2) = 61.0%). However, among 6 controlled studies in restaurant settings, labeling was associated with a nonsignificant -7.63 kilocalorie reduction (95% confidence interval = -21.02, 5.76; P = .264; I(2) = 9.8%). Although current evidence does not support a significant impact on calories ordered, menu calorie labeling is a relatively low-cost education strategy that may lead consumers to purchase slightly fewer calories. These findings are limited by significant heterogeneity among nonrestaurant studies and few studies conducted in restaurant settings.

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Figures

FIGURE 1—
FIGURE 1—
Summary of evidence search and selection of studies evaluating the relationship between menu calorie labeling and total calories ordered or purchased in PubMed, Web of Science, PolicyFile, and PAIS International through October 2013.
FIGURE 2—
FIGURE 2—
Change in calories ordered or purchased per meal or transaction associated with menu calorie labeling compared with standard menus stratified by restaurant and nonrestaurant setting: systematic review and meta-analysis of studies through October 2013. Note. CI = confidence interval. Weights are from random effects analysis. Horizontal lines represent the study 95% confidence intervals. Solid diamonds represent the point estimate (change in kcal ordered or purchased per meal) from each study. The open diamond represents the pooled estimate of the effect of menu labeling and the 95% confidence intervals around the estimate. The dashed line represents the point estimate of the pooled estimate. Results were stratified by study setting (restaurant vs nonrestaurant settings).
FIGURE 3—
FIGURE 3—
Change in calories ordered associated with menu calorie labeling compared with standard menus in restaurant settings stratified by study design: systematic review and meta-analysis of studies through October 2013. Note. CI = confidence interval. Horizontal lines represent the study 95% confidence intervals. Solid diamonds represent the point estimate study (change in kcal ordered or purchased per meal) from each study. The open diamond represents the pooled estimate of the effect of menu labeling and the 95% confidence interval around the estimate. The dashed line represents the point estimate of the pooled estimate.
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