A Meta-Analysis to Determine the Impact of Restaurant Menu Labeling on Calories and Nutrients (Ordered or Consumed) in U.S. Adults

Abstract

A systematic review and meta-analysis determined the effect of restaurant menu labeling on calories and nutrients chosen in laboratory and away-from-home settings in U.S. adults. Cochrane-based criteria adherent, peer-reviewed study designs conducted and published in the English language from 1950 to 2014 were collected in 2015, analyzed in 2016, and used to evaluate the effect of nutrition labeling on calories and nutrients ordered or consumed. Before and after menu labeling outcomes were used to determine weighted mean differences in calories, saturated fat, total fat, carbohydrate, and sodium ordered/consumed which were pooled across studies using random effects modeling. Stratified analysis for laboratory and away-from-home settings were also completed. Menu labeling resulted in no significant change in reported calories ordered/consumed in studies with full criteria adherence, nor the 14 studies analyzed with ≤1 unmet criteria, nor for change in total ordered carbohydrate, fat, and saturated fat (three studies) or ordered or consumed sodium (four studies). A significant reduction of 115.2 calories ordered/consumed in laboratory settings was determined when analyses were stratified by study setting. Menu labeling away-from-home did not result in change in quantity or quality, specifically for carbohydrates, total fat, saturated fat, or sodium, of calories consumed among U.S. adults.

Keywords: adults; calories; energy; food labeling; menu labeling; meta-analysis; nutrients; nutritional labeling; point-of-purchase.

Figure 1

Flow diagram of the literature search and filtering results following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) template.

Figure 2

Forest plot showing the overall and study-specific mean differences with 95% CI. For each condition or subgroup, the full dot represents the point estimate of the menu label effect. The horizontal lines join the lower and upper limits of the 95% CI of these effects. Before-intervention mean calories are shown in the control mean calories column for before and after study designs used by Krieger et al. [103], Pulos and Leng [106], and Downs et al. [102]. ^a SD, Standard Deviation; ^b CI, Confidence Interval; ^c n.a.: Data not available.