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. 2018 Feb 27;2(6):CD009315.
doi: 10.1002/14651858.CD014845.

Energy (calorie) labelling for healthier selection and consumption of food or alcohol

Natasha Clarke, Theresa M Marteau, Mark Pilling, Nia W Roberts, Susan A Jebb, Gareth J Hollands

Energy (calorie) labelling for healthier selection and consumption of food or alcohol

Natasha Clarke et al. Cochrane Database Syst Rev. .

Update in

Abstract

This is a protocol for a Cochrane Review (intervention). The objectives are as follows:

  1. To estimate the effect of energy labelling for food (including non‐alcoholic drinks) and alcoholic drinks on healthier selection (with or without purchasing) and consumption.

  2. To assess possible modifiers – energy label type, setting and socioeconomic status ‐ of the effect of energy labelling on selection and consumption of food and alcohol.

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Conflict of interest statement

Declarations of interest Natasha Clarke declares no financial or other conflicts of interest. Theresa Marteau declares no financial or other conflicts of interest. Mark Pilling declares no financial or other conflicts of interest. Nia Roberts declares no financial or other conflicts of interest. Susan Jebb declares no financial or other conflicts of interest. Gareth Hollands declares no financial or other conflicts of interest.

Figures

1
1
Examples of energy labels used in practice
2
2
Logic model of the process by which energy labelling may have an impact on key behaviours. Blue shaded sections are the focus of the current review.
See this image and copyright information in PMC

References

Additional references

All‐Ireland Hub 2020
    1. All-Ireland Hub for Trials Methodology Research. Education section – Studies within a review (SWAR). Journal of Evidence-Based Medicine 2012;5:188-89. [DOI: 10.1111/j.1756-5391.2012.01193.x] - DOI - PubMed
Bann 2017
    1. Bann D, Johnson W, Li L, Kuh D, Hardy R. Socioeconomic inequalities in body mass index across adulthood: coordinated analyses of individual participant data from three British birth cohort studies initiated in 1946, 1958 and 1970. PLoS Medicine 2017;14 (1):e1002214. [DOI: 10.1371/journal.pmed.1002214] - DOI - PMC - PubMed
Bollinger 2011
    1. Bollinger B, Leslie P, Sorensen A. Calorie posting in chain restaurants. American Economic Journal-Economic Policy 2011;3 (1):91-128.
Clarke 2020a
    1. Clarke N, Pechey E, Kosīte D, König LM, Mantzari E, Blackwell AK, et al. Impact of health warning labels on selection and consumption of food and alcohol products: systematic review with meta-analysis. Health Psychology Review 2020:1-24. [DOI: 10.1080/17437199.2020.1780147] - DOI - PMC - PubMed
Clarke 2020b
    1. Clarke N, Pechey E, Mantzari E, Blackwell AK, De-loyde K, Morris RW, et al. Impact of health warning labels on snack selection: an online experimental study. Appetite 2020;154:104744. [DOI: 10.1016/j.appet.2020.104744] - DOI - PMC - PubMed
Cochrane Public Health Review Group 2011
    1. Cochrane Public Health Group. Guide for Developing a Cochrane Protocol; 24 November 2011. Available at: ph.cochrane.org/sites/ph.cochrane.org/files/public/uploads/Guide%20for%2....
Cowburn 2005
    1. Cowburn G, Stockley L. Consumer understanding and use of nutrition labelling: a systematic review. Public Health Nutrition 2005;8(1):21-8. - PubMed
Crockett 2018
    1. Crockett RA, King SE, Marteau TM, Prevost AT, Stubbs B, Bignardi G, et al. Nutritional labelling for healthier food or non-alcoholic drink purchasing and consumption. Cochrane Database of Systematic Reviews 2018, Issue 2. Art. No: CD009315. [DOI: 10.1002/14651858.CD009315.pub2] - DOI - PMC - PubMed
Daley 2020
    1. Daley AJ, McGee E, Bayliss S, Coombe A, Parretti HM. Effects of physical activity calorie equivalent food labelling to reduce food selection and consumption: systematic review and meta-analysis of randomised controlled studies. Journal of Epidemiology and Community Health 2020;74 (3):269-275. [DOI: 10.1136/jech-2019-213216] - DOI - PubMed
Das 2012
    1. Das P, Horton R. Rethinking our approach to physical activity. Lancet 2012;80 (9838):189-90. [DOI: 10.1016/S0140-6736(12)61024-1] - DOI - PubMed
Deeks 2020
    1. Deeks JJ, Higgins JP, Altman DG, on behalf of the Cochrane Statistical Methods Group. Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.1.9 (updated September 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.
DeGroot 2012
    1. DeGroot MH, Schervish MJ. Probability and Statistics. 4th edition. Boston (MA): Addison-Wesley, 2012.
Department of Health and Social Care  2018
    1. Department of Health and Social Care. Childhood obesity: a plan for action, Chapter 2; June 2018. https://assets.publishing.service.gov.uk/government/uploads/system/uploa....
Department of Health and Social Care 2020a
    1. Department of Health and Social Care. Tackling obesity: empowering adults and children to live healthier lives. www.gov.uk/government/publications/tackling-obesity-government-strategy/... (accessed prior to 8 May 2021).
Department of Health and Social Care 2020b
    1. Department of Health and Social Care. Mandating calorie labelling in the out-of-home sector: Government response to public consultation; 2020. Available at assets.publishing.service.gov.uk/government/uploads/system/uploads/attac....
Dobbs 2014
    1. Dobbs R, Sawers C, Thompson F, Manyika J, Woetzel J, Child P, et al. Overcoming obesity: an initial economic analysis. McKinsey Global Institute; 1 November 2014. www.mckinsey.com/insights/economic studies/how the world could better fight obesity (accessed prior to 8 May 2021).
Dubbert 1984
    1. Dubbert PM, Johnson WG, Schlundt DG, Montague NW. The influence of caloric information on cafeteria food choices. Journal of Applied Behavior Analysis 1984;17 (1):85-92. - PMC - PubMed
Dumanovsky 2011
    1. Dumanovsky T, Huang CY, Nonas CA, Matte TD, Bassett MT, Silver LD, et al. Changes in energy content of lunchtime purchases from fast food restaurants after introduction of calorie labelling: cross sectional customer surveys. BMJ 2011;343:d4464. - PMC - PubMed
EASO 2021
    1. European Association for the Study of Obesity. Obesity statistics. easo.org/media-portal/statistics/ (accessed prior to 8 May 2021).
Eldridge 2020
    1. Eldridge S, Campbell MK, Campbell MJ, Drahota AK, Giraudeau B, Reeves BC, et al. Revised Cochrane risk of bias tool for randomized trials (RoB 2). Additional considerations for cluster-randomized trials (RoB 2 CRT); 10 November 2020. Available at training.cochrane.org/sites/training.cochrane.org/files/public/uploads/S....
EPOC 2017
    1. Cochrane Effective Practice and Organisation of Care (EPOC). Analysis in EPOC reviews. EPOC resources for review authors; 13 March 2019. Available at www.epoc.cochrane.org/sites/epoc.cochrane.org/files/public/uploads/Resou....
European Food Information Council 2018
    1. European Food Information Council (EUFIC). Global Update on Nutrition Labelling; the 2018 edition. Available at www.eufic.org/images/uploads/healthy-living/Executive-Summary-GUNL-2018-....
European Union 2011
    1. European Union. Regulation (EU) No 1169/2011 of the European Parliament and of the Council of 25 October 2011. Official Journal of the European Union L304 of November 2011:18–63.
Food and Drug Administration 2016
    1. Food and Drug Administration (FDA). Guide to creating a front of pack (FoP) nutrition label for pre-packaged products sold through retail outlets; updated November 2016. Available at www.food.gov.uk/sites/default/files/media/document/fop-guidance_0.pdf.
GRADEpro GDT [Computer program]
    1. McMaster University (developed by Evidence Prime) GRADEpro GDT. Version accessed prior to 8 May 2021. Hamilton (ON): McMaster University (developed by Evidence Prime). Available at gradepro.org.
Guyatt 2011
    1. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction - GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology 2011;64(4):383–394. - PubMed
Harnack 2008
    1. Harnack LJ, French SA, Oakes JM, Story MT, Jeffery RW, Rydell SA. Effects of calorie labeling and value size pricing on fast food meal choices: results from an experimental trial. International Journal of Behavioral Nutrition and Physical Activity 2008;5:63. - PMC - PubMed
Health Survey for England 2018
    1. Heath Survey for England (HSE). Health Survey for England 2018. Overweight and obesity in adults and children; 3 December 2019. Available at files.digital.nhs.uk/52/FD7E18/HSE18-Adult-Child-Obesity-rep.pdf.
Higgins 2021a
    1. Higgins JP, Eldridge S, Li T. Chapter 23: Including variants on randomized trials. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021). Cochrane, 2021. Available from handbook.cochrane.org.
Higgins 2021b
    1. Higgins JP, Eldridge S, Li T, Sterne J (editors), on behalf of the RoB 2 working group on crossover trials. Revised Cochrane risk of bias tool for randomized trials (RoB 2) Additional considerations for crossover trials; 18 March 2021. Available at sites.google.com/site/riskofbiastool/welcome/rob-2-0-tool/rob-2-for-cros....
Hollands 2013
    1. Hollands GJ, Shemilt I, Marteau TM, Jebb SA, Kelly MP, Nakamura R, et al. Altering choice architecture to change population health behaviour: a large-scale conceptual and empirical scoping review of interventions within micro-environments. Cambridge: University of Cambridge, 2013. - PMC - PubMed
Hollands 2015
    1. Hollands GJ, Shemilt I, Marteau TM, Jebb SA, Lewis HB, Wei Y, et al. Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No: CD011045. [DOI: 10.1002/14651858.CD011045.pub2] - DOI - PMC - PubMed
Hollands 2016
    1. Hollands GJ, Marteau TM, Fletcher PC. Nonconscious processes in changing health-related behaviour: a conceptual analysis and framework. Health Psychology Review 2016;10 (4):381-94. [DOI: 10.1080/17437199.2015.1138093] - DOI - PMC - PubMed
Hollands 2017
    1. Hollands GJ, Bignardi G, Johnston M, Kelly MP, Ogilvie D, Petticrew M, et al. The TIPPME intervention typology for changing environments to change behaviour. Nature Human Behaviour 2017;1:0140.
Hollands 2019
    1. Hollands, GJ, Carter P, Anwer S, King SE, Jebb SA, Ogilvie D, Shemilt I, Higgins JPT, Marteau TM. Altering the availability or proximity of food, alcohol, and tobacco products to change their selection and consumption. Cochrane Database of Systematic Reviews 2019, Issue 8. Art. No: CD012573. [DOI: 10.1002/14651858.CD012573.pub2] - DOI - PMC - PubMed
Lorenc 2013
    1. Lorenc T, Petticrew M, Welch V, Tugwell P. What types of interventions generate inequalities? Evidence from systematic reviews. Journal of Epidemiology and Community Health 2013;67(2):190-193. [DOI: 10.1136/jech-2012-201257] - DOI - PubMed
Marteau 2012
    1. Marteau TM, Hollands GJ, Fletcher PC. Changing human behaviour to prevent disease: the importance of targeting automatic processes. Science 2012;337(6101):1492-5. - PubMed
McKenzie 2020
    1. McKenzie J, Brennan S. Chapter 12: Synthesizing and presenting findings using other methods. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.
Microsoft 2020 [Computer program]
    1. Microsoft Academic. Version accessed 8 October 2020. Microsoft. Available at academic.microsoft.com/home.
National Centre for Social Research 2012
    1. National Centre for Social Research. National Diet and Nutrition Survey Years 1-4, 2008/09-2011/12. London, UK: National Centre for Social Research, 2012.
NCD Countdown 2020
    1. NCD Countdown 2030 collaborators. NCD Countdown 2030: pathways to achieving Sustainable Development Goal target 3.4. Lancet 2020;396(10255):918-934. [DOI: 10.1016/S0140-6736(20)31761-X] - DOI - PMC - PubMed
NHS Digital 2019
    1. NHS Digital. National Child Measurement Programme, England 2018/19 School Year [NS]; October 2019. Available at digital.nhs.uk/data-and-information/publications/statistical/national-ch... (accessed prior to 8 May 2021).
Obesity Policy Coalition 2018
    1. Obesity Policy Coalition. Policy brief: Kilojoule labelling in chain food outlets. Available at https://www.opc.org.au/downloads/policy-briefs/menu-kj-labelling-in-chai... ; Jan 2018 201 8.
Public Health England 2016
    1. Public Health England. National Diet and Nutrition Survey: Results from Years 5 and 6 (combined) of the Rolling Programme (2012/2013 –2013/2014); 9 September 2016. Available at www.gov.uk/government/statistics/ndns-results-from-years-5-and-6-combined (accessed prior to 8 May 2021).
Public Health England 2017
    1. Public Health England. Health matters: obesity and the food environment; 31 March 2017. Available at www.gov.uk/government/publications/health-matters-obesity-and-the-food-e... (accessed prior to 8 May 2021).
Public Health England 2018
    1. Calorie reduction: the scope and ambition for action; March 2018. https://assets.publishing.service.gov.uk/government/uploads/system/uploa....
Reeves 2020
    1. Reeves B, Deeks J, Higgins JP, Shea B, Tugwell P, Wells GA, on behalf of the Cochrane Non-Randomized Studies of Interventions Methods Group. Chapter 24: Including non-randomized studies on intervention effects. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.
Rehm 2018
    1. Rehm J, Guiraud J, Poulnais R, Shield KD. Alcohol dependence and very high risk level of alcohol consumption: a life-threatening and debilitating disease. Addiction Biology 2018;23 (4):961-968. [DOI: 10.1111/adb.12646] - DOI - PubMed
Review Manager [Computer program]
    1. Nordic Cochrane Centre, The Cochrane Collaboration Review Manager 5 (RevMan 5). Version 5.4.1. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2020.
Robinson 2019
    1. Robinson E, Burton S, Gough T, Jones A, Haynes A. Point of choice kilocalorie labelling in the UK eating out of home sector: a descriptive study of major chains. BMC Public Health 2019;19(1):649. [DOI: 10.1186/s12889-019-7017-5] - DOI - PMC - PubMed
Robinson 2021
    1. Robinson E, Marty L, Jones A, White M, Smith R, Adams J. Will calorie labels for food and drink served outside the home improve public health? BMJ 2021;372:n40. [DOI: 10.1136/bmj.n40] - DOI - PubMed
Royal Society for Public Health 2014
    1. Royal Society for Public Health. Increasing awareness of ‘invisible’ calories from alcohol; November 2014. Available at www.rsph.org.uk/static/uploaded/979245d2-7b5d-4693-a9b3fb1b98b68d76.pdf.
Royal Society for Public Health 2018
    1. Royal Society for Public Health. Labelling the point: towards better alcohol health information; January 2018. Available at https://www.rsph.org.uk/static/uploaded/4ae31b49-c4d7-4355-ad94a660aba36....
Sarink 2016
    1. Sarink D, Peeters A, Freak-Poli R, Beauchamp A, Woods J, Ball K, et al. The impact of menu energy labelling across socioeconomic groups: a systematic review. Appetite 2016;99:59–75. [DOI: 10.1016/j.appet.2015.12.022] - DOI - PubMed
Schünemann 2019
    1. Schünemann HJ, Cuello C, Akl EA, MustafaJörg RA, Meerpohl J, Thayer K, et al. GRADE guidelines: 18. How ROBINS-I and other tools to assess risk of bias in nonrandomized studies should be used to rate the certainty of a body of evidence. Journal of Clinical Epidemiology 2019;111:105-114. [DOI: 10.1016/j.jclinepi.2018.01.012] - DOI - PMC - PubMed
Schünemann 2021
    1. Schünemann HJ, Higgins JPT, Vist GE, Glasziou P, Akl EA, Skoetz N, Guyatt GH. Chapter 14: Completing ‘Summary of findings’ tables and grading the certainty of the evidence. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.2. Cochrane, 2021. Available from handbook.cochrane.org.
Shangguan 2019
    1. Shangguan S, Afshin A, Shulkin M, Ma W, Marsden D, Smith J, et al. A meta-analysis of food labeling effects on consumer diet behaviors and industry practices. American Journal of Preventive Medicine 2019;56 (2):300-314. [DOI: 10.1016/j.amepre.2018.09.024] - DOI - PMC - PubMed
Sheeran 2016
    1. Sheeran P, Webb TL. The intention–behavior gap. Social and Personality Psychology Compass 2016;10 (9):503-518. [DOI: 10.1111/spc3.12265] - DOI
Shemilt 2019
    1. Shemilt I, Thomas J. MAG-Net-ise it! How the use of Microsoft AcademicGraph with machine learning classifiers can revolutionise study identification for systematic reviews. Oral paper accepted for presentation at the 26th Cochrane Colloquium 2019.
Sheron 2016
    1. Sheron N, Gilmore I. Effect of policy, economics, and the changing alcohol marketplace on alcohol related deaths in England and Wales. BMJ 2016;353:i1860. [DOI: 10.1136/bmj.i1860] - DOI - PubMed
Sinha 2015
    1. Sinha A, Shen Z, Song S, Ma H, Eide D, Hsu B-J, et al. An Overview of Microsoft Academic Service (MA) and Applications ; May 2015. http://www2015.thewebconf.org/documents/proceedings/companion/p243.pdf 2015:243-246. [DOI: ]
Statistica 2019
    1. Statistica. UK: Population, by age 2019. www.statista.com/statistics/281174/uk-population-by-age/ (accessed prior to 8 May 2021).
Sterne 2016a
    1. Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomized studies of interventions. BMJ 2016;355:i4919. - PMC - PubMed
Sterne 2016b
    1. Sterne JA, Higgins JP, Elbers RG, Reeves BC, the development group for ROBINS-I. Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I): detailed guidance; 2016. www.riskofbias.info (accessed April 2021).
Sterne 2019
    1. Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:i4898. [DOI: 10.1136/bmj.l4898] - DOI - PubMed
Sterne 2020
    1. Sterne JA, Hernán MA, McAleenan A, Reeves BC, Higgins JP. Chapter 25: Assessing risk of bias in a non-randomized study. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane, 2020. Available from handbook.cochrane.org.
Thomas 2020 [Computer program]
    1. EPPI-Centre EPPI-Reviewer: advanced software for systematic reviews, maps and other evidence synthesis.. Thomas J, Graziosi S, Brunton J, Ghouze Z, O'Driscoll P, Bond M. London: UCL Social Research Institute: EPPI-Centre, 2020.
Tremmel 2017
    1. Tremmel M, Gerdtham U-G, Nilsson PM, Saha S. Economic burden of obesity: a systematic literature review. International Journal of Environmental Research and Public Health 2017;14(4):435. [DOI: 10.3390/ijerph14040435] - DOI - PMC - PubMed
Vasiljevic 2018
    1. Vasiljevic M, Fuller G, Pilling M, Hollands GJ, Pechey R, Jebb SA, et al. What is the impact of increasing the prominence of calorie labelling? A stepped wedge randomised controlled pilot trial in worksite cafeterias. International Journal of Behavioral Nutrition and Physical Activity 2018;15(1):41. [DOI: 10.1186/s12966-018-0671-7] - DOI - PMC - PubMed
Vasiljevic 2019
    1. Vasiljevic M, Fuller G, Pilling M, Hollands GJ, Pechey R, Jebb SA, et al. What is the impact of increasing the prominence of calorie labelling? A stepped wedge randomised controlled pilot trial in worksite cafeterias. Appetite 2019;141:104304. [DOI: 10.1016/j.appet.2019.05.035] - DOI - PMC - PubMed
Welch 2012
    1. Welch V, Petticrew M, Tugwell P, Moher D, O’Neill J, Waters E, et al. PRISMA-Equity 2012 Extension: reporting guidelines for systematic reviews with a focus on health equity. PLoS Medicine 2012;9(10):e1001333. [DOI: 10.1371/journal.pmed.1001333] - DOI - PMC - PubMed
Winkleby 1992
    1. Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: How education, income, and occupation contribute to risk factors for cardiovascular disease. American Journal of Public Health 1992;82(6):816–820. - PMC - PubMed
World Cancer Research Fund 2021
    1. World Cancer Research Fund. NOURISHING framework. www.wcrf.org/int/policy/policy-databases/nourishing-framework (accessed prior to 8 May 2021).
World Health Organization 2004
    1. World Health Organization. Global Strategy, on Diet, Physical Activity and Health. www.who.int/dietphysicalactivity/en/ (accessed prior to 8 May 2021).
World Health Organization 2017
    1. World Health Organization. Alcohol Labelling: A discussion document on policy options; 2017. Available at www.euro.who.int/__data/assets/pdf_file/0006/343806/WH07_Alcohol_Labelli....
World Health Organization 2018
    1. World Health Organization. Global status report on alcohol and health. www.who.int/substance_abuse/publications/global_alcohol_report/en/ (accessed prior to 8 May 2021).
World Health Organization 2020a
    1. World Health Organization. Obesity. www.who.int/news-room/facts-in-pictures/detail/6-facts-on-obesity (accessed prior to 8 May 2021).
Zlatevska 2018
    1. Zlatevska N, Neumann N, Dubelaar C. Mandatory calorie disclosure: a comprehensive analysis of its effect on consumers and retailers. Journal of Retailing 2018;94(1):89-101. [DOI: 10.1016/j.jretai.2017.09.007] - DOI

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