Customer Responses to Mandatory Menu Labeling at Full-Service Restaurants

Background: In 2010, Philadelphia enacted a menu-labeling law requiring full-service restaurant chains to list values for calories, sodium, fat, and carbohydrates for each item on all printed menus. Purpose: The goal of the study was to determine whether purchase decisions at full-service restaurants varied depending on the presence of labeling. Methods: In August 2011, this cross-sectional study collected 648 customer surveys and transaction receipts at seven restaurant outlets of one large full-service restaurant chain. Two outlets had menu labeling (case sites); five outlets did not (control sites). Outcomes included differences in calories and nutrients purchased and customers’ reported use of nutrition information when ordering. Data were analyzed in 2012. Results: Mean age was 37 years; 60% were female; 50% were black/African-American and reported incomes Z$60,000. Customers purchased food with approximately 1600 kcal (food plus beverage, 1800 kcal); 3200 mg sodium; and 35 g saturated fat. After adjustment for confounders, customers at labeled restaurants purchased food with 151 fewer kilocalories (95% CI¼� 270, � 33); 224 mg less sodium (95% CI¼� 457, þ8); and 3.7 g less saturated fat (95% CI¼� 7.4, � 0.1) compared to customers at unlabeled restaurants (or 155 less kilocalories from food plus beverage, 95% CI¼� 284, � 27). Those reporting that nutrition information affected their order purchased 400 fewer food calories, 370 mg less sodium, and 10 g less saturated fat. Conclusions: Mandatory menu labeling was associated with better food choices among a segment of the public dining at full-service restaurants. Consumer education on the availability and use of nutrition information may extend the impact of menu labeling. (Am J Prev Med 2013;45(6):710–719) & 2013 American Journal of Preventive Medicine