Health Policy Brief: Menu-Labeling Policy and Obesity Prevention

Statement of Issue:

The Affordable Care Act (ACA) required chain restaurants to post calorie information on their menus and menu boards (1). However, this policy is insufficient to create healthy diets; many restaurant chains display the calorie information only on websites or posters that may not be readily accessible when consumers are deciding what to eat. And usually people cannot get that information from the non-chain restaurants, because they are not required.

Background:

According to the data from researchers at the Centers for Disease Control and Prevention (CDC), approximately 40% of American adults are now obese in 2016 (2). Obesity may increase the risk of many health problems, including diabetes, heart disease, and certain cancers. Presently, Americans spend over $600 billion annually in foods made outside the home (2). Due to convenient and inexpensive, fast food chains are particularly popular, for example, one third of adults and children eat at fast-food restaurants (2). As we all know, fast food consumption is associated with increased total caloric intake and bodyweight. However, most people are unaware or underestimate the amount of calories, fat, sodium, or sugar in a typical fast-food meal.

In response to high rates of obesity in the USA, the federal menu labeling rule related to poor diet and obesity was the requirement mandates calorie labeling in chain restaurants or similar retail food establishments with 20 or more locations on their menus (1). The policymakers believes that putting nutrition information on menus and menu boards will help people access more nutrition information when they purchase food and beverage, which will lead to a healthier choices.

Landscape:

• Dietitians: The new menu labeling requirements expand job opportunities for dietitians (3). To ensure accuracy of the nutrient content being displayed, many restaurant industries may need knowledgeable dietitians to consult.
• Restaurateurs, particularly the pizza industry: Complying with the menu labeling requirements, some consumers may wouldn’t order certain meals anymore or change restaurant once they realized how many calories they contained. All these will result in reducing the turnover of the restaurants. In addition, the nutrient analyses may create the added expense for restaurateurs. The major cost considerations associated with complying with the policy including hiring the consultants, revising or replacing existing menus and menu boards, training employees to understand nutrition information to ensure compliance (3).
• Restaurant consumers: the new menu labeling policy can help consumers aware the nutrition information at the point of purchase and enable them to make more informed and healthful choices. So as to help prevent chronic disease.

Policy Options:

• The restaurants should add more meals which consists more fruits and vegetable into menus and also make healthy beverage. Restaurants need to be accompanied by measures to improve the affordability and accessibility of healthy foods, particularly fresh products, no trans fats and less saturated fats. Menu labeling on its own is insufficient to create healthy diets. Governments can do more to let the chain restaurants to produce and promote more meal options with low in calories, fat, sugar, and salt.
• Advantages: adding more fruits and vegetable into menus may change consumer and restaurant behavior (4). It could encourage consumers to dine exclusively at restaurants with high fiber meal options. It could motivate the restaurant industry to reformulate products so that they contain more fresh foods.
• Disadvantages: People who want to purchase the less fiber and more energy might use menu labels to help them make higher energy choices and avoid fresh food meals. It will be too costly for chains to analyze their menu items and recipe reformulation. It could result in loss of business.
• The chain restaurant should concern children’s intake amount when post nutrition information on their menus and menu boards. According to the recommendations from the American Heart Association (AHA), the limitation of children’s sugar consumption is no more than 6 teaspoons per day. The restaurant should follow the AHA’s guidance when they develop, reformulate, and updated the menu label. For example, no longer promote soda for children’s meals.
• Advantages: Posting children intake related nutrients information may encourage chains to improve the nutritional content of their menus.
• Disadvantages: Customers expect speedy service at chain restaurants, especially fast-food restaurants. Service will slow if the parents are reading the recommendation of children intake.
• A federal should encourage other establishments not included in the federal regulations, such as non-chain restaurants, schools, hospitals, and other institutions with cafeterias to implement the menu labeling rules voluntarily. If all dining establishments can provide calorie information, the consumer awareness of healthy diet may increase over time. For example, decreasing the frequency of eating out, changing behaviors of food ordering.
• Advantages: Due to widely implemented menu labeling, customer awareness and use of labels may increase, and also generally raise awareness about eating healthfully.
• Disadvantages: to avoid loss of business and make additional lower-calorie options available, restaurants may reformulate menu items and reduce portion sizes.

Policy Recommendation:

Obesity is a complex problem caused by many factors. Menu labeling, especially more vegetable and fruit information on menu, can be part of the solution by giving people healthy diets information. Although fresh foods information provided by the menu label are limited in the ability to influence people’s behaviors, for example some people remain choose whatever they wish to eat, the scope of menu labeling is similar to surgeon general warnings on cigarette packages (5). Menu labeling is a strategy with the potential for broad reach and the purpose is to increase the healthy eating awareness not only the customers but also the restaurateurs. Over time, more and more people may positively purchase high fiber meal at restaurants, as well as some restaurants may offer more high fiber items.

References:

1. https://stateofobesity.org/policy/menu-labeling/
2. https://sites.sph.harvard.edu/evergreen/2017/10/18/understanding-the-impact-of-menu-labeling-on-consumer-and-restaurant-behavior/
3. https://www.todaysdietitian.com/newarchives/0918p38.shtml
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5124489/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4451934/