Collaboration in Civic Spheres

Calories drop, under King County fast-food menu labeling

by Matt Rosenberg May 25th, 2013

A new study by researchers at Public Health – Seattle and King County, just published in the June online edition of the American Journal of Preventive Medicine, finds that King County-mandated menu labeling at major fast food chains may finally be starting to have the desired effect. On average, customers are consuming 870 calories per lunch 16-18 months after labeling began – 38 calories less or the rough equivalent of one slice of bacon. It’s a reversal from initial results 4-6 months afterward showing a caloric increase. Along with other studies the findings “suggest that menu labeling” at fast food outlets “has the potential to contribute to obesity prevention,” the authors write. Last year some of the researchers involved in the new study reported in another paper they were seeing longer-term improvements, but they did not release any actual data at the time.

Taking a longer view
The results are a correlation, not a causation and the study emphasizes that a variety of other factors could have influenced the outcomes. But the authors stress that the “modest” improvements seen are also significant because it’s the first longer-term look at possible connections between required menu labeling at fast-food outlets and caloric intake of customers. Studies elsewhere have focused on changes between baseline measurements and a few months later, but not as much as 16-18 months.

Hold the queso, por favor
Improvements in calorie-cutting were greatest at taco chains, and among women, customers under 40, and in non-low-income and less diverse locales. At coffee chains, the average drop – measured just for barista-prepared drinks – was smaller than at food chains, 22 calories.

One quarter say they’re using the posted info
The study team learned not only about caloric intake but also of who is and isn’t paying attention to the menu information, which includes not only calories for each item, but also fat and sodium content. In participating King County fast food chain locations the percent of patrons who saw the publicly posted caloric data grew to six of 10 by 16-18 months after the labeling began, but the percent who said they used the data to make purchasing decisions was just 23.9 percent.

Reason to be encouraged, says co-author
Still, that information “user” cohort has grown considerably since prior to labeling and now is roughly one-fifth of the 1 million people a week who eat out in fast-food chain spots in King County actually use it in making their buying decisions, said one of the study’s lead authors, Nadine Chan. She is Assistant Chief of Public Health – Seattle and King County’s Assessment, Policy Development and Evaluation Unit.

Multi-pronged approach required
Added Chan, “Just having the calorie information there isn’t going to be a silver bullet, but it is meaningful and useful for some people. This is one strategy in cutting calories” and trying to help consumers avoid becoming overweight or obese. Other pathways include working with the food industry, restaurants and institutional meal providers such as hospitals and schools to offer more healthy choices and more modest portion sizes, Chan said.

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For this probe, researchers compared average caloric intake at a representative sample of major fast-food and coffee chains in King County during a “baseline” period one to three months before before county menu labeling regulations went into effect in January 2009, and then compared that data with 4-6 months later (“Post 1″) and 16-18 months hence (“Post 2″).

At each stage, teams of interviewers descended on 90 percent of the incoming foot traffic, targeting English-speaking patrons age 14 or over with itemized receipts. Chains participating were Subway, McDonalds, Taco del Mar, Taco Time, Starbuck’s, Quizno’s, Tully’s, Jack in the Box, Burger King, and Taco Bell. A total of 50 different sites were involved. There were more than 2,400 participants in each of the first two rounds, and more than 2,700 in the last.

There are 21 other U.S. jurisdictions requiring some form of menu labeling at fast food chain locations, and a new federal menu labeling law will be going into effect, according to the study.


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