Menu Calorie Label Use and Diet Quality: a Cross-Sectional Study

Area of Science:

• Public Health
• Nutrition Science
• Behavioral Science

Background:

• Menu calorie labeling is a public health strategy to encourage healthier food choices in food service establishments.
• Limited evidence exists on the direct association between menu calorie label utilization and actual improvements in dietary intake quality.
• Understanding how menu calorie label use impacts diet quality across different weight statuses is crucial for public health interventions.

Purpose of the Study:

• To investigate the association between the use of menu calorie labels and overall diet quality among U.S. adults dining at restaurants.
• To determine if this association is modified by an individual's weight status (normal BMI, overweight, obesity).

Main Methods:

• Utilized data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018, including adults who visited restaurants.
• Categorized menu calorie label use into 'did not notice,' 'noticed,' and 'used' labels.
• Assessed diet quality using the Healthy Eating Index 2015 (HEI-2015) based on two 24-hour dietary recalls; employed multiple linear regression to analyze associations and tested for effect modification by weight status.

Main Results:

• Among 3,312 participants (representing over 195 million U.S. adults), 27% reported using menu calorie labels.
• Using calorie labels was associated with significantly higher HEI-2015 scores (4.0 points higher) compared to not noticing labels.
• The positive association between label use and diet quality was observed across all weight categories (normal BMI, overweight, obesity), with statistically significant interaction by weight status (p=0.0004).

Conclusions:

• The utilization of menu calorie labels is associated with modestly improved diet quality among adults, irrespective of their weight status.
• Caloric information provided on menus appears to be a potentially useful tool for supporting healthier food choices for a segment of the adult population.
• Further research may explore specific mechanisms and populations benefiting most from menu calorie labeling.