Calorie labels on menus could prevent, delay heart-related deaths
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Key takeaways:
- A policy in England requiring calorie labeling on menus for large food businesses may reduce or delay CVD-related deaths.
- Models suggest the policy may also reduce obesity prevalence.
Mandated calorie labeling for large food businesses in England could prevent more than 700 CV-related deaths during the next 20 years and potentially thousands more if expanded to all English food establishments, modeling data show.
“Previous studies have suggested that calorie labeling on menus has a double effect — it allows customers to make informed decisions and choose options with fewer calories whilst also encouraging companies to reduce the calories in their food,” Zoe Colombet, PhD, MSc, a lecturer in epidemiology and public health at the University of Liverpool, U.K. said in a press release. “The large out-of-home food businesses represent a small portion of all out-of-home food businesses in England, and as more than half of them already provided calorie information on their menus before the introduction of this legislation in 2022, the policy in its current form only impacts a small proportion of all out-of-home food businesses in England.”
As part of a national strategy to combat obesity, the U.K. government implemented mandatory energy labeling for any out-of-home businesses in England that serve food and have at least 250 employees in April 2022. Previous studies from the U.K., the U.S. and Canada suggest menu calorie labeling is associated with people ordering meals with approximately 47 fewer kilocalories and to businesses reducing the average calorie content of their meals by 15 kcal, Colombet and colleagues wrote in The Lancet Public Health. The researchers modeled the impact of menu calorie labeling on obesity and CVD-related deaths in England, also assessing how the effect varies for different socioeconomic groups.
Colombet and colleagues built a comparative assessment model using two scenarios. For the first scenario, the researchers looked at data reflecting the current mandate of calorie labeling only in large out-of-home food businesses, defined as establishments with 250 employees or more. For the second scenario, the researchers assessed a full implementation scenario with calorie labeling used for every out-of-home food business. Researchers compared each scenario with no menu calorie labeling.
For both scenarios, researchers modeled the impact of the policy through assumed changes in energy intake due to either consumer response or product reformulation by retailers, using data from the Office for National Statistics and the National Diet and Nutrition Survey (2009-2019), modeling the effects for 20 years (2022-2041) with results also reported for 10 years.
For each scenario, the model generated the change in obesity prevalence and the total number of deaths prevented or postponed. The baseline scenario assumed the obesity prevalence in England in 2041 would be 27% and there would be 830,000 CVD-related deaths.
Researchers found that the current scenario of menu calorie labeling in large establishments only could reduce obesity prevalence by 0.31 percentage points (absolute; 95% uncertainty interval [UI], 0.1-0.35), which would prevent or postpone 730 CVD deaths (95% UI, 430-1,300) during the next 20 years.
If the menu calorie labeling was expanded to all food businesses in England, researchers found that the health benefits increased to a 2.65 percentage point reduction in obesity prevalence (95% UI, 1.97-3.24) and the prevention or delay of 9,200 CVD deaths (95% UI, 5,500-16,000). Results persisted in analyses stratified by socioeconomic status.
“Our results suggest expanding calorie labeling on menus to all English out-of-home food businesses could play an important part in future government strategies to support people in making healthier choices to tackle obesity,” Colombet said in the release. “However, one policy alone cannot solve England’s obesity crisis. We encourage the government to continue with, and strengthen, the England obesity strategy with a wide range of policies, such as calorie labeling, tackling junk food marketing, and the soft drinks industry levy, which will both reduce obesity and narrow the shocking health inequalities gap in our society.”
The researchers noted that data on calorie reductions associated with the policy within the model was taken from U.S. studies, which may not be transferable to the English population. The models assumed the amounts of energy consumed would not differ by size of business and did not include any major changes to BMI prevalence during the next 20 years.
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