Menu calorie labeling may reduce obesity-related cancer burden, health care costs
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The 2018 introduction of calorie labels to restaurant menus appears to have yielded a net reduction in caloric intake of 20 to 60 calories per meal among Americans, potentially reducing risk for obesity-associated cancers.
A modeling study conducted at Tufts University’s Friedman School of Nutrition Science and Policy and published in BMJ Open estimated that the caloric decrease will prevent at least 28,000 obesity-related cancers and 16,700 cancer deaths among U.S. adults over a lifetime.
“There is strong evidence to suggest that obesity plays an important role in the risk [for] developing cancer — there are 13 types of cancers associated with obesity,” lead author Fang Fang Zhang, MD, PhD, cancer epidemiologist and Neely Family professor at Friedman School, told Healio. “We were supported by the NIH in evaluating the potential impact of population-based strategies to improve diet on reducing cancer burden in the U.S. Our findings suggest that nutrition policies such as menu calorie labeling can be a cost-effective strategy for preventing obesity-associated cancers in this country.”
Zhang spoke with Healio about her study’s findings, their potential impact, and the need for greater public awareness about the link between obesity and various cancers.
Healio: How did you conduct this study?
Zhang: We simulated our population — the age, gender, race, ethnicity, income, education and other demographic characteristics of the U.S. adult population. We used data from the National Health Nutrition Examination Survey (NHANES) on how many calories the U.S. adult population consumes from restaurants. We then took empirical data from previous research that observed changes in calories consumed from purchased meals before and after the labeling policy was implemented, and estimated the daily calories from foods obtained at restaurants were reduced on average by 24. Because people may compensate for choosing lower-calorie items by consuming more later, we assumed the daily calorie reduction was 12 in total. This daily calorie reduction is small, but even with a small reduction, the number of new cancer cases and cancer deaths that can be prevented by menu calorie labeling policies is not trivial.
We found that younger people and minorities would especially benefit from this intervention. This is important because we’re seeing that obesity-associated cancers are rising among younger adults in this county.
Healio: What did your study show about the cost savings associated with reduced caloric intake?
Zhang: The menu calorie labeling policy was associated with net savings of $1.26 billion in health care costs and $1.35 billion in societal costs. We know a lot of cancer screening tools are cost-effective for cancer prevention, meaning the number of quality-adjusted life years gained is favorable in relation to the amount of money we spend. This is great — we want to continue to offer cost-effective cancer screening to Americans and get this to everyone. However, nutrition policy is not only cost-effective, but also cost saving; that is, the costs saved for cancer care are greater than the costs needed to implement the policy. This is primary due to the lower cost of implementing a nutrition policy than the cost of a cancer screening. We hope that this paper highlights the value of nutrition policy as a cost-effective strategy for cancer prevention in this country.
Healio: Is there anything else you would like to mention?
Zhang: I’d like to point out that once a nutrition policy is implemented, it doesn’t only affect consumers. It can also motivate the industry to reformulate their food products in terms of lowering the calories or offering lower-calorie alternatives. The health and economic impact of menu calorie labeling would be doubled with industry reformulation.
- References: Du M, et al. BMJ Open. 2023:doi;10.1138/bmjopen-2022-063614.
- Tufts University. Menu calorie labels estimated to save US billions on cancer care (press release). Available at: https://now.tufts.edu/2023/04/18/menu-calorie-labels-estimated-save-us-billions-cancer-care. Posted April 18, 2023. Accessed June 30, 2023.
For more information:
Fang Fang Zhang, MD, PhD, can be reached at Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave., Boston, MA 02111; email: fang_fang.zhang@tufts.edu.
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