Impact of nutrition labels on menu items offered and calories purchased in New York City, Seattle/King County, and Philadelphia

Introduction: Nutrition information at the point of purchase may help restaurant customers make healthier choices. The effectiveness of nutrition labeling policies is only beginning to be understood. We present updated findings on change in calories purchased from customers of fast food chains in three jurisdictions before and after mandated nutrition labels: New York City, Seattle/King County, and Philadelphia. We will also share findings on changes to menu items. Methods: Using a pre-post natural experiment design, we collected data on awareness and self-reported use of calorie labels as well as data on items purchased from customer surveys and receipts at fast food chains before and after nutrition labels were posted in New York City, Seattle/King County, and Philadelphia. Sample sizes ranged from 2,500 to 11,000 customers. We also collected pre-post menus and associated nutrition information. Results: Customer awareness of calorie labels rose at each site. We will present results describing changes in average calories purchased, including how this outcome varied for customers based on demographic characteristics, awareness of calorie labels, method of information display, chain types, and chains located in lower income, more ethnically diverse areas compared to other areas. We will also describe changes to the number and proportion of menu entree items with moderate caloric values. Discussion: This will be the first evaluation to examine the impact of nutrition labeling policies on calories purchased and menu items offered across multiple locales. Findings will add evidence to inform policymakers about the impact of nutrition labeling policies on customer behavior and what restaurants offer on their menus.