Calorie labeling and food choice: Results from Philadelphia

Introduction: Previous research found minimal or no influence of menu labeling laws on fast food choices. This study evaluates the effect of mandatory calorie labeling policy in Philadelphia, PA, on number of calories purchased by customers. Methods: Philadelphia implemented calorie labeling early in 2010. Baltimore, MD, was selected as a comparison location that has not passed calorie labeling. We interviewed and obtained receipts from customers exiting fast food chains in both cities, pre- and post-labeling. This natural experiment was analyzed utilizing a difference-in-difference design and multivariate regressions. Results: We surveyed 2,128 customers ages 18-65. Respondents were 61% male, 39% female. The majority (71%) identified as black, 18% white, 7% Hispanic/Latino and 3% other. There was no change in mean calories purchased after labeling, though calories purchased decreased in both locations over the study period. Subgroup analysis is pending. After labeling was implemented, 37% of the sample said they saw calorie information, a smaller effect than found in other studies. Approximately 35% of adults who saw labels reported that the information affected their purchase, most (76%) reporting using it to purchase fewer calories. Discussion: Menu labeling did not impact calories purchased by fast food customers and a majority did not recall seeing the information upon leaving the restaurant. We must improve menu labeling policy to influence calories purchased, and investigate whether other policies may increase its effectiveness. However, menu labeling may have other impacts besides reducing calories purchased.