Effects of calorie labeling and value size pricing on fast food meal choices: results from an experimental trial

Lisa J Harnack, Simone A French, J Michael Oakes, Mary T Story, Robert W Jeffery, Sarah A Rydell, Lisa J Harnack, Simone A French, J Michael Oakes, Mary T Story, Robert W Jeffery, Sarah A Rydell

Abstract

Background: Although point-of-purchase calorie labeling at restaurants has been proposed as a strategy for improving consumer food choices, a limited number of studies have evaluated this approach. Likewise, little research has been conducted to evaluate the influence of value size pricing on restaurant meal choices.

Methods: To examine the effect of point-of-purchase calorie information and value size pricing on fast food meal choices a randomized 2 x 2 factorial experiment was conducted in which participants ordered a fast food meal from one of four menus that varied with respect to whether calorie information was provided and whether value size pricing was used. Study participants included 594 adolescents and adults who regularly ate at fast food restaurants. Study staff recorded the foods ordered and consumed by each participant. Participants also completed surveys to assess attitudes, beliefs and practices related to fast food and nutrition.

Results: No significant differences in the energy composition of meals ordered or eaten were found between menu conditions. The average energy content of meals ordered by those randomized to a menu that included calorie information and did not include value size pricing was 842 kcals compared with 827 kcals for those who ordered their meal from a menu that did not include calorie information but had value size pricing (control menu). Results were similar in most analyses conducted stratified by factors such as age, race and education level.

Conclusion: Additional research is needed to better evaluate the effects of calorie labeling and value size pricing on fast food meal choices. Studies in which participants are repeatedly exposed to these factors are needed since long term exposure may be required for behavior change.

Figures

Figure 1
Figure 1
Diagram of 2 × 2 experimental design menus.
Figure 2
Figure 2
Excerpt from calorie menu.
Figure 3
Figure 3
Calorie reference information provided in the bottom right hand corner of the calorie and calorie plus price menus.
Figure 4
Figure 4
Excerpt from price menu.
Figure 5
Figure 5
Excerpt from calories plus price menu.
Figure 6
Figure 6
Excerpt from control menu.
Figure 7
Figure 7
Average energy intake by experimental condition among females (n = 353) and males (n = 241).
Figure 8
Figure 8
Average energy intake by experimental condition among those who reported nutrition was very important or somewhat important (n = 341) or not very important or not at all important (n = 245) when buying foods from a fast food restaurant.
Figure 9
Figure 9
Average energy intake by experimental condition among those who reported price was very important or somewhat important (n = 496) or not very important or not at all important (n = 96) when buying foods from a fast food restaurant.

References

    1. Ogden C, Carroll M, Curlin L, McDowell M, Tabak C, Flegal K. Prevalence of overweight and obesity in the US 1999–2004. J Am Med Assoc. 2006;295:1549–1555. doi: 10.1001/jama.295.13.1549.
    1. Stewart H, Blisard N, Jolliffe D. Let's Eat Out: Americans Weigh Taste, Convenience, and Nutrition. Washington, DC: USDA ERS; 2006.
    1. Lin B, Frazao E. Away-From-Home Foods Increasingly Important to Quality of American Diet. Washington, DC: United States Department of Agriculture Economic Research Service; 1999.
    1. Fast yes, but how good? We rate popular foods from the major chains for taste and nutrition. Consumer Reports. 1997. pp. 10–15.
    1. Hurley J, Corcoran L. Meals to go. Nutrition Action Healthletter. 1998;25:12.
    1. Lin B, Frazao E. Nutritional quality of foods at and away from home. FoodReview. 1997;20:33–40.
    1. Young L, Nestle M. The contribution of expanding portion sizes to the obesity epidemic. Am J Pub Health. 2002;29:246–249. doi: 10.2105/AJPH.92.2.246.
    1. Young L, Nestle M. Expanding portion sizes in the US marketplace: Implications for nutrition counseling. J Am Diet Assoc. 2003;103:231–234. doi: 10.1053/jada.2003.50027.
    1. United States Department of Health and Human Services . The Surgeon General's call to action to prevent and decrease overweight and obesity. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General; 2001.
    1. Nestle M, Jacobson M. Halting the obesity epidemic: A public health policy approach. Pub Hlth Rep. 2000;115:12–24. doi: 10.1093/phr/115.1.12.
    1. Rolls B. The supersizing of America. Nutrition Today. 2003;38:42–53. doi: 10.1097/00017285-200303000-00004.
    1. National Alliance for Nutrition and Activity . From Wallet to Waistline: The Hidden Costs of Super Sizing. Washington DC: The National Alliance for Nutrition and Activity; 2002.
    1. Keystone Center . The Keystone Forum on Away-From-Home Foods: Opportunities for Preventing Weight Gain and Obesity. Washington DC: The Keystone Center; 2006.
    1. Balfour D, Moody R, Wise A, Brown K. Food choice in response to computer-generated nutrition information provided about meal selection in workplace restaurants. J Human Nutr Dietetics. 1996;9:231–237. doi: 10.1046/j.1365-277X.1996.00452.x.
    1. Cinciripini P. Changing food selection in a public cafeteria: An applied behavior analysis. Behavior Modification. 1984;8:520–539. doi: 10.1177/01454455840084004.
    1. Sproul A, Canter D, Schmidt J. Does point-of-purchase nutrition labeling influence meal selections? A test in an army cafeteria. Military Medicine. 2003;168:556–560.
    1. Milich R, Aderson J, Mills M. Effects of visual presentation of caloric values on food buying by normal and obese persons. Percept Mot Skills. 1976;42:155–162.
    1. Mayer J, Brown T, Heins J, Bishop D. A multi-component intervention for modifying food selections in a worksite cafeteria. J Nutr Educ. 1987;19:277–280.
    1. Schmitz M, Fielding J. Point-of-choice nutrition labeling: Evaluation in a worksite cafeteria. J Nutr Educ. 1986;18:S65–S68.
    1. Davis-Chervin D, Rogers T, Clark M. Influencing food selection with point-of-choice nutrition information. J Nutr Educ Beh. 1985;17:18–22.
    1. Dubbert P, Johnson W, Schlundt D, Montague N. The influence of caloric information on cafeteria food choices. J Applied Behavior Analysis. 1984;17:85–92. doi: 10.1901/jaba.1984.17-85.
    1. Albright C, Flora J, Fortmann S. Restaurant menu labeling: Impact of nutrition information on entree sales and patron attitudes. Health Educ Q. 1990;17:157–167.
    1. Colby J, Elder J, Peterson G. The effects of menu item description on food selection in a family style restaurant. Am J Prev Med. 1987;3:171–177.
    1. Yamamoto J, Yamamoto J, Yamamoto B, Yamamoto Adolescent fast food and restaurant ordering behavior with and without calorie and fat content menu information. J Adol Health. 2005;37:397–402. doi: 10.1016/j.jadohealth.2004.10.002.
    1. Krukowski R, Harvey-Berino J, Kolodinsky J, Narsana R, DeSisto T. Consumers may not use or understand calorie labeling restaurants. J Am Diet Assoc. 2006;106:917–920. doi: 10.1016/j.jada.2006.03.005.
    1. Burton S, Creyer E, Kees J, Huggins K. Attacking the obesity epidemic: The potential health benefits of providing nutrition information in restaurants. Am J Pub Health. 2006;96:1669–1675. doi: 10.2105/AJPH.2004.054973.
    1. Horgen K, Brownell K. Comparison of price change and health message interventions in promoting healthy food choices. Health Psychology. 2002;21:505–512. doi: 10.1037/0278-6133.21.5.505.
    1. Stubenitsky K, Aaron J, Catt S, Dela D. The influence of recipe modification and nutritional information on restaurant food acceptance and macronutrient intakes. Pub Health Nutr. 2000;3:201–209. doi: 10.1017/S1368980000000239.
    1. Kozup J, Creyer E, Burton S, Making Healthful food choices The influence of health claims and nutrition information on consumers' evaluations of packaged food products and restaurant menu items. Journal of Marketing. 2003;67:19–34. doi: 10.1509/jmkg.67.2.19.18608.
    1. Mayer J, Heins J, Vogel J, Morrison D, Lankester J, Jacobs A. Promoting low-fat entree choices in a public cafeteria. J Applied Behavior Analysis. 1986;19:397–402. doi: 10.1901/jaba.1986.19-397.
    1. Bergen D, Yeh M. Effects of energy-content labels and motivational posters on sales of sugar-sweetened beverages: Stimulating sales of diet drinks among adults study. J Am Diet Assoc. 2006;106:1866–1869. doi: 10.1016/j.jada.2006.08.002.
    1. French S, Jeffery R, Story M, et al. Pricing and promotion effects on low-fat vending snack purchases: The CHIPS study. Am J Public Health. 2001;91:112–117.
    1. Fiske A, Weber-Cullen K. Effects of promotional materials on vending sales of low-fat items in teacher's lounges. J Am Diet Assoc. 2004;104:90–93. doi: 10.1016/j.jada.2003.10.011.
    1. Hoerr S, Louden V. Can nutrition information increase sales of healthful vended snacks? J Sch Health. 1993;63:386–390.
    1. Larson-Brown L. Point-of-purchase information on vended foods. J Nutr Educ. 1978;10:116–118.
    1. Wilbur C, Zifferblatt S, Pinsky J, Zifferblatt S. Healthy vending: A cooperative pilot research program to stimulate good health in the marketplace. Prev Med. 1981;10:85–93. doi: 10.1016/0091-7435(81)90009-8.
    1. Conklin M, Cranage D, Lambert C. College students' use of point of selection nutrition information. Top Clin Nutr. 2005;20:97–108.
    1. McDonalds USA Nutrition Information Accessed 23/12/08.
    1. McCulloch C, Searle S. Generalized, Linear, and Mixed Models. New York: Wiley; 2001.
    1. McCullum C, Achterberg C. Food shopping and label use behavior among high school adolescents. Adolescence. 1997;32:181–197.
    1. Kristal A, Levy L, Patterson R, Li S, White E. Trends in food label use associated with new nutrition labeling regulations. Am J Public Health. 1998;88:1212–1215. doi: 10.2105/AJPH.88.8.1212.
    1. Bender M, Derby B. Prevalence of reading nutrition and ingredient information on food labels among adult Americans: 1982–1988. J Nutr Educ. 1992;24:292–297.
    1. Neuhouser M, Kristal A, Patterson R. Use of food nutrition labels is associated with lower fat intake. J Am Diet Assoc. 1999;99:45–50. doi: 10.1016/S0002-8223(99)00013-9.
    1. Kreuter M, Brennen L. Do nutrition label readers eat healthier diets? Behavioral correlates of adults use of food labels. Am J Prev Med. 1997;13:277–283.
    1. Guthrie J, Fox J, Cleveland L, Welsh S. Who uses nutrition labeling, and what effects does label use have on diet quality? J Nutr Educ. 1995. p. 27.
    1. Jeffery R, French S, Raether C, Baxter J. An environmental intervention to increase fruit and salad purchases in a cafeteria. Prev Med. 1994;23:788–792. doi: 10.1006/pmed.1994.1135.
    1. French S, Jeffery R, Story M, Hannan P, Snyder M. A pricing strategy to promote low fat snack choices through vending machines. Am J Public Health. 1997;87:849–851. doi: 10.2105/AJPH.87.5.849.
    1. French S, Story M, Jeffery R, et al. Pricing strategy to promote fruit and vegetable purchase in high school cafeterias. J Am Diet Assoc. 1997;97:1008–1010. doi: 10.1016/S0002-8223(97)00242-3.
    1. Hawthorne K, Moreland K, Griffin I, Abrams S. An educational program enhances food label understanding of young adolescents. J Am Diet Assoc. 2006;106:913–916. doi: 10.1016/j.jada.2006.03.004.

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