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Menu Labeling Requirements Lead to Healthier Options at Chain Restaurants

2012-07-19

Improvements are Modest, but They Are a Start, Expert Says in the Journal of the Academy of Nutrition and Dietetics

Media Contacts: Ryan O'Malley, Allison MacMunn
800/877-1600, ext. 4769, 4802 media@eatright.org

The recent Supreme Court decision on the Patient Protection and Affordable Care Act has cleared the way for national requirements about posting nutritional information at chain restaurants. Listing calories, fat content, and sodium levels of menu items at the point of purchase has been promoted as a way to address the obesity epidemic. Increased awareness may lead to healthier consumer choices, and may encourage restaurants to adapt their menus to meet demand. A new study has evaluated the real-life impact of menu labeling in King County, Washington, after new regulations were implemented, and has found some improvement, although most entrées continue to exceed recommended nutritional guidelines. The study is available online in advance of publication in the August issue of the Journal of the Academy of Nutrition and Dietetics.

“Frequent consumption of food away from home is associated with higher caloric intake and higher fat. As noted by the Food and Drug Administration, the cost of the obesity epidemic to families, businesses, and the government was over $117 billion in 2010,” says lead investigator Barbara Bruemmer, PhD, RD, senior lecturer emeritus of the Program in Nutritional Sciences, School of Public Health, University of Washington, Seattle. “All of these issues underscore the need for environmental approaches to help consumers who are looking for better options.”

King County was one of the first jurisdictions to implement menu labeling, in January 2009. The regulations applied to any restaurant with 15 or more establishments in the United States and at least $1 million in annual sales. Dr. Bruemmer and her colleagues wanted to learn whether restaurants would improve their entrées by reformulating items so that they had fewer calories and would replace some menu items with healthier alternatives.

The investigators audited menus at 11 sit-down restaurants and 26 quick-serve chains. They evaluated the nutritional levels of entrées that were on the menu six months after the regulations went into effect and remained on the menu 12 months later, to determine whether individual menu items had been reformulated to improve their nutritional profiles. They also looked at whether all entrées had a better nutrition profile. “We also wanted to know how healthy foods at chain restaurants were overall. How do these meals stack up compared to what we should be aiming for in a good diet?” Dr. Bruemmer said. So they compared the nutritional values of entrées at the restaurants in their study to US Department of Agriculture dietary guidelines.

“We did find evidence of a decrease in energy, saturated fat, and sodium content after the implementation of menu regulations for items that were on the menu at both time periods,” reports Dr. Bruemmer. “We also saw a trend for healthier alternatives across all entrées over time, but only in the sit-down restaurants.”

However, the study found that the majority of entrées were still very high in energy, saturated fats, and sodium, compared to dietary guidelines. “56% of entrees exceeded the recommended level for 1/3 of an adult’s daily needs, while 77% of the entrees exceeded the guidelines for saturated fats, and almost 90% exceeded the sodium guidelines. Yes, we saw improvements, but there is still a long way to go. Those are pretty hefty servings for adults.”

A decline of 41 calories in entrées was seen between the two time periods. “While that doesn’t sound like very much, it is an improvement and it is statistically significant,” says Dr. Bruemmer. “41 fewer calories could easily translate into several pounds lost over a year for an adult. It’s modest, but it’s a start.”

With national guidelines from the Food and Drug Administration expected later this year, Dr. Bruemmer says that consumers need more options in the marketplace and clearer messages about how to use menu labeling information. “People can only respond to what’s available in the environment. If we haven’t yet seen people say, ‘Oh, I found something that meets my needs,’ well, maybe it’s because there aren’t enough moderate options available on the menu. Menu labeling will help people get a handle on this ‘list’ of calories, at the point where they’re making their decisions and putting down their money. This is where America is providing a lot of food to our children. Let’s give families a chance to make an informed decision,” she concludes.

In an accompanying audio presentation (www.andjrnl.org/content/podcast), Dr. Bruemmer discusses the implications of the menu labeling for chain restaurant management, nutrition practitioners, and policy-makers. 

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NOTES FOR EDITORS

“Energy, Saturated Fat, and Sodium Were Lower in Entrées at Chain Restaurants at 18 Months Compared with Six Months Following the Implementation of Mandatory Menu Labeling Regulation in King County, Washington,” by Barbara Bruemmer, PhD, RD; Jim Krieger, MD, MPH, Brian E. Saelens, PhD, Nadine Chan, PhD, MPH. Journal of the Academy of Nutrition and Dietetics, Volume 112/Issue 8 (August 2012), DOI: 10.1016/j.jand.2012.05.011, published by Elsevier.

Full text of this article is available to credentialed journalists upon request. Contact Eileen Leahy at 732-238-3628 or andjrnlmedia@elsevier.com to obtain copies. Journalists wishing to set up interviews with the authors should contact Barbara Bruemmer at bbruemme@u.washington.edu.

An audio presentation featuring Barbara Bruemmer, PhD, RD, is located atwww.andjrnl.org/content/podcast. Excerpts from the video may be reproduced by the media; contact Eileen Leahy to obtain permission.

ABOUT THE JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS

The official journal of the Academy of Nutrition and Dietetics (www.eatright.org), the Journal of the Academy of Nutrition and Dietetics (www.andjrnl.org) is the premier source for the practice and science of food, nutrition and dietetics. The monthly, peer-reviewed journal presents original articles prepared by scholars and practitioners and is the most widely read professional publication in the field. The Journal focuses on advancing professional knowledge across the range of research and practice issues such as: nutritional science, medical nutrition therapy, public health nutrition, food science and biotechnology, food service systems, leadership and management and dietetics education.

The Journal has a current Impact Factor of 3.586 in the Nutrition and Dietetics category of the Journal Citation Reports®, published by Thomson Reuters. It was previously published as the Journal of the American Dietetic Association.

ABOUT THE ACADEMY OF NUTRITION AND DIETETICS

The Academy of Nutrition and Dietetics (www.eatright.org), formerly the American Dietetic Association, is the world’s largest organization of food and nutrition professionals. The Academy is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy.

ABOUT ELSEVIER

Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet (www.thelancet.com) and Cell (www.cell.com), and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier’s online solutions include ScienceDirect (www.sciencedirect.com), Scopus (www.scopus.com), Reaxys (www.reaxys.com), MD Consult (www.mdconsult.com) and Mosby’s Nursing Suite (www.confidenceconnected.com), which enhance the productivity of science and health professionals, and the SciVal suite (www.scival.com) and MEDai’s Pinpoint Review (www.medai.com), which help research and health care institutions deliver better outcomes more cost-effectively.

A global business headquartered in Amsterdam, Elsevier (www.elsevier.com) employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC (www.reedelsevier.com), a world-leading publisher and information provider, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).