Impact of calorie labelling on fast food purchases

#PHTwitJC 14th August 2011    Dumanovsky et al paper screen grab

We have selected this paper for Journal Club on 14/08:

Dumanovsky, T. et al (2011) Changes in energy content of lunchtime purchases from fast food restaurants after introduction of calorie labelling: cross sectional customer surveys. British Medical Journal 2011; 343: d4464. Available here: 

The study attempted to assess the impact of the introduction of calorie labelling in fast food restaurants after legislation came into force in New York City in 2008. It used a cross-sectional survey design, with ‘before’ and ‘after’ legislation data collection. Customer receipts were examined and assessed for calorie content; and customers (in the ‘after’ group) asked whether they had used the calorie information when making their choices. 

This is a policy that has since been rolled out nationally in the USA. In the UK some chains are voluntarily providing this information as part of the current government’s ‘Responsibility Deal’

Is detailed food labelling a way of ‘nudging’ consumers towards healthier options?  Although the term ‘nudge’* is not used in the paper, it seems to be a pertinent concept. Should we be automatically sceptical of public health initiatives that involve the willing participation of the commercial food industry (and, by extension, of others such as tobacco and alcohol corporations)? What evidence does this paper give, that the calorie labelling legislation encouraged the food chains to alter their menus towards ‘healthier’ foods? What evidence is there that it caused behaviour change? How important are individual choices in overall public health terms?

Journal Club Discussion

‘Live’ Public Health Twitter Journal Club will take place on Sunday 14th August, between 20:00 and 21:00 UK time (GMT+1).  To follow and contribute to the discussion, remember to use the #PHTwitJC hashtag, 

 The discussion points for this week are as follows:

1. This paper uses a cross-sectional study design – is this the best design to measure behaviour change? Why or why not? (See CEBM study design notes for pros and cons of method). 

2. Study concluded that customers who used calorie info “made lower calorie choices” – are these results valid?

3. What are the PH implications of this study?  How might these influence future practice/policy?

4. How can we improve upon the evidence generated by this study? What further research would you like to see, and why?

Further reading

 * Nudge: for further reading on the ‘nudge’ debate, see this BMJ ‘head to head’ which is focused on obesity,  from April 2011 and

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2 Responses to Impact of calorie labelling on fast food purchases

  1. Pingback: Summary of PHTwitJC 1 | Public Health Twitter Journal Club

  2. Pingback: From a baker’s shop to Twitter: a new Public Health Journal Club emerges « Public Health Science Communication 2.0

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