Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Commentary
  • Published:

Evidence, discourse and values in obesity-oriented policy: menu labeling as a conversation starter

International Journal of Obesity volume 35, pages 464–471 (2011)Cite this article

Subjects

The new study by Dr Elbel and colleagues provides an opportunity to reflect on where we are with respect to menu labeling as a tool in our antiobesity arsenal and more generally to consider some issues surrounding policy-level proposals for stemming the obesity epidemic. By ‘menu labeling’, I refer to listing the calories of menu items on the menu. In this commentary, I address two aspects: evidence on menu labeling per se; and, at least as important, several scientific, social/political and epistemological issues that generally apply when considering obesity-related policies.

Elbel et al.1 deserve praise for this interesting paper. Dr Elbel previously offered that menu labeling is a good idea and should be implemented, stating ‘I see particular value in it when the options are this versus nothing at all…Given that the problem is so intense, I think we have to try things.’2 Yet, despite his previous favorable view, he does not mince words upon completing his latest study: ‘Our evaluation of New York City's labeling law suggests that… this public policy intervention had no significant effect on purchasing behavior within our study period for a low income, racially and ethnically diverse population of parents and adolescents.’ The authors’ qualifying clauses are appropriate as their study cannot rule out any effect, in any period, for any population. Yet, it certainly is one more bit of evidence tipping the scales toward the conclusion that menu labeling does not have substantial or consistent beneficial effects on energy intake.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Elbel B, Gyafami J, Kersh R . Child and adolescent fast food choice and the influence of calorie labeling: a natural experiment. Int J Obesity 2011; 35: 493–500.

    Article  CAS  Google Scholar 

  2. Winerman L . With menu labeling law, diners will soon know calorie counts, 2010, http://www.pbs.org/newshour/rundown/2010/03/with-menu-labeling-law-diners-will-soon-know-calorie-counts.html# . Accessed 28 December, 2010.

  3. Faith MS, Fontaine KR, Baskin ML, Allison DB . Toward the reduction of population obesity: macro-level environmental approaches to the problems of food, eating, and obesity. Psychol Bull 2007; 133: 205–226.

    Article  PubMed  Google Scholar 

  4. Anderson ML, Matsa DA . Are restaurants really supersizing America? Amer Econ J: Appl Econ (in press). http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1079584. Accessed December 28, 2010.

  5. Robert Wood Johnson Foundation. Menu labeling: does providing nutrition information at the point of purchase affect consumer behavior?, 2009, http://www.rwjf.org/files/research/20090630hermenulabeling.pdf. Accessed 26 December, 2010.

  6. Pulos E, Leng K . Evaluation of a voluntary menu-labeling program in full-service restaurants. Am J Public Health 2010; 100: 1035–1039.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Elbel B, Kersh R, Brescoll VL, Dixon LB . Calorie labeling and food choices: a first look at the effects on low-income people in New York City. Health Aff (Millwood) 2009; 28: w1110–w1121.

    Article  Google Scholar 

  8. Harnack LJ, French SA, Oakes JM, Story MT, Jeffery RW, Rydell SA . Effects of calorie labeling and value size pricing on fast food meal choices: Results from an experimental trial. Int J Behav Nutr Phys Act 2009; 5: 63.

    Article  Google Scholar 

  9. Bollinger B, Leslie P, Sorensen A . Calorie Posting in Chain Restaurants. Unpublished manuscript. http://www.gsb.stanford.edu/news/StarbucksCaloriePostingStudy.pdf. Accessed 29 December, 2010.

  10. Gerend MA . Does calorie information promote lower calorie fast food choices among college students? J Adolesc Health 2009; 44: 84–86.

    Article  PubMed  Google Scholar 

  11. Aaron J, Evans R, Mela D . Paradoxical effect of a nutrition labeling 33. Scheme in a student cafeteria. Nutr Res 1995; 15: 1251–1261.

    Article  Google Scholar 

  12. Tandon PS, Wright J, Zhou C, Rogers CB, Christakis DA . Nutrition menu labeling may lead to lower-calorie restaurant meal choices for children. Pediatrics 2010; 125: 244–248.

    Article  PubMed  Google Scholar 

  13. Roberto CA, Larsen PD, Agnew H, Baik J, Brownell KD . Evaluating the impact of menu labeling on food choices and intake. Am J Public Health 2010; 100: 312–318.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Taber DR, Stevens J, Murray DM, Elder JP, Webber LS, Jobe JB et al. The effect of a physical activity intervention on bias in self-reported activity. Ann Epidemiol 2009; 19: 316–322.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Girz LP . The Effects of Calorie Information on Food Selection and Intake (Master's Thesis). University of Toronto: Toronto, Canada, 2009.

    Google Scholar 

  16. Kuo T, Jarosz CJ, Simon P, Fielding JE . Menu labeling as a potential strategy for combating the obesity epidemic: a health impact assessment. Am J Public Health 2009; 99: 1680–1686.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Cope MB, Allison DB . White hat bias: examples of its presence in obesity research and a call for renewed commitment to faithfulness in research reporting. Int J OBES 2010; 34: 84–88.

    Article  CAS  Google Scholar 

  18. Cope M, Allison DB . White hat bias: a threat to the integrity of scientific reporting. Acta Paediatr 2010; 99: 1615–1617.

    Article  PubMed  Google Scholar 

  19. Hartocollis A . E-mails reveal dispute over city's ad against sodas. New York Times 2010, e-pub ahead of print 29 October 2010.

  20. Emerson GB, Warme WJ, Wolf FM, Heckman JD, Brand RA, Leopold SS . Testing for the presence of positive-outcome bias in peer review: a randomized controlled trial. Arch Intern Med 2010; 170: 1934–1939.

    Article  PubMed  Google Scholar 

  21. Ludwig DS, Brownell KD . Public health action amid scientific uncertainty: the case of restaurant calorie labeling regulations. JAMA 2009; 302: 434–435.

    Article  CAS  PubMed  Google Scholar 

  22. Nestle M, Ludwig DS . Front-of-package food labels: public health or propaganda? JAMA 2010; 303: 771–772.

    Article  CAS  PubMed  Google Scholar 

  23. Brownell KD, Farley T, Willett WC, Popkin BM, Chaloupka FJ, Thompson JW et al. The public health and economic benefits of taxing sugar-sweetened beverages. N Engl J Med 2009; 361: 1599–1605.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Nestle M . Health care reform in action--calorie labeling goes national. N Engl J Med 2010; 362: 2343–2345.

    Article  CAS  PubMed  Google Scholar 

  25. Read JL . The Effect of Point-of-Purchase Nutrition Information on Consumer Choice in Fast Food Restaurants (Master's Thesis). University of Guelph: Ontario, Canada, 2008.

    Google Scholar 

  26. Platkin CS . Think Before You Eat: Calories and Exercise Equivalents Presented on Menus at Point-of-Choice (Doctoral Dissertation). Florida International University: Miami, FL, 2009.

    Google Scholar 

  27. Thomas O, Thabane L, Douketis J, Chu R, Allison DB . Industry funding and the reporting quality of large long-term weight loss trials. Int J Obes 2008; 32: 1531–1536.

    Article  CAS  Google Scholar 

  28. Cox DR, Reid N . The Theory of the Design of Experiments. Chapman & Hall/CRC Press: Boca Raton, FL, 2000.

    Google Scholar 

  29. Campbell DT, Stanley JC . Experimental and Quasi-Experimental Designs for Research. Rand McNally: Chicago, 1963.

    Google Scholar 

  30. Cofield SC, Corona RV, Allison DB . Use of causal language in observational studies of obesity and nutrition. Obes Facts 2010; 3: 353–356.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Food and Drug Administration. Federal Register Final Rule—FR69 6787 Final Rule Declaring Dietary Supplements Containing Ephedrine Alkaloids Adulterated Because They Present an Unreasonable Risk, 2004, http://www.fda.gov/Food/DietarySupplements/GuidanceComplianceRegulatoryInformation/RegulationsLaws/ucm079733.htm. Accessed 8 January, 2011.

  32. Boehmer TK, Brownson RC, Haire-Joshu D, Dreisinger ML . Patterns of childhood obesity prevention legislation in the United States. Prev Chronic Dis 2007; 4: A56.

    PubMed  PubMed Central  Google Scholar 

  33. Yudin H . Opt out, not opt in. Can Med Assoc J 2003; 169: 279.

    Google Scholar 

  34. Sharpe KM, Staelin R, Huber J . Using extremeness aversion to fight obesity: policy implications of context dependent demand. J Consumer Res 2008; 35: 406–422.

    Article  Google Scholar 

  35. Allison DB, Heshka S, Sepulveda D, Heymsfield SB . Counting calories--caveat emptor. JAMA 1993; 270: 1454–1456.

    Article  CAS  PubMed  Google Scholar 

  36. Hu MY . Calorie cards removed from dining halls. Harvard Crimson 2008, http://www.thecrimson.com/article/2008/9/24/calorie-cards-removed-from-dining-halls/.

  37. Bruni F . Disappearing Ink. New York Times 2006, http://dinersjournal.blogs.nytimes.com/2006/08/15/disappearing-ink/?apage=3. Accessed 28 December, 2010.

  38. Quoted in Gandhi A. In: Einhorn L, Gandhi A (eds). Forgiveness and Child Abuse: Would YOU Forgive?, Chapter 17. Robert Reed Publishers: Bandon, OR, 2006. p 71.

  39. Friedman RR . Scientific Studies Related to Menu Labeling. http://www.cspinet.org/new/pdf/yale_rudd_ctr_menu_labeling_grouped_studies.pdf. Accessed 29 December, 2010.

  40. Guthrie JF, Lin BH, Frazao E . Role of food prepared away from home in the American diet, 1977-78 versus 1994-96: changes and consequences. J Nutr Educ Behav 2002; 34: 140–150.

    Article  PubMed  Google Scholar 

  41. Serrano EL, Jedda VB . Comparison of fast-food and non-fast-food children's menu items. J Nutr Educ Behav 2009; 41: 132–137.

    Article  PubMed  Google Scholar 

  42. Yamamoto JA, Yamamoto JB, Yamamoto BE, Yamamoto LG . Adolescent calorie/fat menu ordering at fast food restaurants compared to other restaurants. Hawaii Med J 2006; 65: 231–236.

    PubMed  Google Scholar 

  43. Kirkland A . The environmental account of obesity: a case for feminist skepticism. J Women Culture Society 2011; 36: 463–485.

    Article  Google Scholar 

  44. McAllister EJ, Dhurandhar NV, Keith SW, Aronne LJ, Barger J, Baskin M et al. Ten putative contributors to the obesity epidemic. Crit Rev Food Sci Nutr 2009; 49: 868–913.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Schwartz N, Groves RN, Schuman H . Survey Methods. In: Gilbert D, Fiske ST, Lindzey T (eds). The Handbook of Social Psychology. vol. 1, 4th edn. Oxford University Press: New York, NY, 1998, pp 143–179.

    Google Scholar 

  46. Faure G . Should parents of obese kids lose custody? Time Magazine 2009, http://www.time.com/time/health/article/0,8599,1930772,00.html. Accessed 26 December, 2010.

  47. Murtagh L . Judicial interventions for morbidly obese children. J Law Med Ethics 2007; 35: 497.

    PubMed  Google Scholar 

  48. Martin-Bautista E, Campoy C, Decsi T, Bokor S, von Rosen-von Hoewel J, Laitinen K et al. Obesity related programming statements in infant feeding policies in five European countries. Adv Exp Med Biol 2009; 646: 169–173.

    Article  PubMed  Google Scholar 

  49. Rosen L, Manor O, Engelhard D, Zucker D . In defense of the randomized controlled trial for health promotion research. Am J Public Health 2006; 96: 1181–1186.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Ayres I . Government By Chance. In: Super Crunchers: Why Thinking-by-Numbers Is the New Way to Be Smart, Chapter 3. Bantam Books, 2007.

    Google Scholar 

  51. Green MD, Freedman DM, Gordis L . Reference Guide on Epidemiology. In: Reference Manual on Scientific Evidence, 2nd edn. Federal Judicial Center, Washington, DC, http://www.fjc.gov/public/pdf.nsf/lookup/sciman06.pdf/$file/sciman06.pdf. Accessed 27 December, 2010.

  52. Hill AB . The environment and disease: association or causation? Proc R Soc Med 1965; 58: 295–300.

    CAS  PubMed  PubMed Central  Google Scholar 

  53. Food and Drug Administration. Guidance for industry: Questions and Answers Regarding the Effect of Section 4205 of the Patient Protection and Affordable Care Act of 2010 on State and Local Menu and Vending Machine Labeling Laws. Fed Regist 2010; 75: 164 http://edocket.access.gpo.gov/2010/pdf/2010-21067.pdf.

    Google Scholar 

Download references

Acknowledgements

I am grateful to Drs Kevin Fontaine, Alexis Wood and Kyle Grimes for their helpful comments.

Author information

Authors and Affiliations

  1. Departments of Biostatistics and Nutrition Sciences, Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA

    D B Allison

Authors
  1. D B Allison
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D B Allison.

Ethics declarations

Competing interests

Dr Allison has received grants, honoraria, donations and consulting fees from numerous food, beverage, pharmaceutical companies and other commercial, government and non-profit entities with interests in obesity and nutrition; receives royalties from obesity-related books; and in the past has received funds from litigators representing the restaurant industry in menu-labeling litigation.

Additional information

Disclaimer

The opinions expressed are the author's and not necessarily those of any organization with which he is affiliated.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Allison, D. Evidence, discourse and values in obesity-oriented policy: menu labeling as a conversation starter. Int J Obes 35, 464–471 (2011). https://doi.org/10.1038/ijo.2011.28

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2011.28

This article is cited by

Search

Advanced search

Quick links