Miles on menu may help healthy choices

A recent study and surrounding media has suggested that explaining to energy costs of foods eaten in terms of activity required to utilise the calories may offer a better incentive for a healthy choice by the consumer.[1] Ignoring the concept that ‘a calorie is a calorie is a calorie’ is a flawed one, the impact on choice was interesting.

The researchers recruited 802 US adults through the University of North Carolina weekly newsletter for employees.

Survey participants were randomly assigned to one of four menus:

• a menu with no nutritional information (used as the main comparison in the statistical analysis)
• a menu with calorie information
• a menu with calorie information and minutes to walk to burn those calories
• a menu with calorie information and miles to walk to burn those calories

An example label for a regular burger containing 250 calories indicated it would take 78 minutes to walk off the calories or the equivalent of walking 2.6miles.

Using a web-based survey, all participants were asked to ‘imagine you are at a fast food restaurant (like McDonalds, Burger King or Wendy’s) and are getting ready to order a meal for yourself. Please select what you would order from the menu below based on the information provided. The menu included sandwiches, sides, salads, salad dressing, drinks and desserts. Please select all items that you would order”. The sample menu was a composite of the online menus of common US fast food restaurants without any item pictures.

The researchers then compared the number of calories ordered across the three groups to see if different menu labelling had influenced food choices.

The remainder of the survey collected basic demographic information such as age, gender, race, occupation, current smoking, and education to ensure randomised groups were balanced. In addition, the survey collected variables that could explain variations in the calorie content of meals ordered among participants randomised to the same type of menu, including but not limited to: calorie literacy, body mass index (BMI) and exercise frequency.

Abstract

In this study the authors examined the effect of physical activity based labels on the calorie content of meals selected from a sample fast food menu. Using a web-based survey, participants were randomly assigned to one of four menus which differed only in their labeling schemes (n = 802):

(1) a menu with no nutritional information,

(2) a menu with calorie information,

(3) a menu with calorie information and minutes to walk to burn those calories, or

(4) a menu with calorie information and miles to walk to burn those calories.

There was a significant difference in the mean number of calories ordered based on menu type (p = 0.02), with an average of 1020 calories ordered from a menu with no nutritional information, 927 calories, ordered from a menu with only calorie information, 916 calories, ordered from a menu with both calorie information and minutes to walk to burn those calories, and 826 calories, ordered from the menu with calorie information and the number of miles to walk to burn those calories.

The menu with calories and the number of miles to walk to burn those calories appeared the most effective in influencing the selection of lower calorie meals (p = 0.0007) when compared to the menu with no nutritional information provided).

The majority of participants (82%) reported a preference for physical activity based menu labels over labels with calorie information alone and no nutritional information. Whether these labels are effective in real-life scenarios remains to be tested.

What were the basic results?

The characteristics of the 802 randomised participants were well balanced between the four groups. Most participants were female (88%), had attended higher education (96%), were 40 years old or more (62%) and identified as white (71%). Most of the respondents were currently trying to lose weight (64%) and were trying to limit their calorie intake (65%).

There was a statistically significant difference in the average (mean) number of calories ordered based on the different menu types. The average number of calories ordered from each menu was as follows:

• 1,020 from the menu with no nutritional information
• 927 from the menu with only calorie information
• 916 from the menu with both calorie information and minutes to walk to burn those calories
• 826 from the menu with calorie information and the number of miles to walk to burn those calories

Hence, the menu with calorie information and number of miles walked seemed most effective at influencing the selection of lower calorie meals.

At the end of the survey, participants were asked to indicate which type of food labelling they would prefer to see on a menu. The largest proportion (45%) said they preferred the menu with calories and minutes to walk to burn those calories, 37% preferred the menu with calories and miles to walk to burn those calories, 13% reported the menu with calorie information only and 5% reported the menu with no nutritional information. Merging the groups showed that the majority (82%) preferred labels showing physical activity (time or distance) over menus with calorie information only or no nutritional information at all.

Highlights

► Do physical activity based labels result in the selection of lower calorie meals from a sample menu? ► Physical activity based labels were effective in influencing the selection of lower calorie meals. ► A majority of participants reported a preference for these physical activity based menu labels.

 Reference