The 2014 U.S. Food and Drug Administration (FDA) final rule titled, "Food Labeling: Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Food Establishments," requires information on the calorie content of food items to be clearly displayed on menus. This rule applies to restaurants and similar retail food establishments that are part of a chain with 20 or more locations, doing business under the same name and offering the same menu items. Under this rule, restaurants must provide calorie and other nutrition information for standard menu items, including food on display and self-service food.

Rand Corp., Santa Monica, Calif., conducted a study that looked at how the provision of calorie information on restaurant menus affects consumers. To gain insight on the consumer perspective, participants in the online experiment chose items from the menus of nine different restaurant settings, ranging from fast food outlets to movie theaters. The calorie labels on those menus followed the requirements described in the FDA rule. The survey also collected data on sociodemographic characteristics, attitudes toward food and use of nutrition and calorie labels.

Key findings include:

Objective 1: Consumer choice experiment

• Analysis of participants and their choices suggests that those who selected at least one item displaying calories on menus reduced the energy amount ordered by 30 kilocalories. Providing calorie information did not affect participants' satisfaction with choices they made or their ratings of restaurants.
• Providing calorie information typically had a statistically significant effect in standard meal-type restaurant settings. In contrast, there was no effect of labeling menus with calorie information on the number of calories participants chose in the three non-standard meal-type establishments.
• Participants shown menus with calorie-labeled items and those shown menus without labeling were similarly likely to pick the highest-calorie items. However, participants shown the calorie information were less likely to choose items in the 800- to 1,000-kilocalorie range and more likely to choose items in the 400- to 500-kilocalorie range than those who were not shown that information.
• There is a strong direct association of sociodemographic characteristics with calories ordered. However, there was no interaction effect of seeing calorie-labeled menus with observable characteristics, including gender, age, education, income, race/ethnicity or body mass index on calories chosen. In other words, there was no evidence that the effect of providing calorie information varies by sociodemographic characteristics across all menus.

Objective 2: Evaluation of menu changes over time

• The study found no statistically significant evidence of a change in calories per menu item between 2010 and 2015 for the menus of major chain restaurants.

Recommendations

• If restaurants take into account the combination of a main item and its side dishes (rather than only considering the main item), calories in restaurant offerings seem to have increased, rather than decreased, in recent years. The prevalence of customizable menu items is growing rapidly. Establishing an appropriate and standardized method to determine calorie amounts for customizable dishes will be important if researchers and policymakers want to analyze calorie content in restaurant food in the future.
• It is important to note that greater degrees of customization could undermine the informative effects of menu labeling regulations. One of the goals of such labeling is to provide clear and concise information for consumers to use in making food decisions. Menus heavy on customizable dishes will be more difficult for the consumer to navigate in terms of determining calorie content because they will have to find and add together multiple calorie labels to calculate the final calorie total for an individual choice. This is a heavy cognitive burden for consumers to face at the point of sale. Consumer education may be necessary to raise awareness of the new trend in customized restaurant items and enable consumers to properly use the nutrition information in restaurants.