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Calorie-labelling as an anti-obesity measure
George Thom
Aviemore6th Nov 2014
Background
Catering outlets: increasing
Meals/snacks outside home: increasing
Portion sizes: increasing
……. Obesity prevalence: increasing
Calorie-labelling of meals suggested as an anti-obesity measure,
and now mandatory in some US states.
• But evidence of impact is scarce
How many calories?
Calorie-Labelling: a review of the literatureNikolaou et al
• 14 studies published since 1990 on calorie labelling of meals and entrees• 7 among adults in real-life (restaurant) settings • 6 studies with data for meta-analysis
– Overall, no effect– -124 kcal among customers who noticed the calorie labels
Customers who noticed the calorie-labels
Nutritional compositions of meals offered to young adultsNikolaou et al
2,056 meal-combinations offered at 7outlets analysed Current food provision may favour unwanted weight gain
Means : 773-1189 kcal max 1,774 kcal
How many calories
Prominent calorie-labelling presented every day prevents weight gain in residential students
Nikolaou et al
-6
-4
-2
0
2
4
6
8
10
12
14
2011-2012
Participants
Weig
ht
in k
gW
eigh
t cha
nge
over
9 m
onth
s
No calorie-labelsMean weight change
+3.5kg
• 120 residential students, catered• ITT Weight changes over 9 months
Prominent calorie-labelling presented every day prevents weight gain in residential students
Nikolaou et al
• Consumers could not fail to notice the labels• Weight gain over 9 months abolished by calorie-labelling• Catering food costs reduced by 33%, so potentially sustainable• What about non-residential settings?
-6
-4
-2
0
2
4
6
8
10
12
14
2011-2012
Participants
Weig
ht
in k
g
-6
-4
-2
0
2
4
6
8
10
12
14
2012-2013
Participants
Weig
ht
in k
g
Wei
ght c
hang
e ov
er 9
mon
ths
No calorie-labelsMean weight change
+3.5kg
With calorie-labelsNo weight change
Wei
ght c
hang
e ov
er 9
mon
ths
Calorie-Labelling as an anti-obesity measure Study Setting
• Sales compared:– Intervention sites (calorie-labels)– Control site
• Calorie range of items: 236-544kcal• Prominent calorie-labels in front of sandwiches for 2 weeks• Questionnaire administered to students and staff, on-site and on-line• Sales data one month without labels, then one month with labels
5.4 cms x 9.9 cms
Calorie-Labelling as an anti-obesity measure Methods
Calorie-Labelling as an anti-obesity measure Results: sales data
--p<0.0001-- ----
NS---
During the labelling period
• Total Sales: Intervention sites: -17% Control site: -2%
High-calorie items -30% Low-calorie items -18%
• Sales of unlabelled foods unchanged
Calorie-Labelling as an anti-obesity measure Survey
• Responses Staff = 646 (68% female)Students = 1166 (75% female)
• Ages Staff = 42.4 (SD 10.7) Students = 24.2 (SD 6.9)
• BMI Staff = 25.1 (SD 5.7) Students = 23.2 (SD 5.1)
Calorie-labelling used more by healthy weight students and staff rather than those overweight or obese.
Calorie-labelling for obesity prevention
1. Existing evidence very limited: may reduce calorie purchases 2. Current food provision for young adults, without calorie-labelling,
would favour weight gain3. Calorie labelling prevented weight gain for residential students, and
reduces costs4. Wider use of calorie-labelling in catering outlets
1. Is welcomed by consumers2. Is acceptable to caterers3. Nudges sales towards lower-calorie items4. Abolishes weight gainAcknowledgementsState Scholarships Foundation of Greece
