Few Diners See Calorie Counts, and Those Who Use Them Already Eat Better

Almost everyone eats out, but hardly anyone reads the nutrition information when they do, and the few who do already eat better. That is the main finding of a USDA Economic Research Service (ERS) study, done before federal menu labeling took effect, of who uses nutrition information in restaurants.

Grocery packages must list per-serving calories and nutrients, but food away from home (FAFH) has had no such national rule. Some restaurants provide information voluntarily, and some local governments require calorie labels. The 2010 Patient Protection and Affordable Care Act requires chain restaurants with 20 or more locations to put calorie information on menus, with fat, saturated fat, cholesterol, sodium, carbohydrates, sugars, fiber and protein available in writing on request. The U.S. Food and Drug Administration was finalizing the regulations. ERS researchers set out to study who already uses information restaurants give voluntarily, and who says they would use it, creating a baseline for measuring change after the law.

Who sees it and who uses it

The study used the 2007-08 and 2009-10 Flexible Consumer Behavior Survey (FCBS), part of the National Health and Nutrition Examination Survey (NHANES). It asks whether people ate out in the past 12 months, whether they saw nutrition information on the menu on their last visit, and whether they used it. A 2010 survey of the 400 largest U.S. restaurant chains found that 61 percent gave calorie information for most of their standard menu items.

Because so few saw the information, the share of patrons overall who used it was only 8 percent.

Differences among groups

• Gender. Women and men eat out about equally, but in full-service restaurants 20 percent of women saw nutrition information against 14 percent of men. Women were also likelier to use it: 49 percent against 33 percent in fast-food places, and 60 percent against 48 percent in full-service restaurants. Other research finds men less likely to think nutrition information is useful.
• Race and ethnicity. Hispanics are the least likely to notice information on full-service menus, but those who see it are the most likely to use it: 73 percent, against 53 percent of Whites, 57 percent of Blacks and 61 percent of people of other backgrounds.
• Income. SNAP participants and low-income nonparticipants eat out less than higher-income people. About 85 percent of the first two groups ate at fast-food places, against 93 percent of higher-income people, and 64 percent of SNAP participants ate at full-service restaurants, against 77 percent of low-income nonparticipants and 94 percent of higher-income people. After seeing information in fast-food places, SNAP participants were likelier to use it (52 percent) than higher-income people (41 percent) or low-income nonparticipants (39 percent).

Women are more likely than men to use nutrition information when eating out (USDA ERS).

Users already eat better

People who used nutrition information in full-service and fast-food places had Healthy Eating Index (HEI) scores 7 and 6 points higher on average, on a scale of 0 to 100 measuring how closely a diet follows the Dietary Guidelines for Americans. Those who did not use the information in fast-food places took in more saturated fat daily than users, 29 grams against 24, and full-service users took in about 7 grams less than non-users.

Saturated fat intake among fast-food customers, by use of nutrition information (USDA ERS).

Frequent diners use it less. Among people who ate fast food more than five times a week, 31 percent used the information when they saw it, against 44 percent of those who ate it twice a week or less. Perhaps frequent diners already know the numbers, or they are less inclined toward healthy eating. People who rarely or never kept dark green vegetables at home were as likely to eat in full-service restaurants as others but less likely to see the information, and 35 percentage points less likely to use it. Regular readers of Nutrition Facts labels on store-bought food were more likely to use restaurant information.

Use of Nutrition Facts labels and restaurant nutrition information (USDA ERS).

Who says they would use it

Past use predicts future use: 92 percent of people who had used fast-food menu information said they would often or sometimes use it there in future, and 96 percent for full-service restaurants. People who said they would use it often had the highest HEI scores, followed by those who said sometimes.

What it means

The labeling law assumes consumers will use the information to eat better. This study suggests that those who already use labels in stores and eat well will use restaurant labels too, so people with healthy diets may gain most, while exposure alone may not move those who do not eat well. It may be too optimistic to expect people who have not used nutrition information, or have shown little interest, to eat better after the law. The concern is that labeling could widen nutrition and health disparities between users and non-users, and the researchers say more work is needed on how to raise use of nutrition information among people with poor diets.

Sources

• USDA Economic Research Service, Amber Waves, Calorie Labeling on Restaurant Menus—Who Is Likely to Use It?, drawn from Gregory, Rahkovsky and Anekwe, Consumers' Use of Nutrition Information When Eating Out (2014); rewritten in hubnx's own words.