Menu Labeling Regulations and Calories Purchased at Chain Restaurants

Background: The federal menu labeling law will require chain restaurants to post caloric information on menus, but the impact of labeling is uncertain. Purpose: The goal of the current study was to examine the effect of menu labeling on calories purchased, and secondarily, to assess self-reported awareness and use of labels. Design: Single-community pre–post–post cross-sectional study. Data were collected in 2008–2010 and analyzed in 2011–2012. Setting/participants: 50 sites from 10 chain restaurants in King County, Washington, selected through stratified, two-stage cluster random sampling. A total of 7325 customers participated. Eligibility criteria were: being an English speaker, aged Z14 years, and having an itemized receipt. The study population was 59 % male, 76 % white non-Hispanic, and 53 % aged o40 years. Intervention: A regulation requiring chain restaurants to post calorie information on menus or menu boards was implemented. Main outcome measures: Mean number of calories purchased. Results: No significant changes occurred between baseline and 4–6 months postregulation. Mean calories per purchase decreased from 908.5 to 870.4 at 18 months post-implementation (38 kcal, 95