The impact of mandatory menu energy labelling on socio-economic disparities in overweight and obesity (#241)
Mandatory menu energy labelling is being rolled out in fast food outlets in several Australian states and territories. The policy intends to enable healthy choices and to reduce obesity. Those with a low socioeconomic position (SEP) have a high prevalence of obesity, and consume fast food more often than those with a high SEP. Yet the effectiveness of menu labelling by SEP is unclear. We aimed to summarise the differential evidence of effectiveness of menu labelling across key stages in the intervention logic pathway by SEP.
Databases and reference list searches using menu labelling, food outlet, and SEP terms were conducted in October 2012. The differential effect of menu labelling by SEP on key stages of the intervention logic pathway was extracted and summarised.
We identified six papers that reported the effectiveness of menu labelling by SEP, and six that reported effects for low income populations only. The majority of these twelve studies comprised natural experiments from New York City. Of the six studies in low income populations, two report difficulties in understanding and use of labels, one reported improved calorie estimation of meals, two report no change in calories purchased, and one reported slightly healthier choices. One study reporting label use by SEP, found lower label use for lower SEP groups. Of the five studies reporting the effect of menu labelling on calorie or food purchase (intentions) by SEP, two reported no change, three reported a reduction in calories/unhealthy foods, with one of these studies finding a greater reduction in higher SEP.
Further evidence on the impact of mandatory menu energy labelling in different regions and contexts is required. Based on the limited evidence,it seems unlikely that mandatory menu energy labelling will reduce socio-economic disparities in overweight and obesity; however whether it will increase inequalities is unclear.