Impact of menu labeling on parents and their children in four diverse los angeles communities

Background: The 2010 Federal Patient Protection and Affordable Care Act mandates that fast food/chain restaurants with over 19 outlets clearly display calorie content of all menu items. The impact of calorie menu labeling on consumers is unclear, especially when comparing communities with significant differences in rates of overweight/obesity and access to healthy food choices. Methods: A mixed-methods study using focus groups and venue exit surveys assessed the impact of menu labeling on consumers of three fast food chain restaurants in four diverse socio-demographic Los Angeles County communities. Key Results: The majority of parents (53%) did not notice menu board calorie postings. Of those who did, 17% found the information confusing. Only 14% made an attempt to lower calorie intake. However, focus group respondents from high income communities only indicated they would attempt to lower calorie intake at a later meal. The mean caloric intake was not significantly different for the 38% who regarded their food purchased a snack compared to the 57% who considered their purchase a meal (496 vs. 675 for adults; 465 vs. 542 for children, respectively). Significantly fewer respondents (26% and 37%) from the two communities with lowest socio-economic status offered accurate knowledge of daily recommended calorie consumption compared to respondents from middle and high income communities (48% and 74%). Discussion: Calorie postings does not appear to significantly impact purchasing behavior. Limited knowledge of appropriate calorie intake likely impacts the meaning of posted calories. More calorie education and clearer posting is needed to adequately inform consumers.