Federal Calorie Menu Labeling Policy and Calories Purchased in Restaurants in a National Fast Food Chain: A Quasi-Experimental Study.

Abstract

Menu labels were federally mandated in May 2018; however, to the authors' knowledge, no study has evaluated the impact of the national rollout of this legislation in restaurants using a comparison group to account for potential bias. Using synthetic control methods, Taco Bell restaurants that implemented menu labels after nationwide labeling (n=5,060 restaurants) were matched to restaurants that added calorie labels to menus after local labeling legislation (and before nationwide labeling). The effect of menu labeling on calories purchased per transaction after nationwide labeling between groups (i.e., "later-treated" and "early-treated" restaurants) was estimated using a 2-way fixed effects regression model, with time modeled as relative month from implementation and fixed effects for calendar month and restaurant. In the baseline period, average calories per transaction was 1,242 (SD=178) in the national menu labeling group and 1,245 (SD=183.9) in the comparison group, with parallel trends between groups. Difference-in-differences model results indicated that transactions from restaurants in the national menu labeling group included 7.4 (95% CI=7.3, 7.5) more calories than that was predicted based on the trend in the comparison group. The average number of total transactions per month decreased ∼2% more in the national menu labeling group than in the comparison group. Negligible changes were observed in calories purchased and number of transactions in restaurants that added calorie labels because of national legislation, above and beyond secular changes. Other strategies may be necessary to promote meaningful decreases in daily calories purchased in restaurants in the future.