ArticleJournal of the Academy of Nutrition and Dietetics2020
A Natural Experiment to Evaluate the Nutritional Content of Restaurant Meal Purchases After Calorie Labeling.
Article in Journal of the Academy of Nutrition and Dietetics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Calorie (energy) labelling for changing selection and consumption of food or alcohol.The Cochrane database of systematic reviews · 2025Pooled it
- Comparative Quality Assessment of Five Bread Wheat and Five Barley Cultivars Grown in Romania.International journal of environmental research and public health · 2022Article
- Assessment of Calories Purchased After Calorie Labeling of Prepared Foods in a Large Supermarket Chain.JAMA internal medicine · 2022Article
- Influence of Prefecture-Level Yield of Not-for-Sale Vegetables on Vegetable Intake in Japan: A Natural Experiment.Nutrients · 2022Article
- US Consumer Identification of the Health Benefits of Dietary Fiber and Consideration of Fiber When Making Food Choices.Nutrients · 2022Article
- Changes in the calorie and nutrient content of purchased fast food meals after calorie menu labeling: A natural experiment.PLoS medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundCalorie labeling is mandated in restaurant chains with ≥20 locations nationwide, but the effect of labeling on the nutritional quality of purchased meals in fast-food settings is unclear, especially for adolescents and children.
objectiveTo estimate the effect of calorie menu labeling on the nutrient content and composition of fast-food meal purchases in McDonald's restaurants vs control restaurants.
designFrom 2010 to 2014, customers were sampled during repeated visits to McDonald's restaurants, which voluntarily labeled menus with calorie information in 2012, and 5 control fast-food restaurant chains that had not labeled their menus over the study period. PARTICIPANTS/
settingRestaurant receipts and questionnaires were collected from 2883 adults, 2131 adolescents, and 433 children in 4 New England cities.
main outcome measuresSaturated fat, sugar, sodium, and fiber content of purchased meals, as well as nutrient densities (ie, nutrient content adjusted for total calories), were calculated after linking purchases to nutrition data from restaurant websites. STATISTICAL ANALYSES: Difference-in-differences analyses and linear mixed models were used to examine whether calorie labeling in McDonald's was associated with changes in nutrient content and nutrient density of purchased meals separately in adults, adolescents, and children.
resultsAfter implementation of calorie labeling at McDonald's, adult meals contained on average 4.0% fewer calories from sugar (95% confidence interval: -7.5 to -0.5), but 1.8% more calories from saturated fat (95% confidence interval: 0.7 to 2.9) compared with control chains. The fiber content of children's purchased meals was lower at McDonald's after calorie labeling (change = -1.4 g, 95% confidence interval: -2.5 to -0.3). Calorie labeling was not associated with changes in nutrient quality of adolescent meals.
conclusionsCalorie labeling at McDonald's was associated with a possibly small positive change in the nutritional quality of meals in adults but not in adolescents or children. Efforts are needed to improve the nutritional quality of restaurant meals.
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