Trial reportAmerican journal of preventive medicine2023
Online RCT of Icon Added-Sugar Warning Labels for Restaurant Menus.
Trial report in American journal of preventive medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
8 citing papers in PubMed.
- The Impact of Restaurant Menu Eco Labels on Consumer Meal Selections: An RCT.American journal of preventive medicine · 2026Trial
- Online RCT of Added-Sugar Warning Labels and Spanish-English Label Education.American journal of preventive medicine · 2025Trial
- Support for an Added-Sugar Menu-Labeling Policy among Key United States Population Groups in a Cross-Sectional Sample.Current developments in nutrition · 2026Article
- Effects of a Combined Front-of-Pack Nutrition Label and Nutrition Education Intervention on Healthier Choices of Freshly Prepared Beverages: An Online Randomized Controlled Trial.Foods (Basel, Switzerland) · 2026Article
- How and why researchers and advocates should engage with state and local food policymaking.Nature food · 2025Review
- Article
- De-normalizing sugar-sweetened beverage consumption: effects of tax measures on social norms and attitudes in the California Bay Area.BMC public health · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
introductionTo reduce added-sugar consumption, jurisdictions are considering requiring restaurant menu labels to identify high-added-sugar items. This study examined the impacts of added-sugar warning labels on hypothetical choices, knowledge of items' added-sugar content, and perceptions of high-added-sugar items. STUDY
designThe design was an online RCT. SETTING/
participantsNational sample of adults (N=15,496) was recruited to approximate the U.S. distribution of sex, age, race, ethnicity, and education.
interventionParticipants viewed fast-food and full-service restaurant menus displaying no warning labels (control) or icon-only added-sugar warning labels next to high-added-sugar items (containing >50% of the daily recommended limit).
main outcome measuresThe main outcome measures were hypothetical ordering of ≥1 high-added-sugar item, grams of added sugar ordered, and knowledge of items' added-sugar content assessed in 2021 and analyzed in 2021-2022.
resultsWarning labels reduced the relative probability of ordering ≥1 high-added-sugar item by 2.2% (probability ratio=0.978, 95% CI=0.964, 0.992; p=0.002); improved knowledge of added-sugar content (p<0.001); and led to a nonstatistically significant reduction of 1.5 grams of added sugar ordered, averaged across menus (p=0.07). The label modestly reduced the appeal of high-added-sugar items, increased perceptions that consuming such items often will increase Type 2 diabetes risk, increased perceived control over eating decisions, and increased injunctive norms about limiting consumption of high-added-sugar items (ps<0.001). However, in the warning condition, only 47% noticed nutrition labels, and 21% recalled seeing added-sugar labels. When restricting the warning condition to those who noticed the label, the result for grams of added sugar ordered was significant, with the warning condition ordering 4.9 fewer grams than the controls (95% CI= -7.3, -2.5; p<0.001).
conclusionsAdded-sugar warning labels reduced the probability of ordering a high-added-sugar menu item and increased participants' knowledge of whether items contained >50% of the daily value for added sugar. The modest magnitudes of effects may be due to low label noticeability. Menu warning labels should be designed for noticeability. REGISTRATION: This study was registered at AsPredicted.org #65655.
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Registered trials
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