Evidence map›Paper›PMID 41520993›Full record

Trial reportAmerican journal of preventive medicine2026

The Impact of Restaurant Menu Eco Labels on Consumer Meal Selections: An RCT.

Alexandria E Reimold, Jennifer Falbe, Brent F Kim, Aviva A Musicus, Nina Carr, Raychel Santo, Clara Cho, Cindy W Leung, Christina A Roberto, Julia A Wolfson

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of preventive medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06909019 (The Menu Labels for Environmental Impact and Nutrition Study), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

NCT06909019 nacompletednot on this map

The Menu Labels for Environmental Impact and Nutrition Study (MENU Study): Online Experiment

TypeinterventionalSponsorJohns Hopkins Bloomberg School of Public HealthRan2025 to 2025Enrolled6,294ConditionsFood SelectionArmsControl (QR) Labels, Low Climate Impact Labels, High Climate Impact Labels, Traffic Light Labels, Climate Grade Labels
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Alexandria E ReimoldDepartment of Human Ecology, University of California, Davis, Davis, California.
Jennifer FalbeDepartment of Human Ecology, University of California, Davis, Davis, California.
Brent F KimJohns Hopkins Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Aviva A MusicusDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Nina CarrDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Raychel SantoWorld Resources Institute, Washington, District of Columbia.
Clara ChoWorld Resources Institute, Washington, District of Columbia.
Cindy W LeungDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Christina A RobertoPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Julia A WolfsonDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: jwolfso7@jhu.edu.

Funding

A randomized-controlled evaluation of the effects of non-nutrition menu labels on dietary qualityR01DK139327 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI Julia A Wolfson · 2024 to 2026
$2.1M
NIDDK NIH HHS R01 DK139327
6 · The paper itself

Abstract

introductionFood systems account for ∼30% of the greenhouse gas emissions that contribute to climate change. Climate labels on restaurant menus may help consumers decrease their food-related climate impact and improve meal nutrition given that environmentally sustainable diets are also healthier. This study evaluated the degree to which different climate labels promoted healthier and lower climate impact food choices. STUDY

designThis was an online RCT conducted in 2024, analyzed in 2025. SETTING/

participantsA national sample of 6,221 adults benchmarked to the U.S. Census on sex, race, ethnicity, and age was analyzed.

interventionParticipants were randomized to view a fast-food menu with either a control label or 1 of 4 climate label designs: (1) numeric, (2) climate grade, (3) traffic light, or (4) warning. Labels appeared alongside main menu items and were based on total supply chain greenhouse gas emission associated with each item. Participants were instructed to select a hypothetical lunch meal order.

main outcome measuresThe main outcomes of this study were the selected meals' nutritional quality (measured using a modified Nutrient Profile Index score) and greenhouse gas emission in kilograms of carbon dioxide equivalent per meal.

resultsCompared with participants in the control condition (mean Nutrient Profile Index score=50.6, SE=0.28), those in the traffic light (mean Nutrient Profile Index score=51.3, SE=0.28; p=0.013) and warning (mean Nutrient Profile Index score=51.3, SE=0.28; p=0.015) label groups chose significantly healthier meals (i.e., higher Nutrient Profile Index score). All climate labels resulted in meals with significantly lower greenhouse gas emission than the control (mean greenhouse gas emission=27.5, SE=0.97). Participants in the traffic light condition selected meals with the lowest greenhouse gas emission (mean greenhouse gas emission=22.6, SE=0.97; p<0.001), followed by those in the warning (mean greenhouse gas emission=23.9, SE=0.97; p<0.001), grade (mean greenhouse gas emission=24.6, SE=0.97; p=0.004), and numeric (mean greenhouse gas emission=24.7, SE=0.98; p=0.005) conditions.

conclusionsInterpretive climate labels, particularly traffic light and warning label designs, are a promising way of improving the nutritional quality while reducing the climate impact of restaurant meal orders.

trial registrationThis study is registered at https://clinicaltrials.gov/study/NCT06909019.

Indexed as

Climate ChangeConsumer BehaviorFast FoodsFood LabelingFood PreferencesRestaurantsAdultChoice BehaviorFemaleGreenhouse GasesHumansMaleMealsMiddle AgedNutritive ValueGreenhouse Gases

Identifiers

PMID41520993
PMCPMC12884552

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.