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Food should be labelled with the exercise needed to expend its calories

BMJ 2016; 353 doi: (Published 06 April 2016) Cite this as: BMJ 2016;353:i1856
  1. Shirley Cramer,
  2. chief executive
  1. Royal Society for Public Health, London E1 8AN
  1. scramer{at}

Giving consumers an immediate link between foods’ energy content and physical activity may reduce obesity

More than two thirds of the UK population are either overweight or obese.1 We desperately need innovative schemes to change behaviour at the population level.

Little evidence has shown that the current information on food and drink packaging, including “traffic light” labelling, actually changes behaviour. Packaging should not only provide nutritional information but should also help people to change behaviour.

The Royal Society for Public Health has called for the introduction of “activity equivalent” calorie labelling, with symbols showing how many minutes of several different physical activities are equivalent in the calories expended to those in the product. The aim is to prompt people to be more mindful of the energy they consume and how these calories relate to activities in their everyday lives, to encourage them to be more physically active.

Confusing information

Public polling by the society has shown that almost half (44%) of people find current front-of-pack information confusing.2 Such information needs to be as simple as possible so that the public can easily decide what to buy and consume in the average six seconds people spend looking at food before buying.3

People find symbols much easier to understand than numerical information,4 and activity equivalent calorie labels are easy to understand, particularly for lower socioeconomic groups who often lack nutritional knowledge and health literacy.5 For example, the calories in a can of fizzy drink take a person of average age and weight about 26 minutes to walk off. Given its simplicity, activity equivalent calorie labelling offers a recognisable reference, accessible to everyone.

Initial studies show that this approach can change behaviour by reducing intake or modifying choice.6 7 When the Royal Society for Public Health consulted the public, more than half (53%) said that they would positively change their behaviour as a result of viewing activity equivalent calorie information—by choosing healthier products, eating smaller portions, or doing more physical exercise, all of which could help to counter obesity.2 Although we don’t know about actual behaviour change, initial consultations such as this show promising intentions.

Active lifestyle

We won’t reduce obesity by focusing on diet or physical activity alone. People need to create a balanced relationship between the calories they consume and the calories they expend.

Placing information on food and drink packaging to promote an active lifestyle could be a logical solution to a multifaceted problem, and the benefits of being active go far beyond maintaining a healthy weight. The Academy of Medical Royal Colleges has described regular physical activity as a “miracle cure” because it boosts self esteem, mood, sleep quality, and energy levels and reduces the risk of stress, depression, dementia, and Alzheimer’s disease.8 9

People can’t out-run a bad diet, and messages about the importance of healthy and varied eating must also continue. Some concerns have been raised about activity equivalent calorie labelling and possible negative implications for people with eating disorders—but we have a responsibility to promote measures to tackle the biggest public health challenges facing our society, such as obesity. In any future development of activity equivalent calorie labels, these risks can be mitigated by working with groups who have concerns about the unintended effects of this information.

The public is used to being told to avoid particular drinks and to cut down on specific foods. By contrast, activity labelling encourages people to start something, rather than calling for them to stop.

Food packaging is governed by European legislation, and recent regulations have come into force requiring mandatory nutrition declarations for most pre-packaged food—so any fundamental change to packaging harbours little appetite among European Union officials and food manufacturers.

With this in mind, detailed research should explore the potential effects of activity labelling on consumer choices, including the potential harms. If it’s shown to be an effective means of influencing consumers’ decisions, we would implore law makers and the industry to implement it to reduce obesity in the United Kingdom.


  • Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

  • Provenance and peer review: Commissioned; not externally peer reviewed.


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