Will calorie labels for food and drink served outside the home improve public health?BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n40 (Published 20 January 2021) Cite this as: BMJ 2021;372:n40
- Eric Robinson, university reader1,
- Lucile Marty, postdoctoral research associate1,
- Andrew Jones, university senior lecturer1,
- Martin White, professor of population health research2,
- Richard Smith, professor in health economics3,
- Jean Adams, senior university lecturer2
- 1Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
- 2Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- 3College of Medicine and Health, University of Exeter, Exeter, UK
- Correspondence to: E Robinson
The UK government first proposed mandatory calorie labelling of food and drink served outside the home in England in 2018. Although a consultation took place, no policy has yet been enacted. The increased risk of serious illness and death among people with covid-191 led to the announcement of renewed plans for mandatory calorie labelling in July 2020, alongside other measures targeting the marketing of unhealthy food and a mass media weight loss campaign.
However, consumer behaviour studies suggest that calorie labelling may have at best a modest effect on calories ordered when eating out. Yet, here we argue that calorie labelling may affect diet and obesity through multiple other mechanisms. Only a global evaluation of the policy, with a wide lens on potential mechanisms of effect, will allow us to judge its role in improving public health.
Excessively calorific meals
Public Health England estimates that UK adults consume 200-300 calories a day more than they need to maintain a healthy body weight.2 Some of these excess calories come from sources outside the home—outlets such as takeaways, restaurants, and cafes, where food or drink is ready for immediate consumption.
Less than 20% of UK restaurant chains were voluntarily providing instore calorie labelling in any form in 2018.3 This lack of information may be particularly problematic given the energy content of food served out of the home. We recently found that 91% of main meals served in major UK restaurant chains contained more than 600 kcal—the energy content for a main meal recommended by Public Health England.4 Consistent evidence of easy availability of other food products (eg, beverages, desserts, side dishes) that are high in calories in the out-of-home sector has also been reported …