Supplementing Menu Labeling With Calorie Recommendations to Test for Facilitation Effects

Objectives. We examined the effect on food purchases of adding recommended calorie intake per day or per meal to the mandated calorie information posted on chain restaurant menus. Methods. Before and after New York City implemented calorie posting on chain restaurant menus in 2008, we provided daily, per-meal, or no calorie recommendations to randomized subsets of adult lunchtime customers (n = 1121) entering 2 McDonald's restaurants, in Manhattan and Brooklyn, and collected receipts and survey responses as they exited. In linear and logistic regressions, with adjustment for gender, race, age, and day, we tested for simple differences in calories consumed and interactions between variables. Results. Posting calorie benchmarks had no direct impact, nor did it moderate the impact of calorie labels on food purchases. The recommendation appeared to promote a slight increase in calorie intake, attributable to increased purchases of higher-calorie entrees. Conclusions. These results do not support the introduction of calorie recommendations as a means of enhancing the impact of posted calorie information or reducing the contribution of restaurant dining to the obesity epidemic.