Obama’s administration is taking a bold step in fighting overweight and moreover obesity: requiring chain restaurants and similar food establishments to post information on food calories for their items or dishes on menus and menu boards. The new directive published in November 2014 by the United States’ Food and Drug Administration (FDA) is mandated by the Affordable Care Act passed by Congress in 2010. The expectation is that restaurant customers will consider the nutritional values, particularly calories, of  food items on the menu if the information appears in front of them, inducing them to make more healthy choices. It is estimated that Americans consume a third of their calories dining out. But will consumers, who are not voluntarily concerned about healthy dietary, change their eating behaviour away-from-home just because the information is easily and promptly available?

The new requirements of the FDA apply to restaurant chains with 20 or more outlets, including fast food chains — likely a primary target of the new directive. Detail of total calorie content of food items should appear on print menus (e.g., at full-service restaurants) and menu boards positioned above counters for ordering (e.g., at fast-food restaurants). The rule covers meals served at a table or taken to a table by the customer to be consumed, take-away food like pizzas, and food collected at drive-through windows. Also included are sandwiches-made-to-order at a grocery store or delicatessen, coffee-shops, and even ice-cream parlours. (1)

•  The FDA directive also refers in a separate section to food sold through vending machines by owners or operators of 20 or more machines.

Calorie content in a food item (actually kilocalorie) indicates the amount of energy it provides. Usually the energy intake of consumers from meals, snacks and refreshments is more than the body requires, and the surplus not “burned”   accumulates and adds to body weight. The rule maintains that additional information on components such as calories from total and saturated fat, sodium, carbohydrates, protein, and sugars should be made available on request in writing. Critics could argue that while a summary measure of energy is an important nutritional factor, other nutritional values as those mentioned by the FDA, and more (e.g., fat in grams, Vitamins A and C), also need to be transparent to consumers. Practically, loading menus, and foremost menu boards, with too many nutritional details may be problematic for both business owners and their customers. Therefore, there is logic in focusing on an indicator regarded of higher priority. Nonetheless, restaurants should offer a supplementary menu with greater nutritional values to customers who are interested. Again, the question is how many customers will request and use that extra information.

The food service industry overall reacted positively to the new rules. The National Restaurant Association in the US (representing 990,000 restaurant and food-service outlets) is satisfied with the way the FDA has addressed its major concerns. Contention remains over food sold in amusements parks and cinemas, and regarding fresh sandwiches and salads and ready-to-eat meals made by supermarkets for individual consumers (i.e., single-serving). In fact,  several restaurant chains have already been displaying nutritional information on menus voluntarily for several years to cater for more health-conscious customers and improve their retail-brand image (e.g., Starbucks, McDonalds, Subway). Some chains also provide detailed nutrition information and assistant tools for customers to plan their meals on the chains’ websites. It should further be noted that regulations for posting nutrition information in food-service establishments are in place at the level of local authorities in various cities and counties across the US. Business and regional administrative initiatives are not new in the US as well as in Canada and other countries. However, such measures will be obligatory in the US at a country-level within a year ahead.

Consumers are likely to have some general guidelines (a schema of rules) in memory that they can consult on what is more or less healthy to eat and how much to eat of different items (e.g., “high levels of calories, fat and salt in hamburgers and french fries”, “cream cakes are rich with calories and sugar”). When arriving to a restaurant or coffee-shop, the more conscious consumer may apply those guidelines to compose one’s meal with greater care for his or her health. Yet, the ability to extract accurate nutrition values of food items offered on the menu is likely to be rather limited — our memory is not accurate and retrieving information may also be biased by prior goals or hypotheses. Even if we consider only total calories, we would recall gross estimates or value ranges for general food categories. Consumers furthermore tend to take into account only the alternatives explicitly presented and attribute information available on them in a choice setting (a “context effect”). Information not provided (e.g., has to be retrieved from memory) is likely to be ignored. Customers anxious enough may pull out a mobile device and look up some more accurate nutritional information from an app or a website of the company or a third-party source. But for most consumers, it should appear, there is strong logic as well as justification to provide the nutrition information on specific food items easily accessible at the food outlet to allow them to consider it on-the-spot in their choices.

A probable cause of resistance from consumers to take into account the nutritional content of the food they are about to order is that this might spoil their pleasure of eating the meal.  People commonly prefer to concentrate on which items to order that will be more enjoyable for them on a given occasion. The negative nutritional consequences of the desired food could be considered as ‘cost’, just like monetary price and perhaps even worse, a notion consumers would like to avoid. There is also a prevailing belief that healthier food is less tasty. To make consumers more receptive they would have to be persuaded beforehand that this belief is false or that nutritional components have both positive and negative consequences to consider. Surely consumers have to account for constraints on their preferences; health advocates have to help and ease any barriers to embracing health constraints, or turn pre-conceived constraints into consumers’ own preferences.

We may gain another insight into consumer food choices by considering the comparisons consumers utilise to make decisions. Simonson, Bettman, Kramer and Payne (2013) offer a new integrative perspective on the selection and effect of comparisons when making judgements and choice decisions — how consumers select the comparisons they rely upon vis-à-vis those they ignore, and what information is used in the process. They propose that the comparisons consumers seek have first to be perceived relevant and acceptable responses to the task (e.g., compatible with a goal); these comparisons fall within the task’s Latitude of Acceptance (LOA). They also need to be justifiable. Then, consumers will prefer to rely upon comparisons that are cognitively easier to perform (i.e., greater comparison fluency), given the information available on options. Importantly, even if bottom-up evidence suggests that certain comparisons require less effort to apply, these will be rejected unless they are instrumental for completing the task. Information factors that can facilitate the comparison between options may affect, however, which comparisons consumers perform among those included in the LOA. The following are factors suggested by the researchers that increase the probability that a comparison will be performed: attribute values that can be applied “as-is” and do not need additional calculation or transformation (i.e., “concreteness effect”); alignable input (i.e., values stated in the same units); information perceptually salient; and yet also information that can generate immediate, affective responses. (2)

Let us examine possible implications. Suppose that you visit a grill bar-restaurant of a large known chain. You have to choose the food composition of your meal, keeping with one or more of the following personal goals: (a) “not leave hungry” (satiated); (b) pleasure or enjoyment (taste/quality); (c) “eat healthy” (nutrition); (d) “spend as little as possible” (cost). Calorie values are stated on menu in a column next to price. If the primary goal is to keep a healthy diet you would most likely use calorie information to compare options. However, if “eat healthy” is not a valued goal for you, there is greater chance that calorie information will be ignored — even if values of calories are very easy to read-out, assess and compare. They may be perceived as distraction from considering and comparing, for instance, the ingredients of items that would determine your enjoyment from different food options. Consumers often have a combination of goals in mind, and thus if your goals are nutrition and price, there is an advantage to displaying numeric calorie and price values next to each other across items. It would be more difficult to weigh-in calories with information on ingredients that should predict enjoyment or satiation as your goals. Therefore, it can be important to display nutritional values in a format that facilitates comparison, and not provide too many values. Yet, if “eat healthy” is not one’s goal all those measures are unlikely to have much effect on choice.

• Some would argue that a salient perceptual stimulus can trigger consumer response in the desired direction even unconsciously. That is a matter for debate — according to the viewpoint above strong perceptual or affective stimuli will not be influential if the consumer’s goal is driving him in another direction.

• Given the growing awareness to health, justifying decisions based on calories to others may be received more favourably. Can this be enough to induce consumers to incorporate a nutrition comparison in their decision when it is not their personal goal?

A research study performed by the Economic Research Service (ERS) of the US Department of Agriculture (USDA) examined consumer response to display of nutrition information in food service establishments, comparing between fast-food and full-service chain restaurants. The researchers (Gregory, Rahkovsky, & Anekwe, 2014) show that consumers who see nutrition information have a greater tendency to use it during choice-making in full-service restaurants; overall, women are more sensitive to such information than men (especially using it in fast-food restaurants). Furthermore, they provide support that consumers who are already more conscious and care about a healthful diet are more likely to react positively to nutrition information in restaurants:

• Consumers who inspect always or most of the time the nutrition labeling on food products purchased in a store (enforced in the US for more than twenty years) are more likely to see and then use the nutrition information presented in full-service restaurants (notably, 76% of those who inspect the store-food labeling regularly use the information seen in the restaurant versus 18% of those who rarely or never use the labeling on store-food).
• Additionally, the researchers find that a Healthy Eating Index score (measuring habitude to using nutrition information and keeping a healthy diet) is positively correlated with intention to use nutrition information in fast-food or full-service restaurants (those who would often or sometimes use the information in full-service restaurants score 57-54 versus those who would use it rarely or never who score 50 on a scale of 1 to 100).

Gregory and his colleagues at USDA-ERS argue that following these findings, displaying nutrition information on menus at food-away-from-home establishments may not be enough to motivate consumers not already caring about healthful diet to read and use that information — “It may be too optimistic to expect that, after implementation of the nutrition disclosure law, consumers who have not previously used nutrition information or have shown little desire to use it in the future will adopt healthier diets.”

A research study in Canada involved an interesting comparison between two hospital cafeterias, a ‘control’ cafeteria that displays limited nutrition information on menu boards and an ‘intervention’ cafeteria that operates an enhanced programme displaying nutrition information in different formats plus educational materials (Vanderlee and Hammond, 2014). The research was based on interviews with cafeteria patrons. A significantly higher proportion of participants in the ‘intervention’ cafeteria reported noticing nutrition information (80%) than in the ‘control’ cafeteria (36%). However, among those noticing it, similar proportions (33% vs. 30%, respectively) stated that the information influenced their item choices. Hospital staff were more alert and responsive to the information than visitors to the hospital and patients. This research also indicates that customers who use more frequently nutrition labels on pre-packaged food products are also more likely to perceive themselves being influenced by such information.

Vanderlee and Hammond subsequently found lower estimated levels of calories, fat and sodium in the food consumed in the ‘intervention’ cafeteria than the ‘control’ cafeteria (using secondary information on nutrition content of food items). In particular, customers at the ‘intervention’ cafeteria who specifically reported being influenced by the information consumed less energy (calories).(3)

Actions to consider: Fast-food restaurants may place menus with extended nutrition information, beyond calories, on or next to the counter where customers stand for ordering. Full-service restaurants may place extended menus on tables, or at least a card inviting customers to request such a menu from the waiter. It may be advisable to add one more nutrition value next to calories as a standard (e.g., sugars because of the rise in diabetes and the health complications it may cause). Notwithstanding, full-service restaurants could be allowed to implement the rule during the day (e.g., for business lunch), but in the evening spare customers the pleasure of dining-out as entertainment without worries. Nonetheless, menus with nutrition information should always be available on request.

Nutrition information displayed on menus and menu-boards can indeed help consumers in restaurants, coffee-shops etc., to make more healthy food choices, but it is likely to help mostly those who are already health-conscious and in habit of caring about their healthful diet. Information clearly displayed has a good chance to be noticed; yet, educating and motivating consumers to apply it for a healthier diet should start at home, in school, and in the media. A classic saying applies here: You can lead a horse to the water but you cannot make it drink. Nutrition information may be a welcome aid for those who want to eat more healthy but it is less likely to make those who do not care about healthful diet beforehand to use the information in the expected manner.

Ron Ventura, Ph.D. (Marketing)

Notes:

(1) Overview of FDA Labeling Requirements for Restaurants, Similar Food Retail Establishments and Vending Machines, The Federal Food and Drug Administration (US), November 2014 http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm248732.htm; Also see: “US Introduces Menu Labeling Standards for Chain Restaurants”, Reuters, 24 Nov. 2014. http://www.reuters.com/article/2014/11/25/usa-health-menus-idUSL2N0TE1KP20141125

(2) Comparison Selection: An Approach to the Study of Consumer Judgment and Choice; Itamar Simonson, James R. Bettman, Thomas Karamer, & John W. Payne, 2013; Journal of Consumer Psychology, 23 (1), pp. 137-149

(3) Does Nutrition Information on Menus Impact Food Choice: Comparisons Across Two Hopital Cafeterias; Lana Vanderlee and David Hammond, 2013; Public Health Nutrition, 10p, DOI: 10.1017/S136898001300164X. http://www.davidhammond.ca/Old%20Website/Publication%20new/2013%20Menu%20Labeling%20(Vanderlee%20&%20Hammond).pdf; Also see: “Nutrition Information Noticed in Restaurants If on Menu”; Roger Collier; Canadian Medical Association Journal, 3 Aug., 2013 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735740/