How have restaurant menus changed following England's calorie labelling regulations and who is likely to benefit? A longitudinal analysis of online menu
This longitudinal analysis of online menus in England found that mandatory calorie labelling led to limited menu changes driven primarily by item substitution rather than reformulation, with potential dietary benefits concentrated among men, older adults, and higher socioeconomic groups, raising concerns that such policies could inadvertently widen dietary inequalities.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer
Imagine the restaurant industry in England as a massive, bustling kitchen where thousands of chains serve food to the public. In April 2022, the government hung a new sign on the door: "You must show the calorie count for every dish." This rule applied to big chains with 250 or more employees.
This study is like a detective looking at the menu boards one year later (June 2022 vs. June 2023) to see if the chefs actually changed their recipes or just kept serving the same old dishes with a new label.
Here is what the investigation found, broken down simply:
1. The "Menu Makeover" Was Mostly a Rearrangement
Think of the restaurant menus like a bookshelf. The rule was supposed to make the chefs swap out heavy, calorie-dense books for lighter ones.
- What happened: For most categories (like pizza, fried chicken, and desserts), the "books" on the shelf stayed exactly the same. The average calorie count didn't really budge.
- The exception: There was one group of restaurants that acted differently. These were the chains that already wore a "Healthy" badge on their delivery apps (like Uber Eats or Deliveroo).
- These "healthy" chains didn't necessarily make their existing dishes lighter (reformulation). Instead, they swapped the books on the shelf. They removed some heavy dishes and added new, lighter ones.
- Because of this swapping, the share of main meals under 600 calories (a government-recommended limit for lunch/dinner) went up by about 3.7% in these specific chains.
2. The Coffee Cup Got Heavier
While some chains added lighter food, the coffee situation took a weird turn.
- Across all chains, the number of "lighter" coffees (like black coffee or espresso with little milk) actually dropped by about 10%.
- It seems the coffee menus shifted toward richer, higher-calorie drinks, even though the calorie labels were there.
3. Who Is Eating This New Menu?
The study also looked at who is buying these foods, acting like a census taker at the restaurant door.
- The "Healthy" Chain Shoppers: The people most likely to buy from the chains that added more low-calorie options were men, people in their mid-30s to mid-40s, and those with higher incomes.
- The Coffee Drinkers: Men and older people were the ones buying the most coffee, but since the lighter options disappeared, they are likely drinking the richer versions.
The Big Picture: Who Benefits?
The researchers used a metaphor of a garden.
- If the government's rule made every restaurant change their recipes to be healthier, everyone in the garden (the whole population) would get better nutrition.
- However, the study found that only the "healthy" chains (the ones already trying to be good) made changes.
- The Catch: Because the people who buy from these "healthy" chains are already wealthier and more health-conscious, the gap between them and everyone else might actually widen. The "healthy" options are getting slightly better, but they are landing in the baskets of people who already have good diets, while the rest of the population sees little change.
Summary
The calorie labels were put up, but they didn't force a massive kitchen overhaul.
- Did menus change? Only a little bit, and mostly by swapping items rather than changing recipes.
- Did it help everyone? Probably not. The changes mostly benefited the "healthy" chains, which are frequented by men, middle-aged adults, and wealthier people.
- Did it hurt? The study suggests that if only the "healthy" chains improve, the gap between the health of the rich and the poor might get bigger, rather than smaller.
In short: The labels were posted, but the menu didn't change much for the average person, and the improvements that did happen mostly went to the people who were already eating well.
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