Calorie (energy) labelling for changing selection and consumption of food or alcohol

• DOI: 10.31219/osf.io/pwhs5_v1
• Publication Date: 2025-02-07T14:40:11Z
• Authors: Natasha Clarke; Emily Pechey; Ian Shemilt; Mark Andrew Pilling; Nia Roberts; Theresa Mary Marteau; Susan Jebb; Gareth J Hollands
• Keywords: Overconsumption; Calorie

Background: Overconsumption of food and consumption any amount alcohol increases the risk non-communicable diseases. Calorie (energy) labelling is advocated as a means to reduce energy intake from alcoholic drinks. However, there continued uncertainty about these potential impacts, with 2018 Cochrane review identifying only small body low-certainty evidence. This updates extends provide timely reassessment evidence for effects calorie on people's selection or drinks.Objectives: – To estimate effect (including non-alcoholic drinks) drinks (with without purchasing) consumption.– assess possible modifiers label type, setting, socioeconomic status alcohol.Search methods: We searched CENTRAL, MEDLINE, Embase, PsycINFO, five other published grey literature databases, trial registries, key websites, followed by backwards forwards citation searches. Using semi-automated workflow, we selected records corresponding reports eligible studies, searches current 2 August 2021. Updated were conducted in September 2023 but their results are not fully integrated into this version review.Selection criteria: Eligible studies randomised controlled trials (RCTs) quasi-RCTs between-subjects (parallel group) within-subjects (cross-over) designs, interrupted time series before-after comparing no labelling, applied also needed objectively measure participants' consumption, real-world, naturalistic laboratory, laboratory settings.Data collection analysis: Two authors independently inclusion extracted study data. RoB tool ROBINS-I bias included studies. Where possible, used (random-effects) meta-analyses summary sizes standardised mean differences (SMDs) 95% confidence intervals (CIs), subgroup analyses investigate modifiers, including study, intervention, participant characteristics. synthesised data narrative summary. rated certainty using GRADE.Main results: 25 (23 food, food), comprising 18 RCTs, one quasi-RCT, two four Most real-world field settings (16/25, 13 restaurants cafeterias three supermarkets); six laboratories that attempted mimic setting; settings. assessed impact menus menu boards (18/25); directly on, placed adjacent to, products packaging; labels both product packaging. The most frequently type was simple (20/25), assessing information at least nutrient, calories physical activity equivalent (PACE) (or both). Twenty-four high-income countries, 15 USA, UK, Ireland, France, Canada. (18/25) high populations, while low groups, participants groups. purchasing), which measured purchasing (17/24), eight food.Calorie led reduction (SMD −0.06, CI −0.08 −0.03; 16 19 comparisons, 9850 participants; high-certainty evidence), near-identical when bias, purchasing. There may be larger −0.19, −0.33 −0.05; 8 10 2134 evidence). These suggest that, an average meal 600 kcal, adults exposed would select 11 kcal less (equivalent 1.8% reduction), consume 35 5.9% reduction). direction observed non-randomised broadly consistent Only focused drinks, drinks). Their inconclusive, inconsistent wide CIs encompassing harm benefit, very certainty. Authors' conclusions: Current suggests menus, products, packaging leads reductions purchased, potentially meaningful impacts population health scale. similar purchasing, although it lower insufficient more high-quality needed. Further research moderators intervention particularly status. Wider implementation merit further examination, systemic industry actions, individual harms benefits.