The impact of the English calorie labelling policy on the energy content of food offered and purchased in worksite cafeterias: a natural experiment.

ABSTRACT

BACKGROUND: On 6 April 2022, legislation came into effect in England requiring calorie labels to be applied to food items on menus of larger food businesses. This study aimed to assess the impact of calorie labelling on (a) food purchased and (b) energy content of menu options in worksite cafeterias. METHODS: Product-level sales data and energy content of available items was obtained from 142 worksite cafeterias from January 2022-October 2022. Interrupted-time-series (ITS) analysis with level and slope change evaluated daily energy (kcal) purchased per item, and ITS with level change assessed mean energy per option available on menus before and after calorie labelling. Each analysis was conducted 6 weeks and 6 months from implementation. A post-hoc ITS examined weekly energy purchased per item over a longer period (March 2021-October 2022; 135 sites). RESULTS: There was no evidence calorie labelling changed the energy content of foods purchased (6-week + 0.60 cal/product, 95%CI-2.54, + 3.75; 6-month + 1.59 cal/product, 95%CI-0.96, + 4.16). Post-hoc analyses suggested calorie labels were associated with a reduction in mean energy of items purchased over time (-0.65 kcal/week, 95%CI-0.81,-0.49), but a significant increase (+ 3 kcal, 95%CI + 0.43, + 5.60) at the point of implementation. There was a reduction in the mean energy content of menu options at each seasonal menu change (April 2022-1.79 kcal, 95%CI-3.42,-0.15; July 2022-4.18 kcal, 95% CI-7.65,-0.73). CONCLUSION: This large observational study in worksite cafeterias found no evidence to indicate the introduction of calorie labelling led to any immediate reduction in energy purchased by customers. There was some evidence of increasing impact over time, possibly associated with changes in menu offerings, but this effect was small and cannot be directly attributed to calorie labelling.