The 2018 implementation of menu calorie labels is already helping American adults make healthier choices at restaurants and fast-food operations, with analyses showing a net decrease in caloric intake by 20 to 60 calories per meal out. While this may sound minor, a modelling study led by Tufts University researchers, published April 18 in the journal BMJ Open, estimates this is enough to prevent at least 28,000 obesity-associated cancer cases and 16,700 cancer deaths over a lifetime, saving a combined $2.8 billion in net healthcare and societal costs.
Based on available national nutritional survey data gathered from U.S. adults aged 20+, in the years 2015-2016, and integrated the national cancer statistics, Friedman School of Nutrition Science and Policy researchers modeled how likely it is that Americans will eventually get 13 obesity-related cancers and the resulting burden on the healthcare system. While the study is not a real-world evaluation of the calorie-label policy, mandated by the Affordable Care Act for all chain restaurants with 20 or more outlets, many of the projected statistics were validated by existing cancer statistics.
“It’s important for us to continue to show consumers, policymakers, and industry how small changes can lead to big benefits,” says lead author Mengxi Du, a PhD candidate in Nutrition Epidemiology and Data Science at the Friedman School. “Our population-level view suggests that these labels can be associated with substantial health gains and cancer-related healthcare cost savings that could be doubled with additional industry response, such as by replacing high-calorie menu items with lower-calorie options or reformulating recipes.”
Restaurant meals, which account for 1 in 5 calories consumed by adults, often come with additional calories and added sugars and saturated fats. With studies estimating that obesity-related cancers now represent 40% of all newly diagnosed cancer cases and contribute to 43.5% of total direct cancer care costs, helping people make healthy food choices at home and as they dine out is being seen by researchers and policymakers as a cancer prevention strategy.
The Tufts team’s model, which assumes that menu calorie labels lead to one pound of weight loss per year with no further weight loss, estimated the greatest health gains and net savings among young adults, ages 20-44, who are seeing a disproportionate rise in obesity-associated cancers. Hispanic and non-Hispanic Black individuals are also likely to see more cancer deaths averted, however, there is still work to do to ensure that people of different ethnicities and socioeconomic backgrounds are equally benefiting from food labeling policies.
“People with higher education or income levels are aware of the information in menu labels and how to understand it, but we need to put some effort into education among underrepresented, low-income, or at-risk communities because we still see some disparities,” says Du. “I think people would like to see calorie numbers when they go to a restaurant—even if menus don’t provide comprehensive nutrition information, it helps us all make quick calculations about the food we’re about to purchase.”
“From this research, we can see how labeling policies that effectively encourage consumers to make healthier dietary decisions are a form of cancer prevention—they reduce an individual’s chances of being obese and getting an obesity-associated cancer, while improving quality of life,” says senior study author Fang Fang Zhang, a cancer epidemiologist and Neely Family Professor at the Friedman School. “These policies don’t require a lot of spend, especially when compared to cancer screening costs, but provide a lot of benefits.”
The study is part of the Food Policy Review and Intervention Cost-Effectiveness (Food-PRICE) research initiative, an NIH-funded collaboration of researchers led by Tufts University working to identify nutrition strategies that can have the greatest impact on improving health outcomes in the United States.
Research reported in this article was supported by the National Institutes of Health’s National Institute on Minority Health and Health Disparities under award number R01MD011501. Complete information on authors, funders, and conflicts of interest is available in the published paper. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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What is the cost-effectiveness of menu calorie labelling on reducing obesity-associated cancer burdens? An economic evaluation of a federal policy intervention among 235 million adults in the USA
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