Changes in awareness and use of calorie information after mandatory menu labeling in restaurants in King County, Washington

Am J Public Health. 2015 Mar;105(3):546-53. doi: 10.2105/AJPH.2014.302262. Epub 2015 Jan 20.


Objectives: We examined population-level impact on customer awareness and use and explored potential disparities in outcomes regarding the King County, Washington, regulation requiring chain restaurants to provide calorie information.

Methods: We analyzed 2008 to 2010 Behavioral Risk Factor Surveillance System data from 3132 English-speaking King County residents aged 18 years and older who reported eating at a regulated chain. We used regression models to assess changes in calorie information awareness and use from prepolicy to postpolicy implementation by customer demographics, health status, and restaurant type.

Results: Calorie information awareness and use increased significantly from 2008 to 2010. Unadjusted analyses indicated that the proportion who saw and used calorie information tripled, from 8.1% to 24.8%. Fully adjusted analyses confirmed significant increases. After policy implementation, White, higher income, and obese respondents had greater odds of seeing calorie information. Women, higher income groups, and those eating at a fast-food versus a sit-down chain restaurant were more likely to use this information.

Conclusions: Significant increases in calorie information awareness and use following regulation support the population-wide value of this policy. However, improvements varied across race, income, and gender.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Behavioral Risk Factor Surveillance System
  • Cross-Sectional Studies
  • Decision Making
  • Energy Intake*
  • Fast Foods / statistics & numerical data
  • Feeding Behavior*
  • Female
  • Food Labeling / legislation & jurisprudence*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Obesity / prevention & control*
  • Obesity / therapy
  • Regression Analysis
  • Restaurants / classification
  • Restaurants / legislation & jurisprudence*
  • Restaurants / statistics & numerical data
  • Sex Distribution
  • Social Class
  • Washington
  • Young Adult