The impact of menu energy labelling across socioeconomic groups: A systematic review

Introduction: Menu energy labelling at point of purchase is gaining traction worldwide, yet the potential impact for different socioeconomic groups is unclear. We aimed to summarise evidence on the effectiveness of menu energy labelling by socioeconomic position (SEP).

Methods: A systematic search for papers published to September 2015 was conducted using terms for labelling, food outlets, and SEP. Quality of studies was assessed. Results were summarised across stages of an intervention logic pathway.

Results: Eighteen papers were identified. Of twelve studies reporting the effect of menu energy labelling in low SEP populations, six reported on purchase outcomes. All but one of these reported no positive effect of the policy for this population. Two of the five studies that compared purchase outcomes of menu labelling across SEP groups reported that the policy was effective overall. These two studies reported either a significant decline in fast food calories purchased from consumers in high (but not low) SEP neighbourhoods or a significantly greater decline in calories purchased among consumers visiting stores in higher SEP neighbourhoods post policy implementation. None of the included papers reached the highest quality score.

Conclusions: The current evidence describing the impact of menu energy labelling within or across SEP is limited in quantity and quality. Of the two studies that reported a positive benefit of menu energy labelling overall, both identified a greater effect on fast food purchases among consumers visiting stores in high compared to low SEP neighbourhoods. It is difficult to know whether the absence of effectiveness reported in low SEP populations represents a true lack of effectiveness or is a result of a more general lack of policy effectiveness or the limited quality of the reviewed studies.