Health Check study: Voluntary menu labelling

Exit surveys were conducted with restaurant patrons to examine noticing and use of nutrition information, and food consumption in restaurants participating in the Health Check Food Service Program.  Surveys were conducted with 1,126 patrons in four restaurants participating in the Health Check program  and 4 “Comparison” restaurants matched on menu type. Environmental scans of restaurants were conducted to examine the availability of nutrition information within each outlet. Data collection was conducted in May – June 2013.

Availability of nutrition information in restaurant environment
The Health Check symbol appeared on all menus/menu boards in restaurants participating in Health Check Food Service Program, and was accompanied by an explanation of the symbol in all cases.  None of the Health Check or Comparison restaurants provided nutrient information for all items on the menu/menu board. Calorie information for some items was available on the menus/menu boards in three of the Health Check restaurants and none of the Comparison restaurants. One Health Check restaurant and two Comparison restaurants had nutrition information for all menu items in easily accessible customer areas, such as on a poster. Additional nutrition information was provided on request at five locations: two of the four Health Check restaurants and three of four Comparison restaurants.  One Health Check restaurant had a nutrition information pamphlet available to take home.  The three restaurants that did not have nutrition information available directed the Research Assistant to their websites.

Noticing nutrition information and the Health Check logo in restaurants
Awareness of the Health Check logo among patrons of Health Check restaurants was low: only 5% of patrons in Health Check restaurants recalled seeing the Health Check logo anywhere in the restaurant. Respondents from both Health Check and Comparison restaurants were more likely to report seeing calorie information, which was not required, but can be displayed as part of the Health Check Food Service Program at the time of the study. Participants at Health Check and Comparison restaurants were equally likely to believe that nutrition information was “easily accessible” in the restaurant (an average of 5 on a 10-point scale).

Use of nutrition information and the Health Check logo to guide menu selection
Participants at Health Check restaurants were more likely to say their order was influenced by nutrition information in restaurants. Approximately one in ten participants at Health Check restaurants said their order was influenced by nutrition information, compared to 1 in 20 participants at Comparison restaurants. At Health Check restaurants, approximately one third of those who noticed nutrition information said that it influenced their order, compared to 16% at Comparison restaurants.

Consumption and nutrient intake
Overall, participants at Health Check restaurants consumed less saturated fat, carbohydrates, and more protein and fibre than participants at Comparison restaurants. Approximately 15% of participants (87) at Health Check restaurants ordered at least one item with a Health Check symbol. Among participants at Health Check restaurants, those that ordered a Health Check item consumed  items with substantially fewer calories, less fat, sodium, carbohydrates and more protein than patrons at the same restaurants who did not order a Health Check item. Among the 87 participants that ordered a Health Check item, only 8 (9%) recalled seeing the Health Check symbol in the restaurant and only 25 (29%) were aware that they had ordered a Health Check item when asked.

Recognition and comprehension of Health Check logo
Recognition of the Health Check symbol was very high, consistent with other research: when shown the logo, 91% of all participants reported recognizing the symbol. More than half reported seeing the symbol on pre-packaged grocery products, and more than a quarter reported seeing the symbol in a restaurant. The vast majority of participants associated the symbol with “healthier” or “more nutritious” food items. Very few differences in recognition and comprehension of the Health Check symbol were observed between participants at Health Check and Comparison restaurants.

Conclusions
Overall, the findings indicate that the Health Check Food Service Program is associated with greater levels of noticing and using nutrition information when selecting meals compared to Comparison restaurants. Nutrient intake at Health Check restaurants was also more favourable with respect to consumption of saturated fat, carbohydrates, protein and fibre than at Comparison restaurants. The extent to which these differences in consumption are attributable to the Health Check Food Service Program are unclear, particularly given that few participants noticed the Health Check symbol and participants were more likely to notice other nutrition information not included as part of the program. Restaurants participating in the Health Check Food Service Program may provide menu selections with a more favourable nutrition profile, which may reflect the type of restaurants that “self-select” into the program or may be a direct result of participating in the program.

Read the full report: Health Check Restaurant Report

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