The worldwide increase in obesity has been driven by global trade liberalization, economic growth and rapid urbanization. Owing to the scope and complexity of the obesity epidemic, prevention strategies and policies across multiple levels are needed in order to have a measurable effect. Although many putative causes of the obesity epidemic exist, in this Review the effect of globalization on global trends in obesity prevalence is discussed and population-based interventions from several countries are reviewed. The authors make broad policy recommendations for obesity and chronic disease prevention at the global population level.

Global obesity: trends, risk factors and policy implications

One-third of adults are now obese, and children's obesity rates have climbed from 5 to 17 percent in the past 30 years. The causes of the nation's obesity epidemic are multi-factorial, having much more to do with the absence of sidewalks and the limited availability of healthy and affordable foods than a lack of personal responsibility. The broad societal changes that are needed to prevent obesity will inevitably affect activity and eating environments and settings for all ages. Many aspects of the obesity problem have been identified and discussed; however, there has not been complete agreement on what needs to be done to accelerate progress. Accelerating Progress in Obesity Prevention reviews previous studies and their recommendations and presents five key recommendations to accelerate meaningful change on a societal level during the next decade. The report suggests recommendations and strategies that, independently, can accelerate progress, but urges a systems approach of many strategies working in concert to maximize progress in accelerating obesity prevention.The recommendations in Accelerating Progress in Obesity Prevention include major reforms in access to and opportunities for physical activity; widespread reductions in the availability of unhealthy foods and beverages and increases in access to healthier options at affordable, competitive prices; an overhaul of the messages that surround Americans through marketing and education with respect to physical activity and food consumption; expansion of the obesity prevention support structure provided by health care providers, insurers, and employers; and schools as a major national focal point for obesity prevention. The report calls on all individuals, organizations, agencies, and sectors that do or can influence physical activity and nutrition environments to assess and begin to act on their potential roles as leaders in obesity prevention.

Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation

We examined the influence of menu calorie labels on fast food choices in the wake of New York City’s labeling mandate. Receipts and survey responses were collected from 1,156 adults at fast-food restaurants in low-income, minority New York communities. These were compared to a sample in Newark, New Jersey, a city that had not introduced menu labeling. We found that 27.7 percent who saw calorie labeling in New York said the information influenced their choices. However, we did not detect a change in calories purchased after the introduction of calorie labeling. We encourage more research on menu labeling and greater attention to evaluating and implementing other obesity-related policies.

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Calorie Labeling And Food Choices: A First Look At The Effects On Low-Income People In New York City

We study the impact of mandatory calorie posting on consumers’ purchase decisions, using detailed data from Starbucks. We find that average calories per transaction falls by 6%. The effect is almost entirely related to changes in consumers’ food choices—there is almost no change in purchases of beverage calories. There is no impact on Starbucks profit on average, and for the subset of stores located close to their competitor Dunkin Donuts, the effect of calorie posting is actually to increase Starbucks revenue. Survey evidence and analysis of commuters suggest the mechanism for the effect is a combination of learning and salience.

Calorie Posting in Chain Restaurants

Objective The US Food and Drug Administration and Institute of Medicine are currently investigating front-of-package (FOP) food labelling systems to provide science-based guidance to the food industry. The present paper reviews the literature on FOP labelling and supermarket shelf-labelling systems published or under review by February 2011 to inform current investigations and identify areas of future research. Design A structured search was undertaken of research studies on consumer use, understanding of, preference for, perception of and behaviours relating to FOP/shelf labelling published between January 2004 and February 2011. Results Twenty-eight studies from a structured search met inclusion criteria. Reviewed studies examined consumer preferences, understanding and use of different labelling systems as well as label impact on purchasing patterns and industry product reformulation. Conclusions The findings indicate that the Multiple Traffic Light system has most consistently helped consumers identify healthier products; however, additional research on different labelling systems’ abilities to influence consumer behaviour is needed.

/pdf/the-science-on-front-of-package-food-labels-4z6og0bsgk.pdf

The science on front-of-package food labels

Objectives. We assessed the impact of restaurant menu calorie labels on food choices and intake.Methods. Participants in a study dinner (n = 303) were randomly assigned to either (1) a menu without calorie labels (no calorie labels), (2) a menu with calorie labels (calorie labels), or (3) a menu with calorie labels and a label stating the recommended daily caloric intake for an average adult (calorie labels plus information). Food choices and intake during and after the study dinner were measured.Results. Participants in both calorie label conditions ordered fewer calories than those in the no calorie labels condition. When calorie label conditions were combined, that group consumed 14% fewer calories than the no calorie labels group. Individuals in the calorie labels condition consumed more calories after the study dinner than those in both other conditions. When calories consumed during and after the study dinner were combined, participants in the calorie labels plus information group consumed an averag...

https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.2009.160226

Evaluating the impact of menu labeling on food choices and intake

In this observational study, we determined how frequently consumers accessed on-premises nutrition information provided at chain restaurants. The number of patrons entering and accessing nutrition information was recorded at 8 locations that were part of 4 major restaurant chains (McDonald's, Burger King, Starbucks, and Au Bon Pain). Only 6 (0.1%) of 4311 patrons accessed on-premises nutrition information before purchasing food. This very small percentage suggests that such information should be more prominently displayed, such as on restaurant menu boards, to help customers make informed decisions.

https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2008.136457

An observational study of consumers' accessing of nutrition information in chain restaurants.

In this observational study, we determined how frequently consumers accessed on-premises nutrition information provided at chain restaurants. The number of patrons entering and accessing nutrition information was recorded at 8locationsthatwerepart of4 major restaurant chains (McDonald’s, Burger King, Starbucks, and Au Bon Pain). Only 6 (0.1%) of 4311 patrons accessed on-premises nutrition information before purchasing food. Thisverysmallpercentagesuggests that such information should be more prominently displayed, such asonrestaurantmenuboards,tohelp customersmakeinformeddecisions.

Henry Agnew

Papers

Evaluating the impact of menu labeling on food choices and intake

An observational study of consumers' accessing of nutrition information in chain restaurants.

AnObservationalStudyof Consumers'Accessingof NutritionInformationin ChainRestaurants