Calorie labels cut intake slightly, but alcohol impact unclear

By Priyanjana Pramanik, MSc.Reviewed by Lily Ramsey, LLMJan 21 2025

A comprehensive review highlights small but meaningful reductions in calorie selection and consumption from food labeling, while evidence for alcohol remains inconclusive.

Study: Calorie (energy) labelling for changing selection and consumption of food or alcohol. Image Credit: asiandelight/Shutterstock.com

In a recent publication in the Cochrane Database of Systematic Reviews, researchers estimated the effect of calorie labeling on the selection and consumption of food and alcoholic and non-alcoholic links.

Their findings indicate that calorie labeling if implemented broadly, could reduce energy selection, purchase, and consumption, though further research is warranted.

Background

Poor diets, including high consumption of unhealthy fats, sugars, salt, and alcohol, contribute significantly to global obesity and non-communicable diseases like heart disease, diabetes, and cancer.

These health issues cause millions of deaths annually, especially in disadvantaged groups, and impose significant economic costs. Despite the desire for healthier lifestyles, many struggle to maintain them due to environmental influences.

Calorie labeling on food and drinks is one intervention to promote healthier choices. This includes mandatory nutritional labels on packaged foods in various countries and calorie information on menus in some regions. While alcohol products often lack calorie labeling, there is growing advocacy for its inclusion.

Calorie labeling can potentially improve public health by encouraging better food and drink selections, leading to reduced calorie intake and weight management. However, the effectiveness of this intervention can vary based on factors like the setting, type of label, and socioeconomic status.

About the study

As part of the search criteria, researchers included both randomized controlled trials (RCTs) and non-randomized studies to assess the impact of calorie labeling on food and drink choices. The review included studies on children and adults.

Calorie labeling of food and drinks was the primary focus. To be included, the labels used in the studies had to display clear calorie information and be visible at the point of consumption or selection.

If other interventions were combined with calorie levels, they were included only if the effect of labeling could be isolated. Studies were excluded if they did not allow a clear measurement of the calorie label’s impact.

Primary outcomes were the selection or consumption of food and drinks, measured objectively. Only actual behavior data, not intentions or hypothetical scenarios, were included.

After identifying eligible studies from scientific literature databases and other resources, the research team constructed a dataset that included information about the study, setting (including country and level of intervention), characteristics of the participants studied (including ethnicity, gender, age, and socioeconomic status), the type of product, description of the label, duration of exposure to the intervention, and outcomes, including selection or consumption.

Findings

After a rigorous screening process, 25 studies, including 18 RCTs, one quasi-RCT, and six non-randomized studies, were included in the review. Most were conducted in high-income countries, with settings ranging from restaurants and worksite cafeterias to supermarkets and laboratories.

Participant demographics varied, with 16 studies including adults over 18 and others including adolescents and children. Socioeconomic and weight status data were reported variably, with several studies featuring overweight or obese participants.

First, researchers explored the effects of calorie labeling on the selection of food and non-alcoholic drink items found in RCTs. Calorie labeling on menus or food items slightly reduces the calories selected, with high-certainty evidence showing a small average decrease of about 11 kcal per meal.

This analysis included 16 studies with 9850 participants, mostly comparing simple calorie labels to no labels. Most research took place in real-world settings like restaurants. Sensitivity analyses confirmed the results, indicating the reduction is consistent across different settings and types of labels.

Six non-randomized studies also assessed the impact of calorie labeling on food and non-alcoholic drink purchases. Most studies in the United States showed a reduction in calories purchased, with decreases ranging from 14 to 73 kcal per transaction.

In the United Kingdom studies found a reduction in energy purchased from labeled products. These results were consistent with randomized studies.

Ten comparisons from eight studies with 2,134 participants evaluated the effects of calorie labeling on food consumption. The results suggest that calorie labeling may reduce energy intake by about 35 kcal per meal (5.9%), but the evidence is of low certainty due to study limitations and short-term settings.

Subgroup analyses indicated a larger effect in laboratory settings and among higher socioeconomic status participants.

For alcoholic drinks, two studies found no clear impact on energy selection or alcohol units, and the evidence is of very low certainty, with significant uncertainty about real-world effects. The review found no studies that examined the impact of labeling on alcoholic drink consumption.

Conclusions

The review suggests that calorie labels on food products can reduce the energy selected and consumed, with modest but potentially meaningful effects. For food, calorie labeling resulted in a 1.8% reduction in energy selected and a 5.9% reduction in energy consumed.

However, the evidence for alcohol is limited, with no clear impact on selection or consumption. The evidence shows that quality is high for food selection but low for food consumption and very low for alcohol. The intervention’s effectiveness is consistent across settings, but its impact may be less in high-deprivation areas.