Some people may not want to know exactly how many calories are in a Starbucks Frappucino or Bloomin’ Onion from Outback Steakhouse. Nevertheless, the Food and Drug Administration has required the information to be displayed on the menus of chain restaurants in the US since 2018, and a similar rule was introduced in Britain in 2022.
But does calorie count really change the way people eat? There is some evidence that they have a small but tangible impact, according to a new systematic review from the Cochrane Collaboration.
The study found that calorie labels prompted people to select foods with an average of 1.8% fewer calories than without calorie labels – the difference between a 600-calorie meal and a 589-calorie meal.
That’s not much. But small daily changes “can have meaningful effects if sustained over the long term,” Gareth Hollands, co-author of the review and researcher at University College London, said in a news conference. He mentioned a United Kingdom government report which found that 90% of people aged 20 to 40 in England gain up to 9 kilograms (about 20 pounds) over a decade.
Reducing 24 calories per day would prevent that increase, Hollands said. “Many of us could benefit from some help maintaining our weight by cutting small numbers of extra daily calories that account for much of the population’s weight gain.”
While the review is valuable, it’s difficult to draw conclusions about the average effect of calorie labeling given the different types of studies included in the review, said Christina Roberto, associate professor of health policy at the University’s Perelman School of Medicine of Pennsylvania. studied the impact of food labeling requirements and was not involved in the study.
But she agreed with the review’s overall conclusion that calorie labeling has some influence on consumer choices.
“I find it quite incredible that it works at all,” Roberto said. “It’s such a light intervention, it’s just a few numbers on a menu, it’s incredibly cost-effective, and you do get these little discounts.” For these reasons, she said, the calorie labeling policy “feels like a no-brainer.
The Cochrane review included 25 studies on the effects of calorie labeling, including 16 that took place in restaurants, cafeterias and supermarkets rather than laboratories. (All but one of the studies in the meta-analyses focused on eating places; that study took place in a French supermarket and looked at ready-to-eat foods, pastries, bread and canned ready meals such as cooked beans. ) Twenty-four of the studies were conducted in high-income countries such as the US, Great Britain, Ireland, France and Canada. An earlier version of the review was published in 2018and has now been updated with more recent research.
The study also found that calorie labels can lead people to eat smaller portions of the foods they select: on average, about 5.9% less. But most studies on portion sizes were conducted in labs and not in the real world, leaving researchers with little confidence in this conclusion.
Two studies included in the review focused on the effects of alcoholic beverage labels, but the results were inconclusive. Most countries do not require nutrition labels on alcoholic beverages. In the US, the Alcohol and Tobacco Tax and Trade Bureau, which regulates most alcohol products, is weighing new rules on what information companies must disclose.
While restaurant chains in the US have been required to list calorie counts on menus for six years, some state and local governments have introduced these requirements even earlier, including New York City in 2008. under former New York Mayor Michael Bloomberg. (STAT’s coverage of commercial health determinants is funded by Bloomberg Philanthropies but is editorially independent.) In the U.S., four in five Americans say they regularly consult nutrition labels when deciding whether to purchase an item, according to the most recent data from a study by the United States Department of Agriculture. Labels have less influence on Americans when they eat out; 43% said it influenced their decisions at fast-food and sit-down restaurants, the same study found.
The research shows that calorie labeling works, according to Aviva Musicus, scientific director of the Center for Science in the Public Interest, which has long advocated such policies. “Labeling is just one of many tools we must use to address our country’s chronic disease crisis,” she said. “But transparency through calorie labeling and other forms of labeling is an important first step in helping consumers get the information they need.”
Experts, including Hollands, agreed that calorie labels are certainly not a panacea. “These types of interventions would ideally be introduced alongside a broader range of approaches, including those that place more pressure on industry than on individuals,” he said. Examples of this are taxes such as those of the United Kingdom soft drink tax and marketing restrictions such as a UK rule set to come into effect from October 2025 ban products with a lot of fat, sugar or salt ban advertising on TV before 9 p.m. and completely ban online advertising for those foods.
Regardless of the extent to which calorie labels influence people’s food choices, some health experts have argued in recent years that calories are the wrong metric to focus on when it comes to improving health.
“Calories are an outdated, outdated and, in my opinion, useless form of information to get people to eat healthier,” says Giles Yeo, a geneticist at the University of Cambridge who focuses on the links between genes, food intake and obesity.
The problems with calorie labels are twofold, Yeo said. First, “If you try to compare different foods, you know nothing about the nutritional value of the food.” If you had to choose between, say, a burrito bowl and a BLT at a restaurant, information about the protein, fiber, fat or sodium in each item would be more useful than calories in guiding people toward healthy choices.
In response to such concerns, the FDA this week proposed new labels on the front of packaged foods that would highlight the amount of saturated fat, added sugars and sodium in a single serving.
The other problem, Yeo said, is that calorie counting “targets the concerned people rather than the people who need it most, who are likely to buy cheap processed food because they can afford it. We need to think about how we can make healthy food available to society as a whole in a fair way.”
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