How have restaurant menus changed following England's calorie labelling regulations and who is likely to benefit? A longitudinal analysis of online menu

BackgroundThe introduction of mandatory calorie labelling among large food businesses (chains) in England in 2022 has been found to have little impact on consumer behaviour, but overall calories on restaurant menus have decreased slightly. This study examined menu changes post policy implementation, and the population groups likely to have been affected most. MethodsMenu data from 169 chains in Great Britain were extracted from two online food delivery platforms in June 2022 and June 2023. We selected 10 categories (specific foods or chains) jointly with public and policy advisors. Menu changes over time were assessed with multilevel models accounting for whether an item was continuously on the menu and for the type of chain. Where changes were found, we assessed differences in purchasing frequency by consumer characteristics using 2022 OOH purchase data (Worldpanel by Numerator, GB OOH Panel). ResultsChanges were observed in two (out of 10) categories examined and were driven by changing items on the menu rather than reformulating continuous dishes. Chains that used a healthy tag on the delivery website increased the share of mains under 600 kcal by 3.7 percentage points (95% CI 0.2 to 7.2), while average calories did not change (-17.6 kcal/item, 95% CI -38.7 to 3.4). Men, people aged 35-44 years and with high SES were found to purchase more frequently from these chains. Across all chains, the share of lower-calorie coffees decreased by 10 pp (95% CI -18.0 to - 0.02), with purchasing more frequent among men and increasing with age. ConclusionsAlthough data were available for one year only post-policy implementation, menu changes among the investigated foods and chains were limited. While menu change may equitably improve population dietary health, dietary inequalities may exacerbate if only healthy chains already offering lower-calorie food change their menus.