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Effect of calorie labelling in the out-of-home food sector on adult obesity prevalence, cardiovascular mortality, and social inequalities in England: a modelling study

Colombet, Z, Robinson, E, Kypridemos, C, Jones, A and O'Flaherty, M (2024) Effect of calorie labelling in the out-of-home food sector on adult obesity prevalence, cardiovascular mortality, and social inequalities in England: a modelling study. The Lancet Public Health, 9 (3). e178-e185. ISSN 2468-2667

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Background England implemented a menu calorie labelling policy in large, out-of-home food businesses in 2022. We aimed to model the likely policy impact on population-level obesity and cardiovascular disease mortality, as well as the socioeconomic equity of estimated effects, in the adult population in England. Methods For this modelling analysis, we built a comparative assessment model using two scenarios: the current implementation scenario refers to actual deployment only in large (≥250 employees), out-of-home food businesses, whereas the full implementation scenario refers to deployment in every out-of-home food business. We compared each scenario with a counterfactual: the scenario in which no intervention is implemented (ie, baseline). For both scenarios, we modelled the impact of the policy through assumed changes in energy intake due to either consumer response or product reformulation by retailers. We used data from the Office for National Statistics and the National Diet and Nutrition Survey 2009–19, and modelled the effect over 20 years (ie, 2022–41) to capture the long-term impact of the policy and provided mid-period results after 10 years. We used the Monte Carlo approach (2500 iterations) to estimate the uncertainty of model parameters. For each scenario, the model generated the change in obesity prevalence and the total number of deaths prevented or postponed. Findings The current implementation scenario was estimated to reduce obesity prevalence by 0·31 percentage points (absolute; 95% uncertainty interval [UI] 0·10–0·35), which would prevent or postpone 730 cardiovascular disease deaths (UI 430–1300) of the 830 000 deaths (UI 600 000–1 200 000) expected over 20 years. However, the health benefits would be increased if calorie labelling was implemented in all out-of-home food businesses (2·65 percentage points reduction in obesity prevalence [UI 1·97–3·24] and 9200 cardiovascular disease deaths prevented or postponed [UI 5500–16 000]). Results were similar in the most and the least deprived socioeconomic groups. Interpretation This study offers the first modelled estimation of the impact of the menu calorie labelling regulation on the adult population in England, although we did not include a cost-effectiveness analysis. Calorie labelling might result in a reduction in obesity prevalence and cardiovascular disease mortality without widening health inequalities. However, our results emphasise the need for the government to be more ambitious by applying this policy to all out-of-home food businesses to maximise impact.

Item Type: Article
Subjects: B Philosophy. Psychology. Religion > BF Psychology
T Technology > TX Home economics > TX341 Nutrition. Foods and food supply
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Psychology (from Sep 2019)
Publisher: Elsevier BV
SWORD Depositor: A Symplectic
Date Deposited: 29 Feb 2024 12:48
Last Modified: 14 Mar 2024 11:51
DOI or ID number: 10.1016/s2468-2667(23)00326-2
URI: https://researchonline.ljmu.ac.uk/id/eprint/22717
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