Calories on menus ‘may prevent 9,000 heart disease deaths if implemented widely’

More than 9,000 heart disease-related deaths could be prevented in England over the next two decades if all restaurants, fast food outlets, cafes, pubs and takeaways put calories on their menus, a modelling study suggests.

Scientists said under the current Government policy, which only covers large food businesses with 250 or more employees, around 730 deaths from cardiovascular diseases may be prevented between 2022 and 2041.

The findings, published in the journal Lancet Public Health, also suggest the current policy would reduce obesity prevalence in England by 0.31 percentage points in the next 20 years, whereas a full implementation of the policy – across all food businesses – would reduce this by 2.65 percentage points.

The researchers said their results “emphasise the need for the Government to consider extending this policy to all food businesses to maximise public health benefits as part of a broader England obesity strategy”.

Martin O’Flaherty, professor in epidemiology at the University of Liverpool, said: “Over one in four adults in England are currently living with obesity, with trends suggesting this is set to increase.

“Our research estimates that the current calorie labelling legislation will prevent hundreds of deaths from cardiovascular disease over the next 20 years; however, a much larger impact is possible if the Government were more ambitious in their aims to tackle the obesity epidemic in England and extended the policy to all out-of-home food businesses.”

In April 2022, the Government implemented mandatory calorie labelling in England for businesses that serve food as part its national obesity strategy.

The aim is to help diners make healthier choices and combat the nation’s growing obesity problem.

Similar legislation is being considered in Wales and Scotland.

To understand more about the future impact of calories on menus, the researchers looked at how the current policy – which applies to around 18% of food businesses – would influence two key outcomes, obesity and cardiovascular disease.

Dr Zoe Colombet, lecturer in epidemiology and public health at the University of Liverpool, said: “Obesity increases the risk of cardiovascular disease and diabetes, which also could lead to cardiovascular disease.

“Hence, reducing obesity will result in a reduction of cardiovascular disease, and, in the longer term, other diseases related to obesity such as some types of cancer and joint diseases.”

The team found that without any menu calorie labelling policy an estimated 830,000 deaths associated with cardiovascular disease would occur by 2041.

Modelling suggests that under the current policy around 730 deaths can be prevented over the next 20 years, and if it was extended to all food businesses in England, then about 9,200 deaths could be prevented – almost 13 times more.

Dr Colombet said: “Our results suggest expanding calorie labelling on menus to all English out-of-home food businesses could play an important part in future government strategies to support people in making healthier choices to tackle obesity.

“However, one policy alone cannot solve England’s obesity crisis.

“We encourage the Government to continue with, and strengthen, the England obesity strategy with a wide range of policies, such as calorie labelling, tackling junk food marketing, and the soft drinks industry levy, which will both reduce obesity and narrow the shocking health inequalities gap in our society.”

She also said understanding the cost to small businesses is essential, and mechanisms to provide help to implement and monitor the policy need to be discussed.

The researchers also said there other areas of policy impact that their study did not investigate, such as eating disorders.

Eric Robinson, professor of psychology at the University of Liverpool, said: “Policymakers must consider multiple factors when making decisions and future research is required about the cost-effectiveness of the policy, the impact on consumers and businesses, as well as the potential unintended negative consequences such as those on eating disorders.”

Commenting on the study, Dr Duane Mellor, registered dietitian and senior lecturer at Aston Medical School in Birmingham, said it is vital that potential public health policies are thoroughly tested through modelling before considering their implementation.

He said there are other studies that suggest calorie labelling in some instances “can lead to increased consumption as it is seen as better value for money”.

Dr Mellor said: “This highlights that calorie labelling on menus in isolation could have the potential to have the opposite effect. It is important to look at the overall nutritional balance of meals and how they fit into an overall dietary pattern.

“It is not sensible to focus on foods solely on their energy content to assess how healthy or not they are.”