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Point-of-choice kilocalorie labelling practices in large, out-of-home food businesses: a preobservational versus post observational study of labelling practices following implementation of The Calorie Labelling (Out of Home Sector) (England) Regulations 2021.

Accepted version
Peer-reviewed

Change log

Authors

Jones, Andrew 
Adams, Jean 
Bishop, Tom 

Abstract

BACKGROUND AND OBJECTIVES: On 6 April 2022, the UK government implemented mandatory kilocalorie (kcal) labelling regulations for food and drink products sold in the out-of-home food sector (OHFS) in England. Previous assessments of kcal labelling practices in the UK OHFS found a low prevalence of voluntary implementation and poor compliance with labelling recommendations. This study aimed to examine changes in labelling practices preimplementation versus post implementation of mandatory labelling regulations in 2022. METHODS: In August-December 2021 (preimplementation) and August-November 2022 (post implementation), large OHFS businesses (250 or more employees) subject to labelling regulations were visited. At two time points, a researcher visited the same 117 food outlets (belonging to 90 unique businesses) across four local authorities in England. Outlets were rated for compliance with government regulations for whether kcal labelling was provided at any or all point of choice, provided for all eligible food and drink items, provided per portion for sharing items, if labelling was clear and legible and if kcal reference information was displayed. RESULTS: There was a significant increase (21% preimplementation vs 80% post implementation, OR=40.98 (95% CI 8.08 to 207.74), p<0.001) in the proportion of outlets providing any kcal labelling at point-of-choice post implementation. Only 15% of outlets met all labelling compliance criteria post implementation, with a minority of outlets not presenting labelling in a clear (33%) or legible (29%) way. CONCLUSION: The number of large businesses in the OHFS providing kcal labelling increased following the implementation of mandatory labelling regulations. However, around one-fifth of eligible outlets sampled were not providing kcal labelling 4-8 months after the regulations came into force, and the majority of businesses only partially complied with government guidance. More effective enforcement may be required to further improve kcal labelling practices in the OHFS in England. PREREGISTRATION: Study protocol and analysis strategy preregistered on Open Science Framework (https://osf.io/pfnm6/).

Description

Keywords

Health policy, Nutrition, Obesity, Public health

Journal Title

BMJ Open

Conference Name

Journal ISSN

2044-6055
2044-6055

Volume Title

Publisher

BMJ
Sponsorship
National Institute for Health and Care Research (NIHR200689)
MRC (MC_UU_00006/7)
This report is independent research commissioned and funded by the Department of Health and Social Care Policy Research Programme (Implementation and assessment of mandatory kcal labelling in the out-of-home sector, NIHR200689). The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. JA, TB, TB, ME, SS and MW are supported by the MRC Epidemiology Unit, University of Cambridge [UKRI grant number MC/UU/00006/7]. MP receives support from the NIHR Applied Research Collaboration ARC NWC and Alzheimer’s Society and is funded through a Post-Doctoral Fellowship. ER is funded by the National Institute for Health and Care Research (NIHR) Oxford Health Biomedical Research Centre (BRC), Economic and Social Research Council (ES/W007932/1) and European Research Council (Grant reference: PIDS, 803194). The views expressed are those of the authors and not necessarily those of the funders, NHS or Department of Health and Social Care.
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