Evaluating the impact of mandatory nutrition information on menus.

描述(由申请者提供)：超重是一系列慢性病的危险因素。目前，超过三分之二的美国成年人肥胖或超重，儿童肥胖率不断上升。据估计，超重和肥胖每年的医疗成本为1690亿美元，即使是在人群水平上，每天减少100卡路里的卡路里摄入量也可以节省多达580亿美元。在快餐店和其他餐馆增加“户外”卡路里摄入量是肥胖率上升的原因之一。2013年，美国将成为世界上第一个实施要求在菜单上贴上营养标签的联邦法规的国家。规定规定，卡路里含量必须出现在价格旁边的菜单上，并在销售点提供额外的营养信息。这些规定将适用于20家或更多的连锁餐厅，这些餐厅占美国餐厅游客的绝大多数。联邦菜单标签法规将开创一个新的国际先例，也是自强制要求提供预包装食品的营养信息以来，营养教育中最重要的政策干预之一。美国六个州和几个城市已经实施了类似的政策。目前这项研究的主要目标是使用一种“事前”准实验设计，在美国和加拿大进行“基线”和“后续”措施，作为“控制组”，在没有实施或计划实施任何法规的情况下，检查人群水平对菜单上的营养信息对饮食模式的影响。这项研究将包括在事前和事后进行的具有全国代表性的电话调查，以及在事前和事后对餐厅顾客进行的面对面离职调查。首先，在计划于2012年底、2013年初实施的联邦菜单条例实施前后，将在两个司法管辖区对1000名有代表性的参与者进行基于人口的电话调查。在实施之前和之后，还将在西雅图-温哥华和芝加哥-多伦多这四个配对城市中的每个城市对1000名参与者进行退出调查。西雅图是此前实施菜单标签规定的美国司法管辖区之一。出口调查将在每个城市的两个地点对5家全套服务餐厅和5家快餐店的顾客进行。将在同一时期(实施前和实施后12个月)进行具有代表性的电话调查和离职调查，采用平行措施评估离职调查数据可推广到人口层面的程度。注意，已经进行了基线数据收集：仅为后续数据收集申请资金。总体而言，本研究有可能为营养标签的证据基础做出重要贡献，并评估预防肥胖症的新政策措施。这项研究将有助于确定在餐厅菜单上要求营养信息是否会改变摄入量，包括这种影响是否会在不同的亚群中有所不同。

DESCRIPTION (provided by applicant): Excess body weight is a risk factor for a range of chronic diseases. Currently, more than two thirds of US adults are obese or overweight, with increasing rates of childhood obesity. The medical costs of overweight and obesity have been estimated at $169 billion per year, and even modest population-level reductions in calorie intake of 100 calories per day could save as much as $58 billion. Increasing calorie intake "outside the home" at fast-food and other restaurants has contributed to the rise in obesity. In 2013, the US will become the first country in the world to implement federal regulations requiring nutritional labeling on menus. The regulations mandate that calorie amounts appear on menus next to the price and that additional nutrient information be made available at the point-of-sale. The regulations will apply to chains of 20 or more restaurants, which account for the vast majority of restaurant visits in the US. The federal menu labeling regulations will establish a new international precedent and are among the most significant policy interventions in nutrition education since mandated nutrition information on pre-packaged foods. Six US states and several cities have already implemented similar policies. The primary objective of the current study is to examine the population level impact of nutritional information on menus on dietary patterns using a "pre-post" quasi- experimental design in which "baseline" and "follow-up" measures will be conducted in the US and Canada, which will serve as the "control group given that no regulations have been implemented or are planned. The study will consist of nationally representative phone surveys at pre and post, and face-to-face exit surveys of restaurant patrons at pre and post. First, population-based telephone surveys will be conducted with representative samples of 1,000 participants in both jurisdictions before and after the implementation of the federal menu regulations, scheduled for late 2012, early 2013. Exit surveys will also be conducted with 1,000 participants before and after implementation in each of four paired cities: Seattle-Vancouver, and Chicago- Toronto. Seattle is among the US jurisdictions that have previously implemented menu labeling regulations. Exit Surveys will be conducted with patrons of 5 "full service" and 5 fast-food restaurants at two locations in each city. The representative phone surveys and Exit Surveys will be conducted during the same period (before and 12 months after implementation) using parallel measures to assess the extent to which the data from Exit Surveys can be generalized to the population level. Note that baseline data collection has already been conducted: funding is requested for follow-up data collection only. Overall, the current study has the potential to make important contributions to the evidence base on nutritional labeling and to evaluate a novel policy measure for preventing obesity. The study will help to establish whether requiring nutritional information on restaurant menus modifies intake, including whether the effects may differ among sub-populations.