Evaluating the impact of mandatory nutrition information on menus.

描述（由申请人提供）：超重是一系列慢性疾病的危险因素。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。超重和肥胖的医疗费用估计每年为1690亿美元，即使是人口水平每天减少100卡路里的热量摄入也可以节省多达580亿美元。在快餐店和其他餐馆“外出”时卡路里摄入量的增加导致了肥胖人数的上升。2013年，美国将成为世界上第一个实施联邦法规，要求在菜单上标注营养成分的国家。该法规规定，卡路里含量必须出现在菜单价格旁边，并在销售点提供额外的营养信息。该规定将适用于拥有20家或更多餐厅的连锁店，这些餐厅占美国餐馆访问量的绝大多数。联邦菜单标签法规将建立一个新的国际先例，并且是自强制要求预包装食品提供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。当前研究的主要目的是使用“前后”准实验设计来检查菜单上的营养信息对饮食模式的人口水平影响，其中“基线”和“后续”措施将在美国和加拿大进行，这将作为“对照组”，因为没有实施或计划实施任何法规。这项研究将包括在前后进行具有全国代表性的电话调查，以及在前后对餐馆顾客进行面对面的调查。首先，将在联邦菜单法规（定于2012年底、2013年初）实施前后，在两个司法管辖区对1,000名有代表性的参与者进行人口电话调查。此外，还将在西雅图-温哥华和芝加哥-多伦多这四个配对城市分别对1,000名参与者进行退出调查。西雅图是此前实施过菜单标签法规的美国司法管辖区之一。退出调查将在每个城市的两个地点对5家“全方位服务”餐厅和5家快餐店的顾客进行。代表性电话调查和退出调查将在同一时期（实施前和实施后12个月）采用平行措施进行，以评估退出调查的数据可以推广到人口水平的程度。请注意，基线数据收集工作已经开展：只要求为后续数据收集工作提供资金。总的来说，本研究有可能为营养标签的证据基础做出重要贡献，并评估预防肥胖的新政策措施。这项研究将有助于确定在餐厅菜单上标注营养信息是否会改变饮食摄入量，包括在不同人群中是否会产生不同的影响。

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.