Understanding the Effect of Calorie Menu Labels on Obesity: Producer and Consumer Responses to the ACAs Calorie Posting Requirement

 描述(由申请人提供)：该项目的总体目标是通过检查消费者行为和餐厅菜单的变化，确定平价医疗法案(ACA)的菜单标签要求是否以及为什么会影响肥胖。由于外出就餐与肥胖的关系，以及消费者难以准确确定菜单项目的营养含量，ACA要求连锁餐厅在菜单上张贴卡路里信息。这一要求将于2015年12月1日起实施，并建立在2008年首次实施的类似州和地方法律的基础上。初步证据表明，在之前引入菜单标签要求的县，随着时间的推移，身体质量指数(BMI)的变化比附近县有所下降。相比之下，之前对当地菜单标签法的研究主要是检查大型连锁餐厅点菜的变化，通常发现在菜单上张贴卡路里计数后，购买的卡路里数量变化很小或没有变化。由于这些要求，如此狭隘的关注错过了餐厅菜单和消费者行为的许多其他潜在变化。该项目通过检查ACA菜单标签要求在全国范围内的执行情况以及该要求对行为的更广泛影响，大大扩展了先前的文献。具体地说，这个项目将评估 ACA的菜单标签要求(1)餐厅菜单产品和价格，(2)消费者饮食习惯，(3)体力活动，(4)身体质量指数和肥胖。在实施菜单标签要求之前和之后的一段时间内，受该要求影响的组和未受影响的组之间的差异差异比较将提供对菜单标签影响的估计。受影响的餐厅是指拥有20家或更多门店的连锁店，这些连锁店以前没有自愿在菜单上张贴卡路里，而且位于没有事先获得当地授权的地区。受影响的消费者是居住在县或州的个人，没有ACA前的卡路里张贴规定。为了构建这些估计，这个项目将涉及收集和分析来自连锁餐厅的菜单和营养成分，调查以前有卡路里张贴要求的地区和周围地区的消费者，并分析结果数据，以及分析来自行为风险因素监测系统(BRFSS)的数据。该项目的预期成果是了解更多地获得卡路里张贴要求形式的信息对肥胖的影响，以及卡路里张贴影响肥胖症的机制。因此，该项目将向政策制定者和研究人员通报《平价医疗法案》中公布卡路里的规定是否以及如何影响肥胖率。

 DESCRIPTION (provided by applicant): The overall aim of this project is to determine whether and why the Affordable Care Act's (ACA) menu labeling requirement impacts obesity by examining changes in consumer behavior and restaurant menus. Due to the relationship between eating outside of the home and obesity and the difficulty of consumers in accurately determining the nutritional content of menu items, the ACA requires chain restaurants to post calorie information on menus. This requirement will be implemented on December 1, 2015 and builds upon similar state and local laws first implemented in 2008. Preliminary evidence suggests that changes in body mass index (BMI) over time in counties that previously introduced a menu labeling requirement fell in recent years relative to nearby counties. In contrast, prior research on local menu labeling laws primarily examines changes in items ordered at large chain restaurants and generally finds small or no changes in the amount of calories purchased after calorie counts are posted on menus. Such a narrow focus misses numerous other potential changes in restaurant menus and consumer behavior due to these requirements. This project significantly expands on the prior literature by examining the nationwide implementation of the ACA's menu labeling requirement and examining the broader impacts of this requirement on behavior. Specifically, this project will evaluate the impact of the ACA's menu labeling requirement on (1) restaurant menu offerings and prices, (2) consumer eating habits, (3) physical activity, and (4) body mass index and obesity. Difference-in-differences comparisons over time before and after the implementation of the menu labeling requirement among groups affected by the requirement and groups not affected will provide estimates of the impact of menu labeling. Affected restaurants are chains with 20 or more locations that did not voluntarily previously post calories on menus and are located in areas without a prior local mandate. Affected consumers are individuals living in counties or states without a pre-ACA calorie posting mandate. To construct these estimates, this project will involve collecting and analyzing menus and nutritional content from chain restaurants, surveying consumers in areas with prior calories posting mandates and surrounding regions and analyzing the resulting data, and analyzing data from the Behavioral Risk Factor Surveillance System (BRFSS). The expected outcomes of this project are an understanding of the impact of greater access to information in the form of calorie posting requirements on obesity and the mechanisms through which calorie posting influences obesity. Thus, this project will inform policymakers and researchers about whether and how the calorie posting mandate in the Affordable Care Act impacts obesity rates.