Environmental and Individual Factors Affecting Menu Labeling Utilization: A Qualitative Research Study

Published:February 09, 2013DOI:


      Obesity is a prominent public health concern that disproportionally affects low-income and minority populations. Recent policies mandating the posting of calories on menus in fast-food chain restaurants have not proven to uniformly influence food choice. This qualitative research study used focus groups to study individual and environmental factors affecting the use of these menu labels among low-income minority populations. Ten focus groups targeting low-income residents (n=105) were held at various community organizations throughout New York City over a 9-month period in 2011. The focus groups were conducted in Spanish, English, or a combination of both languages. In late 2011 and early 2012, transcripts were coded through the process of thematic analysis using Atlas.ti for naturally emerging themes, influences, and determinants of food choice. Few participants used menu labels, despite awareness. The most frequently cited as barriers to menu label use included: price and time constraints, confusion and lack of understanding about caloric values, as well as the priority of preference, hunger, and habitual ordering habits. Based on the individual and external influences on food choice that often take priority over calorie consideration, a modified approach may be necessary to make menu labels more effective and user-friendly.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • New York City Department of Health and Mental Hygiene
        Notice of adoption of a resolution to repeal and reenact sec. 81.50 of the New York City health code, 2008.
        (Accessed February 16, 2012)
        • Flegal K.
        • Carroll M.
        • Kit B.
        • et al.
        Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010.
        JAMA. 2012; 307: 491-497
        • Drewnowski A.
        • Rehn C.
        • Solet D.
        Disparities in obesity rates: Analysis by ZIP code area.
        Soc Sci Med. 2007; 65: 2458-2463
        • Elbel B.
        • Kersh R.
        • Brescoll V.
        • et al.
        Calorie labeling and food choices: A first look at the effects on low-income people in New York City.
        Health Aff. 2009; 28: w1110-w1121
        • Dumanovsky T.
        • Huang C.
        • Nonas C.
        • et al.
        Changes in energy content of lunchtime purchases from fast food restaurants after introduction of calorie labeling: Cross sectional customer surveys.
        BMJ. 2011; 343: d4464
        • Powell L.
        • Chaloupka F.
        • Bao Y.
        The availability of fast food and full-service restaurants in the United States: Associations with neighborhood characteristics.
        Am J Prev Med. 2007; 33: S240-S245
        • Bassett M.
        • Dumanovsky T.
        • Huang C.
        • et al.
        Purchasing behavior and calorie information at fast food chains in New York City, 2007.
        Am J Public Health. 2008; 98: 1457-1459
        • Braun V.
        • Clarke V.
        Using thematic analysis in psychology.
        Qual Res Psychol. 2006; 3: 77-101


      J. Schindler is a public health specialist, BLH Technologies, Inc, Rockville, MD.


      K. Kiszko is a senior research coordinator, Department of Population Health, New York University School of Medicine, New York.


      C. Abrams is a program manager, Department of Population Health, New York University School of Medicine, New York.


      N. Islam is an assistant professor, Department of Population Health, New York University School of Medicine, and director, New York University Prevention Research Center, New York.


      B. Elbel is an assistant professor, Department of Population Health, New York University School of Medicine, and New York University Wagner School of Public Service, New York.