Barriers and facilitators of consumer use of nutrition labels at sit-down restaurant chains

Objective: Numerous localities have mandated that chain restaurants post nutrition information at the point of purchase. However, some studies suggest that consumers are not highly responsive to menu labelling. The present qualitative study explored influences on full-service restaurant customers' noticing and using menu labelling. Design: Five focus groups were conducted with thirty-six consumers. A semi-structured script elicited barriers and facilitators to using nutrition information by showing excerpts of real menus from full-service chain restaurants. Setting: Participants were recruited from a full-service restaurant chain in Philadelphia, Pennsylvania, USA, in September 2011. Subjects: Focus group participants were mostly female, African American, with incomes <$US 60 000, mean age 36 years and education 14.5 years. At recruitment, 33% (n 12) reported changing their order after seeing nutrition information on the menu. Results: Three themes characterized influences on label use in restaurants: nutrition knowledge, menu design and display, and normative attitudes and behaviours. Barriers to using labels were low prior knowledge of nutrition; displaying nutrition information using codes; low expectations of the nutritional quality of restaurant food; and restaurant discounts, promotions and social influences that overwhelmed interest in nutrition and reinforced disinterest in nutrition. Facilitators were higher prior knowledge of recommended daily intake; spending time reading the menu; having strong prior interest in nutrition/healthy eating; and being with people who reinforced dietary priorities. Conclusions: Menu labelling use may increase if consumers learn a few key recommended dietary reference values, understand basic energy intake/expenditure scenarios and if chain restaurants present nutrition information in a user-friendly way and promote healthier items.