The impact of displaying nutrition serving information on retail food service operations in hospitals 

On January 1st 2017, a new law in Ontario came into effect requiring restaurant chains with 20 locations or greater to display nutritional information on their menus. The Healthy Menu Choices Act, which was first proposed in May 2015, necessitates the calorie content of all standardized food and beverage items to be displayed on menus and advertisements to encourage customers to make informed decisions regarding food choices in hopes of making healthier decisions. This legislation exempts food service premises located within schools, daycares, and correctional institutes as well as those serving food prepared for patients in hospitals and residents of long-term care facilities. However, it does apply to food service operations in hospitals not providing food specifically for inpatients, such as food courts. While many hospitals are moving towards offering more healthy options, it is not yet known whether displaying nutrition serving information will contribute to this goal. Moreover, this legislation may have other impacts on retail food service operations in hospitals.

Firstly, this new legislation may impact the amount of food purchased, as well as the actual choices made by customers. Individuals may see calorie information and decide to buy less of a product, a smaller size, or to not upgrade to a “meal combo” at fast food establishments. In turn, this could lead to a decrease in revenue. Unpredictability in how customers’ choices may change could also affect ordering, and potentially result in food waste if restaurant chains are unable to accurately predict changes. Upon seeing calorie information, customers may also be motivated to choose lower calorie options on the menu. This could cause a shift in popular menu items, and chain restaurants may need to diversify their menus to offer more of these options to cater to their customers’ wants.

In New York City, where calorie content has been displayed in restaurants with greater than 15 locations since July 2008, a trend towards customers buying healthier options occurred in fast food establishments that offered a greater number of healthy choices. Customers that bought food at restaurants that offered several low-calorie options were more likely to consume less calories overall. This highlights not only the ability for such a legislation to result in customer behaviour change, but also the opportunity for restaurants to adapt their sales tactics to meet customer demand; offering low-calorie options would promote their sales.

However, the impacts mentioned above assume that customers are aware of the health implications of calories being displayed on a menu. While individuals working in food service or with a background in nutrition may be quite familiar with an individual’s daily calorie requirements, customers may not have the knowledge required to critically appraise the caloric content of a specific menu item, and thus may not use the nutrition information displayed to make a choice. Although a statement regarding the average daily requirements of an individual is required to be displayed on menus, this may not provide a full picture of the meaning of calories for some customers. This could also impact food service operations in that customers may turn to food service personnel to answer their questions regarding the nutrition information displayed. Thus, employees may require additional training to be able to accurately answer any customer questions, especially in hospital settings where customers may be more health-conscious. Moreover, customers may start out paying close attention to caloric values on menus since they are new, but they may also start tuning out the numbers once they get used to seeing them.

Lastly, there are associated costs with the new legislation, including updating menus, signage, and boards, testing the caloric value of all foods offered including different flavours and toppings, and a cost of compliance, as all menu and promotional items have to be redesigned.

The bottom line? The Healthy Menu Choices Act is a step in the right direction toward ensuring customers are able to make informed food choices. While it may come at an initial increased cost, food service operations may be able to capitalize on adapting their menus and sales tactics to focus on the demand for healthier, lower calorie alternatives. We’ll be looking out for studies determining the impact of this legislation on the health of Ontarians and of food service operations in the long-term!