Menu calorie labeling may reduce obesity-related cancer burden and health care costs


Disclosures: Zhang does not report material financial information.

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The 2018 introduction of calorie labels on restaurant menus appears to have resulted in a net reduction in calorie intake of 20 to 60 calories per meal among Americans, potentially reducing the risk of obesity-associated cancers.

A modeling study conducted at Tufts University’s Friedman School of Nutrition Science and Policy and published in BMJ open estimated that calorie restriction will prevent at least 28,000 obesity-related cancers and 16,700 cancer deaths among US adults over a lifetime.

Quote from Fang Fang Zhang, MD, PhD

“There is strong evidence to suggest that obesity plays a major role in risk [for] develop cancer: There are 13 types of cancers associated with obesity,” the lead author Tusk Tusk Zhang, MD, PhD, cancer epidemiologist and Neely family professor at the Friedman School, he told Healio. “We were supported by the NIH in evaluating the potential impact of population-based strategies to improve diet on reducing the cancer burden in the United States. Our findings suggest that nutritional policies such as menu calorie labeling may be a cost-effective to prevent obesity associated cancers in this country”.

Zhang spoke with Healio about her study’s findings, their potential impact, and the need for greater public awareness of the link between obesity and various types of cancer.

Helium: How did you conduct this study?

Zhang: We simulated our population: age, gender, race, ethnicity, income, education, and other demographic characteristics of the US adult population. We used data from the National Health Nutrition Examination Survey (NHANES) on how many calories the US adult population consumes from restaurants. We therefore took empirical data from previous research that observed changes in calories consumed from purchased meals before and after the labeling policy was implemented, and estimated that daily calories from foods obtained in restaurants were reduced by an average of 24. people can compensate by choosing fewer -calories by consuming more later, we assumed the daily calorie reduction was 12 in total. This daily calorie reduction is small, but even with a small reduction, the number of new cancer cases and cancer deaths that can be prevented by menu calorie labeling policies is not trivial.

We found that young people and minorities would particularly benefit from this intervention. This is important because we are seeing obesity associated cancers on the rise among young adults in this county.

Helium: What did you study show on the cost savings associated with reduced calorie intake?

Zhang: The menu calorie labeling policy was associated with a net saving of $1.26 billion in health care costs and $1.35 billion in social costs. We know that many cancer screening tools are cost-effective for cancer prevention, meaning that the number of quality-adjusted life years gained is favorable in relation to the amount of money we spend. This is great — we want to continue to bring affordable cancer screening to Americans and get it to everyone. However, the nutritional policy is not only convenient, but also economical; that is, the costs saved for cancer treatment are greater than the costs required to implement the policy. This is mainly due to the lower cost of implementing a nutrition policy than the cost of a cancer screening. We hope this paper highlights the value of nutrition policy as a cost-effective strategy for cancer prevention in this country.

Helium: Is there anything else you would like to mention?

Zhang: I would like to emphasize that once a nutrition policy is implemented, it is not just about consumers. It can also motivate the industry to reformulate their food products in terms of reducing calories or offering low-calorie alternatives. The health and economic impact of menu calorie labeling would double as industry reformulates.

For more information:

Tusk Tusk Zhang, Doctor of Medicine, PhD, can be reached at the Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave., Boston, MA 02111; email:

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