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Article Excerpt
Given substantial concern about the many negative consequences associated with the American obesity epidemic, legislation which would require chain restaurants to provide nutrition information on menus and menu boards has been proposed at the federal, state, and local levels. Two studies examine the effects of nutrition disclosure on consumer evaluations and purchase intentions while also considering potential moderating effects due to gender differences and motivation levels. Results indicate that nutrition disclosures can have an impact on consumer product evaluations and preferences, particularly for restaurant items that are less healthful than anticipated.
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Obesity, a major health concern in the United States, has reached epidemic proportions (CDC 2008). Given its importance and scope, it is not surprising that the issue of obesity has received a great deal of attention in both the academic and popular presses. Obesity is associated with a number of chronic conditions and diseases such as cancer, diabetes, and heart disease (CDC 2008; Manson and Bassuk 2003); heart disease alone accounts for approximately 29% of all U.S. deaths (CDC 2004). Of these more than 700,000 deaths, 16.8% occurred among persons younger than 65 years of age which the CDC classifies as premature. Many Americans now wonder, "What factors are behind the increasing prevalence of obesity-related diseases which are responsible for the premature deaths of so many?"
Many public policy makers, public interest groups, and concerned citizens have viewed the restaurant industry to be at least partially responsible (CCPHA 2007; Rabin 2007). In the last 30 years, the amount of money spent on food purchases outside the home has risen 20% and accounts for almost half of American's total yearly expenditures on food (Lin, Frazao, and Guthrie 1999). The positive correlation between increasing restaurant patronage and the rising prevalence of obesity has raised questions about the healthfulness of restaurant menu items. In fact, many consumers and public health advocates now believe that the provision of nutrition information on restaurant menus and menu boards should be required.
The lack of easily accessible, objective nutrition information in restaurants is a significant public policy issue, with important consumer health and welfare implications. In fact, one of the primary objectives of the U.S. Department of Health and Human Services has been to improve health literacy by 2010 (U.S. Department of Health and Human Services 2001). Health literacy is concerned with the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health (Kickbusch and Nutbeam 1998). Important aspects of health literacy include both external factors such as having relevant information that is easily accessible (e.g., calories and nutrient content levels found on Nutrition Facts panels) and internal factors, such as consumer motivation and knowledge levels which influence the processing and utilization of information used in health-related decision-making processes. Thus, in order to be health literate, consumers must be information literate; that is, they must be able to obtain and apply relevant health-related information.
While the Nutrition Labeling and Education Act (NLEA) requires the nutrition labeling of most packaged food products, foods prepared for immediate consumption, such as those served by restaurants, are exempt. From a health literacy perspective, there may be significant negative, long-term health-related implications associated with this exemption if consumers (1) misestimate the calorie and nutrient content of restaurant prepared foods, especially if those foods are relatively unhealthy (i.e., high in calories and fat), (2) lack relevant, objective, and easily accessible nutrition information, and (3) use inaccurate expectations of calorie and nutrient content when making purchase decisions. While consumers may be able to distinguish between relatively more and less-healthful foods, there is some evidence that they are generally unaware of the extent to which many items are unhealthy (Backstrand et al. 1997; CCPHA 2007; Wansink and Chandon 2006). For example, a survey in California showed that two-thirds (68%) of the respondents missed all four questions on a quiz that asked them to select the fast food menu item that had the fewest calories, most fat, least salt, and most calories (CCPHA 2007). This suggests that within the context of away-from-home food consumption, consumers' health literacy is quite low, and it is likely to be even lower in some demographic segments. If this is the case, then current mandates such as found in New York, Seattle, and the recent bill in the state of California requiring nutrition disclosure on menus and menu boards may prove to be of great importance to consumers' ability to make healthy food selections (Office of the Governor of the State of California 2008). Requiring restaurants to provide nutrition information at the point of purchase may potentially improve literacy by allowing consumers to gain "access to, understand, and use information in ways which promote and maintain good health" (Kickbusch and Nutbeam 1998). This is consistent with the role of information in financial literacy where the disclosure of easy to understand information is viewed as a way of enhancing consumers' financial literacy and important outcomes (Kozup and Hogarth 2008).
The National Restaurant Association (NRA) projects that $558 billion will be spent at restaurants in 2008, and the percentage of food dollars spent outside the home is expected to continue to grow (NRA 2008). Study 1 is a fast food menu experiment that addresses how differences in gender may moderate the impact of nutrition-related information disclosures on fast food item evaluations and choice. Study 2 extends our research to table service restaurant menu items and examines how motivation to process nutrition information, in addition to gender, influences consumer responses. Thus, similar to the role of information provision to increase financial literacy (e.g., Kozup and Hogarth 2008), these studies consider whether nutrition disclosures on menus can enhance the use and understanding of information to impact dietary judgments and decisions that will promote consumer health and welfare.
STUDY 1
Conceptual Background and Hypotheses
Nutrition Disclosures for Restaurant Menus and Menu Boards
The MEAL 2008 and Labeling Education and Nutrition Act (LEAN) 2008 Acts, both under recent congressional consideration, would require chain restaurants to post calorie and/or nutrition information for all menu items (Jennings 2008). Similar legislative initiatives have already been passed at state and local levels (NRA 2008). This legislation aims to increase consumers' access to nutrition information, which will enable them to make more informed decisions when eating outside the home. Prior research has shown that consumer expectations about calories for more "healthful" restaurant items are relatively accurate, but expectations for less "healthful" items are incorrect (Burton et al. 2006). In fact, the calorie and nutrient levels of less healthful menu items are often substantially underestimated even by professional nutritionists (e.g., Backstrand et al. 1997; Wansink and Chandon 2006). This finding suggests that calorie disclosures could be an important aspect in efforts to promote health literacy.
According to expectancy disconfirmation theory (Oliver 1980), the divergence between expected and actual nutrition values found by Wansink and Chandon (2006) and Backstrand et al. (1997) should decrease both product evaluations and purchase intentions. Expectancy disconfirmation theory posits that consumers' attitudes and purchase intentions decrease when product experience fails to meet prior expectations. Consumers develop expectations prior to acquiring objective product knowledge and will compare those expectations to subsequent knowledge and experience. If experience meets expectations, attitudes are confirmed; but if experience fails to meet expectations, the opposite will occur. This suggests that calorie disclosures for food items will impact product evaluations, and the effect will be stronger for items that do not meet calorie expectations. However, disclosures will have less effect on items that are...
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