How have restaurant menus changed after implementation of mandatory calorie labelling and who is likely to benefit? A longitudinal analysis of online menu data in Great Britain

Background The introduction of mandatory calorie labelling among large food businesses (chains) in England in 2022 has been found to have little impact on consumer behaviour but overall calories on restaurant menus have decreased slightly. This study examined menu changes post policy implementation and explored respective purchasing frequency across population groups. Methods Menu data from 169 chains in Great Britain were extracted from two online food delivery platforms in June 2022 and June 2023. We selected 10 categories (specific foods or chains) jointly with public and policy advisors. Menu changes over time were assessed with multilevel models accounting for whether an item was continuously on the menu and the type of chain. We assessed differences in purchasing frequency of respective categories by consumer characteristics using consumer out-of-home purchasing data from 2022. Results Changes were observed in 2 of 10 categories examined. Chains that used a ‘healthy’ tag on the delivery website increased the share of main meals under 600 kcal by 3.7 percentage points (95% CI 0.2 to 7.2), while average calories showed no pronounced changes (−17.6 kcal/item, 95% CI −38.7 to 3.4). This finding was sensitive to methodological choices. Men, people aged 35–44 years and with high socioeconomic status were found to purchase more frequently from chains presenting themselves as healthy. Across all chains, the share of lower-calorie coffees decreased by 10 percentage points (95% CI −18.0 to −0.02), with greater purchases among men and with increasing age. Conclusions This study found limited menu change among the examined foods and chains over 1 year following policy implementation. While menu changes may provide potential for improving population diets, tentative findings suggest that dietary inequalities may be exacerbated if predominantly ‘healthy’ chains already offering lower-calorie food change their menus.