Added sugar warning labels on restaurant menus could help consumers reach for healthier products

Do you really want to order a soft drink with your burger? Just one soda can have more added sugars than the full daily limit recommended for most adults.

Seeing a warning icon on a restaurant’s menu can help consumers spot the high amounts of added sugars hidden in menu items -; and it may even convince them to reach for healthier products like water.

Those are the observations recorded in a new study from the University of California, Davis. In a national survey that sampled more than 1,300 adults, researchers found that added sugar warnings with icons plus text, or icons only, were effective at conveying a “high added sugar” warning message to people. The investigation took place in 2021.

Excessive added sugars in our food supply are a leading cause of type 2 diabetes, which is expected to affect about half of all American adults in their lifetime.”

Desiree Sigala, lead author of the study, UC Davis postdoctoral researcher, Department of Molecular Biosciences

The study, published online in the July issue of the journal preventive medicine, is believed to be the first of its kind to design and test the effects of added sugar warnings on restaurant menus. And while the U.S. Food and Drug Administration requires major restaurant chains to make some nutritional information available in restaurants, there’s currently no requirement that added sugars be disclosed for restaurant foods, researchers said.

This leaves consumers in the dark about the high levels of added sugars in their meals, which can contribute to negative health outcomes, researchers said. New York City recently attempted to address this problem by passing a law requiring added sugar warnings on prepackaged restaurant menu items. Policymakers across the country are considering similar warnings about added sugars on restaurant menus.

“By exposing the high amount of added sugars in common restaurant foods, these warnings can help consumers make informed decisions,” said senior author Jennifer Falbe, UC Davis assistant professor of nutrition and human development in the Department of Human Ecology. “But more importantly, requiring these warnings could incentivize restaurants to offer a wider variety of options that aren’t loaded with sugar.”

The pictograms, designed by the research team, resemble stop, yield and “caution” road signs.

Warning icons are an easy way to provide consumers with nutritional information and nudge companies to improve the health of their products without taking up space on the menu, researchers said.

In the online, randomized study, participants were shown either a control label (a QR code), one of six possible warning labels for added sugars only, or one of the icons combined with three text variations: “high in added sugars.” “high sugars” and “sugar warning”. Each icon contained an exclamation point or an exclamation point with a spoon. While icon-plus-text and icon-only labels had favorable responses among participants compared to the control labels for the outcomes of perceived effectiveness and knowledge of the added sugar content of items, there were no significant differences when comparing icon-only with icon-plus text labels, researchers said.

According to the researchers, the design of the labels was based on sodium warning labels required by law for chain restaurant menus in New York City and Philadelphia.

In addition, most of the study participants, or 80%, supported the added sugar warning labels used on restaurant menus.

“These promising results support the need to further develop and test warning labels with added sugars in restaurant menus by conducting experiments with menu order results to determine behavioral effects,” Falbe said.

In addition to Falbe and Sigala, co-authors are Marissa G. Hall, Department of Health Behavior, Gillings School of Global Health, University of North Carolina, Chapel Hill; Aviva A. Musician, Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health; Christina A. Roberto, Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania; Sarah E. Solar, Department of Human Ecology, and Sili Fan, Department of Statistics, UC Davis; DeAnna Nara and Sarah Sorscher, Center for Science in the Public Interest.

The study was funded directly by Bloomberg Philanthropies and through a sub-award from the Center for Science in the Public Interest. Falbe has additional support from the National Institutes of Health and the United States Department of Agriculture. Sigala has support from the National Institutes of Health. The content is the sole responsibility of the authors and does not necessarily represent the official views or policies of the funders.