Menu changes following England’s calorie labelling regulations in the out-of-home food sector (CARO)
Research Team: Alexandra Kalbus, Michael Essman, Laura Cornelsen, Esther Curtin and Chiara Rinaldi
Who's involved: LSHTM, University of Cambridge, Camden & Islington Public Health Department, ADPH London, DIGEST Public Advisory group
January 2025 – August 2025
The CARO project will assess whether calorie labelling could be a useful policy in driving reformulation or menu changes. It will do so by investigating specific food groups and restaurants with academic, public and policy relevance. The project furthermore has a strong focus on inequalities by examining who is likely to benefit from reformulation and menu changes using consumer purchase data. Together with the broader evaluation projects, this project will inform decision makers on implementation, continuation and adaptation of the calorie labelling regulations.
Diet-related disease, including obesity, type 2 diabetes, heart disease and cancer, is a major public health concern in England. The government introduced mandatory calorie labelling in 2022, where large businesses must display calorie information of their menu items. New research suggests that following the policy, businesses decreased overall calories of menu items. The CARO project aims to understand which foods and restaurants are driving this reduction, and who is most likely to benefit from such reformulation and menu changes. This will help inform decision makers on the policy’s effectiveness and further health strategies.
Diet-related ill health is a major public health burden in the UK. Food environments are a key driver of our diet and therefore an important policy focus. As part of the English government’s effort to improve food environments and make it easier to eat healthily away from home, large businesses have been required to show calorie information of prepared food since April 2022. Recent evaluation work of the calorie labelling regulations found that while there was no change in people’s purchasing behaviour, businesses decreased the calories on their menus overall. There is a need to understand what drives this calorie reduction, that is which foods and restaurants, and who is most likely to benefit from it.
The CARO (Menu Changes Following England’s Calorie Labelling Regulations in the
Out-of-Home Food Sector) project aims to address this gap by
This project will examine case studies and comprises three key areas of work:
Co-designing research priorities: To decide which foods and restaurants are most meaningful for public and practice, we will hold involvement sessions with our Public Involvement Panel and with members of Local Authorities to jointly determine research priorities, i.e. foods and restaurants. Up to 20 research priorities will be identified based on:
Desk-based analysis: We will then systematically analyse the identified research priorities in a quantitative analysis. We will exploit large data on out-of-home foods offered on from online food delivery platforms and consumer out-of-home food purchases. We will explore:
Collaborative interpretation of findings: We will meet again with the Public Involvement Panel to reflect on the results of the desk-based analysis and what they mean for the policy, its effectiveness, inequalities, and public health.
We work closely with partners from the public and policy stakeholders. Our project team includes a public collaborator from the public advisory group DIGEST and two practice collaborators based in local governments. Research priorities are co-designed and findings jointly interpreted with members of the public and local government.
Findings from this project will be shared through a dissemination event, a policy stakeholder meeting, research briefing, and presentation at conferences. Main outputs will be a graphic summary of the project and its main findings, and a publication in an academic journal.
Understanding the impact of mandatory calorie labelling in out-of-home food environments in England
If you are interested in this project and would like to find out more, please contact Alexandra Kalbus Alexandra.Kalbus@lshtm.ac.uk
Kalbus AI, Kumar R, Rinaldi C, Curtin E, King J, Reynolds P, et al. 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. BMJ Nutrition, Prevention & Health. 2026;:bmjnph-2026-001540. https://doi.org/10.1136/bmjnph-2026-001540
Kalbus A, Rinaldi C. Calorie labelling regulations in England: menu change not behaviour change? Public Health Nutrition. 2025;28(1):e125. doi:10.1017/S1368980025100682
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