***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Background Recent legislation has required calorie labels on restaurant menus as a means of improving Americans ’ health .  Despite the growing research in this area , no consensus has been reached on the effectiveness of menu labels . This suggests the possibility of heterogeneity in responses to caloric labels across people with different attitudes and demographics . The purpose of this study was to explore the potential relationships between caloric intake and diners ’ socio-economic characteristics and attitudes in a restaurant field experiment that systematic ally varied the caloric information printed on the menus . Methods We conducted a field experiment in a full service restaurant where patrons were r and omly assigned to one of three menu treatments which varied the amount of caloric information printed on the menus ( none , numeric , or symbolic calorie label ) . At the conclusion of their meals , diners were asked to complete a brief survey regarding their socio-economic characteristics , attitudes , and meal selection s. Using regression analysis , we estimated the number of entrée and extra calories ordered by diners as a function of demographic and attitudinal variables . Additionally , irrespective of the menu treatment to which a subject was assigned , our study identified which types of people are likely to be low- , medium- , and high-calorie diners . Results Results showed that calorie labels have the greatest impact on those who are least health conscious . Additionally , using a symbolic calorie label can further reduce the caloric intake of even the most health conscious patrons . Finally , calorie labels were more likely to influence the selection of the main entrée as opposed to supplemental items such as drinks and desserts . Conclusions If numeric calorie labels are implemented ( as currently proposed ) , they are most likely to influence consumers who are less health conscious – probably one of the key targets of this legislation . Unfortunately , numeric labels did little for those consumers who were already more knowledgeable about health and nutrition . To reach a broader group of diners , a symbolic calorie label may be preferred as it reduced caloric intake across all levels of health consciousness Purpose . Determine the effect of menu labels displaying the energy content of food items or the exercise equivalent on energy ordered and consumed at lunch and energy intake for the remainder of the day in young adults . Design . Subjects were r and omized to a menu with no labels ( no-labels ) , menu with kilocalorie labels displaying the energy content of the food items ( kcal-labels ) , or menu with exercise labels displaying the minutes of brisk walking needed to burn the food energy ( exercise-labels ) . Setting . The study was conducted in one dining area located in a metabolic kitchen at the Texas Christian University and another located in a residence occupied by graduate students . Subjects . Of the 300 subjects , 55.7 % were female , 77.3 % were college students , 88 % were white , and 88 % were non-Hispanic . Mean body mass index and age were 24.2 ± 4.5 kg/m2 and 21.9 ± 2.3 years , respectively . Intervention . All menus contained the same food/beverage choices . Subjects ordered and consumed foods/beverages for lunch from the menu to which they were assigned . Subjects were blinded to study purpose . Measures . Energy ordered and consumed at lunch were assessed from the weight of the food ordered and consumed , respectively , and the energy content of the same foods available on the restaurant Web site . Postlunch energy intake was assessed by food recall . Analysis . Analysis of covariance , adjusted for premeal hunger levels and gender , determined the effect of menu type on energy ordered and consumed and postlunch energy intake . Results . Significant menu effect was observed for energy ordered ( p = .008 ) and consumed ( p = .04 ) at lunch . The exercise-labels group ordered significantly ( p = .002 ) less energy ( adjusted mean [ confidence intervals ] : 763 [ 703 , 824 ] kcal ) at lunch , compared to the no-labels group ( 902 [ 840 , 963 ] kcal ) but not compared to the kcal-labels group ( 827 [ 766 , 888 ] kcal ) . The exercise-labels group also consumed significantly ( p = .01 ) less energy ( 673 [ 620 , 725 ] kcal ) at lunch , compared to the no-labels group ( 770 ( 717 , 823 ) kcal ) but not compared to the kcal-labels group ( 722 [ 669 , 776 ] kcal ) . Energy ordered and consumed were not different between kcal-labels and no-labels groups . There was no difference in postlunch energy intake by menu type . Conclusion . The menu with exercise-labels result ed in less energy ordered and consumed and this did not lead to greater energy consumption post lunch , compared to the menu with no-labels in young adults largely made up of normal-weight , non-Hispanic white college students Increased visibility of food labels is a potential method to reduce the rate of obesity . However , few empirical studies have investigated the impact of nutrition labeling on food selection or energy intake . This study tested the hypothesis that nutrition labeling in combination with nutrition label education would promote reductions in energy intake using a laboratory-based paradigm . Forty-seven male ( n=24 ) and female ( n=23 ) participants visited the Nutrition and Health Research Laboratory for a single lunch session during the months of May through August 2009 . Participants were r and omly assigned to one of two video groups ( Nutrition Labeling Education or Organic Food Movement ) and one of two labeling conditions ( Nutrition Labels or No Labels ) . Participants watched a short educational video and then consumed a buffet lunch . Data were analyzed using a three-way analysis of covariance with sex , video condition , and labeling group as the between-subject factors and age and race as covariates . There were main effects of sex and nutrition label condition on lunch energy intake with females consuming less than males and people with nutrition labels consuming less energy than those without , regardless of sex or video condition . Examination of energy intake from low-energy-density and high-energy-density foods showed that the nutrition labeling group consumed less energy from both low-energy-density and high-energy-density food sources . These data support the use of nutrition labels as a way to reduce energy intake Background This study assessed the impact of kilojoule ( kJ ) labelling alone or accompanied by a social marketing campaign on food sales and selection of less energy-dense meals by young adults from a university food outlet . Methods There were two kJ labelling intervention phases each of five weeks : ( 1 ) kJ labelling alone ( 2 ) kJ labels with marketing material s ( “ 8700 kJ campaign ” ) . Food sales of labelled items were tracked during each intervention and five weeks after . Food sales during interventions were also compared with historical sales of foods in the same 10-week period in the previous year . A sub sample of young adults ( n = 713 ; aged 19–24 ) were surveyed during both the interventions to assess awareness , influence , sentiment and anticipated future impact of kJ labels and the social marketing campaign respectively . Results There were no differences in sales between the kJ labelling with social marketing and the 5-weeks of labelling before and after . The percentage sale of chicken Caesar burger ( 3580 kJ , P = 0.01 ) , steak and chips ( 4000 kJ , P = 0.02 ) and the grill burger ( 5500 kJ , P = 0.00 ) were lower in the year with menu labelling and social marketing campaign . Only 30 % students were initially aware of the kJ labels on the menu but 75 % of students were accepting of kJ labelling , after they were made aware . Respondents viewing the marketing campaign elements and then using kJ values on the menu selected meals with a lower mean energy content ; constituting a reduction of 978 kJ ( p < 0.01 ) even though the majority cl aim ed that the 8700 kJ campaign would not impact their food choices . Conclusions Point-of-purchase energy labelling may be an effective method to encourage better food choices when eating out among young adults . However , further efforts to increase awareness and provide education about energy requirements to prevent weight gain will be needed Chain restaurants will soon need to disclose calorie information on menus , but research on the impact of calorie labels on food choices is mixed . This study tested whether calorie information presented in different formats influenced calories ordered and perceived restaurant healthfulness .  Participants in an online survey were r and omly assigned to a menu with either ( 1 ) no calorie labels ( No Calories ) ; ( 2 ) calorie labels ( Calories ) ; ( 3 ) calorie labels ordered from low to high calories ( Rank-Ordered Calories ) ; or ( 4 ) calorie labels ordered from low to high calories that also had red/green circles indicating higher and lower calorie choices ( Colored Calories ) . Participants ordered items for dinner , estimated calories ordered , and rated restaurant healthfulness . Participants in the Rank-Ordered Calories condition and those in the Colored Calories condition ordered fewer calories than the No Calories group . There was no significant difference in calories ordered between the Calories and No Calories groups . Participants in each calorie label condition were significantly more accurate in estimating calories ordered compared to the No Calories group . Those in the Colored Calories group perceived the restaurant as healthier . The results suggest that presenting calorie information in the modified Rank-Ordered or Colored Calories formats may increase menu labeling effectiveness OBJECTIVES We assessed the impact of restaurant menu calorie labels on food choices and intake . METHODS Participants in a study dinner ( n=303 ) were r and omly assigned to either ( 1 ) a menu without calorie labels ( no calorie labels ) , ( 2 ) a menu with calorie labels ( calorie labels ) , or ( 3 ) a menu with calorie labels and a label stating the recommended daily caloric intake for an average adult ( calorie labels plus information ) . Food choices and intake during and after the study dinner were measured . RESULTS Participants in both calorie label conditions ordered fewer calories than those in the no calorie labels condition . When calorie label conditions were combined , that group consumed 14 % fewer calories than the no calorie labels group . Individuals in the calorie labels condition consumed more calories after the study dinner than those in both other conditions . When calories consumed during and after the study dinner were combined , participants in the calorie labels plus information group consumed an average of 250 fewer calories than those in the other groups . CONCLUSIONS Calorie labels on restaurant menus impacted food choices and intake ; adding a recommended daily caloric requirement label increased this effect , suggesting menu label legislation should require such a label . Future research should evaluate menu labeling 's impact on children 's food choices and consumption Consumers have difficulty using  nutrition information .  We hypothesized that graphically delivering information of select nutrients relative to a target would allow individuals to process information in time-constrained setting s more effectively than numerical information . Objectives of the study were to determine the efficacy of the graphical method in ( 1 ) improving memory of nutrient information and ( 2 ) improving consumer purchasing behavior in a restaurant . Values of fiber and protein per calorie were 2-dimensionally plotted alongside a target box . First , a r and omized cued recall experiment was conducted ( n=63 ) .  Recall accuracy of nutrition information improved by up to 43 % when shown graphically instead of numerically . Second , the impact of graphical nutrition signposting on diner choices was tested in a cafeteria . Saturated fat and sodium information was also presented using color coding . Nutrient content of meals ( n=362 ) was compared between 3 signposting phases : graphical , nutrition facts panels ( NFP ) , or no nutrition label . Graphical signposting improved nutrient content of purchases in the intended direction , whereas NFP had no effect compared with the baseline . Calories ordered from total meals , entrées , and sides were significantly less during graphical signposting than no-label and NFP periods . For total meal and entrées , protein per calorie purchased was significantly higher and saturated fat significantly lower during graphical signposting than the other phases . Graphical signposting remained a predictor of calories and protein per calorie purchased in regression modeling . These findings demonstrate that graphically presenting nutrition information makes that information more available for decision making and influences behavior change in a realistic setting OBJECTIVE : Our aim was to determine whether nutrition labeling on menus would lead to lower-calorie choices for children . METHODS : We performed a r and omized , controlled experiment in a primary care pediatric clinic in Seattle , Washington . Parents of children 3 to 6 years of age presenting for an appointment were eligible . Parents were ineligible if they never ate fast food , if they were not English speaking , if their child was too sick , or if they had already participated . This was a convenience sample , with r and omization performed in blocks of 6 . Parents were presented with a McDonald 's menu and were asked to select meals for themselves and their child . The menus were identical for both groups except for the presence of nutrition information for the intervention group . RESULTS : There were 99 participants , for a participation rate of 82 % . There were no significant differences in demographic characteristics between the groups . Parents in the intervention arm  ordered an average of 102 fewer calories for their children than did control subjects ( 567.1 cal vs 671.5 cal ; P = .04 ) . With adjustment for parent 's gender , race , education , and BMI , fast food frequency , and child 's BMI z score , the difference remained significant ( P = .004 ) . There was no difference in energy between the 2 groups in the parents ' choices for themselves . CONCLUSION : This study is the first to suggest that labeled menus may lead to significantly lower calorie content in restaurant meals purchased for children In 2010 , the United States ( US ) enacted a restaurant menu labeling law . The law also applied to vending machine companies selling food . Research suggested that providing nutrition information on menus in restaurants might reduce the number of calories purchased . We tested the effect of providing nutrition information and ‘ healthy ’ design ations to consumers where vending machines were located in college residence halls . 
    Output:
    
Conclusions Nutrition labels had a moderate but positive effect on dietary intake of college students