While some fast food restaurants in the United States have started to include calorie counts in their menus, customers noticing them and using the added nutritional information to make healthier food choices appears to be associated with income and education level. These are findings from a recent research conducted by two graduate students, under the supervision of nutrition researcher Punam Ohri-Vachaspati, at the School of Nutrition and Health Promotion at Arizona State University.

Students Jessie Green and Alan Brown studied the correlation between the use of calorie menu labels and demographic characteristics of the clients at a national fast food chain. The study, entitled “Sociodemographic Disparities among Fast-Food Restaurant Customers Who Notice and Use Calorie Menu Labels,” which was published in the Journal of the Academy of Nutrition and Dietetics, revealed that despite the fact that about 60% of the participants noticed the calorie menu labels, only 16% used it to make their choices.

It is the first time this new trend of adding calorie labels has been analyzed in comparison with the probability of clients noticing and using it according to mixed income, education and race. The conclusions also demonstrated that customers with higher incomes were twice more likely to notice the calorie labels, and three times more likely to use them.

“Studies show consumers and nutritionists alike have trouble estimating the calorie and nutrient content of a restaurant meal,” Ohri-Vachaspati said in a press release. “Because fast food is a popular choice among Americans, we wanted to see how effective menu labeling was and if it helped customers make healthier choices. What we found, however, was that while the majority of customers noticed the labels, a very small percentage reported using them to influence their purchasing decisions and customers with lower income and lower education levels reported using menu labels to a much lesser extent.”

The study included receipts and survey data from 29 McDonald’s restaurants in both low and high income neighborhoods, located in the Phoenix metropolitan area. The researchers decided to study McDonald’s since the chain had already implemented calorie labels in their menus about three years ago.

The idea to conduct this pioneering study came from fast food being the second major contributing factor to children’s and adolescents’ diets, and the fact that fast food chains with 20 or more restaurants in the country were recently mandated to post calorie labels on the menus by the Patient Protection and Affordable Care Act. The idea is to help consumers make more informed decisions, as well as avoid obesity and other related chronic health problems.

In addition, the U.S. Food and Drug Administration recently published guidelines to take effect on December 1, 2015 that determine calorie content on menus, which state that “2,000 calories a day is used for general nutrition advice, but calorie needs vary.” Green believes that “including a statement with the daily calorie recommendations is key because it provides customers with the necessary context to make calorie labels meaningful.”

Ohri-Vachaspati added that in order for the guidelines to be effective, the policy needs to impact all clients — particularly the ones with lower incomes, given the results of their study. “It’s not just the calories that count, it’s the context. People need to know how to interpret the information,” she added.

“Once menu labeling is implemented, the fast-food industry and public health community must work together to make it easier for consumers from all income and education backgrounds to understand and use this information. We need effective ways to get those who only notice the information to start using it,” Ohri-Vachaspati said.

In addition, the nutrition researcher also suggested improving education in schools about the use of calorie labels for children to become more informed and health-focused consumers. The results of the study supported the idea of effective public policies aimed towards reducing consumed calories. The researcher believes that despite the fact that only a group of people notice them, and even less use them, calorie labels are a step in the right direction.