# Nutritional Calorie Labeling and Menu Ordering Practices Among US Adults With Chronic Illnesses

## TL;DR

People with chronic illnesses in the US don't pay enough attention to calorie labels, and this doesn't affect their food choices.

## Contribution

This study reveals that calorie awareness does not lead to healthier menu choices among those with chronic illnesses.

## Key findings

- Only obese individuals were more likely to notice calorie information.
- Noticing calorie information did not lead to ordering fewer calories.
- Dietary counseling should be included in chronic illness management.

## Abstract

Background: The relationship between diet and the management of chronic illnesses is well established. However, it is unknown the extent to which people with chronic illnesses pay attention to nutritional information and act upon the information obtained. We evaluated the menu ordering practices of adults with chronic illnesses.

Methods: We analyzed the 2018 Health Information National Trends Survey (HINTS 5 Cycle 2). Our analytic cohort included 3,154 respondents (weighted population size=228,464,822) who answered questions regarding a personal history of diabetes, hypertension, heart disease, and obesity. They also answered questions about their nutritional habits regarding whether they noticed caloric information at fast-food or sit-down restaurants and how that information influenced their dietary choices.

Results: Among respondents with these chronic illnesses, only obese patients were significantly more likely to pay attention to caloric information (OR=1.56; 95%CI: 1.06-2.31). However, noticing the calorie information was not associated with ordering less calories among all categories of respondents with chronic illnesses.

Conclusion: US adults with chronic illnesses do not pay sufficient attention to the calorie information of their diet. Furthermore, awareness of the calorie information did not influence their dietary choices. Healthcare professionals should incorporate dietary counseling into the management of chronic illnesses of their patients.