Perceived Effect of Calorie Count Display on Customers’ Eating Behaviors in Food Facilities of Eastern Province, Saudi Arabia: A Mixed Method Study

Abstract

Background

As the Saudi Food and Drug Authority (SFDA) has recently requested all food facilities to display the calorie count on their menus, this study aimed to identify the perceived changes in costumers’ eating behaviours in response to the calorie count display (CCD) policy in the Eastern Province.

Methods

This was a mixed methods study. The first being quantitative, using a cross-sectional questionnaire which included 400 customers of both genders, aged 10 years and older, and was collected at food facilities from three cities in the Eastern Province. Customers completed a self-administered questionnaire and handed their registered receipts. Collected receipts were used to calculate the total calories ordered per customer. The second method is a qualitative in-depth interview with food facility managers.

Results

Customers who reported checking the CCD were 30.5% of the total sample, and 58.2% of them changed their order accordingly. The mean calories ordered were 36 kcal less in customers checking the CCD than those who do not (P=0.674). Customers who exhibit healthy lifestyle habits calculate their daily consumed calories, knowledgeable of the recommended daily caloric intake (RDCI), dining in a dine-in restaurant, and have an educational level of above high school were more likely to check the CCD. This study found that customers who cared to check the CCD were more likely to change their eating behavior. It has been found that only a small percentage (12% to 18%) of customers were knowledgeable regarding the RDCI. After the implementation of the policy, restaurant managers reported a positive change in customers eating behavior, which was more profound in females and athletes.

Conclusion

There is a significant association between checking the CCD and positive behavioral changes in customers’ eating behaviors. The results of this study suggest that further enforcement and awareness raising are crucial to increase the number of customers checking and using the CCD.

Keywords:

• calories
• energy intake
• restaurants
• Saudi Arabia
• behavior
• nutritional

Abbreviations

SFDA, Saudi Food and Drug Authority; CCD, calorie count display; RDCI, recommended daily caloric intake; BMI, body mass index; IBW, ideal body weight; SPSS, Statistical Package for the Social Sciences; SAR, Saudi Arabian Riyal; kcal, kilocalorie; SD, standard deviation; PACE, Physical Activity Calorie Expenditure label; COVID-19, coronavirus disease 2019.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

Before filling the questionnaire, written consent was obtained from either customer themselves or their guardians in case of minors. Customers and guardians have been told that confidentiality will be maintained by collecting the data anonymously, where the names or national ID will not be asked. For the restaurants’ managers, they were informed that the interview and their answers are required to be recorded, and all information provided including restaurant’s name will be kept confidential and will only be used for the purpose of study. The aim of this study and type of consent has been approved by the IRB of Imam Abdulrahman Bin Faisal University as an unbudgeted project (IRB-2019-01-283). This study was conducted in accordance with the Declaration of Helsinki.

Acknowledgment

We would like to acknowledge the following medical students for their great efforts in the data collection process, Fahad AlBassam, Ammar Binammar, Ahmed AlKhalifah, Nawal Jalalah, Amal AlSalman, Sara AlAli, Ali AlHabrti, Mohammed AlHashim and Dina AlHatlani.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest.

Additional information

Funding

The manuscript was non-funded.