Barriers and facilitators to the implementation of a qualitative menu labeling in a self-service buffet restaurant: operators and employees perspectives
DOI:
https://doi.org/10.12957/demetra.2025.83947Keywords:
Food service. Qualitative Research. Interpretative information. Food labeling.Abstract
Introduction: Eating out is associated with consuming lower-nutritional-quality foods. Restaurants can provide menu labeling for culinary preparations to assist consumers in their food choices. Qualitative information, such as ingredient lists and symbols indicating healthy options, appears to be more effective compared to quantitative models. However, the implementation relies on the collaboration and involvement of employees. Objective: To examine operators' and employees' perspectives about barriers and facilitators to the implementation of qualitative menu labeling in a self-service buffet restaurant. Methods: Qualitative methods were applied in a single case-study scenario at a self-service buffet restaurant in a Brazilian capital city. Participants comprised 11 employees and 2 operators (n = 13), representing 93% of the restaurant staff. During the intervention phase, a five-day period involved labeling six daily culinary preparations, including the culinary name of the dish and ingredients list, and highlighting organic ingredients in the menu descriptions. Then, individual interviews were conducted and thematic analysis organized responses into different themes and subthemes. Results: Minimal barriers were reported, with only one concern raised by the owner regarding consumers' perception of low nutritional quality ingredients. Conversely, numerous facilitators were identified, such as ingredient standardization, optimization of working time, and fulfillment of consumers' right to information. Conclusion: Both employees and operators considered this qualitative menu labeling model easy to implement. The approach was deemed advantageous for operators and enhanced the overall consumer experience. Recommendations included conducting similar qualitative studies in distinct locations and quantitative studies with larger samples to validate these findings on a broader scale.
Downloads
References
1. Andrade GC, Gombi-Vaca MF, Louzada MLDC, Azeredo CM, Levy RB. The consumption of ultra-processed foods according to eating out occasions. Public Health Nutr. 2020;23:1041-8. https://doi.org/10.1017/S1368980019002623.
2. Polsky JY, Garriguet D. Eating away from home in Canada: impact on dietary intake. Health Rep. 2021;32:18-26. https://doi.org/10.25318/82-003-x202100800003-eng.
3. Wellard-Cole L, Davies A, Allman-Farinelli M. Contribution of foods prepared away from home to intakes of energy and nutrients of public health concern in adults: a systematic review. Crit Rev Food Sci Nutr. 2022;62:5511-22. https://doi.org/10.1080/10408398.2021.1887075.
4. Gesteiro E, García-Carro A, Aparicio-Ugarriza R, González-Gross M. Eating out of Home: Influence on Nutrition, Health, and Policies: A Scoping Review. Nutrients. 2022;14. https://doi.org/10.3390/nu14061265.
5. Landais E, Miotto-Plessis M, Bene C, Maitred’Hotel E, Truong MT, Somé JW, et al. Consumption of food away from home in low- and middle-income countries: a systematic scoping review. Nutr Rev. 2023;81:727-54. https://doi.org/10.1093/nutrit/nuac085.
6. Bezares N, McClain AC, Tamez M, Rodriguez-Orengo JF, Tucker KL, Mattei J. Consumption of Foods Away from Home Is Associated with Lower Diet Quality Among Adults Living in Puerto Rico. J Acad Nutr Diet. 2023;123:95-108.e10. https://doi.org/10.1016/j.jand.2022.06.009.
7. Wright B, Bragge P. Interventions to promote healthy eating choices when dining out: A systematic review of reviews. Br J Health Psychol. 2018;23:278-95. https://doi.org/10.1111/bjhp.12285.
8. Beltrán MPD, Romero YMH. Healthy eating and restaurants. A review of recent evidence in the literature. Cien Saude Colet. 2019;24:853-64. https://doi.org/10.1590/1413-81232018243.03132017.
9. Olstad DL, Teychenne M, Minaker LM, Taber DR, Raine KD, Nykiforuk CIJ, et al. Can policy ameliorate socioeconomic inequities in obesity and obesity-related behaviours? A systematic review of the impact of universal policies on adults and children. Obesity Reviews. 2016;17:1198-217. https://doi.org/10.1111/obr.12457.
10. Patiño SRG, Zhou M, Gomes FS, Lemaire R, Hedrick V, Serrano E, et al. Effects of Menu Labeling Policies on Transnational Restaurant Chains to Promote a Healthy Diet: A Scoping Review to Inform Policy and Research. Nutrients 2020;12. https://doi.org/10.3390/nu12061544.
11. Sinclair SE, Cooper M, Mansfield ED. The influence of menu labeling on calories selected or consumed: a systematic review and meta-analysis. J Acad Nutr Diet. 2014;114:1375-1388.e15. https://doi.org/10.1016/j.jand.2014.05.014.
12. Kiszko KM, Martinez OD, Abrams C, Elbel B. The Influence of Calorie Labeling on Food Orders and Consumption: A Review of the Literature. J Community Health. 2014;39:1248-69. https://doi.org/10.1007/s10900-014-9876-0.
13. Long MW, Tobias DK, Cradock AL, Batchelder H, Gortmaker SL. Systematic Review and Meta-analysis of the Impact of Restaurant Menu Calorie Labeling. Am J Public Health. 2015;105:e11-24. https://doi.org/10.2105/AJPH.2015.302570.
14. Fernandes AC, Oliveira RC, Proença RPC, Curioni CC, Rodrigues VM, Fiates GMR. Influence of menu labeling on food choices in real-life settings: a systematic review. Nutr ver. 2016;74:534-48. https://doi.org/10.1093/nutrit/nuw013.
15. Bleich SN, Economos CD, Spiker ML, Vercammen KA, VanEpps EM, Block JP, et al. A Systematic Review of Calorie Labeling and Modified Calorie Labeling Interventions: Impact on Consumer and Restaurant Behavior. Obesity. 2017;25:2018-44. https://doi.org/10.1002/oby.21940.
16. Cantu-Jungles TM, McCormack LA, Slaven JE, Slebodnik M, Eicher-Miller HA. A Meta-Analysis to Determine the Impact of Restaurant Menu Labeling on Calories and Nutrients (Ordered or Consumed) in U.S. Adults. Nutrients. 2017;9:1088. https://doi.org/10.3390/nu9101088.
17. Robinson E, Polden M, Langfield T, Clarke K, Calvert L, Colombet Z, et al. Socioeconomic position and the effect of energy labeling on consumer behaviour: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2023;20. https://doi.org/10.1186/s12966-023-01418-0.
18. Fernandes AC, Rieger DK, Proença RPC. Perspective: Public Health Nutrition Policies Should Focus on Healthy Eating, Not on Calorie Counting, Even to Decrease Obesity. Advances in Nutrition. 2019;10:549-56. https://doi.org/10.1093/advances/nmz025.
19. Oliveira RC, Proença RPC, Salles RK. The right to food and nutrition information in restaurants: a review. Demetra: Alimentação & Saúde. 2012;7:47-58. https://doi.org/10.12957/demetra.2012.3278
20. Fernandes AC, Oliveira RC, Rodrigues VM, Fiates GMR, Proença RPC. Perceptions of university students regarding calories, food healthiness, and the importance of calorie information in menu labelling. Appetite. 2015;91:173-8. https://doi.org/10.1016/j.appet.2015.04.042.
21. Fogolari N, Souza AD, Bernardo GL, Uggioni PL, Oliveira RC, Rodrigues VM, et al. Qualitative menu labelling in university restaurants and its influence on food choices: A systematic review and synthesis without meta‐analysis. Nutr Bull. 2023;48:160-78. https://doi.org/10.1111/nbu.12612.
22. Kerins C, McHugh S, McSharry J, Reardon CM, Hayes C, Perry IJ, et al. Barriers and facilitators to implementation of menu labelling interventions from a food service industry perspective: A mixed methods systematic review. Int J Behav Nutr Phys Act. 2020;17. https://doi.org/10.1186/s12966-020-00948-1.
23. Zick A, Wake Y, Reeves S. Nutrition labeling in restaurants: A UK-based case study. Nutr Food Sci. 2010;40:557-65. https://doi.org/10.1108/00346651011090365.
24. Pitts SBJ, Graham J, Mojica A, Stewart L, Walter M, Schille C, et al. Implementing healthier foodservice guidelines in hospital and federal worksite cafeterias: barriers, facilitators and keys to success. J Hum Nutr Diet. 2016;29:677-86. https://doi.org/10.1111/jhn.12380.
25. Brown T, Vanderlinden L, Birks A, Mamatis D, Levy J, Sahay T. Bringing Menu Labelling to Independent Restaurants: Findings from a Voluntary Pilot Project in Toronto. Can J Diet Pract Res. 2017;78:177-81. https://doi.org/10.3148/cjdpr-2017-014.
26. Vasiljevic M, Cartwright E, Pilling M, Lee MM, Bignardi G, Pechey R, et al. Impact of calorie labelling in worksite cafeterias: A stepped wedge randomised controlled pilot trial. Int J Behav Nutr Phys Act. 2018;15. https://doi.org/10.1186/s12966-018-0671-7.
27. Vasiljevic M, Fuller G, Pilling M, Hollands GJ, Pechey R, Jebb SA, et al. What is the impact of increasing the prominence of calorie labelling? A stepped wedge randomised controlled pilot trial in worksite cafeterias. Appetite. 2019;141. https://doi.org/10.1016/j.appet.2019.05.035.
28. Nevarez CR, Lafleur MS, Schwarte LU, Rodin B, Silva P, Samuels SE. Salud Tiene Sabor: a model for healthier restaurants in a Latino community. Am J Prev Med. 2013; 44:186-92. https://doi.org/10.1016/j.amepre.2012.11.017.
29. Vanderlee L, Vine MM, Fenton NE, Hammond D. Stakeholder Perspectives on Implementing Menu Labeling in a Cafeteria Setting. Am J Health Behav. 2016;40:371-80. https://doi.org/10.5993/AJHB.40.3.9.
30. Alkhaldy AA, Taha DS, Alsahafi SE, Naaman RK, Alkhalaf MM. Response of the public and restaurant owners to the mandatory menu energy-labelling implementation in restaurants in Saudi Arabia. Public Health Nutr. 2020;23:3435-47. https://doi.org/10.1017/S1368980020000245.
31. Martínez-Donate AP, Riggall AJ, Meinen AM, Malecki K, Escaron AL, Hall B, et al. Evaluation of a pilot healthy eating intervention in restaurants and food stores of a rural community: A randomized community trial. BMC Public Health. 2015;15. https://doi.org/10.1186/s12889-015-1469-z.
32. Fogolari N, Oliveira RC, Bernardo GL, Uggioni PL, Geraldo APG, Proença RPC, et al. Influence of qualitative menu labeling on diners’ food choices: A controlled quasi-experiment in self-service buffet restaurants. Appetite. 2024; 203:1-9.https://doi.org/10.1016/j.appet.2024.107698.
33. Oliveira RC, Fernandes AC, Proença RPC, Hartwell H, Rodrigues VM, Colussi CF, et al. Menu labelling and healthy food choices: a randomised controlled trial. Br Food J. 2018;120:788-803. https://doi.org/10.1108/BFJ-04-2017-0248.
34. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77-101. https://doi.org/10.1191/1478088706qp063oa.
35. Cajander N, Reiman A. High performance work practices and well-being at restaurant work. European Journal of Tourism, Hospitality and Recreation. 2019;9:38-48. https://doi.org/10.2478/ejthr-2019-0005.
36. Brazilian Health Regulatory Agency. Resolution – RDC n. 360, of December 23, 2003 – Approves the Technical Rules for Packaged Food Labeling and Becomes it Mandatory. Brasília: Ministry of Health; 2003. [Accesso 22 outubro 2023]. Disponível em: https://extranet.who.int/nutrition/gina/sites/default/filesstore/BRA%202003%20RDC%20360.pdf
37. Brazilian Health Regulatory Agency. Resolution – RDC n. 429, of October 8, 2020 – Regulates the Nutritional Labeling of Packaged Foods, Establishing New Mandatory Information. Brasília: Ministry of Health; 2020. (Accesso 22 outubro 2023). Disponível em: http://antigo.anvisa.gov.br/documents/10181/3882585/RDC_429_2020_.pdf/9dc15f3a-db4c-4d3f-90d8-ef4b80537380
38. Maestro V, Salay E. Nutritional and health information released to consumers by commercial fast food and full service restaurants. Ciênc Tecnol Aliment. 2008;28:20816. https://doi.org/10.1590/S0101-20612008000500032
39. Chaddad MCC. Information on the presence of allergens on food labels: the state’s duty to ensure people with allergy have the right to health and adequate food. Demetra: Alimentação, Nutrição & Saúde. 2014;9:369-92. https://doi.org/10.12957/demetra.2014.10350.
40. Miranda CC, Gama LLA. Inadequate labeling of allergenic food: the risk for individuals with food hypersensitivity. Demetra: Alimentação, Nutrição & Saúde. 2018;13:731-43. https://doi.org/10.12957/demetra.2018.32906.
41. Droulers O, Amar J. The legibility of food package information in France: an equal challenge for young and elderly consumers? Public Health Nutr. 2016;19:1059-66. https://doi.org/10.1017/S1368980015002141.
42. Madilo FK, Owusu-Kwarteng J, Parry-Hanson Kunadu A, Tano-Debrah K. Self-reported use and understanding of food label information among tertiary education students in Ghana. Food Control. 2020;108:106841. https://doi.org/10.1016/j.foodcont.2019.106841.
43. Urban LE, McCrory MA, Dallal GE, Das SK, Saltzman E, Weber JL, et al. Accuracy of stated energy contents of restaurant foods. JAMA. 2011;306:287-93. https://doi.org/10.1001/jama.2011.993.
44. Ozdemir B, Caliskan O. A review of literature on restaurant menus: Specifying the managerial issues. Int J Gastron Food Sci. 2014;2:3-13. https://doi.org/10.1016/j.ijgfs.2013.12.001.
45. Akutsu R, Botelho, RA, Camargo EB, Sávio KEO, Araújo WC. The technical cards as quality instrument for good manufacturing process. Rev Nutr. 2005;18:277-9
46. Rebouças LT, Santiago LB, Martins LS, Menezes ACR, Araújo MPN, Almeida RCC. Food safety knowledge and practices of food handlers, head chefs and managers in hotels’ restaurants of Salvador, Brazil. Food Control. 2017;73:372-81. https://doi.org/10.1016/j.foodcont.2016.08.026
47. Cunha DT, Rosso VV, Stedefeldt E. Food safety performance and risk of food services from different natures and the role of nutritionist as food safety leader. Cien Saude Colet. 2018;23:4033-42. https://doi.org/10.1590/1413-812320182312.21042016.
48. Thomas E. Food for thought: Obstacles to menu labelling in restaurants and cafeterias. Public Health Nutr. 2016;19:2185-9. https://doi.org/10.1017/S1368980015002256.
49. Creswell JW. Research design: Qualitative, quantitative, and mixed methods approaches. 3rd ed. Thousand Oaks, CA: Sage;2003.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Natalia Fogolari, Rossana Pacheco da Costa Proença , Camila Lunardi Mondadori Messaggi , Pauline Bitzer Rodrigues, Aline Nalon Zaghi, Renata Carvalho de Oliveira , Greyce Luci Bernardo , Paula Lazzarin Uggioni , Ana Carolina Fernandes
This work is licensed under a Creative Commons Attribution 4.0 International License.
STATEMENT OF AUTHORSHIP RESPONSIBILITY
Title of the manuscript:
________________________________________________________
1. Statement of responsability
I certify that I have participated in the work above specified and take public responsibility for its content.
I certify that the manuscript represents an original work and that none of the material in the manuscript has been previously published, is included in another manuscript, or is currently under consideration for publication elsewhere, whether in printed form or in electronic media, except that described in the attachment.
In case of acceptance of this text by Demetra: Alimentação, Nutrição & Saude, I declare to be in accordance with the policy of public access and copyright adopted by Demetra, which provides as follows: (a) the authors retain the copyright and grant to the Journal the right of first publication, the work being simultaneously licensed under the Creative Commons Attribution License, which allows the sharing of the work with acknowledgment of authorship and initial publication in this journal; (b) authors are authorized to enter additional contracts separately for non-exclusive distribution of the version of the work published in this journal (eg, publishing in institutional repository or book chapter), with acknowledgment of authorship and initial publication in this journal; and (c) authors are permitted and encouraged to post and distribute their work online (eg, in institutional repositories or on their personal page) at any point before or during the editorial process, as this may lead to productive changes, as well as increase the impact and citation of the published work.
2. Conflict of Interest Statement
I certify that there is no conflict of interest in connection with the submitted article.
Date, signature and full address of all authors.
