In 2008, New York City became the first city implement menu labeling. Now with Supreme Court ruling in favor of the Patient Protection and Affordable Care Act, where it is now a national requirement to advertise nutritional information at chain restaurants, researchers evaluated the real world impact of menu labeling.

The Supreme Court ruling enforces menu labeling on any restaurant with 20 or more establishments in the U.S. operating under the same brand.

Conducted by Barbara Bruemmer, PhD, RD, from the University of Washington in Seattle, and lead study author, investigators audited 11 menus at sit-down restaurants and 26 fast food chains. Researchers evaluated nutritional levels of meals, six months after the ruling and 18 months later, to observe whether or not restaurant chains had improved the nutritional profile of entrees. With the use of the U.S. Department of Agriculture dietary guidelines, Dr. Bruemmer and her team compared the meals to what is considered to be healthy diet laid out by the USDA guidelines.

The study revealed majority of meals still remained very high in energy, saturated fats and sodium compared to the dietary guidelines with 56 percent of meals surpassing the recommended level for one-third of an adult daily needs. Researchers found that 77 percent of meals exceeded guidelines for saturated fats and nearly 90 percent surpassed the sodium guidelines.  However, there was a reduction in 41 calories between the two intervals. According to Dr. Bruemmer, 41 calories equate to several pounds lost annual for an adult.

"While that doesn't sound like very much, it is an improvement and it is statistically significant," Dr. Bruemmer said.

Though there will be new national guidelines from the Food and Drug Administration published later this year, Dr. Bruemmer believes consumers need more options to maintain healthy eating habits and unambiguous menu labeling.

"People can only respond to what's available in the environment. If we haven't yet seen people say, 'Oh, I found something that meets my needs,' well, maybe it's because there aren't enough moderate options available on the menu. Menu labeling will help people get a handle on this 'list' of calories, at the point where they're making their decisions and putting down their money. This is where America is providing a lot of food to our children. Let's give families a chance to make an informed decision," she concludes. The study was published in the Journal of the Academy of Nutrition and Dietetics.