3. Aim
The aim of this rapid review is to assess how OOH food businesses have responded to mandatory and voluntary menu calorie labelling policies, with a focus on compliance, operational responses, and impacts on menu offerings.
3.1 Review questions
Compliance and implementation
To what extent do OOH food businesses comply with mandatory and voluntary menu calorie labelling initiatives in jurisdictions where these have been implemented?
Business impact
What operational, financial, and practical impacts are associated with mandatory and voluntary menu calorie labelling in OOH settings?
Changes in calorie content
Is the introduction of menu calorie labelling, whether mandatory or voluntary, associated with changes in the calorie content of food and drinks offered by OOH food businesses?
4. Methods
4.1 Review design
A rapid review was undertaken to identify and summarise evidence on OOH food business responses to menu calorie labelling (energy information at the point of choice). The review followed streamlined methods consistent with the Cochrane Rapid Reviews Methods Group interim guidance. These included single-reviewer screening with second-reviewer consistency checks on a sample of records, targeted grey literature searching, and narrative synthesis of heterogeneous evidence to support policy decision-making within a rapid review timeframe.
4.2 Search strategy
Searches were conducted in December 2025 using PubMed and Web of Science to identify peer reviewed literature published between 2015 and 2025 (inclusive) and in English. No restrictions were applied to study design or outcome measures. Searches were conducted using individual country terms for the United States, United Kingdom, England, Ireland, Australia, New Zealand, Saudi Arabia, South Korea, Germany, France, Canada and Brazil, and were also run without country restrictions to capture multi-country and general studies. Countries were selected based on existing menu labelling legislation (see Appendix A), and/or similarity to the UK dietary context: a broadly comparable high-income, market-based food service environment, making findings potentially informative for policy transfer. In addition, a targeted grey literature search was undertaken using Google to identify relevant non-academic sources, including media reporting, industry commentary and publicly reported perspectives from businesses affected by calorie labelling. Grey literature sources were included where they provided jurisdiction-relevant information on implementation, business responses, operational burden, or stakeholder perspectives directly related to menu calorie labelling. Sources were used to complement peer reviewed evidence on business experience and implementation challenges, rather than as equivalent evidence on effectiveness.
Full details of the database search strategies, including search terms and combinations, are provided in the Supplementary Material.
4.3 Study selection
Records from the database and grey literature searches were collated and duplicates removed. Screening was conducted by a single reviewer at title, abstract, and full-text stages. A second independent team member conducted consistency checks on 10% of title/abstract records and all full-text inclusion decisions.
Studies were included if they examined mandatory or voluntary menu calorie labelling in OOH settings and reported outcomes relating to (i) compliance and implementation, (ii) operational or business impacts, or (iii) changes in the calorie content of food and drink offered following introduction of the policy. Studies focusing primarily on consumer outcomes, review articles, and publications outside the date range were excluded. Studies were eligible if they addressed calorie/energy information at the point of choice; studies addressing broader nutrient information were included where they related to the implementation of menu calorie labelling policies. Primary and secondary school meal settings were not a target focus of the review; however, institutional food-service settings such as workplace and university outlets were included where they operated as OOH food-service environments.
4.4 Data extraction and synthesis
Data were extracted using a structured template capturing publication details, country or jurisdiction, study design, business setting, data sources, outcomes of interest, and key findings. Where reported, information on future strategies or recommendations was also extracted to inform potential policy considerations.
Given the heterogeneity of study designs and outcomes, findings were summarised narratively. Evidence was organised into three thematic areas identified during data extraction:
- Business compliance with labelling requirements
- Business responses and operational impacts
- Changes in calorie content of menu items following implementation