Introduction
Restaurants worldwide are increasingly aligning with environmental sustainability trends by using ecolabels to signify dishes with lower environmental impact. Ecolabels, which identify foods that are more environmentally sustainable, have the potential to influence consumer choices toward healthier options and reduce the carbon footprint of meals. However, until now, the effectiveness of ecolabels in shifting consumer food choices in restaurant settings has been largely untested. This trial aimed to evaluate whether displaying ecolabels on restaurant menus improves the nutritional quality and reduces the carbon footprint of meals selected by consumers.
Study Design, Setting, and Participants
This randomized clinical trial was conducted online from September to October 2024 and involved a nationally representative sample of U.S. adults aged 18 years and older. Participants were randomly assigned into two groups: an ecolabel arm and a control arm. Each participant viewed a simulated menu from a popular full-service restaurant and selected the items they wished to order. The study adhered to the intention-to-treat principle, meaning that all participants were analyzed in the groups to which they were originally assigned, regardless of adherence.
Intervention Details
Participants in the ecolabel arm viewed menus that displayed ecolabels—visual markers indicating a lower carbon footprint—next to entrées and appetizers rated below the median carbon dioxide equivalent (CO2e) emissions level of 1.625 kilograms per item. Conversely, participants in the control arm viewed identical menus without any ecolabel indicators.
Outcomes and Assessment Methods
The primary outcome measured was the overall healthfulness of meal selections, assessed via the Ofcom Nutrient Profiling Model, which scores foods from 0 to 100 with higher scores representing healthier choices. Secondary outcomes included nutrient content analysis—measuring fiber, protein, sugar, saturated fat, and calories—and total carbon footprint of selected entrées, appetizers, and complete meal orders (including drinks and desserts).
Results
A total of 3,147 participants completed the study, with an equal gender distribution (50% men) and a mean age of 34.5 years.
While participants exposed to ecolabels selected entrées and appetizers with slightly higher healthfulness scores than the control group, this difference was not statistically significant (Average Differential Effect [ADE], 0.45; 95% Confidence Interval [CI], -0.18 to 1.09; P = .16). Similarly, healthfulness scores for entire orders showed no statistically significant difference between groups (ADE, 0.47; 95% CI, -0.09 to 1.03; P = .10).
Significantly, participants in the ecolabel arm chose meals containing higher fiber content both in entrées and appetizers (ADE, 0.87 grams; 95% CI, 0.12–1.62; P = .02) and in complete orders (ADE, 0.82 grams; 95% CI, 0.07–1.56; P = .03), compared to the control group. No significant differences were observed in protein, sugar, saturated fat, or calorie content.
Notably, selections by ecolabel arm participants exhibited significantly lower carbon footprints for both entrées and appetizers (ADE, -0.78 kg CO2e; 95% CI, -1.25 to -0.32; P < .001) and entire orders (ADE, -0.81 kg CO2e; 95% CI, -1.27 to -0.34; P < .001), compared to controls. These reductions corresponded to a small but meaningful effect size (Cohen's d = -0.12).
Discussion
This trial demonstrates that ecolabeling on restaurant menus can effectively reduce the carbon footprint associated with consumer meal choices without compromising, and even slightly improving, certain nutritional aspects such as fiber intake. The finding that ecolabels did not significantly change overall healthfulness scores may indicate that quickly adopted sustainable choices were not universally healthier according to the scoring metric, yet the increase in fiber is a positive nutritional outcome.
The absence of changes in protein, sugar, saturated fat, and calorie content suggests that ecolabels primarily influence choices related to environmental impact rather than comprehensive dietary improvements. Importantly, the clear reduction in carbon emissions highlights ecolabels’ value as a practical and low-cost intervention to promote climate-conscious dining.
Clinical and Public Health Implications
Given the growing urgency to address climate change, strategies that steer consumer behavior toward lower-carbon food options are warranted. Implementing ecolabels in restaurants could scale broadly without significant operational costs, harnessing consumer interest in sustainability to achieve environmental benefits.
Furthermore, the modest improvement in dietary fiber intake affirms that ecolabels may also contribute to better nutrition. Encouraging food service establishments to adopt ecolabels alongside nutrition education could amplify health and environmental outcomes.
Limitations and Future Research
This study was conducted in an online setting with simulated menus, which may differ from real-world restaurant experiences and purchasing behavior. Additionally, the study population was limited to U.S. adults, so results may vary in other cultural or demographic contexts.
Further research should explore long-term impacts of ecolabel exposure, investigate effects in diverse populations, and assess complementary measures such as consumer education or economic incentives to enhance outcomes.
Conclusions
Menu ecolabels represent a promising, scalable strategy to reduce the carbon footprint of restaurant meal selections without diminishing nutritional quality. By signaling environmentally sustainable options, ecolabels can empower consumers to make more climate-conscious food choices, aiding global efforts toward sustainability and public health improvement.
Trial Registration
ClinicalTrials.gov Identifier: NCT06584539.
Reference
Grummon AH, Zeitlin AB, Lee CJY, Collis C, Cleveland LP, Musicus AA, Petimar J. Ecolabels and the Healthfulness and Carbon Footprint of Restaurant Meal Selections: A Randomized Clinical Trial. JAMA Network Open. 2025 Aug 1;8(8):e2524773. doi: 10.1001/jamanetworkopen.2025.24773. PMID: 40758354; PMCID: PMC12322791.
