Salt Warnings on Menus Spur Healthier Choices: Study

Findings from a study published today in The Lancet Public Health provide the strongest evidence to date that salt warning labels on restaurant menus are perceived by consumers as effective in discouraging selection of high-salt items, prompt greater awareness of salt content when ordering, and significantly reduce the amount of salt actually ordered.

The research, led by Dr Rebecca Evans at the University of Liverpool, is the first of its kind in the UK and included both an online and a real-world randomised controlled trial (RCT), with findings supporting the potential of menu labelling as a scalable public health strategy.

"Our study has found that salt warning labels on menus help people make healthier choices," said Dr Rebecca Evans, Postdoctoral Researcher in Psychology and lead author. "Given that excess salt intake is a leading cause of diet-related disease, this kind of labelling policy could play a vital role in improving population health."

This is the first real-world randomised controlled trial globally to evaluate salt labelling in a full-service restaurant environment.

Key findings

Salt warning labels used in the study identified items exceeding 50% of the recommended UK daily salt limit (6g) and were tested in both hypothetical and real restaurant contexts.

  • In an online RCT with 2,391 UK adults, salt warning labels
    • were perceived by participants as effective in discouraging selection of high-salt items, and
    • reduced salt ordered by 0.26g per meal
  • In a real-world trial conducted at a Liverpool restaurant with 454 participants, labelled menus
    • were perceived by participants as effective in discouraging selection of high-salt items
    • prompted greater awareness of salt content when ordering, and
    • reduced salt ordered by 0.54g per meal

Across both trials, labels were found to be equally effective regardless of age, sex, or education level-suggesting the intervention may be helpful for all and therefore will not exacerbate health inequalities.

"This study demonstrates that even small nudges at the point of purchase can encourage healthier choices," added Dr. Evans.

Sonia Pombo, Head of Impact and Research at Action on Salt, welcomed the findings: "This important new study adds to the growing evidence that clear and visible salt warning labels on menus can positively influence consumer choices and reduce salt intake. With excessive salt in out-of-home meals contributing to high blood pressure and thousands of preventable deaths each year, the findings offer a simple but powerful tool for policymakers. Eating out is no longer an occasional indulgence - it's a routine part of daily life. Yet many meals are loaded with salt, often without our knowledge or consent. If we're serious about protecting public health and saving lives, salt reduction must be front and centre of the UK's food policy agenda."

Public support and policy relevance

The study also found strong public support for implementing salt warning labels on menus, with approximately two-thirds of participants backing the idea as a government policy.

The UK currently lacks mandatory nutrient warning policies in restaurants, despite government commitments to reduce salt intake and a recommendation from the World Health Organization to introduce menu labelling. A now growing number of studies worldwide suggest warning labels on packaged food and menus are needed by consumers and effective in promoting healthier food choices.

"We now have UK-specific evidence that this type of policy is valued by consumers and helps them make informed choices," said Dr Evans. "We hope to see government action to bring restaurant labelling in line with other national nutrition goals."

"Businesses in the out of home food sector sell menu items which contain more than an entire day's worth of salt and consumers are left completely unaware" said Prof Eric Robinson. "Government need to better regulate the out of home food sector so that the food being provided to the public promotes rather than compromises health"

About the research

The study was funded by the National Institute for Health and Care Research (NIHR) Oxford Health Biomedical Research Centre (BRC) and the European Research Council.

Researchers from Liverpool John Moores University, Bath Spa University, and the University of California, Davis also collaborated on the study, contributing to study design, implementation, and analysis.

This research adds to growing international evidence that simple, cost-effective menu labelling interventions can support healthier food choices and reduce population-level salt intake.

The full article, "Salt warning labels in the out-of-home food sector: online and real-world randomised controlled trials," is available here: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(25)00143-4/fulltext

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