obesity reviews doi: 10.1111/obr.

12364

Public Health/Behaviour

Impact of food labelling systems on food choices and

eating behaviours: a systematic review and meta-
analysis of randomized studies

M. Cecchini and L. Warin

Health Division, OECD, Paris, France Summary

Received 13 July 2015; revised 3 November
2015; accepted 4 November 2015
Address for correspondence: Dr M. Cecchini,
OECD, Health Division, 2, Rue André-Pascal,
Paris 75016, France.
E-mail: Michele.cecchini@oecd.org
Food labels are considered a crucial component of strategies tackling unhealthy di-
ets and obesity. This study aims at assessing the effectiveness of food labelling in in-
creasing the selection of healthier products and in reducing calorie intake. In
addition, this study compares the relative effectiveness of traffic light schemes,
Guideline Daily Amount and other food labelling schemes. A comprehensive set
of databases were searched to identify randomized studies. Studies reporting homo-
geneous outcomes were pooled together and analysed through meta-analyses. Pub-
lication bias was evaluated with a funnel plot. Food labelling would increase the
amount of people selecting a healthier food product by about 17.95% (confidence
interval: +11.24% to +24.66%). Food labelling would also decrease calorie
intake/choice by about 3.59% (confidence interval: 8.90% to +1.72%), but results
are not statistically significant. Traffic light schemes are marginally more effective in
increasing the selection of healthier options. Other food labels and Guideline Daily
Amount follow. The available evidence did not allow studying the effects of single
labelling schemes on calorie intake/choice. Findings of this study suggest that nutri-
tion labelling may be an effective approach to empowering consumers in choosing
healthier products. Interpretive labels, as traffic light labels, may be more effective.

Keywords: Calorie intake, food choice, food labelling, meta-analysis, obesity.

obesity reviews (2016) 17, 201–210

Introduction exacerbated a switch to lower-priced (per calorie) and less

Dietary patterns have gone through substantial changes
during the last 30–40 years. Calorie availability has been
increasing worldwide by approximately 580 kcal per capita
per day (1). At the same time, calorie consumption has sig-
nificantly risen in the USA (2) and in a number of Euro-
pean countries (3). A substantial part of this upsurge can
be attributed to increased consumption of ultra-processed
products (i.e. ready-to-consume foodstuff mostly made
from industrial ingredients) that now account for up to
more than 50% of total calorie intake in high-income
countries (4). The recent economic crisis may have further
healthy food (5).
Underpinned by these trends, unhealthy diet and one of its
consequences, obesity, have become a major public health
concern (6). The latest data show that the majority of the
adult population in the OECD area and one in five children
are overweight or obese (7). If recent trends continue, these
figures will inevitably worsen (8). In 2010 alone, more than
11 million deaths worldwide were amenable to diseases re-
lated to unhealthy diet and obesity, including diabetes, can-
cers and cardiovascular diseases (9).
Food labelling is increasingly considered a crucial compo-
nent of comprehensive strategies to tackle unhealthy diet

201
© 2015 World Obesity 17, 201–210, March 2016
202 Impact of food labelling M. Cecchini & L. Warin
and associated chronic diseases (10). For example, EU, the
USA, the UK and Chile are all discussing or implementing
new legislation on food labelling (7). In particular, food la-
bels are regarded as a possible tool to empower consumers
and to facilitate healthier food choices (11). Previous studies
in the field suggest that food labelling would be associated
with healthier eating habits (12–20) and would be a cost-
effective intervention (21). However, the majority of studies
are based on a relatively small sample, and in some cases, re-
sults appear mixed. Previous systematic reviews have
mainly focused on consumers understanding of food label-
ling schemes (22,23) and did not attempt to quantify the ef-
fects of food labelling in changing food choices.
This systematic review and meta-analysis enrich the liter-
ature by providing a quantitative assessment of the impact
of food labelling. In particular, this analysis aims at
assessing the effectiveness of food labelling schemes in in-
creasing the selection of healthier products and in reducing
calorie intake/choice. The secondary objective is to deter-
mine whether food labels’ format influences choices and
consumption. This analysis considers three types of food la-
belling schemes: traffic light, Guideline Daily Amount
(GDA) and other types of food labelling (e.g. front-of-pack
logos). Traffic light and GDA are among the most widely
adopted nutrition labelling schemes (7) and are central to
the ongoing policy (24) and academic debate (25).
Methodology
This review was restricted to peer-reviewed studies that
were designed to evaluate the impact of food labelling in
terms of likelihood of selection of either a healthier option
or calorie choice/intake. Studies had to be randomized and
should include a control population with either a
‘before/after’ design or a ‘case/control’ design. The inclusion
of randomized studies minimizes the influence of confound-
ing factors and increases the strength and reliability of the
pooled results. Studies that did not focus on consumers or
that took marketing or psychological perspectives were ex-
cluded. For example, we excluded studies that investigated
the type of labelling format that looks more appealing to
consumers. In addition, the review protocol excluded stud-
ies that evaluated menu labelling as well as studies that
did not provide the requested quantitative data to feed the
meta-analysis. Finally, studies had to be in English or French
and had to be published between January 2008 and April
2015 when the final search took place.
The search was conducted using the following databases:
Pubmed, Biomed, Science Direct, Sage Database, Google
Scholar, EBSCO Host Database Academic. Searched key-
words included were the following: ‘Food labelling’, ‘traffic-
light labelling’, ‘traffic-light nutrition labelling’, ‘Nutrition la-
belling’, ‘Nutrition claims labelling’, ‘Nutrition claims regula-
tion’, ‘EU regulation food labelling’, ‘EU nutrition labelling
17, 201–210, March 2016
obesity reviews
program’, ‘Traffic light label’, ‘Public health nutrition’,
‘Health logo’ ‘pick the tick’, ‘Guideline Daily Amounts’, ‘the
Heart Symbol’, ‘the Choices logo’, ‘The Choices program in
the Netherlands’, ‘The Keyhole program in Sweden’, ‘Pro-
gram less salt is healthier’, ‘Green check marks’, ‘EU regula-
tion food labelling’, ‘EU nutrition labelling program’ and
‘EU nutritional labelling program’. The search strategy was
developed on a previous systematic review of interventions
to promote healthy diet and physical activity (26). We identi-
fied all the papers on food labelling included in the review,
and then, we extracted all the keywords from the identified pa-
pers. The retrieved keywords were searched individually or in
combination using the standard Boolean operators.
A full version of the articles meeting the inclusion criteria
was obtained and analysed. Papers were divided into three
categories: GDA, traffic light and other food labelling, ac-
cording to the type of food labelling investigated. If a study
evaluated multiple types of labelling, results for each type
were considered as an independent study. A researcher ex-
tracted all the information on the characteristics of the study
including the geographical area where the study was con-
ducted, the food studied and the target population as well
as the quantitative data needed to carry out the meta-
analysis (i.e. sample sizes, means and standard deviations
of control and intervention groups). In some cases, missing
dimensions, usually standard deviations, had to be calcu-
lated by using standard approaches (27).
This analysis focuses on two outcomes. The first outcome
is the number of people that, following the implementation
of food labelling, switches to a healthier product. The out-
come was analysed as a percentage by dividing the number
of people choosing the healthier option by the total number
of people in the group. The second outcome is change in cal-
orie intake/choice following the introduction of a food la-
belling scheme. For some studies, food quantities (e.g.
grammes of pizza or cereals) or food nutrients (e.g.
grammes of fat) had to be converted into calories using a
nutrient database (28). Included studies investigated a
broad range of products with different calorie content. To
adjust for this heterogeneity, the change in calorie intake
in the intervention group was scaled to a percentage by
reporting it to the calorie intake of the control group. A sec-
ond set of analyses investigated the two same outcomes in
terms of, respectively, standardized mean difference (SMD)
and absolute number of calories. Details of the methodol-
ogy and results can be found in Appendix 2. Data were
analysed with STATA 13 (StataCorp, College Station, TX,
USA). Forest plots were generated, and overall estimates
of the pooled relation and 95% confidence intervals (CI)
were calculated with the use of fixed-effect and random-
effect models. Heterogeneity across studies was tested with
the I2 statistics (29). In case of low heterogeneity (30), we
carried out a graphical assessment of the potential publica-
tion bias through a funnel plot (31).
© 2015 World Obesity
obesity reviews
Results
A total of 137 articles were originally retrieved and se-
lected for the review (Fig. 1); 76 studies were discarded
because they were not peer-reviewed original investiga-
tions. Most of the documents consisted in reports from
international organizations, opinion pieces and other types
of reports. Another 52 studies were pulled out for review
but excluded in a second step because they did not meet
our inclusion criteria. Only nine studies met our inclusion
criteria and reported all the data needed to carry out a
meta-analysis. Three out of these nine studies focused on
food intake, purchase or choice (13,14,18); other five re-
ported data on food choice healthiness (15–17,19,20),
while one study reported results for the two dimensions
(12). The majority of the studies (12,14–17,19) assessed
front-of-pack labelling; three studies (13,18,20) did not
explicitly specify the position of the label. Two studies
(19,20) reported results in a format that was not directly
comparable with the other studies and were excluded
from the main analyses but were included in the addi-
tional set of analyses (Appendix 2) after transformation
into an SMD. The key characteristics of all the studies
included in the analyses are reported in Table 1. The full
list of studies identified in the systematic review is re-
ported in Annex 1.
Six studies (12,13,15,16,19,20) assessed the effectiveness
of at least two different food labelling schemes with the pa-
per by Watson et al. (15) assessing seven different variants.
All the studies were carried out in high-income countries
with the USA, Australia and the UK being the three most rep-
resented countries (two studies each). Other three studies
were carried out in France, Germany and Canada. Five
Figure 1 Flow diagram of the literature search and filtering results of the systematic review.
© 2015 World Obesity
Impact of food labelling M. Cecchini & L. Warin 203
studies were designed as experimental analyses: three of
them were carried out in a controlled setting (12,14,18)
and two in a real-world setting (13,17). The remaining four
studies were carried out as online randomized trials
(15,16,19,20). The majority of studies were carried out on
a relatively small sample of participants (median number of
participants 703) with only three studies enrolling more than
1000 participants (15,17,19). Some studies concluded that
food labelling may have some effect on consumers’ choice
(15,18,19). However, often, individual studies did not find
any statistically significant effect on consumption (13,14).
Various studies (17,32–34) suggest that other factors (e.g.
socio-demographic characteristics) may have an effect in de-
termining how food labelling influences food selection.
Figure 2 presents the results of the meta-analysis for
selecting/purchasing a healthier option. Results are pre-
sented as the share (expressed in percentage) of purchasers
that, following the introduction of food labelling, switches
to a healthier product. Single studies present very heteroge-
neous estimates. The effectiveness of food labelling ranges
between 3.50% (CI: 7.32% to +0.32%) and +52.20%
(CI: 47.61% to 56.79%). Studies in the GDA category pres-
ent more homogeneous estimates, while the category other
food labels shows the highest heterogeneity. Under the as-
sumptions of a random-effect model, food labelling can be
expected to increase the number of people selecting a
healthier option by about 17.95% (CI: 11.24% to
24.66%). All the three categories of food labelling included
in the analysis present a positive, statistically significant ef-
fect. Traffic light is the most effective labelling scheme and
increases the number of people selecting a healthier option
by 29.36% (CI: 19.73% to 39.00%). Other food labels
and GDA follow with, respectively, an increase of 14.69%
17, 201–210, March 2016
 Table 1 Main characteristics of the studies included in the meta-analysis

Author, year Country/ Type of study Type of food Type of food Population Outcome Authors’
geographical and setting labelling system studied of interest conclusions
area studied

Borgmeier and Hamburg, Experiment in (i) simple ‘healthy choice’ tick; 78 foods from different 420 adult subjects from Food choice, Different food label formats

17, 201–210, March 2016

Westenhoefer, 2009 Germany controlled setting (ii) multiple traffic light label; food categories a random sample from envisaged differ in the understanding of
(iii) monochrome Guideline Hamburg population consumption consumers. Traffic lights
Daily Amount label; have the best effects and
(iv) coloured Guideline influence most the perceived
Daily Amount label; and healthiness of food but, despite
(v) ‘no label’ condition. this, are unlikely to influence food
choice and consumption.
Crockett et al., 2014 London, UK Experiment in (i) green low-fat label; Popcorn 287 participants Consumption Contrary to predictions,
real-world setting (ii) red high-fat label; attending a no main effects of nutritional
and (iii) no label London cinema labels on consumption
were identified.
Roberto et al., USA Experimental in The Smart Choices Cereals 216 US consumers Food choice Calories per serving information
204 Impact of food labelling M. Cecchini & L. Warin

2012 (appetite) controlled setting front-of-package nutrition on front-of-pack labels can increase
label in the USA knowledge, but the Smart Choices
symbol has little impact on behaviour.
Watson et al., 2014 Australia Randomized Seven different front-of-pack Nine pairs of commonly 4357 grocery shoppers Label use and The number of correct responses
online trial labelling schemes comprising purchased food products in Australia understanding in the control group was significantly
variants of the traffic light less than in other schemes (P < 0.05).
labelling scheme and Even without an accompanying
the percentage daily intake education campaign, front-of-pack
scheme, and a star labels can assist shoppers
rating scheme to make healthy choices.
Roberto et al., USA Randomized (i) no label; (ii) traffic light; US brand name products 703 US consumers Food choice Overall, those in the traffic
2012 (AJPM) online trial (iii) traffic light and protein/fiber selected from eight recruited through light condition performed better
traffic light; (iv) facts up front; categories an online database than those in the facts up front
(v) facts up front and info on conditions on measures of nutrition
‘nutrients to encourage’ knowledge and label perceptions.
Gaigi et al., 2015 Marseille, Experiment in Logo ‘Le Choix Vita+’ Dairy products, cooked 2083 French consumers Purchase There was no main impact of the
France real-world setting meals and fresh snacks logo on food purchase, probably
because of several factors such as
lack of visibility of the logo on
supermarket shelves and clients’
low socio-economic group.
Spanos et al., 2015 Australia Experiment in Serving size labels Pizza 104 female undergraduate Food intake The nature of the information provided
controlled setting students at an Australian influences how much participants eat.
university Participants had lower consumption
obesity reviews

© 2015 World Obesity

obesity reviews Impact of food labelling M. Cecchini & L. Warin 205

claims elicited more positive responses

than the taste control claim. The taste
(CI: 3.56% to 25.82%) and 11.85% (CI: 5.43% to

had no effect on choice of snacks.

In both studies, all nutrition-related

review evidence, nutritional labels

18.28%). Results obtained by standardizing the input data

control claim was rated the least

with the SMD approach (Annex 2) and by including two

In line with recent systematic

of pizza if the same portion
additional studies (19,20) confirm that traffic lights are the

4 servings’ compared to
was labelled ‘contains
most effective labelling scheme. GDA becomes the second

‘contains 2 servings’.

influential or useful.
most effective intervention.
Findings of the analyses on the effectiveness of food
conclusions

labelling schemes in modifying calorie intake/choice are

Authors’

presented in Fig. 3. Results are presented as change in

calorie intake/choice (percentage of the control group). A
second set of analyses, reporting the effectiveness in terms

Food choice,

consumption
of absolute number of calories, are presented in Annex 2.
Purchasing
of interest

intentions
Outcome

Studies generally report homogeneous, largely overlapping

desired
effects. Homogeneity across studies is also confirmed by
low levels of the I2 statistics. Seven out of the 12 included
interventions show that calorie intake/choice decreases once
1017/1002 consumers

those food labels are introduced. However, no single study

for, respectively, plant

presents a statistically significant effect, and often, CIs are

sterols/oat fibre

several times the size of the expected effect. Pooling together

representative
955 people

all the interventions returns an average effect of 3.59%

Population

of the UK
studied

(CI: 8.90% to +1.72%). This means that, on average,

food labelling schemes can be expected to decrease calorie
intake/choice by about 3.6%. However, this figure is not
statistically significant.
Given the low number of studies included in the GDA and
traffic light categories, it is recommended not to compare re-
lowering claims
Foods carrying

Chocolate and
Type of food

sults across subcategories as this would provide no mean-

cholesterol-

cereal bars

ingful conclusion. Other food labels have an effect of

2.88% (CI: 10.08% to +4.32%), which is slightly lower,
but not statistically significantly different from the overall
results. Analyses carried out in terms of absolute number
of calories (Annex 2) confirm the findings of the main
analysis.
Cholesterol-lowering

Studies included in Fig. 3 were also graphically assessed

labelling system

for any potential publication bias through a funnel plot

Emoticons and
claims on food
Type of food

(Fig. 4). The studies were plotted with the estimated effect
food labels
colours on
studied

on the horizontal axis and the standard error of the

estimated effect on the vertical axis. Studies with a smaller
sample scatter more widely at the bottom of the graph,
while larger studies are closer to the true effect of the in-
Type of study

Randomized

Randomized

tervention and are positioned in the upper part of the

and setting

online trial

online trial

diagram. Studies that are more precise fall within the

95% CI. In the absence of a publication bias, the plot
should look symmetric.
geographical
Country/

Canada

Discussion
area
Table 1. (Continued)

UK

This systematic review and meta-analysis summarize the

Vasiljevic et al., 2015

current evidence on how different food labelling schemes

Wong et al., 2014

may modify the selection of healthier products and calorie

intake/choice. Results of the meta-analysis show that
Author, year

food labelling may play a significant role in facilitating

consumers to select healthier food products. Traffic light
schemes, in particular, would be the most effective food

© 2015 World Obesity 17, 201–210, March 2016

206 Impact of food labelling M. Cecchini & L. Warin
Figure 2 Effect of food labels in selecting/purchasing a healthier option. CI, confidence interval; D + L, random-effects estimate–DerSimonian and Laird
method; GDA, Guideline Daily Amount; I V, fixed-effects estimate–inverse variance method; WMD, weighted mean difference.
labelling scheme in steering consumers’ choices. Conversely,
our findings show a less clear picture in terms of whether
food labelling schemes affect calorie choice or consumption.
Overall, food labels would have the potential to decrease
calorie choice/intake. However, single studies report large
CIs, suggesting that different individuals respond to the
introduction of food labels with a wide range of behaviours,
indifference included.
Previous systematic reviews in the field focused on con-
sumers understanding of food labelling schemes (22,23)
and on whether menu labels would affect selection and
consumption of calories in restaurants (35,36). This
study enriches the literature by investigating the effective-
ness of food labels in increasing the selection of healthier
products and in modifying calorie choice/intake. Our
results suggest that menu labels and food labels may
have similar effects on consumers’ eating behaviours.
Previous literature showed that this may happen because
17, 201–210, March 2016
obesity reviews
consumers would have only a limited understanding of
the information provided by food labels (37). Findings
of our study support this hypothesis by showing that
interpretive nutrition labels, as traffic light systems, are
more effective in helping consumers in choosing healthier
products.
Another reason may also explain why significant positive
effects on food choice are not followed by a decrease in cal-
orie choice/intake of a similar magnitude. Calorie content is
only one of the multiple dimensions affecting the healthiness
of products. For example, consuming a product with re-
duced salt content is healthier but does not reduce calorie
intake. Again, substituting unhealthy nutrients (e.g. trans
fats) with healthier options (e.g. polyunsaturated fats) may
not produce any significant effect on calorie intake. The
so-called ‘halo effect’ may also play a key role. Consumers
tend to generalize to a whole food product a piece of infor-
mation found on the label (38). This especially applies in the
© 2015 World Obesity
obesity reviews
Figure 3 Effect of food labels on calorie intake/choice (percentage of control group). CI, confidence interval; D + L, random-effects estimate–DerSimonian
and Laird method; ES, effect size; GDA, Guideline Daily Amount; I V, fixed-effects estimate–inverse variance method; WMD, weighted mean difference.
Figure 4 Funnel plot of studies analysing the effect of food labels on
calorie intake/choice.
case of nutrient and health claims. For example, if a logo
states that a product is a source of whole grain, consumers
tend to think that the product is also low in calories,
© 2015 World Obesity
Impact of food labelling M. Cecchini & L. Warin 207
saturated fats and sugar (38). As a result, consumers may
even end up being tempted to eat more than they would
otherwise. Consumers may also compensate a healthy
dietary choice with consumption of other unhealthy food.
For example, diet-beverage consumption is associated with
higher calorie intake from discretionary food (39).
The majority of the studies meeting the inclusion
criteria were carried out in controlled settings or as online
trials. Little is known on the potential transferability of
the obtained effects to a real-world shopping situation
(e.g. supermarkets) where most food purchase takes place.
However, previous studies (21,23,40) concluded that
about two-thirds of consumers read nutrition labels before
purchasing a food product. In addition, users of food labels
would benefit from a small decrease in body mass index,
which would eventually decrease the likelihood of develop-
ing chronic diseases as diabetes, cancers and cardiovascular
diseases. This would produce a significant increase in
population health and savings in health expenditure.
17, 201–210, March 2016
208 Impact of food labelling M. Cecchini & L. Warin
Findings of this study have strong policy implications.
Many countries are in the process of debating, developing or
implementing new food labelling schemes (7,41). Results of
our work support the implementation of food labelling as a
key tool to tackle unhealthy diet and obesity. Food labels em-
power consumers by providing nutrition information (23).
Food labels may also prompt the industry to produce healthier
food through nutrient reformulation (38,42). In fact, product
reformulation may actually be one of the main mechanisms
through which food labels could impact consumers’ diets
(42) in the short term as changing people’s behaviour is more
complex and may require longer than changing the environ-
ment. It is up to policymakers to decide the trade-off between
completeness of information and facility of understanding.
This analysis suggests that interpretive nutrition labels may
be marginally more effective in steering consumers’ choices.
This investigation has three main strengths. First, previ-
ous literature focused on analysing whether consumers un-
derstand labelling. This study, instead, investigates the
effects of labelling on selecting foodstuff. Thus, it quantifies
how much food labels can modify diets and, eventually,
obesity prevalence. Second, this study goes beyond a quali-
tative analysis of the literature by pooling together quantita-
tive evidence in a meta-analysis. Therefore, the results of
this work can be used to compare the effectiveness of food
labels with other labelling policies (e.g. menu labelling)
and, more broadly, with other policies to tackle overweight
and obesity (e.g. counselling and mass media campaigns).
Third, this study compares the marginal effects of different
labelling schemes producing new evidence about the ex-
pected effectiveness of GDA labels, traffic light labels and
other types of food labels.
The main potential limitation of this study lies with the
quality of the studies included in the meta-analysis. The ma-
jority of studies are based on a relatively small sample, par-
ticularly by considering that the total number of
participants is often divided into groups to test different
food labelling schemes. Too small samples may not have
enough statistical power to fully account for possible con-
founders (e.g. socio-demographic conditions and price).
Small samples may also explain most of the cross-study
(analysis on the selection of healthy options) and within-
study (analysis on calorie intake/choice) heterogeneity that
we found in the retrieved studies. The inevitable assump-
tions we had to make cluster together slightly different la-
belling formats could be, instead, a limitation for the
analyses by type of labelling scheme. For example, this
study groups together standard GDA labels with their
‘coloured’ variant in which levels of nutrients are empha-
sized by a traffic light approach. It cannot be excluded that
variants of the same scheme have different effects.
Future research on food labelling should focus on address-
ing three key deficiencies. The first concerns the small samples
of the studies that do not allow for full consideration of
17, 201–210, March 2016
obesity reviews
confounders and preclude analyses by population subgroups.
Second, there is a need of a higher number of studies carried
out in the ‘real world’ as opposed to laboratory settings. These
two issues could be addressed with a closer collaboration be-
tween researchers and retailers, e.g. by carrying out large-scale
randomized trials entailing the introduction of innovative la-
bels in a random group of stores. The linkage of sales data
with ‘loyalty programmes’ data would provide a solution to
the two aforementioned issues. Finally, researchers should
standardize study protocols and, in particular, outcome defini-
tions. A number of studies had to be discarded because results
were reported in non-standard units of measure (e.g. 43–45)
or studied unusual outcomes (e.g. 46,47).
In conclusion, from the evidence produced by this system-
atic review and meta-analysis, it appears that food labelling
schemes would have a statistically significant effect in
steering consumers’ choice towards healthier products. In-
terpretive nutrition labels, as traffic light schemes, may be
more effective than other approaches. Food labels could
also help consumers in choosing/consuming foodstuff with
lower calorie content, but the available evidence is currently
too limited to produce statistically significant results.
Conflict of interest statement
No conflict of interest statement.
Acknowledgements
The opinions expressed and arguments employed herein are
solely those of the authors and do not necessarily reflect the
official views of the OECD or of its member countries.
Supporting information
Additional Supporting Information may be found in the
online version of this article, http://dx.doi.org/10.1111/
obr.12364
Appendix 1. List of studies retrieved in the systematic
review but discarded.
Appendix 2. Additional results.
Figure A1. Effect of food labels in selecting/purchasing a
healthier option.
Figure A2. Effect of food labels on calorie intake/choice
(absolute calories).
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