title: Potential Effect of Physical Activity Calorie Equivalent (PACE) Labeling on Adult Fast Food Ordering and Exercise.
abstract: BACKGROUND
  Numeric calorie content labels show limited efficacy in reducing the number of calories ordered from fast food meals. Physical activity calorie equivalent (PACE) labels are an alternative that may reduce the number of calories ordered in fast food meals while encouraging patrons to exercise.
  
  
  METHODS
  A total of 1000 adults from 47 US states were randomly assigned via internet survey to one of four generic fast food menus: no label, calories only, calories + minutes, or calories + miles necessary to walk to burn off the calories. After completing hypothetical orders participants were asked to rate the likelihood of calorie-only and PACE labels to influence (1) food choice and (2) physical activity.
  
  
  RESULTS
  Respondents (n = 823) ordered a median of 1580 calories from the no-label menu, 1200 from the calories-only menu, 1140 from the calories + minutes menu, and 1210 from the calories + miles menu (p = 0.0001). 40% of respondents reported that PACE labels were "very likely" to influence food item choice vs. 28% for calorie-only labels (p<0.0001). 64% of participants reported that PACE labels were "somewhat likely" or "very likely" to influence their level of physical activity vs. 49% for calorie-only labels (p<0.0001).
  
  
  CONCLUSIONS
  PACE labels may be helpful in reducing the number of calories ordered in fast food meals and may have the added benefit of encouraging exercise.
authors.affiliation: School of Medicine, University of North Carolina, Chapel Hill, NC, United States of America.
authors.forename: Ray
authors.initials: R
authors.lastname: Antonelli
authors.affiliation: Department of Family Medicine, University of North Carolina, Chapel Hill, NC, United States of America.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Viera
mesh_terms: D000328:Adult; D002149:Energy Intake; D015444:Exercise / Q000502:physiology*; D057140:Fast Foods; D005260:Female; D005515:Food Labeling; D005518:Food Preferences; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009765:Obesity / Q000517:prevention & control; D011897:Random Allocation; D012147:Restaurants; D011795:Surveys and Questionnaires; D016138:Walking