{
  "abstract": "Background A mandatory menu calorie labelling policy was implemented in large out-of-home food businesses in England in 2022 and is now considered for adoption in other European countries. Evidence on its impact remains limited, particularly in European contexts, and how it compares to widely implemented policies like sugar-sweetened beverage (SSB) taxation. This study aimed to estimate the impacts of mandatory menu calorie labelling and SSB taxation on obesity prevalence and cardiovascular (CVD) mortality in Belgium and Germany.Methods We conducted microsimulation analyses over a 20-year simulation horizon (2022–2041) for Belgian and German populations aged 30–89 years using a synthetic population with individual traits (sex, age, education), energy intake, body mass index, and CVD mortality informed by national databases. We modelled two mandatory menu calorie labelling scenarios: (1) partial implementation (large out-of-home food businesses with ≥250 employees) and (2) full implementation (all out-of-home food businesses) and three SSB tax scenarios (10%, 20%, 30%). We estimated the impacts based on assumed policy effects on consumer response and food industry reformulation. For each policy scenario compared to the counterfactual scenario (e.g., without any additional policy), we estimated the reduction in obesity prevalence and the number of CVD deaths prevented or postponed.Results We estimated larger impacts of menu calorie labelling when mandated for all out-of-home food businesses rather than only large out-of-home food businesses in Belgium and Germany. Implementing menu calorie labelling in all out-of-home food businesses would potentially prevent obesity prevalence by 3.61 (95% uncertainty interval-UI: 2.78 to 4.30) and 4.28 (95% UI: 3.64 to 5.06) percentage points and postpone 1,600 (95% UI: 400 to 3,800) and 30,000 (95% UI: 10,000 to 58,000) CVD deaths in Belgium and Germany, respectively. We estimated greater impacts of implementing higher SSB tax rates. Implementing a 30% SSB tax would result in reduced obesity prevalence by 0.27 (95% UI: 0.17 to 0.43) and 0.27 (95% UI: 0.17 to 0.39) percentage points and prevented 2,500 (95% UI: 800 to 5,200) and 16,000 (95% UI: 7,500 to 28,000) CVD deaths in Belgium and Germany, respectively. Our modelling by education level showed that SSB taxation may prevent more CVD deaths in low-education group, while mandatory menu calorie labelling may have a greater impact in reducing CVD deaths in high-education group.Conclusion Mandatory menu calorie labelling and SSB taxation were estimated to reduce obesity prevalence and prevent CVD deaths in Belgium and Germany. Implementing both policies as complementary policy instruments will be important in addressing obesity and associated CVD burden.",
  "authors": [
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "I Gusti Ngurah Edi Putra"
    },
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Martin O’Flaherty"
    },
    {
      "affiliations": [
        "Professorship of Public Health and Prevention, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany"
      ],
      "name": "Karl MF Emmert-Fees"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Public Health, Sciensano (Scientific Institute of Public Health), Brussels, Belgium"
      ],
      "name": "Maria Salve Vasquez"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Liverpool, Liverpool, UK"
      ],
      "name": "Rebecca Evans"
    },
    {
      "affiliations": [
        "Institute of Epidemiology, Helmholtz Zentrum München, Research Center for Environmental Health (GmbH), Neuherberg, Germany",
        "Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany",
        "German Centre for Diabetes Research (DZD), Partner Site: Munich-Neuherberg, Germany"
      ],
      "name": "Annette Peters"
    },
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Chris Kypridemos"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Public Health, Sciensano (Scientific Institute of Public Health), Brussels, Belgium"
      ],
      "name": "Nicolas Berger"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Liverpool, Liverpool, UK"
      ],
      "name": "Eric Robinson"
    },
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Zoé Colombet"
    }
  ],
  "title": "OP69 Estimated impacts of menu calorie labelling policy and sugar-sweetened beverage taxation on obesity prevalence and cardiovascular mortality in Belgium and Germany: a modelling study",
  "uid": "d35418c0-ff9d-5144-bfd7-033cb69736d2"
}