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Project Title

Effects of Physical Activity Calorie Expenditure (PACE) Food Labeling

Funding Dates



A recent randomized trial using hypothetical scenarios found that people select foods totaling fewer calories when shown physical activity calorie expenditure (PACE) food labels. In this project, the effect of PACE food labels on actual point-of-decision food purchasing behavior and physical activity (PA) is tested. The study team is partnering with Blue Cross and Blue Shield of North Carolina to test the effects of the labels in three of their campus cafeterias that serve over 3600 employees. Primary outcomes include amount of calories purchased by individuals in three cohorts (tracked by receipts and self-report) and PA as measured by accelerometry and gym use. As secondary measures, calories purchased and gym use will also be measured in aggregate (campus level). Secondary outcomes will also include changes in body mass index, blood pressure, glucose level, and cholesterol level among individuals in the cohorts. Pre-intervention to post-intervention outcomes using interrupted time-series analysis as well as intervention to a control group will be compared. The groups are followed for a total of 24 months. Project results provide valuable evidence on the effectiveness of menu labeling and inform new policy intervention approaches which might in time lead to healthier Americans.

Research Areas 

Cardiovascular Health, Obesity, and Diabetes
Nutrition and Physical Activity

Principal Investigator

Alice Ammerman, DrPH and Anthony J Viera, MD, MPH


National Institutes of Health


Effects of physical activity calorie expenditure (PACE) labeling: study design and baseline sample characteristics
Effect of calories-only vs physical activity calorie expenditure labeling on lunch calories purchased in worksite cafeterias