Childhood obesity remains a growing concern worldwide, with 20% of children and adolescents classified as overweight or obese in 2022. In England, an estimated 40% of children leave primary school living with overweight or obesity.
Evidence suggests that an excessive consumption of ultra-processed, energy-dense foods with little nutritional value is a major contributing factor.
While calorie labelling is considered a way to promote healthier choices, many schools do not implement such labelling in their canteens, leading to students making uninformed choices about what they eat. Our study found that introducing PACE labels led to a small reduction in purchases of cakes and biscuits over a six-week period.
A new approach: PACE labelling
PACE labelling expresses the calorie content of food items as an amount of physical activity – measured in minutes or miles/kilometres. For example, a muffin of 600 calories may take an average adolescent 60 mins of running to expend the energy it contains.
PACE labelling aims to contextualise the energy and calorie content of food while encouraging people to make healthier food choices.
Our study set out to test how useful this approach to food labelling is in reducing discretionary food purchases by adolescents in school canteens.
Previous studies in the UK and USA report that PACE labelling is easier to understand and perhaps preferred because the information is displayed in a more meaningful way.
The research
We worked with 11 schools over a six-week period, who either displayed PACE labelling on sweet treats in their canteen or continue as usual with no labelling.
The analysis was based on around 99,000 purchases of cakes and biscuits across the 11 participating schools, with no major issues reported with the implementation of the labels.
This study found a small reduction in the purchases of cakes and biscuits in school canteens - approximately 11 fewer purchases per 100 students per week.
However, some concerns were raised about the potential for misinterpretation, as the number of calories burned varies depending on body weight and activity level. While this is true, population averages are commonly used in obesity prevention messages.
There were also some concerns about the possible impact of the labelling on students’ mental health and wellbeing – particularly the risk of promoting eating disorders. Whilst there is currently no evidence that links the labelling to increases in eating disorders, this area needs further research.
What this means
PACE labelling could serve as a useful low-cost strategy to help young people make healthier food choices at school. Short-term implementation appears generally feasible for some schools, though concerns around wellbeing may present a barrier.
This small, simple change of inserting PACE labelling in school canteens has the potential to encourage behaviour change and support healthier habits.
What’s next?
Future studies should examine the longer-term impacts of PACE labelling and determine whether the effects, are sustained over time. Research should also explore the impact of PACE labelling on physical activity levels.
Food for thought (light bite, lasting effect)
PACE labelling offers a cost-effective way to promote healthier food choices as part of a broader obesity prevention strategy. With growing evidence suggesting it is easier to understand and more meaningful than traditional traffic-light food labels. PACE provides easily digestible nutritional information in a more relatable format.
This simple approach could be the next step in tackling the nationwide issue of unhealthy food choices in adolescents.
NIHR Research Intern