Do Better-informed Individuals make Healthier Choices? Evidence from Calorie Labeling and Weight Gain During Pregnancy

Does disclosure of dietary information lead to healthier choices and outcomes? We use calorie labeling laws (CLLs) to investigate the effect of information on people’s health behaviors and outcomes. These laws mandate the disclosure of calorie content of fast food items to the public, exogenously raising the level of available information. While previous studies in the United States emphasized the impact of CLLs on adult obesity, we instead focus on pregnant women, a subpopulation that is likely to be more sensitive to new dietary information. Medical literature suggests that diet and weight management during pregnancy play a crucial role in determining the health outcomes of both the mother and the newborn. For example, obesity and excessive weight gain during pregnancy, both highly prevalent in the U.S., are associated with risk factors such as gestational diabetes and pregnancy induced hypertension, and increase the likelihood of complications during pregnancy and labor. Therefore, it is important to understand the role information plays in dietary choices during pregnancy and their subsequent impact on health outcomes for both mothers and newborns.

We use Natality Data from the National Vital Statistics System and employ a difference-in-differences strategy to analyze the impact of the 2008 Calorie Labeling Mandate in New York City (NYC). In order to make sure our results are not unique to NYC, we do the same analysis for King County where similar CLLs took effect. We control for maternal characteristics, county and year fixed effects and the timing of adoption and implementation of CLLs. Various sensitivity checks and placebo tests strengthen the confidence in our findings.

We find statistically significant declines of 4.11 percent and 2.71 percent in weight gain during pregnancy for NYC and King County, respectively. Moreover, the proportion of pregnant women who gain more than 15 kg during pregnancy decreases by 3.28 percent (p-value<10 %) in NYC and by 7.73 percent (p-value <1 %) in King County. In addition, we find a statistically significant decline in the prevalence of pregnancy associated hypertension for both places. In NYC, the results show a decline in post-term pregnancies (gestation>=42 weeks), a condition which obese mothers are more likely to suffer, and finally, we find a decrease in fetal macrosomia (birth weight>4000 grams), which may complicate labor and increase the risk of health problems for the newborn after the birth.

These results suggest that available information has a significant impact on maternal weight gain during pregnancy. This impact seems to translate into a decrease in the incidence of risk factors and complications during pregnancy and labor, which may have repercussions for the health of the mother and the child long after the birth. Our findings imply that providing expecting mothers with necessary information and raising awareness about the consequences of their choices should be an integral part of policies towards maternal and child health.