A restaurant nutrition-labeling regulation was accompanied by some, but not uniform, improvements in two counties—one regulated and one nonregulated.

Posting nutrition information at restaurants is a recent attempt to improve eating habits of Americans.

This study examines restaurant environments before and after a nutrition-labeling regulation took effect in King County, Washington as compared to Multnomah County, Oregon.

Using the same quick-service chain restaurants, King County, a newly regulated county, was assessed before, six, and 18 months after regulation enforcement. Multnomah County, a nonregulated county, was assessed over a six-month period. Data was collected using the Nutrition Environment Measures Survey-Restaurant version audit, with data from 2008 through 2010.

Key Findings:

• Between King County and Multnomah County, overall availability of healthy options and facilitation of healthy eating did not increase differentially.
• There was a substantial increase in onsite nutrition information posting after the new regulation in King County.
• There was evidence of a decrease in barriers to healthful eating, including promotion and encouragement to overeat or engage in unhealthy eating, among King County restaurants.
• The healthfulness of kid’s menus improved over time, but not differentially by county.

Sample size and number of time points limits this study. However, this study is among the first to examine changes in restaurant environment before and after regulation enforcement. This study proves important as nutrition labeling becomes nationwide.