The purpose of this study was to examine the effect of different menu labelling formats on healthy food choices in a real restaurant setting. This cross-sectional, randomised and controlled parallel-group trial was conducted in Brazil in 2013. 313 university students were randomly assigned to one of three parallel groups with different menu labelling formats. Of these, data from 233 students were analysed. The others did not attend and were excluded. Intervention group 1 (n=88) received information in the form of a traffic light system plus guideline daily amounts, while intervention group 2 (n=74) was presented with an ingredients list plus highlighted symbols. The control group (n=71) received a menu with no menu labelling. Data were collected on one weekday in a restaurant setting. Trial outcomes were assessed by healthy food choices. Healthy food choices were significantly higher among students who received the menu showing an ingredients list plus highlighted symbols. The same menu labelling format positively affected healthy food choices in women, not overweight participants and who often ate out more than twice a week. A menu labelling format that presented an ingredients list and highlighted symbols was positively associated with healthy food choices among university students in Brazil. This type of labelling could be adopted in future legislation on menu labelling in Brazil and around the world
