Using Your Mind (and Brain) to Make Healthier Choices

Fast food tastes so good but is so bad for you. Fruits and vegetables are much healthier choices, but it's hard to get people to change their dietary habits. Everyone from foodies to legislators is telling us why we need to sample from the produce and not the candy aisle. Unfortunately, research in behavioral economics shows that these measures often have the opposite intended effects. Paradoxically, people will eat less healthily, when they know what they're eating. Ignorance seems to be bliss when it comes to indulging our taste buds as we step into a restaurant, whether it's a local McDonald's or New York's posh Oyster Bar.

George Loewenstein, Professor of Economics and Psychology at Carnegie Mellon University, has pioneered important and fascinating behavioral economics research on diet and health choices, including a NY Times Op-Ed. You can learn more about his work including a webcast and paper available online in which he discusses factors contributing to obesity, including the posting of calorie charts (these are lengthy but well worth your time if you want to explore the topic further).

Conventional economics assumes that our choices are made on the basis of rational consideration of alternatives. In behavioral economics, the foibles of human decision-making are brought to light. For example, we are easily led to buy products because they cost more, not less. Luxury marketers are already aware of this fact in practice, which is why some stores, even in hard economic times, never reduce their products (try finding Louis Vuitton purses on sale, for instance!).

The principles of behavioral economics are no more evident than when we are faced with menu choices in restaurants, causing us to throw rational decision-making to the winds. One of the big problems is that (surprise, surprise) when you go to a restaurant, you're hungry. Your hypothalamus issues the demand "FEED ME!" Your hypothalamus is the part of the lower brain regions, structures not noted for their ability to perform complex mathematical calculations. All the hypothalamus cares about is getting nutrients of any kind into the bloodstream, and now.

So, there's that lovely calorie chart posted on the wall, but our hypothalamus pays no attention. What about the prefrontal cortex, the part of the brain that does make wise decisions? Although some customers will give voice to their upper brain regions, these tend to be the people already motivated to watch their weight. If the calorie chart wasn't posted, they would bring along one of their own, perhaps even one they downloaded ahead of time online (now that is the prefrontal cortex at work!).

Sometimes the prefrontal cortex thinks it is making a good decision through that wonderful defense mechanism of rationalization. "Hey," it says, "that Big Mac has 704 calories, but the Caesar salad with dressing has 510." Rationalization leads you to decide that it's not even a 200 calorie difference, so what's the big deal? Behavioral economists talk about the fact that these small decisions on one occasion don't seem "that bad" (especially when your hypothalamus is jumping up and down screaming for sustenance). Over time, of course, these little 200 calorie decisions do add up. But at the moment, you're not into the business of projecting far into the future. As Freud would say, the id trumps the super-ego.

Of course all this is based on the premise that people actually read calorie charts, and as we know, they don't. You can bring a hungry person to a restaurant but you can't make that person read past the menu. Now, here's where there is some potential to change behavior.

Behavioral economics tells us that people will often revert to whatever the default choice is when given options. Big Macs automatically come with cheese and a mayo-based sauce. What if those calorie boosting add-ons required you to make an additional request? Going with the default principle would mean that your 704 calorie indulgence now has closer to what that Caesar salad would offer. In fact, what Loewenstein and like-minded behavioral economists are suggesting is a policy whose name might scare some people: paternalistically assymetry. Or, if you prefer, choices of convenience. Make the default option the healthy one, in other words.

There are many factors contributing to the obesity epidemic in the United States, but fast food meals with their low price tags and ubiquitous presence in the highways and byways of the land, loom large in the list of causes. We've learned recently from a University of Buffalo study that living near convenience stores and restaurants rather than grocery stores may also contribute to weight gain in women. We have to be careful here in that, as I've pointed out in previous blogs, correlation doesn't equal causation. Your street address doesn't cause your weight gain. Instead, a third factor, most likely economic status of the neighborhood, is the big culprit here. There are more convenience stores and fast-food restaurants in poorer neighborhoods. If people don't have cars to drive out to the suburbs where the large supermarkets with healthier alternatives, hypothalamus or not, they'll eat what's close by. And many of these healthier food stores aren't cheap. Whole Foods isn't nicknamed "Whole Wallet" for nothing.

Turns out that even these healthy-sounding bills of fare are not such great news for our bodies. When you stop to read the small print, you'll wonder if "whole food" might not mean "whole lot of bad stuff." Let's say you're going to browse around for a nutricious breakfast or morning snack. What could be better than the "Morning Glory Muffin"? You see visions of lovely little blue flowers as you wander around the meadow, pouring wonderful nutrients into your health-food craving prefrontal cortex. Clouds loom overhead once you read the fine print about what is actually in that mere 99g innocent-sounding delight: 310 calories (160 from fat), 18g total fat, 1.5g saturated fat, 0g trans fat, 4g protein, 36g total carbohydrate (1g dietary fiber, 13g sugar), 70mg cholesterol, 310mg sodium. Sure this stacks up better than some McDonald's breakfast offerings, but it's not much of an improvement over some options including a warm cinnamon bun (mmm...).

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The principle of convenience or least effort in decision-making applies to many other health-related areas. Consider the default shoe options now being offered by retailers from Jimmy Choo to Target. Teeteringly high platforms and stilettos are now the rule of the rack. The healthy (and fashionable) alternatives with their humdrum names ("Naturalizer" to name one), are either not advertised or available (or cheap, for that matter). Similarly, the elevators in many buildings gleam brightly and temptingly at front entrances with their polished steel and glass surfaces. Staircases are hidden behind imposing doors that appear to lead only to emergency exits (and could sound an alarm). Stairwells are ugly, dirty, and poorly lit. In restaurants and bars throughout the world (less and less in developed countries), we have to ask to be seated in a non-smoking section. The list goes on and on.Consumers are constantly being tempted to slide into unhealthy default options that over time cause our health to deteriorate.

How can you avoid the trap of the easy but unhealthy default option? Here are five suggestions:

1. Make the commitment to engage your prefrontal cortex. No matter what sorts of unrealistic demands your hypothalamus makes for quick and easy decisions get started on effortful processing. Think about what you're doing, project your decisions into the future, and imagine the outcomes.

2. Be a non-conformist. You're out with your friends for a good time and those cheese-covered nachos that they order are sounding awfully good. Don't be afraid to get a veggie plate instead (and I don't mean a deep-friend veggie plate). Go ahead and have ONE or two nachos to go along with the gang. Chances are, though, that once you buck the nachos trend, your friends may also be mooching off your platter.

3. Read the fine print. It's annoying how small the "nutrition facts" charts are on packaged foods. Never mind- read them and be sure to read the serving sizes as well. If you're afraid of looking uncool because you need to whip out your reading glasses, so what? No one will care (revert to principle #2, above).

4. Support paternalistic assymetry. Start a campaign at work to beautify the stairwells. Suggest that retailers make healthy alternatives more prominent. When you cook meals for your family, don't add the salt or butter ahead of time to those green beans but make them ask first. You can adopt the Bloomberg principle and gradually reduce the additives such as sugar so that over time they're not missed as much.

5. Question what's in a name. We are all so easily duped by euphemistic names that we rarely question what's being offered to us. Make sure that the so-called healthy alternative you've selected isn't loaded with sugar, sodium, and unhealthy fat substitutes. Here's where healthy skepticism can really be "healthy."

It's not easy to resist the trends of society, our friends, and even our brains when it comes to making good lifestyle choices. But with some effort and a few simple steps, you can make that all important start toward healthy self-fulfillment.

But whatever you do, please don't take this advice with a grain of salt!

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Copyright Susan Krauss Whitbourne, Ph.D. 2010

Susan is the author of 15 books including her most recent book, "The Search for Fulfillment."

Copyright Susan Krauss Whitbourne, Ph.D. 2010