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Scientific Strategies for Healthier Eating

Small tweaks to how and where we dine can lead to healthier choices.

Tudokin/Wikimedia Commons
Self-serve salad bars create friction to healthy eating.
Source: Tudokin/Wikimedia Commons

College students return to campuses nationwide this month, and if they’re like many other Americans, they’ve made a resolution to be healthier in 2020. There’s fascinating psychology behind why we seek a fresh start at the New Year, and there are various behaviorally informed strategies to help us keep those resolutions. But what can colleges do to support students (not to mention faculty and staff) in their healthy eating goals?

Regardless of whether they live in dorms or commute, many students rely on campus dining to make it through their day. Colleges, therefore, have a unique opportunity to influence students’ eating, which could help schools to fulfill both their educational and social welfare missions. How we steer students' food choices through the structure of our campus dining options could have a tremendous impact on their health.

Change the Defaults

The 2008 book Nudge: Improving Decisions About Health, Wealth, and Happiness, identified perhaps the most powerful and reliable nudge: changing the default. People are more likely to save for retirement, be an organ donor, or receive texts about their child’s academic performance when the default is to automatically enroll them in the program (forcing them to opt out if they wish) rather than asking them to sign up (opt in) for it.

Defaults are so powerful because they influence behavior through at least four unique channels:

  1. Defaults make it easier to choose a particular option by no longer requiring any action (known as reducing friction).
  2. When people are inattentive, defaults direct them toward a particular option.
  3. When people are unsure of what to do, defaults suggest a normative option.
  4. When defaults suggest a normative option, it activates people’s inherent desire to conform or fit in.

Researchers have long questioned, however, whether defaults could affect arenas in which people have strong opinions, like food choices. Two recent studies demonstrate that what we decide to eat is not as intrinsic as we might believe.

Whenever my wife attends a conference, or a wedding, or flies overseas, she’s always on high alert for how to change her meal preference to vegetarian. Researchers from iNudgeyou wondered: What if vegetarianism was the default, and people had to indicate their desire to eat meat? The default meal option was manipulated at three academic conferences, all hosted in Copenhagen and attended by about 470 people total. When the default option included meat, an average of 6 percent of conference-goers requested the vegetarian meal. But when the default option was vegetarian, an average of 87 percent of attendees stuck with it!

Preference for the default extends to individual ingredients. An experiment with 226 customers at a Dutch university canteen manipulated whether the sandwich van de dag was made with white or whole-wheat bread. Customers could request the nondefault type of bread, which required the server to transfer the toppings from a premade sandwich to a different bun. When sandwiches were premade on white, only 20 percent of people requested whole wheat, despite surveys showing a strong preference for whole-wheat buns. But when sandwiches were premade on whole wheat, 94 of people went with the default.

Reduce Friction

These studies reveal that people usually stick with the status quo, even when it overrides their food preferences. Moreover, even a tiny amount of friction, like having to find and click a box, or waiting an extra 10 seconds for a different type of bread, is enough to drastically sway eating behaviors. Reducing friction, therefore, seems like a sure-fire way to improve people’s food choices.

Staff Sgt. Teresa J. Cleveland/Joint Base Langley-Eustis
What if this checkout lane was filled with fruits and veggies?
Source: Staff Sgt. Teresa J. Cleveland/Joint Base Langley-Eustis

Enter any grocery store (or hardware, electronics, or home goods store) and you’ll find sweet and salty snacks for sale in the checkout aisle. Retailers know that people make impulsive purchases at these moments, no matter what else they’re buying. But are these impulse buys only for unhealthy foods? Researchers manipulated whether healthy foods (e.g., fruit, muesli bars) or unhealthy foods (e.g., chocolate bars, potato chips) were available at the cash register at three identical shops located on train platforms in the Netherlands. When moved up front, sales of healthy items increased by over 50 percent compared to the week before.

Convenience may then be key to increasing healthy eating. In another study, 88 Danes ate from a buffet featuring rice, chili con carne, and two types of salad. When salads were preportioned into bowls, instead of requiring people to scoop their salad into an empty bowl or to build their salad from individual ingredients, salad consumption increased by an average of 45g or 34kcal.

Prime Healthy Thoughts

Would you like fries with that?

This famous phrase, repeated at fast-food joints around the world, has become somewhat of a punchline, yet restaurants still ask because people are susceptible to suggestion. Two studies reveal, however, that these verbal prompts can be just as effective at getting people to add healthy foods to their plates.

RitaE/pixabay
MMMMM...fruit quark...
Source: RitaE/pixabay

The first study sought to encourage people recuperating in a Dutch hospital to eat more protein. When patients called in their lunch order, they were asked if they wished to add fruit quark or a yogurt drink, two protein-rich but easy-to-consume foods. This simple question prompted 45 percent of people to order fruit quark or yogurt, compared to only 6.5 percent of control patients. Importantly, only one person reported not eating the protein snack, and there was no evidence that people who ate more protein at lunch compensated by eating less protein during dinner.

The second study examined breakfast sales at a small Dutch café where, for an extra charge, you could add orange juice, fruit salad, or pancakes to the 1€ standard breakfast of an omelet sandwich, croissant, and coffee or tea. Over nine weeks, when cashiers asked customers if they wanted orange juice, sales nearly doubled (from 20 percent to 40 percent). And when cashiers asked about fruit salad for one week, sales nearly tripled (from 3 percent to 9 percent).

Final Thoughts

There are several reasons why our colleagues in dining services should take heed of lessons from these studies. Nudges to encourage healthy eating increased sales at the Dutch café and snack stations, which would benefit campus stores and restaurants with à la carte service. Moreover, four out of five customers felt good about moving healthy items to the checkout kiosk, and more than 85 percent of people approved of making vegetarian menus the default option. Nudges like these, therefore, could be good for customer health, satisfaction, and the bottom line.

Even though most people reading this probably have no control over campus dining, perhaps you can inquire as to how colleges might redesign their offerings to encourage healthy eating. For example, salads can be premade and ready to eat (reduced friction), while burgers and tacos would require assembly (increased friction). Sandwiches and burritos might be prepared as lettuce bowls by default, with people having to ask for bread or a wrap. Verbal prompts to customers to make healthy choices—especially if they come at no extra cost—could be very persuasive. Small tweaks to the ways in which people choose their meals while on campus could make all the difference in their keeping those resolutions for better eating in 2020.

References

Friis, R., Skov, L. R., Olsen, A., Appleton, K. M., Saulais, L.…Perez-Cueto, F. J. A. (2017). Comparison of three nudge interventions (priming, default option, and perceived variety) to promote vegetable consumption in a self-service buffet setting. PLoS One, 12(5), e0176028.

Hansen, P. G., Schilling, M., & Malthesen, M. S. (2019). Nudging healthy and sustainable food choices: Three randomized controlled field experiments using a vegetarian lunch-default as a normative signal. Journal of Public Health.

Kroese, F. M., Marchiori, D. R., & de Ridder, D. T. D. (2015). Nudging healthy food choices: A field experiment at the train station. Journal of Public Health, 38(2), e133-e137.

van der Zanden, L. D. T., van Essen, H., van Kleef, E., de Wijk, R. A., & van Trijp, H. C. M. (2015). Using a verbal prompt to increase protein consumption in a hospital setting: A field study. International Journal of Behavioral Nutrition and Physical Activity, 12(1), 110-120.

van Kleef, E., Seijdell, K., Vingerhoeds, M. H., de Wijk, R. A., & van Trijp, H. C. M. (2018). The effect of a default-based nudge on the choice of whole wheat bread. Appetite, 121, 179-185.

van Kleef, E., van den Broek, O., & van Trijp, H. C. M. (2015). Exploiting the spur of the moment to enhance healthy consumption: Verbal prompting to increase fruit choices in a self-service restaurant. Applied Psychology: Health and Well-being, 7(2), 149-166.

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