“Use healthy snacks to ruin your appetite!”
-Dr. Arya M. Sharma
Research published in Social Science and Medicine presented evidence of a simple, convenient, and cheap method for eliciting unconscious healthy snack choices in children with excess weight.
This study was conducted by Juan Miguel Benito-Ostolaza, Rebeca Echavarri, Adiadna Garcia-Prado, and Nuria Oses-Eraso at the Institute for Advance Research in Business and Economics and the Public University of Navarre, in Spain.
In high-income countries across the globe, an increased Body Mass Index (BMI) in children has been on the rise for the last 40 years. Obesity is associated with physical disabilities (e.g., issues walking), emotional challenges (e.g., low self-esteem), and health risks (e.g., diabetes). The high prevalence of childhood obesity can be partly attributed to the use of ineffective, fear-instilled approaches that attempt to promote behavior change by focusing on negative health complications.
When presenting children with educational information about food choices, the way in which it is framed matters. Old school methods of improving children’s diets have taken the form of giving information about the risks associated with unhealthy food and benefits associated with healthy food. These outdated methodologies assume that when a child is told about negative consequences related to an unhealthy diet, they will adjust their behavior accordingly. However, this type of intervention has been found to be insufficient to actually change a child’s behavior.
Since eating is a routine behavior, the interventions used to correct obesity need to target both deliberate and unconscious eating behaviors. Food choices are not made simply via conscious decision-making processes alone. Rather, underlying automatic brain processes caused by a cue in the environment tend to have larger influences on food choice.
By implementing small, subtle changes in the environment where decisions about food choices are made, a concept called nudging, one can alter food choice behavior. Nudging can be imposed in relation to food choices in many ways such as: setting rules (e.g., attending an educational program), making healthy choices easier and convenient (e.g., increased visibility of healthy food) and exploiting social norms (e.g., making a desired behavior seem popular).
This study aimed to evaluate the effect of nudging, using positive and negative visual stimuli, on children’s snack choices at school. The visual stimulus was used to investigate automatic associative brain processes in an attempt to guide children’s snack choice through a positive association with healthy food.
Child participants were between the ages of 8- and 9-years old. Overall, 257 children received parental permission to participate, of which 10 were excluded on account of dietary restrictions.
Participants entered a school facility for a mid-morning, pre-lunch snack and were assigned to one of three conditions: control, positive treatment or negative treatment. In the control condition, participants were not exposed to any visual stimulus. The positive treatment condition presented a poster of a happy face emoji surrounded by fruits and vegetables, whereas the negative treatment condition presented an angry face emoji surrounded by heavily-processed and high-in-sugar foods (e.g., donuts).
Once assigned to a condition, one by one, participants were welcomed into a room by the same experimenter (using the same wording) who recorded their height and weight. Located in this room, no more than 1.5 meters away from where a participant was assessed, was a poster (nudging stimulus) with positive or negative stimuli associated with healthy or unhealthy food choices, or no poster at all.
After height and weight were assessed, participants were directed towards a table with a covered box containing two snack choices -- a healthy snack with different types of fruits (e.g., banana) or an unhealthy snack with different highly-processed and high-in-sugar foods (e.g., chocolate cookie). The experimenter then lifted the cover and asked the participant to choose a snack.
Before leaving, participants were also asked about their snack choice during the same break (mid-morning, pre-lunch) from the day before the experiment.
The researchers determined that participants who were nudged with positive visual stimuli were more likely to choose the healthy option, but participants nudged with negative visual stimuli did not exhibit any difference in health-food preference.
However, when considering only participants in the positive stimulus treatment group (e.g., happy face emoji poster) and analyzing the results across genders, the researchers found that a significantly greater proportion of girls chose the healthy snack compared to boys. It was also revealed, in the positive stimulus treatment group, that the proportion of girls without excess weight choosing the healthy snack was higher than the proportion of boys without excess weight.
The results also indicated that in the positive stimulus treatment group, regardless of gender, the proportion of children with excess weight choosing the healthy snack was greater than those without excess weight.
Finally, when boys brought snacks that included fruit on the previous day, they had a higher probability of choosing the healthy snack in all conditions of the experiment. Interestingly, this effect was the opposite for girls.
Previous attempts to curb childhood obesity have not been effective due, in part, to the educational information children receive regarding their food choices. Rather than just scaring children with negative health risks associated with unhealthy food, these findings suggest that adding encouraging nudges towards healthy food can be an effective way to get kids to eat well. These positive associations encourage the unconscious decision-making brain processes to lean towards healthy food choices.