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© 2008, Johns Hopkins University. All rights reserved.
Impact of environmental factors
on individual food choices
Sara N Bleich, PhD
World Health Summit
October 21, 2012
© 2008, Johns Hopkins University. All rights reserved.
Obesity Trends Among US Adults
BRFSS, 1990, 2000, 2010
Behavioral Risk Factor Surveillance System, CDC
2000
2010
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
© 2008, Johns Hopkins University. All rights reserved. Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health
examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 2011.
© 2008, Johns Hopkins University. All rights reserved.
Outline
• Behavioral economics and food choice
• Impact of environmental factors on consumer food choices
• Implications for policy
© 2008, Johns Hopkins University. All rights reserved.
We do not behave rationally
• Standard economic theory assumes that individuals maximize their own wellbeing BUT decisions that prevent individuals from reaching rationally intended goals play a significant role in food choices
• Individuals invest upwards of $40 billion dollars annually to restrict their own eating behavior in the form of diet plans
Klein S. Does paying for obesity therapy make cents? Gastroenterology. 2005; 128: 530.
© 2008, Johns Hopkins University. All rights reserved.
Outline
• Behavioral economics and obesity
• Impact of environmental factors on consumer food choices
• Implications for policy
© 2008, Johns Hopkins University. All rights reserved.
Portion sizes play a role in how much we eat
• People consume 30% more calories when offered the largest portion than when offered the smallest portion
• Larger portions led to greater calorie intake
Rolls BJ, Morris EL, Roe LS. Portion size of food affects energy intake in normal-weight and overweight men and women. The
American journal of clinical nutrition. Dec 2002;76(6):1207-1213
© 2008, Johns Hopkins University. All rights reserved.
Visual cues influence consumption
Example: Give some people soup in self-refilling soup bowls, half had normal bowls; ask them to rate the soup and estimate how much they ate
• People given self refilling bowls ate 73% more
• The groups perceived that they ate the same amount
• Both groups thought they ate less
• People in the self refilling bowl condition did not feel more full
Wansink, B., Painter, J.E., North, J., 2005. Bottomless bowls: why visual cues of portion size may influence intake. Obes Res
13 (1), pp. 93-100.
© 2008, Johns Hopkins University. All rights reserved.
Variety increases consumption
• Having many different choices (colors, flavors) increases consumption
• People offered an assortment of 10 colors of jellybeans ate 43% more than those offered 7 colors
• People offered the jellybeans in a mixed assortment ate 69% more than those offered jellybeans sorted by color
Wansink B. Environmental factors that increase the food intake and consumption volume of unknowing consumers. Annu Rev
Nutr 2004;24:455-79.
© 2008, Johns Hopkins University. All rights reserved.
Impulse marketing
• Encourages spur-of-the-moment, emotion-related purchases that are triggered by seeing the product or a related message
• Goods placed in prominent end-of-aisle locations
account for about 30% of all supermarket sale1
• Vendors pay a slotting fee to retail markets to guarantee
that their products will be placed in these locations
• Placing products in prominent locations or spots
where consumers will see them at the end of their
shopping journey can increase their sales by as
much as a factor of five2
1Sorenson H. Inside the mind of the shopper. Upper Saddle River, NJ: Pearson Education, 2009. 2Curhan RC. The effects of merchandising and temporary promotional activities on the sales of fresh fruits and vegetables in
supermarkets. J Mark Res 1974;11:286-294
© 2008, Johns Hopkins University. All rights reserved.
Why are we so responsive to the environment?
• People lack the capacity to fully control their eye gaze, and what they look at the longest is the strongest predictor of what we will buy
• Most purchasing decisions are made very quickly and automatically without substantial cognitive input, usually in less than a second
• Choices of foods high in fat and sugar are made more quickly than healthy food choices
• Even when trying to make healthful choices, our ability to
resist palatable foods declines when we are distracted, under
stress, tired, etc
• Most people don't recognize that the placement of products influences their purchases or eating behavior and typically deny the existence of contextual influences, even when they are pointed out
Wedel M, Pieters R. Visual marketing: from attention to action. New York: Taylor & Francis Group/Lawrence Erlbaum
Associates, 2008; Thomas M, Desai KK, Seenivasan S. How credit card payments increase unhealthy food purchases: visceral
regulation of vices. J Consumer Res 2011;38:126-139
l.
© 2008, Johns Hopkins University. All rights reserved.
© 2008, Johns Hopkins University. All rights reserved.
© 2008, Johns Hopkins University. All rights reserved.
© 2008, Johns Hopkins University. All rights reserved.
Take home messages
• Food choices are often automatic and made without full conscious awareness
• Food choices DO NOT reflect true preferences
• A large proportion of people claim that they want to lose
weight but only a small proportion who are actually able
to do so → human behavior doesn't always conform
with states goals
• What and how much people eat are highly influenced by contextual factors that they may not recognize and therefore cannot easily resist
Cohen et al (2012). Candy at the Cash Register — A Risk Factor for Obesity and Chronic Disease. New England Journal of
Medicinel.
© 2008, Johns Hopkins University. All rights reserved.
Outline
• Behavioral economics and obesity
• impact of environmental factors on consumer food choices
• Implications for policy
© 2008, Johns Hopkins University. All rights reserved.
Behavioral economic principles for policy
change • Policies should encourage healthier eating without
restricting the choices available to the individual or reducing the profit opportunity of the food manufacturer
• Policies that address unconscious consumer behaviors may be effective in creating both greater profits for the marketer and better health outcomes for the consumer
Just, D.R., Payne, C.R., 2009. Obesity: Can Behavioral Economics Help? Annals of Behavioral Medicine 38 pp. S47-S55.l.
© 2008, Johns Hopkins University. All rights reserved.
An example of a policy alternative based
on behavioral economics • Current US law prohibits marketers from claiming that a
certain type of packaging could discourage overeating
• This policy removes the possibility of marketers profiting from selling food packaged to reduce consumption
• A government agency could provide a third party certification for portion size norms similar to organic foods
• Therefore, a company that wishes to label their foods as a healthy portion would submit their packaged foods to a government process to determine if the packaging encourages healthy levels of consumption
Just, D.R., Payne, C.R., 2009. Obesity: Can Behavioral Economics Help? Annals of Behavioral Medicine 38 pp. S47-S55.l.
© 2008, Johns Hopkins University. All rights reserved.
Research needed to inform policy
• More research needed to identify which marketing strategies place people at risk or undermine their health
• This kind of knowledge should be applied in informing
regulations that could govern the design and placement
of foods in retail outlets to protect consumers
• Test new approaches to reduce risk such as limiting the types of foods that can be displayed in prominent end-of-aisle locations
• Harnessing marketing research to control obesity could
help millions of people who desperately want to reduce
their risks of chronic diseases
Cohen et al (2012). Candy at the Cash Register — A Risk Factor for Obesity and Chronic Disease. New England Journal of
Medicine.
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