Using Behavioral Economics in School Cafeterias to Promote Healthier Eating Prepared for Urban and Environmental Policy Institute By Liz Bartlett, MPH

Transcription

1 Using Behavioral Economics in School Cafeterias to Promote Healthier Eating Prepared for Urban and Environmental Policy Institute By Liz Bartlett, MPH Food Service Directors Challenge In recent years, there has been a major push to improve the nutritional quality of meals served in schools through the National School Lunch Program. While many school districts have made great strides in increasing the nutritional quality of the foods that they serve, others face significant hurdles in implementing these important but difficult changes. At the very root of the challenge of serving nutritious food in schools is the need to resolve the tension between working within budget constraints and offering menu options that students find appealing. Adding to this tension is the reality that the less healthy items that many students prefer are often the highest-margin foods on the menu. Food service directors challenge is to balance these three elementsstaying within budget, meeting student satisfaction, and offering nutritious meals. Sometimes, this balancing act may feel like an impossible task. The growing discipline of behavioral economics offers innovative and promising strategies to improve nutrition of school meals without hurting financial solvency. The following overview is designed to provide an introduction to this field, and to examine some of its applications for school food services.

2 Introduction to Behavioral Economics in Food Choice Behavioral economics as applied to food choice and consumption is a field pioneered by self-proclaimed behavioral engineer Dr. Brian Wansink, a professor in the Applied Economics and Management Department at Cornell University. In his words, this emerging discipline combines the behavioral models of psychology with the decision models of economics to highlight how biases in perception, memory or thought processes may influence purchasing decisions [1]. Through observational studies as well as extensive experimental research in his own Food and Brand Lab at Cornell, Dr. Wansink has formulated theories that explain how the environment affects our eating habits and taste preferences. He theorizes that the way that our food is labeled, presented and served can substantially influence what kinds of food we eat and the quantities that we consume. More recently, Dr. Wansink has developed strategies to promote healthier eating in schools in a movement he has dubbed Smarter Lunchrooms. Behavioral economics can be used as a tool to help identify triggers that lead to consumption (and overconsumption) foods- either healthy or less healthy- in school cafeterias. Dr. Wansink s Smarter Cafeteria strategies aim to engineer the cafeteria environment to create cues that have been demonstrated to subtly influence food selection decisions. Why Behavioral Economics Strategies Work in School Cafeterias Behavioral economics strategies may make a more lasting impact on students eating habits than severely restricting food availability. The strategies were devised based on the principle that people display characteristics of reactance and self-attribution. Reactance describes the phenomenon that when people feel coerced into doing something, they often react by rebelling. When dietary changes are imposed from the outside, these changes are unlikely to stick with the individual; instead, she or he will return to favored foods when the restrictions are no longer in place. In contrast, according to the principle of self-attribution, when people feel they have made a decision for themselves, they are more likely to take ownership of that decision. The ability to take ownership in decision-making will better serve individuals in uncontrolled, real-world environments where options are available. The next section briefly summarizes the key elements of Wansink s concepts and guidelines. Each element is then described in more detail in the following section of this report.

3 Summary of Key Smarter Lunchroom Concepts 1. Use appetizingly descriptive food labels to entice students to choose healthier options 2. Present healthy foods in attractive displays to increase their desirability 3. Increase or decrease salience (noticeability or prominence) of healthy or unhealthy foods: a. Display healthy items in visible, easy to access places b. Place unhealthy items in less prominent and less accessible places 4. Understanding that availability of choice increases consumption, a. Increase number of choices for fruits and vegetables b. Decrease number of choices for desserts and chips 5. Incentivize purchase of an entire healthy meal by pre-packing and offering it in an express line that minimizes wait time 6. Systemize verbal prompts to select a healthier item from cafeteria staff 7. Provide trays, for ease of carrying healthier side items like salads and fruit 8. Understanding that size of serving utensils and dishes affects amounts of consumption, a. Opt for smaller dishes and serving implements for desserts and other less healthy items b. Use larger dishes and serving implements for salads and healthy sides

4 Key Behavioral Economics Strategies for Optimizing Healthful Nutrition in School Cafeterias 1. Use Descriptive Food Labels for Healthy Foods One of the easiest, least expensive, and most powerful behavioral economics strategies to influence students food choice is to use descriptive food labels. Research shows that the addition of appetizing names for foods can increase their sales by 27% [2]. Furthermore, use of such labels has shown to have a positive effect on consumers enjoyment of the food, and overall attitudes toward the cafeteria. Practical Application: In your cafeteria, this strategy can help you highlight healthy menu items with labels that entice students to select them. Use vivid adjectives to pique students expectations about the quality and taste of these food items. Dr. Wansink presents several themes to use to help with creating appetizing food labels: 1. Sensory Labels: Heighten expectations of healthy menu items by describing the taste, smell, and feel of the food. Examples: Snappy Seasonal Carrots, Velvety Vanilla Bean Yogurt with Succulently Sweet Mixed Berries, Creamy Carrot Soup 2. Nostalgic Labels: Use words that trigger associations of family, tradition, national origin, and wholesomeness. Examples: Abuela s Secret Black Bean Soup Recipe, Classic Old World Rigatoni, Triple Gold Medal Homemade Veggie Chili 3. Geographic Labels: Use words that bring to mind specific geographic regions- by either naming the regions themselves, or creating imagery associated with a place. Examples: Yucatan Coast Frijol con Puerco, Shanghai Nights Chicken and Broccoli Stir-fry, Pacific Shores Fish Fillets

5 2. Create Attractive Displays Displaying healthy foods in attractive bowls or baskets is another effective, lowcost strategy to increase the nutritional quality of foods selected and consumed in school cafeterias. Researchers led by Dr. Wansink observed a 58% boost in fruit sales in a New York school after they moved the cafeteria s fruit from a stainless steel tray into an attractive basket lit with an ordinary desk lamp [3]. In another study of simple cafeteria alterations, the same strategy more than doubled fruit sales [4]. Practical Application: Making similar changes in your cafeteria should require very little cost and energy. Think about which healthy foods could be displayed more attractively- some examples are whole fruit or packages of baby carrots. Visit a store that sells discount housewares and select an appropriately-sized attractive bowl to display these items. Get creative with the display, combining use of lighting or signage to further highlight the healthy items. 3. Alter Salience of Healthy and Unhealthy Foods When Dr. Wansink discusses a food s salience within a cafeteria, he is referring to its prominence or conspicuousness. When food is displayed at the front of the lunch line, at eye level, or at locations along the lunch line where waiting occurs, that food has a high degree of salience. The placement of food can have a dramatic impact on its demand. Placing healthy foods like vegetables at the front of the line has increased their sales by 10-15% [5]. Another prominent place to display healthy foods is wherever students must wait. This may often occur at the end of a lunch line, near the cash register. Placing foods that can be selected as healthy impulse buys is another strategy that can be used to improve nutrition in cafeterias. Fruit and other easy-to-grab, healthy snacks may be the best items to situate near the cash register. One school

6 in New York quadrupled its fruit sales simply by moving the fruit near the cash register, and placing it in an attractive bowl [5]. Increasingly, schools are adding salad bars to their daily offerings, but many schools report low use among their students. Oftentimes, increasing the salad bar s salience by moving it to a prominent place in the cafeteria can dramatically change its popularity. Dr. Wansink s team found in one school that moving a salad bar away from the wall and relocating it in front of the cashier nearly tripled sales [4]. Practical Application: To maximize students selection of healthy foods, place vegetables at the start of the lunch line, and fruits and other healthy snacks at the end of the lunch line, where students wait to pay. Move the salad bar to a position in the cafeteria where students will have to walk past it. And move less healthy food away from prominent positions in the cafeteria, avoiding their placement in eye-level displays and at slow-moving places in the line. 4. Increase Variety for Healthier Foods, Decrease Variety for Unhealthy Foods Studies have shown that the availability of a greater variety of a food type will lead to increased consumption of that food. This finding is particularly significant in a climate where it is estimated that only 35% of students who attend schools that require students to take a vegetable actually consume their vegetable [6]. In an experiment involving 240 junior high students split into two groups, Dr. Wansink found that students who had a choice between two vegetables were far more likely to eat their vegetable than those who were forced to take the only

7 vegetable available. While only 69% of the students who were required to take carrots actually ate them (83 out of 120), 91% of the students who selected carrots in the group who had a choice between carrots and celery consumed their vegetable (94 out of 103) [6]. This important finding can be applied in reverse to junk food. Offering a smaller variety of chips, desserts, and the like can lead to an overall decrease in consumption of these foods [7]. Practical Application: In your cafeteria, offer a very limited amount of choice in desserts, chips, and the like, while allowing several choices for fruits, veggies, and other healthy items. 5. Create Time-Saving Incentives with an Express Checkout for Prepackaged, Healthful Meals Another promising strategy relies on a cafeteria s compatible infrastructure and an adequate number of staff. Schools that have adequate resources can offer a healthy express line that will save students valuable time during lunch period as an incentive for buying a healthy meal. Creating this time incentive for nutritious food choices can double the sales of these healthy meals [4]. Practical Application: If your school has the resources to do so, consider creating a cafeteria line designated for students who do not select chips or dessert or any other predetermined, unhealthy items. Another, perhaps easier option is to create an express line for people buying pre-packaged healthy meals that are quick to pick up and purchase. For this strategy, a snack counter or outdoor kiosk would work well as a point of sale.

8 6. Systemize Verbal Prompts from Cafeteria Staff at Checkout Another easily employable strategy for boosting healthy food sales is to request that cafeteria workers ask students if they would like an additional healthy item upon check out. Studies have shown that when a cafeteria worker suggests that a student take a piece of fruit, the number of children eating (not just taking) fruit increases by 70% [9]. At another school, when cafeteria workers began asking students if they wanted a salad, salad sales increased by one third [4]. Practical Application: Train staff to ask students if they would like a piece of fruit, a salad, or a healthy side when they check out. 7. Offer Use of Trays for Ease of Carrying Side Salads and Vegetables The ease or difficulty with which students are able to carry their food can have an impact on which foods they select. Many schools have stopped offering trays in an effort to minimize waste. However, in an experiment at a college cafeteria, Dr. Wansink and his team of researchers discovered that while there was no decrease in the amount of waste generated by the students who did not have access to trays, changing this factor led students to take 26% fewer salads [6]. Despite the decrease in vegetable consumption, Wansink observed that consumption of desserts did not drop proportionately; only 8% fewer desserts were taken when trays were not made available [6]. Practical Application: Have trays readily available for students use, particularly for schools that feature salad bars and side plates of vegetables and fruits.

9 8. Offer Appropriately-Sized Serving Dishes and Implements The size of plates, bowls, and serving utensils all act as perceptual prompts influencing how much food people serve, and ultimately eat. Even in the case where these perceptual cues are inappropriately sized (usually because they are too large), people often still use them as markers indicating suitable amounts for consumption. Multiple studies show that people who use large plates, bowls, and glasses consistently consume between 22-31% more food or fluid than those with smaller eating and drinking vessels [8]. Practical Application: Serving containers and implements should be well matched for the foods that they are intended for. Plates that hold desserts should be small to limit dessert consumption. Plates located at the salad bar, however, should be larger to accommodate more vegetables. This particular strategy may not be feasible in cafeterias that utilize one plate for all their offerings. However, such cafeterias could still stock a variety of serving utensils for serving a range of entrees and sides. The spoon that serves taco meat should be smaller than the one used for steamed vegetables. The difference in size will act to subconsciously guide students in serving appropriate portions of each food. Conclusion Behavioral economics offers simple, cost-effective strategies that can substantially change nutritional intake of students dining in school cafeterias. These strategies can be employed to introduce new healthy items in a way that students will be more likely to try and enjoy them. The strategies can also be used to increase the popularity of a cafeteria s current healthier offerings. Since behavioral economics methods are easy and inexpensive to implement, feel free to be creative and experiment with different strategies. Track changes to learn what is working, and which strategies might need further refinement. Ask for feedback from your students to understand what appeals most to them. Learn more about Smarter Lunchrooms, and share your experiences with other food service directors and cafeteria managers at the website below. For More Information:

10 References [1] Just, DR, Wansink, B. (2009) Smarter lunchrooms: Using behavioral economics to improve meal selection. Choices 24(3) [2] Wansink, B, Painter, JM, Van Ittersum, K. (2001) Descriptive menu labels effect on sales. Cornell Hotel and Restaurant Administrative Quarterly 42(6)68-72 [3] Cornell Food & Brand Lab (2010, June 4). How smarter school lunchrooms increase fruit sales. ScienceDaily. Retrieved from /releases/2010/06/ htm [4] Wansink, B (2011, March) Smarter lunchrooms and smarter houses: From mindless eating to mindlessly eating better [PowerPoint slides]. Paper presented at the Annual Eat Smart New York Conference- Mindless Eating, It s a Snap! Albany, NY Retrieved from: [5] Lewine, E. (2011) Meal plan. Hemispheres Magazine. Retrieved from: [6] Just, DR & Wansink, B. (2009) Smarter lunchrooms: Using behavioral economics to improve meal selection. Choices: The Magazine of Food, Farm and Resource Issues 24(3) [7] Just, DR, Mancino, L, Wansink, B. (2007) Could behavioral economics help improve diet quality for nutrition assistance program participants? (USDA and Economic Research Service publication, report number 43) Washington, DC. [8] Wansink, B. (2004) Environmental factors that increase the food intake and consumption volume of unknowing consumers. Annual Review of Nutrition [9] Swartz, MB (2007) The influence of a verbal prompt on school lunch fruit consumption: A pilot study. International Journal of Behavioral Nutrition and Physical Activity 4(6), 5