brian wansink, ph.d. food and brand lab cornell university
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Smarter Lunchrooms That Guide Students to Healthier Choices. Brian Wansink, Ph.D. Food and Brand Lab Cornell University. School Nutrition Association – 37 th LAC March 2, 2009. Special Thanks to Three Incredible Colleagues. David Just. Collin Payne. Jennifer Noble. - PowerPoint PPT PresentationTRANSCRIPT
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Brian Wansink, Ph.D.Brian Wansink, Ph.D.
Food and Brand LabFood and Brand LabCornell UniversityCornell University
School Nutrition Association – 37School Nutrition Association – 37thth LAC LACMarch 2, 2009March 2, 2009
Smarter LunchroomsSmarter Lunchrooms That Guide Students to Healthier That Guide Students to Healthier
ChoicesChoices
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2
Collin Payne
Special Thanks to Three Incredible Colleagues
David Just
Jennifer Noble
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Smarter LunchroomsSmarter Lunchrooms That Guide Students to Healthier That Guide Students to Healthier
ChoicesChoices
I’ll finish with helping you think of a I’ll finish with helping you think of a small plan you can start today.small plan you can start today.
I’ll show new 2 studies that show how I’ll show new 2 studies that show how changes can be made to changes can be made to lunchrooms that guide or nudge lunchrooms that guide or nudge students into eating healthier students into eating healthier (without (without compensating later)compensating later)
I’ll start with a overview of I’ll start with a overview of compensation compensation behaviorbehavior
. . . and its key . . . and its key implications for implications for school lunchesschool lunches
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What’s Compensation Behavior?What’s Compensation Behavior?
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What’s Compensation Behavior?What’s Compensation Behavior?
oror
Why do some people Why do some people gain gain weight weight when they go on diets?when they go on diets?
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What Do People Do When They What Do People Do When They Go on Diets?Go on Diets?
The Target BehaviorThe Target Behavior
1) They start exercising1) They start exercising
2) They start eating 2) They start eating low-fat or healthy low-fat or healthy foodsfoods
The Compensating The Compensating BehaviorBehavior
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What Do People Do When They What Do People Do When They Go on Diets?Go on Diets?
The Target BehaviorThe Target Behavior
1) They start exercising1) They start exercising
2) They start eating 2) They start eating low-fat or healthy low-fat or healthy foodsfoods
The Compensating The Compensating BehaviorBehavior
1) They eat more than they 1) They eat more than they burn – “I deserve it”burn – “I deserve it”
2) They overeat the foods 2) They overeat the foods and and they reward they reward themselves later – “I themselves later – “I deserve it”deserve it”
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We Often See Compensating We Often See Compensating Behavior with ChildrenBehavior with Children
What We “Pressure”What We “Pressure”
1)1) ““Clean Your Plate”Clean Your Plate”
2)2) ““Go to your room”Go to your room”
3)3) ““I want you to stop I want you to stop ‘hanging out’ with ‘hanging out’ with Spike”Spike”
What We “Get”What We “Get”
1)1) ..
2)2) ..
3)3) . .
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We Often See Compensating We Often See Compensating Behavior with ChildrenBehavior with Children
What We “Pressure”What We “Pressure”
1)1) ““Clean Your Plate”Clean Your Plate”
2)2) ““Go to your room”Go to your room”
3)3) ““I want you to stop I want you to stop ‘hanging out’ with ‘hanging out’ with Spike”Spike”
What We “Get”What We “Get”
1)1) The next day…poured The next day…poured more snacks more snacks (APedMedicine (APedMedicine 2008)2008)
2)2) More “unacceptable” More “unacceptable” behaviorsbehaviors
3)3) . . .. . .
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If We Were to Tell Students If We Were to Tell Students What to Eat (or not eat) at School, What to Eat (or not eat) at School,
What Compensating Behavior Might We Get?What Compensating Behavior Might We Get?
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Different Compensating Different Compensating Behaviors. . .Behaviors. . .
You can’t eat double chocolate chunk peanut butter cookies at lunch.
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Different Compensating Different Compensating Behaviors. . .Behaviors. . .
I can’t wait until
snack time.I’m going start bringing my own
lunch with whatever I want
I’m going to McCookie King for lunch.
I’m going to have 3 cookies when I
get homeYou can’t eat double
chocolate chunk peanut butter cookies at lunch.
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How Do We Prevent the How Do We Prevent the Compensating Behavior of Compensating Behavior of
StudentsStudents
Nudge them or guide them into making good Nudge them or guide them into making good decisions, decisions, without them realizing itwithout them realizing it..
Change the Lunchroom and we can change Change the Lunchroom and we can change their behaviortheir behavior• We can say “No cookies,” orWe can say “No cookies,” or• We can nudge them into getting an appleWe can nudge them into getting an apple
““Stealth Health” Stealth Health” (Wansink 2006)(Wansink 2006)
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A Example:A Example:
ProblemProblem Bottle-neck in lunch Bottle-neck in lunch
lines at cash registerlines at cash register
Lots of unhealthy Lots of unhealthy food aroundfood around
Kids impulse buy Kids impulse buy unhealthy foodunhealthy food
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A Example:A Example:
ProblemProblem Bottle-neck in Bottle-neck in
lunch lines at lunch lines at cash registercash register
Lots of unhealthy Lots of unhealthy food aroundfood around
Kids impulse buy Kids impulse buy unhealthy foodunhealthy food
Solution 1:Solution 1: Move snacksMove snacks Disad: Lost revenue; Disad: Lost revenue;
won’t do itwon’t do it
Solution 2:Solution 2: Replace unhealthy with Replace unhealthy with
healthy healthy Result: Better & = Result: Better & =
revenuerevenue
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Part II.Part II.
Two Studies on DesigningTwo Studies on Designing
Smarter LunchroomsSmarter Lunchrooms
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School Lunches and BehaviorSchool Lunches and Behavior School lunches offer substantial control ofSchool lunches offer substantial control of
• Content and portions Content and portions • PricesPrices• Eating environmentEating environment• Food environmentFood environment• Choice mechanismChoice mechanism• Payment and parental controlPayment and parental control
High SchoolsHigh Schools• Flexibility in choiceFlexibility in choice• Prepayment accounts (restrictions are possible) and cash payment Prepayment accounts (restrictions are possible) and cash payment
optionsoptions
Debate has focused primarily on content Debate has focused primarily on content
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What to Do?What to Do?
Take “Bad” foods Take “Bad” foods off the Menuoff the Menu
• What’s bad mean?What’s bad mean?• Lower Lower
participation?participation?• Higher food costs?Higher food costs?• Disempowering?Disempowering?
Guide or ”Nudge” Guide or ”Nudge”
Better DecisionsBetter Decisions
• Are there Are there environmental environmental adaptations we could adaptations we could make to help kids make make to help kids make smarter decisions?smarter decisions?
EmpoweringEmpowering Higher participationHigher participation Less subjectiveLess subjective
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How Do You Determine What How Do You Determine What Lunchroom Changes Might Work?Lunchroom Changes Might Work?
Observe 100s of high school lunch periodsObserve 100s of high school lunch periods• Identify empirical anomaliesIdentify empirical anomalies• Screen anomalies Screen anomalies (theory x intervention relevance)(theory x intervention relevance)
• Observational audit Observational audit (power & moderators)(power & moderators)
One anomaly . . .One anomaly . . .• Students who pay with cash buy more healthy foods Students who pay with cash buy more healthy foods
and less unhealthy foodsand less unhealthy foods
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Does Cash Make You Eat Better?Does Cash Make You Eat Better?
Observed & coded 207 Observed & coded 207 cash meal and 212 debit cash meal and 212 debit meal purchasersmeal purchasers
• Milk/water vs. punch/juice/popMilk/water vs. punch/juice/pop• Extra fruit/vegetable vs. dessertExtra fruit/vegetable vs. dessert
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Does Cash Make You Eat Better?Does Cash Make You Eat Better?
Observed & coded 207 cash meal Observed & coded 207 cash meal and 212 debit meal purchasersand 212 debit meal purchasers
• Milk/water vs. punch/juice/popMilk/water vs. punch/juice/pop• Extra fruit/vegetable vs. dessertExtra fruit/vegetable vs. dessert
Findings:Findings:• Cash buyers bought made more positive and fewer Cash buyers bought made more positive and fewer
negative food choicesnegative food choices
Why?Why?• Self-selection?Self-selection?• Debt deferral?Debt deferral?
Invisible money & invisible Invisible money & invisible consequencesconsequences
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Lunch Payment StudyLunch Payment Study
We used the Trillium dining facility at We used the Trillium dining facility at CornellCornell• Serves thousands of students a dayServes thousands of students a day• Used familiar foods; purchased at costUsed familiar foods; purchased at cost
155 (55% male) 18-19 year olds155 (55% male) 18-19 year olds Cafeteria: recruited on-site + creditCafeteria: recruited on-site + credit $10 + $10 toward food$10 + $10 toward food
• Cash, debit, restricted debitCash, debit, restricted debit
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Suppose you had to chooseSuppose you had to choose
Entrees Bacon Cheese Burger $5.00 Chicken Breast $5.00 Turkey Sandwich $4.50 Chicken Fingers (3 pc.) $4.00 Sides Salad $2.00 Baked Potato Chips $1.00 Macaroni and Cheese $2.50 French Fries $1.50 Dessert Brownie $1.50 Peaches $1.00 Drinks Skim Milk $1.00 Soda $1.00 Water $1.50
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ResultsResults
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Restricted Debit Cards Restricted Debit Cards Alter Spending Alter Spending BehaviorBehavior
More on healthy.More on healthy.Less on unhealthy.Less on unhealthy.--------------------------------------------Same overall.Same overall.
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Calorie Intake Differs Widely Calorie Intake Differs Widely Across Payment ConditionsAcross Payment Conditions
More healthy calories.More healthy calories.Less unhealthy Less unhealthy calories.calories.--------------------------------------------Fewer overall calories.Fewer overall calories.
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Food-by-Food Food-by-Food DifferencesDifferences
Students with Restricted Students with Restricted Debit Cards purchase more Debit Cards purchase more of (some of the) of (some of the) healthier healthier
foods foods and less of (some of and less of (some of the) the) less healthy foods less healthy foods than than those using either cash or those using either cash or
debitdebit
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Asking Students to Pay Cash for Asking Students to Pay Cash for Items like Desserts, Fries, and Soft Items like Desserts, Fries, and Soft DrinksDrinks
Decreased how Decreased how much of these much of these items they boughtitems they bought
Increased how Increased how much milk, water, much milk, water, and fruit they and fruit they boughtbought
Conclusion: Making students pay cash for the Conclusion: Making students pay cash for the “indulgences” still gives them the freedom “indulgences” still gives them the freedom
to do so, and doesn’t seem to lead to to do so, and doesn’t seem to lead to compensating behavior (because they had a compensating behavior (because they had a
choice)choice)
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Study 2: Making Vegetables Study 2: Making Vegetables CoolCool
Thanks to theThanks to the
Robert Wood Johnson FoundationRobert Wood Johnson Foundation
(Healthy Eating Research grants)(Healthy Eating Research grants)
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Eating habits in the home don’t end at breakfast…or in
childhood
And healthy food doesn’t exactly top a child’s Top 10 List of favorite food.But what if it did?
Subtle environmental interventions
Changing the name of peas to Power PeasChildren in 1st or 2nd grade took 60% more
It overcame (-) associations with a simple yet “power”ful manipulation
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Which is Tastier?Which is Tastier?
Beans and RiceBeans and Rice
Macaroni and CheeseMacaroni and Cheese
Green beansGreen beans
Traditional Red Beans and Traditional Red Beans and RiceRice
Creamy Macaroni and CheeseCreamy Macaroni and Cheese
Flash-frozen-fresh Garden Flash-frozen-fresh Garden State Green beansState Green beans
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Taking it to the next level Taking it to the next level Introducing favorable Introducing favorable
icons with healthy icons with healthy foodsfoods• Induce healthy food Induce healthy food
choicechoice• Invoke positive Invoke positive
thoughtsthoughts
Stickers Stickers (also low cost and (also low cost and effective)effective)
Cookies are now a “sometime food”
Color
Toy
Cartoon Character
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Tomato/Carrot Lunch Study• Effects of label “X-ray vision carrot” on post treatment• Data points: M, Tu, Th, F• Kids were exposed to: Food of the Day (FoD) AND/OR X-
ray vision carrots (Xray) conditions on Tue and Thu (M-baseline, F-post treatment).
• Thus, some kids were exposed to FoD twice, some kids Xray twice, and some kids both FoD and Xray (randomized).
• Kids were asked to take and eat carrots (DV: # of carrots taken and eaten)
Descriptive Words and Healthy Eating (3)
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-5
-4
-3
-2
-1
0
1
2
3
4
5
FoD Xray
carr
ots
tak
en c
om
par
ed to b
asel
ine
•Related-sample t test comparing participants exposed to FoD twice with those exposed to Xray twice on carrots taken on post treatment compared to baseline, t(49) = -1.78, p = .08
Descriptive Words:Carrot Results
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Significant influences of environmental factors (e.g., package size and label) on eating.
These findings can be used to increase the intake of healthy foods (e.g., cereals and fruit).
General Findings
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Subtle environmental Subtle environmental interventions in creative menu interventions in creative menu
namingnaming
Low-costLow-cost Low involvementLow involvement Simple yet powerful—important to find ways to Simple yet powerful—important to find ways to
decrease obesity ratesdecrease obesity rates Can make changes without burdening the Can make changes without burdening the
school food budgetschool food budget Immediately adopt and tailor to your situationImmediately adopt and tailor to your situation
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Does This Work in the Long-Term?Does This Work in the Long-Term?
This is not a positive This is not a positive reinforcement/intervention scenario (no reinforcement/intervention scenario (no room cleaning reward)room cleaning reward)• These often failThese often fail
It enhances, or makes more salient, foods It enhances, or makes more salient, foods to convey a + meaningto convey a + meaning• What was the 2What was the 2ndnd favorite kid’s food in 1928? favorite kid’s food in 1928?
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PART 3: NEXT STEPSPART 3: NEXT STEPS
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Possible Next Steps . . .Possible Next Steps . . .
1. Share your own Smarter Lunchroom ideas at 1. Share your own Smarter Lunchroom ideas at www.SmarterLunchrooms.orgwww.SmarterLunchrooms.org
2. Consider . . .2. Consider . . .HS: Cash payments for “indulgences”HS: Cash payments for “indulgences”
Elementary: Ask a new staffer to play the Name GameElementary: Ask a new staffer to play the Name Game
3. Become a research partner (or media partner)3. Become a research partner (or media partner)
4. Pilot a new program with us 4. Pilot a new program with us
5. Be a model “Lunchroom of the Future”5. Be a model “Lunchroom of the Future”(Criteria: New facility, HS, media-friendly, wide menu, not high income) (Criteria: New facility, HS, media-friendly, wide menu, not high income)
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Thank Thank YouYouPossible Next Steps . . .Possible Next Steps . . .
1. Share your own Smarter Lunchroom ideas at 1. Share your own Smarter Lunchroom ideas at www.SmarterLunchrooms.orgwww.SmarterLunchrooms.org
2. Consider . . .2. Consider . . .HS: Cash payments for “indulgences”HS: Cash payments for “indulgences”
Elementary: Ask a new staffer to play the Name GameElementary: Ask a new staffer to play the Name Game
3. Become a research partner (or media partner)3. Become a research partner (or media partner)
4. Pilot a new program with us 4. Pilot a new program with us
5. Be a model “Lunchroom of the Future”5. Be a model “Lunchroom of the Future”(Criteria: New facility, HS, media-friendly, wide menu, not high income) (Criteria: New facility, HS, media-friendly, wide menu, not high income)
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Lunchroom of the FutureLunchroom of the Future
New Middle School in ______New Middle School in ______ Designing a Lunchroom of the Designing a Lunchroom of the
FutureFuture Objective:Objective:
• Start from the bottom upStart from the bottom up• Provide a vivid profile of what a Provide a vivid profile of what a
Healthy Choice Lunchroom will look Healthy Choice Lunchroom will look likelike
Launch in Fall 2010 Launch in Fall 2010
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Next Steps Next Steps
Suggestions about studiesSuggestions about studies Synergy ideas with other USDA Synergy ideas with other USDA
centerscenters• Food and Nutrition ServicesFood and Nutrition Services• Other areas?Other areas?
Implementation ideasImplementation ideas Dissemination issuesDissemination issues
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Thank youThank you
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www.MindlessEating.orgwww.SmallPlateMovement.org
www.foodpsychology.cornell.eduwww.foodpsychology.cornell.eduEducation Resources:Education Resources: Lesson plans, in-class exercises, posters, cartoons Lesson plans, in-class exercises, posters, cartoons
Science Fair Grants (K-12 + 4-H):Science Fair Grants (K-12 + 4-H): Book royalty proceeds Book royalty proceeds
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