A few weeks ago, I was listening to a radio interview with Sheena Iyengar who was discussing the research she did for her new book The Art of Choosing. Iyengar is a professor at Columbia University School of Business and a well-known expert on the study of choice – how we make choices and how they affect our lives. It is a subject close to the heart of anyone working in the field of chronic disease treatment and prevention with its focus on getting people to make the choices-particularly about diet and exercise– necessary to stay healthy. Study after study has confirmed that educating individuals about risks and how to avoid them isn’t enough to trigger behavior changes. So what else should we be doing?
Over the past few years we’ve been listening to a national debate about how to address America’s obesity epidemic, which is costing us $147 billion each year and is a major contributor to diabetes, heart disease and some forms of cancer. It has also become an epidemic among our children, with one in six classified as obese.
Last month when the First Lady launched her Let’s Move campaign aimed at reducing childhood obesity, questions about choice were very much a part of the conversation. Who and what are responsible for creating this problem? Americans are ambivalent about the question, with many believing it is a matter of individual choice. But public health officials see it a different way. They believe that we need to change our “obesogenic” environment, which promotes increased food intake, unhealthful foods and physical inactivity. Tom Frieden, who heads the Centers for Disease Control, is the lead author on a compelling article in Health Affairs about how to tackle the problem. And there is no ambivalence in his prescription for change:
“Reversing obesity is not going to be done successfully with individual effort. It will be done successfully as a society only with societal effort…We got to this stage of the epidemic because of a change in our environment. And only a change in our environment again will allow us to get back to a healthier place…”
One way the Let’s Move campaign hopes to change the environment is by helping parents make healthier choices for their families, including the choices they make in their supermarkets each week. We know that the current nutrition labeling on the side or back of packages is not doing the trick. Reading the labels, which are based on serving size and percentages of daily allowance, takes time and requires a parent to do multiple mental calculations while standing in a grocery store, often with the children in tow. Research here and abroad suggests that simplified, front-of-pack labeling is far more effective in helping parents make healthy choices.
At the recent Food Summit sponsored by the Atlantic, FDA Commissioner Peggy Hamburg talked about steps the FDA is taking to alter the environment in supermarkets in a way that will signal consumers about healthy choices without requiring them to examine the back of a package and solve math problems in their heads while shopping. FDA is in the process of developing front-of -pack labeling guidelines that will supplement, rather than replace, the current nutrition labeling. Hamburg and her group are fielding research to test a number of options and will be collaborating with industry to identify and implement the most effect approaches.
One option they are examining is the system the UK put In place a few years ago. Their system of “traffic light labeling” puts color coded symbols on the front of food packages to alert consumers to the amount of fats, saturated fats, sugars and salts. The actual ingredient is written next to the light. Red lights indicate the food is high in an ingredient that we should be limiting in our diets. Yellow lights mean that a product isn’t high or low in a particular category and green signals the healthiest choices. The notion is that a system like this one would allow parents to make quick decisions at-a-glance when faced with the sometimes overwhelming number of choices that confront them in the average American shopping aisle.
Back to Dr. Iyengar and her research on choice: During her interview, Iyenger told a fascinating story about research conducted several years ago on consumer preference for Coke vs. Pepsi. Researchers used MRI technology to measure the response of subjects to sips of soda preceded by different signals. Each subject was told that each sip might or might not be Coke, but, in fact, only Coke was being used. In half the cases, sips of soda were preceded by a picture of a Coke can while the other half were preceded by a light. Three out of every four subjects preferred the taste that was preceded by the Coke image even though they were never drinking anything but Coke. Seeing the Coke can also lit up the MRI with stimulated activities in other parts of the subjects’ brains associated with previous emotional experiences. In Dr. Iyengar’s words, people were “tasting the brand,” rather than the soda.
Wouldn’t it be wonderful if we could find a front-of-pack image for healthy foods that would light up our brains the same way and help us make better choices for ourselves and our children?