'Fight fire with fire': Health lessons we can all learn from Big Food

If we are to win the burgeoning public health battle, which is seeing our waistlines expanding as a result of more sedentary behavior and a rise in chronic disease, we need to take a leaf from the book of junk-food marketing.
This is the argument of Ichiro Kawachi, a professor of social epidemiology at Harvard.
“It boils down to changing behavior,” says Kawachi, who spoke at the International Congress of Behavioral Medicine in Melbourne last week.
“We all know what’s good for us and what isn’t, but the problem is very few of us are able to stick to our intentions or align our intentions with our behavior. And that is the great challenge of behavioral management – how do you get people to change behaviors and stick to them?”
This is where behavioral economics, which uses psychological insights into human behavior to explain economic decision-making, can help. As behavioral economics branched into the study of how we eat and move, the food industry swooped.
“All the stuff relevant to health [is] published in marketing journals and consumer journals,” Kawachi says.
While the food industry has used the insights, the public health side has lagged behind, attempting to appeal to our rational brains.
“We have this huge gap in what the two sides are doing, so we need to get on board to fight fire with fire,” Kawachi explains.
THE THREE ‘BIG’ PROBLEMS
“There are three big reasons behavior change is very difficult,” Kawachi says. “The first is that most of the things we advise the public to do – don’t smoke, exercise regularly instead of sitting in front of the TV, drink in moderation etcetera – all these behaviours turn out to have a counter party – a huge industry which stands to make billions of dollars by convincing us to do the opposite.”
The tobacco industry, for example, spends in seven days what the government spends in one year, Kawachi explains.
“They have much deeper pockets than we do … so that’s one huge problem.”
Secondly, many of our behaviors are entrenched in certain social contexts – whether it’s drinking or eating certain foods together, an environment which encourages or allows time for exercise, or the money to afford healthy food each day.
“So, there’s a social inequality aspect that’s hard to address without addressing the structural problem like income inequality,” Kawachi says of the price problem.
Others argue that health foods are not necessarily more expensive, but that junk food simply appeals to our taste buds and our laziness.
The taste and convenience factors are not lost on Kawachi.
“The third reason, I think, is that in trying to persuade people to act healthy, our interventions have often relied on what I think are outdated principles of behavioral design,” he says.
“When you look at how a lot of interventions are carried out … they tend to assume that most people plan or rationalize their way through behaving healthily. In fact that’s not how most of our decisions are made in our daily lives … most of the time we act in a mindless, automatic way based on habit.”
Unwittingly, we make hundreds of food-related decisions each day from how much to eat, to when, to whether to put salt on that or sugar in this.
These decisions are based on things we’re unaware of – what’s accessible, in our line of sight, what looks tasty and even how big our plates and bowls are (the bigger they are, the more we eat, research shows).
“So our behavioral interventions have not addressed this until recently,” Kawachi explains. “We appeal to nutrition and health but we don’t appeal to tasty, so we need to do a better job of using the principles that the other side have been using all along.”
That includes appeals to our emotions instead of our intellect, but not just any emotion.
“If you look at public health advertisements they appeal to fear – we try to scare the bejesus out of people by saying ‘if you don’t do this you’ll get horrible looking lungs or teeth’,” Kawachi says.
Instead we need a more “nuanced” approach, he argues, appealing to our sense of fun, as many junk food advertisers do.
“We need to make activities seem like a challenge or fun, not a duty or obligation,” Kawachi says. “I think we can do a lot better in health communication … Most importantly, don’t mention the word health.
“The moment you try to sell a food as healthy …Your lizard brain says ‘well if it’s healthy it must taste bad’.”
But aren’t gluten-free and sugar-free “health” food sales are going through the roof?
“All that stuff is not done by the health-food people, but by the junk-food marketers,” Kawachi says. “When you look at the preponderance of food labelled gluten-free, transfat-free, this and that free, it’s all junk food.
“The reason why they do that is that, if you are selling food that’s bad for you then it’s an advantage to market it as healthy. Most people know that a bag of chips is tasty – your rational brain is telling you that you better not eat it because you’ll undo the hours you’ve spent at the gym, so the best way to market it is to stick a huge label on the front saying ‘gluten-free’ or ‘organic’.”
LESSONS WE CAN LEARN FROM BIG FOOD
Nudging
Nudging, as the term implies, is subtly pushing us in the desired direction.
Kawachi says this technique can be utilized to push us towards healthier choices.
“There’s a whole series of small things that don’t cost very much that nudge people in healthier directions without them having to think about it too much,” he says. “For example, in a school cafe setting, putting the broccoli at the front of the queue and the chips at the end, near the checkout, has been shown to significantly influence the consumption of broccoli compared to chips because kids just line up and start filling up their plates and they run out of space by the time they come to the end.”
Similarly, research shows that making people pay with cash rather than debit cards or have to line up in a separate queue for discretionary items “significantly decreases consumption of these impulse items” because “it’s a tiny hassle”.
Framing
“The way we frame food items is right now greatly to the advantage of the marketing side, not the public health side,” Kawachi says.
Processed meat, for example, is often sold as being 85 per cent fat free instead of 15 per cent fat, which Kawachi says would “make consumers think twice”.
Similarly, milk fat percentages confuse people.
“Most consumers – including most of my public health team – have no idea what that means,” Kawachi admits. “They think 2 per cent milk means 98 per cent fat-free, which it isn’t. Two per cent milk just means 2 per cent fat by weight, whereas by calories it’s roughly the same as full-fat milk.
“Basically it takes a lot of mental effort to think about these things all the time. So most of us, including me, make all our decisions automatically.” Health promoters need to make sure “that whatever the defaults are in the environment are aligned with our ultimate self interest – to behave healthily without having to make too much of an effort.”
TAKE HOME MESSAGES
We can practise Big Food techniques at home, Kawachi says.
We are, let’s face it, lazy. So we can use that to our advantage, by having apples on the kitchen bench and hiding away foods we want to eat less of (or not having them in the house at all).
We can swap big plates and bowls for smaller ones and even, as Kawachi did when his children were growing up, move the television.
“We moved the television from dining room to the second floor – just moving it one floor up killed their television viewing,” he says, chuckling. “They could still watch it if they wanted, they just couldn’t be bothered.”
He also suggests curfews on wireless at home to encourage a better night’s sleep and exercise.
“It’s just 24/7 unless parents fight back with their own nudges,” Kawachi says.
“These habits are formed early in life – so what you do in your home when your child is still young is going to be very decisive in terms of their lifelong habits.”
* This article was originally written and published on http://www.watoday.com.au/lifestyle/health-and-wellbeing/nutrition/fight-fire-with-fire-health-lessons-we-can-all-learn-from-big-food-20161213-gt9v3b.html