Effects of a thin body shape nudge and other determinants of adolescents’ healthy and unhealthy food consumption in a school setting

Effects of a Nudging Cue Targeting Food Choice in a University Cafeteria: A Field Study

Many students approaching adulthood often choose high-calorie food products. Concurrently, health interventions applied during this life phase can potentially lead to a healthier lifestyle. Nudge health interventions in experimental cafeteria settings have been found to improve eating behavior effectively, yet research in real-world settings is lacking. Accepting nudges as health interventions impacts nudge effectiveness. The present study applies a pretest-posttest design for a period of three consecutive weeks (no nudge, nudge, no nudge), testing the effectiveness of the so-called Giacometti cue on the number of calories purchased in a real-world cafeteria. Students were exposed to the nudge during the intervention week when entering the cafeteria and when choosing their meals. After purchasing a meal, their choice was recorded, and they completed a questionnaire. The Giacometti cue immediately reduced the number of calories purchased (comparing weeks one and two). After nudge removal, an effect was identified, increasing the number of calories purchased (comparing weeks two and three). Contrary to expectations, higher nudge acceptance resulted in more calories purchased. Neither awareness of the nudge's presence when buying food nor the interaction between acceptance and awareness played a role. We explore potential explanations for the Giacometti cue's effects.

A Descriptive Qualitative Study of the Perceptions of Regulatory Authorities, Parents, and School Canteen Owners in the South of Ecuador about the Challenges and Facilities Related to Compliance with the National Regulation for School Canteens

The prevalence of overweight and obesity in the Ecuadorian school population continues to increase. An important factor in children's nutrition is the food offered in school canteens. The objective of this study was to explore the perceptions of the challenges faced by and facilities of school canteens in the provinces of southern Ecuador in terms of complying with national regulations. For this qualitative descriptive study, semi-structured interviews were conducted in 2021 with six school canteen owners, six school directors, five health experts, and seven parents of children attending school from three provinces, Cañar, Azuay, and Morona Santiago, in Ecuador. The data were transcribed and subsequently analyzed in ATLAS ti. The participants indicated several challenges to comply with the regulations of school canteens, such as the expenses generated by them, the lack of control of street food vendors in the surroundings of the schools, and the lack of trained personnel. Regarding the facilities, they highlighted that the regulation for cleaning and hygiene are more easily fulfilled. Standards and control of the food stipend in school canteens are required to ensure a supply of healthy food for the children. Multiple challenges and strategies are proposed to improve the eating habits of the school population and to improve the nutrition of schoolchildren.

Attention to detail: A photo-elicitation study of salience and packaging design for portion control and healthy eating

Evidence demonstrates that food packaging attracts consumers to purchase and has the potential to nudge consumers towards healthy choices, including reducing portion size. However, food purchasing decisions are often automatic and packaging features may go unnoticed. Therefore, it is important to understand what consumers identify as most salient about packaging: what they notice and why, and which elements might nudge consumers towards healthy options and smaller portions of high-energy-density foods. This study explored consumer perception of food packaging, investigated specific features associated with portion control and elicited design ideas to improve packaging for healthy eating and downsizing. A qualitative approach was adopted applying a participant-driven photo-elicitation (PDPE) task with in-depth interviews. Participants were 25 adults living in the UK (aged 20-32 years; 17 females, 8 males, x ¯ BMI = 23 kg/m² ). Participants took photographs of 10 food packages according to salience (n = 5) and portion control (n = 5). These were uploaded to a secure site and then discussed at the interview, which was transcribed and analysed. The salience of packaging was described in terms of trust building, stimulating appetite and relating to self-identity, whereas for portion control, themes included structural reminders, healthy prompts and portion awareness. Packaging can be designed to make health value or serving size more salient by prompting portion control and increasing the attractiveness of packaging. While food purchase decisions happen with little deliberation, when probed, consumers provide useful insights for packaging design to assist portion control.

Are You "Nudgeable"? Factors Affecting the Acceptance of Healthy Eating Nudges in a Cafeteria Setting

Research has identified nudging as a promising and effective tool to improve healthy eating behavior in a cafeteria setting. However, it remains unclear who is and who is not “nudgeable” (susceptible to nudges). An important influencing factor at the individual level is nudge acceptance. While some progress has been made in determining influences on the acceptance of healthy eating nudges, research on how personal characteristics (such as the perception of social norms) affect nudge acceptance remains scarce. We conducted a survey on 1032 university students to assess the acceptance of nine different types of healthy eating nudges in a cafeteria setting with four influential factors (social norms, health-promoting collaboration, responsibility to promote healthy eating, and procrastination). These factors are likely to play a role within a university and a cafeteria setting. The present study showed that key influential factors of nudge acceptance were the perceived responsibility to promote healthy eating and health-promoting collaboration. We also identified three different student clusters with respect to nudge acceptance, demonstrating that not all nudges were accepted equally. In particular, default, salience, and priming nudges were at least moderately accepted regardless of the degree of nudgeability. Our findings provide useful policy implications for nudge development by university, cafeteria, and public health officials. Recommendations are formulated for strengthening the theoretical background of nudge acceptance and the susceptibility to nudges.

Cafeteria Online: Nudges for Healthier Food Choices in a University Cafeteria-A Randomized Online Experiment

Many people do not consume as much healthy food as recommended. Nudging has been identified as a promising intervention strategy to increase the consumption of healthy food. The present study analyzed the effects of three body shape nudges (thin, thick, or Giacometti artwork) on food ordering and assessed the mediating role of being aware of the nudge. Students (686) and employees (218) of a German university participated in an online experimental study. After randomization, participants visited a realistic online cafeteria and composed a meal for themselves. Under experimental conditions, participants were exposed to one out of three nudges while choosing dishes: (1) thin body shape, (2) thick body shape, and (3) the Giacometti artwork nudge. The Giacometti nudge resulted in more orders for salad among employees. The thin and thick body shape nudges did not change dish orders. Awareness of the nudge mediated the numbers of calories ordered when using the Giacometti or thin body shape nudges. These findings provide useful insights for health interventions in occupational and public health sectors using nudges. Our study contributes to the research on the Giacometti nudge by showing its effectiveness when participants are aware (it is effective under conditions where it is consciously perceived).