As Loudly As We Demand Better Health Choices, We Must Demand A Better Environment
This post originally appeared in June in Huffington Post Healthy Living, under the title “If We Want People To Eat Real Food, We Must Make It Easier To Eat Real Food.” It has been reposted here with permission by the author, population health consultant and friend of NBE, Brad Stulberg.
I want to commend Mark Bittman on the underlying message in his recent editorial in the New York Times, “What Causes Weight Gain.” Bittman suggests that as much as we need research to “determine precisely what causes diet related chronic illnesses,” we also need a program that will get this “single, simple message across: eat real food.” While we have yet to isolate what in our diet is contributing to obesity and related disease, it is likely not the sugar in an apple, the fat in an almond, or the sodium in beets. So while we work on identifying what is causingAmerica’s weight problem, a broad campaign telling people to “eat real food” is a good first step in reversing the trend.
But if we are serious about that message, we need to make eating real food a whole lot easier, and recognize that people may need a little help. The burgeoning field of Behavioral Science (e.g., Behavioral Economics, Cognitive Psychology) shows that people often fail to make rationale decisions that are in their best self interest, even when they want to.
For example, if you ask people if they would prefer fruit or chocolate as a snack at a meeting next week, the vast majority say fruit. But when next week comes around and you present the same group with both fruit and chocolate, most take the chocolate.
Another powerful principle founded in Behavioral Economics is the effect of the default option: people tend to select the default, or in other words, “go with the flow,” even when the desicion is on serious matters such as finance or whether to donate one’s organs. These are just two of many examples that illustrate the influence of context and environment on our decisions.
In their hit book Nudge, Richard Thaler and Cass Sunstein coin the term “choice architecture,” and encourage both policy makers and individual actors to proactively design environments that will help (or nudge) people to make decisions consistent with their true preferences. One of the biggest take-aways from Behavioral Economics is that environment matters, and often outweighs individual willpower.
I’ve experimented with this myself and found that when I stock the kitchen with just real food, I eat real food. But when I stock the kitchen with a mix of real food and highly processed junk food (or what some experts have called “food-like substances”) I eat the crap. This should come as no surprise since nearly every element of junk food is scientifically engineered to be addictive — from amount of added sugars, to the texture, to the packaging it comes wrapped in.
Take this outside of my personal kitchen and the odds of making a healthful eating choice only get worse. Walk the aisles of your local grocery store and see what is at eye level (you’ll have a greater chance of selecting these foods). My guess is the vast majority of it is not real food. Check what types of snacks are offered by the cash registers in the “impulse buy” section of the store. I doubt you’ll find ready-to-eat packs of fruits and vegetables.
Unfortunately, grocery stores are just the tip of the iceberg. Everything from restaurants, to convenience stores (which substitute for grocery stores in some low-income areas), to even some school meal programs are environments that make junk food the path of least resistance and/or default option. When it comes to eating healthy, the deck is rigged against us.
If we are going to invest in a broad campaign telling people to “eat real food,” we must also invest in a broad campaign to make eating real food an “easier” choice to make. This is no small task, and will require policy that favors “choice architecture” that is likely to upset the food industry. It is at least a five- to 10-year project, but one we must commit to if we are serious about confronting obesity. In the mean time, stock your kitchen with only real food.
Brad Stulberg is a population health consultant for a large integrated health care system, as well as a freelance writer. His work has appeared in Huffington Post Healthy Living, NPR Boston, The LA Times, and Men’s Fitness. You can find more of his work at his website, bradstulberg.com, and you can follow him on twitter: @BStulberg