How food overconsumption has hijacked our notions about eating as a pleasurable activity

The negative effects of overconsumption of food have been extensively studied, with a focus on overweight and negative food attitudes. In this overview, we argue that this negative perspective has spilled over to food consumption in general, which is in contrast with eating as a pleasurable activity that contributes to people's well-being. We review four areas of research that have recently emerged: (de)moralization of food consumption, moderate eating for pleasure, intuitive and mindful eating, and the social benefits of eating. Throughout these four themes, it becomes clear that there needs to be a clear distinction between overconsumption of food, bearing negative consequences, and normal levels of food consumption. The latter is positively associated with enjoyment, contentment, and our social and psychological well-being

Misperceived eating norms: Assessing pluralistic ignorance in the food environment

The current food environment communicates the social norm that it is normal to consume large amounts of unhealthy and unsustainable foods. However, it is unknown whether people endorse this norm because they agree with it, or whether they endorse it because they overestimate the degree to which other people agree with this norm – a phenomenon that is labeled as ‘pluralistic ignorance’. We examined the possible presence of pluralistic ignorance by corroborating previous pluralistic ignorance literature in the food environment among a large representative sample of community residents (N = 433). In addition, we aimed to better assess pluralistic ignorance by comparing multiple dimensions, including how participants perceived themselves and other people in the importance, frequency, normalcy, and intentions of consuming healthy and sustainable food. We analyzed the perceptions with paired t-tests and our findings show that participants considered themselves to be healthier and more sustainable eaters than other people on all four dimensions. However, they did not think that other people were eating unhealthy or unsustainable. Participants themselves held low intentions to eat more healthily or sustainably and believed others had similar low intentions. Together, these findings reveal that there is a discrepancy between the perception of oneself and others regarding healthy and sustainable eating norms, which may suggest pluralistic ignorance. However, it is unclear whether this discrepancy would actually influence behavior, as suggested by the pluralistic ignorance literature, since people consider themselves healthier and more sustainable consumers who may not adjust their standards to perceptions of other people. We speculate they may use this discrepancy as justification in order to be complacent. In the discussion we consider these implications and next steps for future researc

Personal values, motives, and healthy and sustainable food choices: Examining differences between home meals and restaurant meals

People are increasingly eating out in restaurants, where meals tend to be higher in calories, less nutritious, and contain more meat. In this paper, we argue that differences in the motivational processes underlying people’s food choices could help to explain why food choices made in restaurants are typically unhealthier and less sustainable than at home. Using online survey data from 301 Dutch participants, we compared the influence of stable personal values and transient food choice motives on the healthiness and sustainability of meals chosen in a hypothetical choice task, which was geared to the home and restaurant consumption contexts. As expected, participants opted for unhealthy and meat-based meals more often in the restaurant than the home context. Conservation values related negatively and self-transcendence values positively to choosing sustainable meals both in the home and in the restaurant context, although the relation with self-transcendence values was significantly weaker in the restaurant context. Also, taste and social eating were considered more important for choosing restaurant meals, while health was a more important motive for food choices at home. Finally, model comparisons revealed that motives were better predictors of healthy meal choices in both contexts, while the influence of values and motives on sustainable meal choices was more similar. In conclusion, the results from the present study enhance our understanding of differences between choosing home and restaurant meals by providing an account of the values and motives associated with the healthiness and sustainability of home and restaurant meal choices

Make it a habit: how habit strength, goal importance and self-control predict hand washing behaviour over time during the COVID-19 pandemic

Objective: Hand washing has been at the core of recommendations and guidelines that aim to curb infectious diseases in general, and COVID-19 in particular. As hand washing comes down to an individual’s behaviour, we aimed to study how individual psychological variables influence hand washing over time during the COVID-19 pandemic. Design: Over the course of 20 weeks, participants answered questions about their hand washing behaviour, goal importance, habit strength and self-control. Participants from an experimental and a control condition completed a baseline and final measurement, and the experimental condition was invited to bi-weekly measurements through reminders. Main outcome measure: Hand washing behaviour over the past 14 days was assessed by self-report at baseline and final measurement, and additionally repeatedly over the course of 20 weeks in the experimental condition. Results: Hand washing behaviour decreased over time, but this decrease was buffered by habit strength and goal importance. The decrease was smaller in the experimental condition that received reminders every 2 weeks. Conclusion: Sending personal reminders on hand washing behaviour contributes to hand washing behaviour. Moreover, taking habit strength and goal importance, and to a lesser extent self-control into account is important when designing interventions to promote hand washing behaviour

Using misperceived social norms as a license: does pluralistic ignorance trigger complacency in the food environment?

The current food environment strongly communicates the normality of consuming unhealthy and unsustainable food products. However, it is unclear whether people truly support this unhealthy and unsustainable social norm, or that they follow the norm (reluctantly) because they believe that other people agree with it, a phenomenon that is generally known as pluralistic ignorance. While previous research has documented the existence of pluralistic ignorance in a variety of settings, it is unknown to what extent it directly influences behavior and which mechanism may account for this influence. The present study examines whether the perception that others seem to agree with unhealthy and unsustainable eating norms acts as a license to not change one’s eating behavior and leads to complacency. We assessed pluralistic ignorance by comparing self- and other-scores on the importance, frequency, normalcy, and intentions dimensions of consuming healthy and sustainable food in a large sample of Dutch participants (N = 415). To investigate the effect of pluralistic ignorance on self-licensing and complacency, we calculated healthy and sustainable ‘misperception scores’ per dimension. Healthy eating misperceptions only marginally predicted self-licensing, but healthy misperceived intentions did predict an increase in complacency. Sustainable eating misperceptions seem more influential because misperceptions on importance and frequency predicted an increase in self-licensing, and sustainable misperceived normalcy predicted a decrease in complacency and intentions predicted an increase in complacency. These findings suggest that pluralistic ignorance may be more influential in sustainable eating since people could be uncertain what appropriate sustainable food choices are. Prospects for future research and suggestions to address pluralistic ignorance to potentially increase healthy and sustainable food choices are discussed

Prompting vegetable purchases in the supermarket by an affordance nudge: Examining effectiveness and appreciation in a set of field experiments

The supermarket is a promising location for stimulating healthier food choices by nudging interventions. However, nudging healthy food choices in the supermarket has shown weak effects to date. The present research introduces a new nudge based on the concept of affordances – i.e., an animated character – that invites interaction with healthy food products and examines its effectiveness and appreciation in a supermarket context. We present findings of a series of three studies. In Study 1, evaluations of the new nudge were collected, revealing that the nudge was appreciated. In Studies 2 and 3, field experiments were conducted to test the nudge's effect on vegetable purchases in a real-life supermarket. Study 3 demonstrated that vegetable purchases increased significantly (up to 17%) when the affordance nudge was placed on the vegetable shelves. Furthermore, customers appreciated the nudge and its potential for implementation. Taken together, this set of studies presents compelling findings illustrating the potential of the affordance nudge for increasing healthy choices in the supermarket

The role of attention and health goals in nudging healthy food choice

Introduction: Nudging is a promising intervention technique that supports people in pursuing their healthy eating goals. Recent research suggests that, despite previous assumptions, disclosure of the presence of a nudge does not compromise nudge effectiveness. However, it is unknown whether attention to a nudge affects nudge effects. We assessed the role of attention systematically, by examining explicit and implicit attention to nudges, while also exploring healthy eating goals as a potential moderator. Methods: Participants were assigned to a nudge (i.e., a shopping basket inlay with pictures of healthy items) or control condition (i.e., a shopping basket inlay with neutral pictures) and chose a snack in an experimental supermarket field study. Explicit and implicit attention (with a mobile eye-tracker) to nudges, healthiness of snack choice, and healthy eating goals were assessed.  Results: Results showed that attention to the nudge did not hamper the nudge’s effect. Furthermore, individuals with strong healthy eating goals made healthier food choices in the nudge condition. Individuals with weak to non-existent healthy eating goals were not influenced by the nudge.  Discussion: Findings are in line with the viewpoint that nudging does not by definition work ‘in the dark’, and suggests that nudges support people in adhering to their healthy eating goal

Participant recruitment, baseline characteristics and at-home-measurements of cardiometabolic risk markers: insights from the Supreme Nudge parallel cluster-randomised controlled supermarket trial

Background: Recruiting participants for lifestyle programmes is known to be challenging. Insights into recruitment strategies, enrolment rates and costs are valuable but rarely reported. We provide insight into the costs and results of used recruitment strategies, baseline characteristics and feasibility of at-home cardiometabolic measurements as part of the Supreme Nudge trial investigating healthy lifestyle behaviours. This trial was conducted during the COVID-19 pandemic, requiring a largely remote data collection approach. Potential sociodemographic differences were explored between participants recruited through various strategies and for at-home measurement completion rates.  Methods: Participants were recruited from socially disadvantaged areas around participating study supermarkets (n = 12 supermarkets) across the Netherlands, aged 30–80 years, and regular shoppers of the participating supermarkets. Recruitment strategies, costs and yields were logged, together with completion rates of at-home measurements of cardiometabolic markers. Descriptive statistics are reported on recruitment yield per used method and baseline characteristics. We used linear and logistic multilevel models to assess the potential sociodemographic differences.  Results: Of 783 recruited, 602 were eligible to participate, and 421 completed informed consent. Most included participants were recruited via letters/flyers at home (75%), but this strategy was very costly per included participant (89 Euros). Of paid strategies, supermarket flyers were the cheapest (12 Euros) and the least time-invasive (< 1 h). Participants who completed baseline measurements (n = 391) were on average 57.6 (SD 11.0) years, 72% were female and 41% had high educational attainment, and they often completed the at-home measurements successfully (lipid profile 88%, HbA1c 94%, waist circumference 99%). Multilevel models suggested that males tended to be recruited more often via word-of-mouth (ORfemales 0.51 (95%CI 0.22; 1.21)). Those who failed the first attempt at completing the at-home blood measurement were older (β 3.89 years (95% CI 1.28; 6.49), whilst the non-completers of the HbA1c (β − 8.92 years (95% CI − 13.62; − 4.28)) and LDL (β − 3.19 years (95% CI − 6.53; 0.09)) were younger.  Conclusions: Supermarket flyers were the most cost-effective paid strategy, whereas mailings to home addresses recruited the most participants but were very costly. At-home cardiometabolic measurements were feasible and may be useful in geographically widespread groups or when face to face contact is not possible.  Trial registration: Dutch Trial Register ID NL7064, 30 May 2018, https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7302

Real-world nudging, pricing, and mobile physical activity coaching was insufficient to improve lifestyle behaviours and cardiometabolic health: the Supreme Nudge parallel cluster-randomised controlled supermarket trial

Background: Context-specific interventions may contribute to sustained behaviour change and improved health outcomes. We evaluated the real-world effects of supermarket nudging and pricing strategies and mobile physical activity coaching on diet quality, food-purchasing behaviour, walking behaviour, and cardiometabolic risk markers. Methods: This parallel cluster-randomised controlled trial included supermarkets in socially disadvantaged neighbourhoods across the Netherlands with regular shoppers aged 30–80 years. Supermarkets were randomised to receive co-created nudging and pricing strategies promoting healthier purchasing (N = 6) or not (N = 6). Nudges targeted 9% of supermarket products and pricing strategies 3%. Subsequently, participants were individually randomised to a control (step counter app) or intervention arm (step counter and mobile coaching app) to promote walking. The primary outcome was the average change in diet quality (low (0) to high (150)) over all follow-up time points measured with a validated 40-item food frequency questionnaire at baseline and 3, 6, and 12 months. Secondary outcomes included healthier food purchasing (loyalty card-derived), daily step count (step counter app), cardiometabolic risk markers (lipid profile and HbA1c via finger prick, and waist circumference via measuring tape), and supermarket customer satisfaction (questionnaire-based: very unsatisfied (1) to very satisfied (7)), evaluated using linear mixed-models. Healthy supermarket sales (an exploratory outcome) were analysed via controlled interrupted time series analyses. Results: Of 361 participants (162 intervention, 199 control), 73% were female, the average age was 58 (SD 11) years, and 42% were highly educated. Compared to the control arm, the intervention arm showed no statistically significant average changes over time in diet quality (β − 1.1 (95% CI − 3.8 to 1.7)), percentage healthy purchasing (β 0.7 (− 2.7 to 4.0)), step count (β − 124.0 (− 723.1 to 475.1), or any of the cardiometabolic risk markers. Participants in the intervention arm scored 0.3 points (0.1 to 0.5) higher on customer satisfaction on average over time. Supermarket-level sales were unaffected (β − 0.0 (− 0.0 to 0.0)). Conclusions: Co-created nudging and pricing strategies that predominantly targeted healthy products via nudges were unable to increase healthier food purchases and intake nor improve cardiometabolic health. The mobile coaching intervention did not affect step count. Governmental policy measures are needed to ensure more impactful supermarket modifications that promote healthier purchases. Trial registration: Dutch Trial Register ID NL7064, 30 May 2018, https://www.onderzoekmetmensen.nl/en/trial/2099

Real-world nudging, pricing, and mobile physical activity coaching was insufficient to improve lifestyle behaviours and cardiometabolic health: the Supreme Nudge parallel cluster-randomised controlled supermarket trial

Background: Context-specific interventions may contribute to sustained behaviour change and improved health outcomes. We evaluated the real-world effects of supermarket nudging and pricing strategies and mobile physical activity coaching on diet quality, food-purchasing behaviour, walking behaviour, and cardiometabolic risk markers. Methods: This parallel cluster-randomised controlled trial included supermarkets in socially disadvantaged neighbourhoods across the Netherlands with regular shoppers aged 30–80 years. Supermarkets were randomised to receive co-created nudging and pricing strategies promoting healthier purchasing (N = 6) or not (N = 6). Nudges targeted 9% of supermarket products and pricing strategies 3%. Subsequently, participants were individually randomised to a control (step counter app) or intervention arm (step counter and mobile coaching app) to promote walking. The primary outcome was the average change in diet quality (low (0) to high (150)) over all follow-up time points measured with a validated 40-item food frequency questionnaire at baseline and 3, 6, and 12 months. Secondary outcomes included healthier food purchasing (loyalty card-derived), daily step count (step counter app), cardiometabolic risk markers (lipid profile and HbA1c via finger prick, and waist circumference via measuring tape), and supermarket customer satisfaction (questionnaire-based: very unsatisfied (1) to very satisfied (7)), evaluated using linear mixed-models. Healthy supermarket sales (an exploratory outcome) were analysed via controlled interrupted time series analyses. Results: Of 361 participants (162 intervention, 199 control), 73% were female, the average age was 58 (SD 11) years, and 42% were highly educated. Compared to the control arm, the intervention arm showed no statistically significant average changes over time in diet quality (β − 1.1 (95% CI − 3.8 to 1.7)), percentage healthy purchasing (β 0.7 (− 2.7 to 4.0)), step count (β − 124.0 (− 723.1 to 475.1), or any of the cardiometabolic risk markers. Participants in the intervention arm scored 0.3 points (0.1 to 0.5) higher on customer satisfaction on average over time. Supermarket-level sales were unaffected (β − 0.0 (− 0.0 to 0.0)). Conclusions: Co-created nudging and pricing strategies that predominantly targeted healthy products via nudges were unable to increase healthier food purchases and intake nor improve cardiometabolic health. The mobile coaching intervention did not affect step count. Governmental policy measures are needed to ensure more impactful supermarket modifications that promote healthier purchases. Trial registration: Dutch Trial Register ID NL7064, 30 May 2018, https://www.onderzoekmetmensen.nl/en/trial/2099