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3 Strategies for Eating Healthier—Which One Works Best?

There's new research on the most effective strategies for changing behavior. Which one is best at helping you eat healthier?

By
Monica Reinagel, MS, LD/N, CNS,
Episode #547
eating healthier

Could your eating habits be better?

You’re in good company. Despite decades of haranguing by parents, health professionals, government agencies, and podcasters, the average American is still eating too much sugar and highly processed foods and too few fruits and vegetables. We’re taking in too many calories and too few nutrients. As a result we’re both overweight and undernourished.

The causes of our dietary discretions are well-documented. The proliferation of cheap, high-calorie, and  hyper-palatable food and beverages, as well as the normalization of huge portion sizes and constant snacking have created an environment and culture in which it takes super-human effort and willpower to not overeat. 

The question: How do we change all this? Put calories on restaurant menus? Hide the ice cream in the back of the freezer? Serve dinner on smaller dinner plates? Post healthy eating messages in cafeterias, breakrooms, and on our refrigerators at home? 

You name it, someone has tried it. And many of these strategies work—at least a little. But are any of them really making a dent? 

Best ways to promote healthy habits

What are the most effective ways to encourage healthy behaviors that will ultimately result in improved health? A pair of French researchers (Romain Cadario and Pierre Chandon) set out to find out. They identified 96 research studies that employed various strategies for nudging people toward healthy choices and compared their results to determine which seemed to be most effective. 

In this particular study, the researchers calculated how each nudge impacted total daily calorie intake. Now, admittedly, reducing calories is not the only way a nudge might improve your nutrition. But with obesity being such a primary concern, it’s certainly relevant. And this metric does allow us to compare the effects of a lot of different types of interventions. 

A nudge was defined as anything that altered people’s behavior without outright forbidding something or using economic incentives.

A nudge, in this case, was defined as anything that altered people’s behavior without outright forbidding something or using economic incentives. For example, if an employer wanted to encourage their employees to drink less soda and more water, they could remove all the soda from the vending machines or double the the price of the soda in so that bottled water was much cheaper. But neither of those would be nudges.

A nudge is something that influences the choices that you make (or, in the language of the researchers, alters the choice architecture) without removing your ability to make or afford a different choice. The researchers found that nudges divided themselves into three categories.

Nudge type #1: What you know

Cognitive strategies try to affect what you know. They aim to make you think a bit more before making a selection or taking a bite. Cognitive nudges include things like adding calorie counts to restaurant menus. Or, in the case of our employer who wants their employees to drink less soda, a cognitive nudge might be to hang a poster next to the soda machine showing how much sugar is in a 20-ounce bottle of soda. Another type of cognitive nudge is using logos or icons to identify healthier choices. Putting a heart icon on higher fiber cereals or a broccoli icon next to lower calorie menu items would both be examples of this type of nudge

Over the past ten or twenty years, a lot of energy and money has been invested in cognitive nudges, like adding calorie counts to menus and changing the way calories are displayed on packaged foods. Unfortunately, of the three types of nudges, cognitive strategies are the least impactful. In terms of average impact on calorie intake, cognitive nudges reduced typical intake by about 64 calories.

Nudge type #2: How you feel

The second category of nudges are affective strategies. These try to change the way you feel about a food or a behavior, without necessarily changing what you know. Affective nudges include applying appealing words and images to healthy choices—instead of offering you a side of carrots, I offer you citrus-infused Spring carrots. On a menu, I might include beautiful photographs of the salads but not the fried foods. 

Affective strategies focus on making certain foods more desirable or influencing how you feel about a certain choice.

Another type of affective nudge is known as “healthy eating calls.” This is when a sign or a server suggests that a certain choice is more desirable. “Would you like to split a dessert?” Or, “We can substitute a salad for the fries, if you prefer.” or, “Our pasta also comes in half-portions.”   

Instead of trying to inform you about the nutritional attributes of a food, affective strategies focus on making certain foods more desirable or influencing how you feel about a certain choice.  Appeals to the senses and emotions are somewhat more effective than appeals to reason. In terms of reducing calorie intake, affective nudges are almost twice as impactful as cognitive ones, reducing energy intake by about 130 calories a day, or 7.5%.

Nudge type #3: What you do

The third category of nudges are behavioral strategies. These try to change what you do without necessarily affecting what you know or feel. In fact, behavioral nudges can function without you even being aware of them. 

One popular category of behavioral nudge is making the healthy choice the easy choice. For example: placing green salads in convenient grab-and-go containers at the center of the store but having the fried chicken in the back of the store, where you have to wait in line for a deli worker to put it in a container for you.  

Another example of this type of behavioral nudge is to put the vegetables and grilled salmon and other healthy items at the beginning of a buffet line and the less nutritious items (like biscuits or macaroni and cheese) at the end, when you have less room on your plate. 

Use smaller plates and containers for calorie-dense items, like pasta, chips, or soda, and larger plates and containers for low calorie dishes like salads, vegetables, water, and cut fruit.

A third example of a behavioral nudge is to use smaller plates and containers for calorie-dense items, like pasta, chips, or soda, and larger plates and containers for low calorie dishes like salads, vegetables, water, and cut fruit. 

As you may have anticipated, the behavioral nudges were the most effective of all. Overall, they reduced calorie intake by more than 200 calories or 12%.  And in particular, changing the size of portions and plates was the most effective of the behavioral strategies, reducing calorie intake by more than 300 calories per day.   

If this strategy sounds familiar, it’s probably because I was just talking about this very concept in my episode on portion distortion and how to reset it. 

Why research matters

The results of this analysis show why research like this is so valuable. We’ve tried a lot of different ways to push back against an environment that seems hell bent on making us heavier and less healthy than we want to be. And the most effective strategies are up to six times more impactful than the least effective strategies—which, up until now, have been where we’ve been investing most of our resources. 

It turns out that, when it comes to making healthier choices, knowing more doesn’t always translate into doing better.

It turns out that, when it comes to making healthier choices, knowing more doesn’t always translate into doing better. But we are powerfully impacted by ease and convenience. 

How can you take advantage of this in your own home and life? How can you make the healthy choice easier and more convenient for yourself and your family members? Things like keeping healthy choices front and center and unhealthy foods out of sight really can make a difference. Serving dinner on smaller plates and wine in smaller glasses can too. For more strategies, see my articles on Why we Overeat and Ending Portion Distortion

And for more support on creating the mindset, habits, and behaviors that lead to weighing less without dieting, join our the free Weighless Life Facebook Group.

ABOUT THE AUTHOR

Monica Reinagel is a board-certified licensed nutritionist, author, and the creator of one of iTunes' most highly ranked health and fitness podcasts. Her advice is regularly featured on the TODAY show, Dr. Oz, NPR, and in the nation's leading newspapers, magazines, and websites. Do you have a nutrition question? Call the Nutrition Diva listener line at 443-961-6206. Your question could be featured on the show. Stay in the nutrition loop! Listen and subscribe to the Nutrition Diva show on Apple, Spotify, or wherever you get your podcasts.

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About the Author

Monica Reinagel, MS, LD/N, CNS

Monica Reinagel is a board-certified licensed nutritionist, author, and the creator of one of iTunes' most highly ranked health and fitness podcasts. Her advice is regularly featured on the TODAY show, Dr. Oz, NPR, and in the nation's leading newspapers, magazines, and websites. Do you have a nutrition question? Call the Nutrition Diva listener line at 443-961-6206. Your question could be featured on the show. 

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