Everyone with an interest in health—or just with open eyes—knows that obesity has reached epidemic levels, and not just in the rich world. More than 50 percent of men in Tonga and 50 percent of women in Kuwait, Kiribati, Micronesia, Libya, Qatar, Tonga and Samoa are obese (compared with 34 percent of women in the United States).
Now the business world is starting to pay attention. A McKinsey report published just last week,Overcoming obesity: An initial economic analysis, estimates the economic impact of obesity at US$2 trillion annually, or 2.8 percent of global GDP. Reacting to this publication, the Financial Times explained that this is almost equal to the global cost of war and terrorism. The Economist has also been diligently documenting the massive impact of obesity on everything from earnings to marriages.
The McKinsey report summarised what we know about the effectiveness of 44 interventions aimed at reducing obesity. Unsurprisingly, the report recommended a multi-pronged approach requiring engagement from governments, educators, healthcare providers, individuals, but also the food industry. The problem is that these solutions focus on taxation, restriction, warning, and, more generally, promoting long-term health over the short-term pleasure of eating on which the food industry is currently built. No wonder then that these measures are bitterly opposed by the food industry in areas ranging from labelling laws to what food can be served in school lunches.
Can “big food” actually help fight obesity?
I can already imagine my friends and colleagues in health science rolling their eyes at this question. Not only do they see food marketing as one of the major contributors of the obesity crisis (and they are right, as I have made myself clear in a recent review paper). They have concluded that big food cannot possibly play “any constructive role” in this crisis and that they are just as bad, or perhaps even worse than “big tobacco.”
The research I have conducted at INSEAD over the last 10 years shows that it is possible to improve public health while preserving the economic health of a vital sector of our industry. But before we get to the solution, we need to understand why companies cannot simply choose to sell healthier foods or reformulate them to be healthier.
Let them sell broccoli
I know that some parents have been able to train their kids to love salad and spurn chocolate, but they are the exception. Neonatal facial expressions in infant humans, apes, monkeys and lemurs show happiness after tasting sugar but express disgust after tasting bitter tastes.
Source: Steiner et al. 2001
Still unconvinced? Watch this hilarious television commercial for Crest toothpaste showing, in hidden camera, how kids react to vegetable-based healthy Halloween candies.
And it’s not just children. In this video, George H.W. Bush, explains that he does not like broccoli, that his mother made him eat it, but as President of the United States he’d decided not to eat it anymore. That’s why Mondelēz launched Broccolu, its newest healthy snack, on April 1st (a joke, of course).
Health halos and the limits of food reformulation
Because big food can’t just switch to selling broccoli, they have invested a lot effort and science to improve the nutritional quality of the food that people enjoy by removing salt, sugar and fat. This is all good until consumers find out. When people think that food has been “improved” to be healthier (i.e., “processed”), they react in two ways that are both negative from a business and healthy eating standpoint.
The first response, most common among men, is to reject the “Frankenfood” because they cannot believe that food can be both healthy and tasty—which is and will remain the number one factor driving food choices. This explains why food companies have often experimented with food reformulation for their “healthier” sub-brands (say nonfat yoghurt), while leaving their main brands untouched—and unimproved. Or they have stealthily improved their food without trumpeting it, and therefore without getting any credit for it.
The second response, which is particularly common among people who are dieting or overweight, is to choose the healthier food but eat more of it—a lot more. With my colleague Brian Wansink, we bought M&M’s® and told people that they were “low-fat” M&M’s or just regular M&M’s. The results? Consumption increased by 16 percent among people with a normal weight and by 46 percent for people who were overweight. Worse, people expected that their calorie intake had stayed the same because, as they said “if they are low-fat, they have fewer calories and you can eat more, right?” Wrong. A “low-fat” label means that the amount of fat has been reduced by at least 30 percent, but it says nothing about calories. Often, the number of calories stays the same because the fat is simply replaced with more sugar.
Source: Wansink & Chandon 2006
Nutrition claims are not the only way foods acquire this “health halo” which leads to overeating. In another study conducted at INSEAD, I showed that people underestimate the calorie content of foods that are generally considered healthy and overestimate it for the foods that are considered unhealthy (a sort of “health horn” if you like). For example, people think that a can of Minute Maid® apple juice with no sugar added contains 43 percent fewer calories than a can of Coca-Cola® when it actually has 10 percent more calories.
From quality to quantity?
As I hope these examples have made clear, the food industry cannot fight obesity just by improving the nutritional quality of the portfolio of foods that it sells. Because people care first and foremost about taste, then value and convenience, and only then (and not always) about health, it is absolutely impossible to improve the healthiness of food if people even just imagine that taste is compromised. I believe that a solution lies in complementing this “qualitative” approach with a more quantitative one.
Rather than “improving” the food, let’s keep the taste that people love but market it in such a way that they are willing to pay more for less of it. Making more by selling less to happier consumers could be a triple win for public health, business, and eating enjoyment. How? By improving the perception of food portion and package sizes and by marketing on the sensory pleasure of eating, rather than on value. I will present the evidence that it is possible in a future post on “Business-Friendly Solutions to Fight Obesity”. Those who are in a hurry can already see it in the scholarly articles that I have written on this topic.
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Anonymous User
Labelling with info. on calories, legislated is a sure way to get public attention forcing foods producers to comply. The cost of Obesity should be broadcast in all mass media.
suggestions to improve, if not already considered.Anonymous User
Recent action in the US under the Affordable Care Act will require calorie counts on all menus of chain restaurants. How this will impact consumer choice remains to be seen but there are some interesting studies from New York City.
One food executive said he envisioned smaller portions to keep calories down. He was issuing it as somewhat a threat but many saw it as a positive.
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Anonymous User
30/12/2014, 08.04 am
Dear Professor,
Your magic words: "a business-friendly solution".
But we are talking about a public health problem. A heavily regulated issue, and correctly so. A problem that will be addressed by health authorities, just like vaccination, drug addiction, influenza, ebola have. The industry that is making its profits in the current environment should adapt to regulatory restrictions, and most of its action has been to prevent label disclosures, to mix information, to mislead the consumer and so on. There is no excuse just like there was no excuse for tobacco industry. The two are very similar. So here's a suggestion for your next research: school menu diet and long-term implications in forming consumer attitudes to food, packaging, labelling and meal preparation. You can do in same country, different schools and demographics, or across countries comparing for example Japan with the UK. You may find that children indeed like vegetables in some parts of the world.
Finally, please add Pubmed to your research habits. Your language on calories is outdated but it will not be difficult to catch up.