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Sticker Shock: Can We Make Temptation Less Tempting?

Liking fries, not in spite of, but because they're unhealthy with permission
Source: with permission

"We like fries not in spite of the fact that they're unhealthy but because of it." So said Malcolm Gladwell, author of Blink and The Tipping Point, in an article written some years ago in The New Yorker. He added, "... nothing is more deadly for our taste buds than the knowledge that what we are eating is good for us." Gladwell was discussing how McDonald's French fries came to be so perfectly and reliably cooked every time. The problem, though, is that they became not much more "than a delivery vehicle for fat." Over the years, the fries have become somewhat healthier as they are no longer cooked in trans fats or, to the delight of vegetarians, in beef tallow. But as we all know, Americans generally don't go to McDonald's to eat healthy. The hamburger, the McLean Deluxe, for example, explained Gladwell, was then an unmitigated failure, even though in blind taste tests, people actually thought the healthier burger tasted better. But once people knew it was healthy, they rejected it.

Ten years later, are we eating any better now that calories are clearly posted in our fast food chain restaurants? In fact, some of us are suffering from "sticker shock:" we had been notoriously poor at estimating the calorie count in many of our favorite foods despite an interest in watching our calories. For example, who had any idea that one piece of Starbuck's reduced fat Very Berry (even sounds healthy) Coffee Cake could have 350 calories and 10 grams of fat, a piece of pumpkin bread could have 390 calories and 15 grams of fat, or one raspberry scone could have 500 calories and 26 grams of fat? Has knowledge of these calorie counts had any effect on our consumption? Apparently, so far, not so much!

A recent study, published in the American Journal of Public Health, by Tamara Dumanovsky and her colleagues, is the second part of an earlier study sponsored by the New York City Health Department. This previous study, before the mandated posted calorie counts, found that one in three customers in fast food restaurants was purchasing as many as 1000 calories for lunch alone--half of a full day's recommendations for adults. In 2008, New York City became the first state to mandate "clear and conspicuous" calorie postings. This most recent study, sampling around 1200 adults,(representing 15 different chains) compared consumption three months before the mandated calorie posting and then three months after. Though customers varied by fast food chain in how much they were actually cognizant of the posted calorie counts, (e.g. 87% of McDonald's customers but only 70% of customers at Starbucks, for example), in general, only about 27% of customers (and a substantially lower percentage in older customers) said that the calorie information actually affected their purchases. Though the percentage of customers who were aware of calorie counts had increased considerably after the mandate, the proportion of those using the information was still quite low (on average, from one in four to one in five, depending on age, location of the restaurant, etc.) The researchers concluded that calorie postings, while clearly increasing awareness of nutritional information, seem not necessarily to have had a major impact yet in getting the majority of us to make healthier choices. with permission
Source: with permission

Part of the problem is that we have so many options among our food choices. And we can make choices based on many factors, as for example, when we choose foods on the basis of cost or convenience. Cognitively, we are, of course, capable of choosing a less desirable alternative for reasons such as health. In that sense, we are different from other species. Imagine, for example, a carnivorous animal having an internal dialogue about whether to choose the grass (e.g. salad) rather than eat its kill or even whether to eat a second animal once it is full from the first.

One of the most puzzling questions, though, is why we humans choose to eat foods when we know they are unhealthy and even seem to prefer these unhealthy foods. In other words, why is providing nutritional information about the fat, sugar, and salt content of fast food not necessarily enough for the majority of people? The answer is not an obvious one. After all, humans are probably unique in the animal kingdom for being capable of extrinsic motivation in its full form. This is motivation as a means to something else, according to psychologist Roy Baumeister, who has his own blog, Cultural Animal. Our cognitive abilities enable us to visualize potential outcomes. This is different from intrinsic motivation-or motivation to satisfy our own immediate needs. And we are capable of self-regulation-we can reconsider and stop an action. Sometimes, though, this extrinsic motivation fails us: we either lose sight of or minimize future benefits (e.g. maintaining a healthy weight) in favor of immediate wishes to indulge. The challenge is to make temptation less tempting: align short-term and long-term goals to reduce any discrepancy between short-term and long-term consequences.

More from Sylvia R. Karasu M.D.
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