Nutritional psychology is an interdisciplinary field wherein nudges, features of choice architecture, can be used to influence healthy eating. 

Nutritional psychology is an interdisciplinary field that sits broadly at the intersection of psychological, behavioral, psychosocial, cognitive, and nutritional sciences.¹ The concept of “nudging” stems from the work of Nobel Laureate Richard Thaler and Holberg Prize winner Cass Sunstein,^2,3 and is an element of decision-making architecture that and can be used to “nudge” people toward making a particular decision while not restricting options or coercing a particular behavior to occur. Together, nutritional psychology and nutritional nudges could help patients with obesity and diabetes eat healthy and lose weight.

Overview: Nudging and Nutritional Psychology

Nudges are designed such that a person’s decision-making context is changed in a way that facilitates predictability in their behavior. By modifying the environment in which a decision is made, nudges facilitate selecting a preferred option while not restricting choices or options. For example, by automatically enrolling employees into 401K contributions, people are nudged toward saving for retirement (employees can always opt out). In the context of nudging toward healthy eating, a person’s environment can be changed so that healthy food options are more visible and more accessible. For example, in a study examining decisions regarding fruits and vegetables in a cafeteria, changing the variety and range of options so that fruits and vegetables were more dominant resulted in greater consumption.⁴

Nutritional psychology explores how the foods people consume affect their health outcomes, emotions, brain health, and overall psychological well-being. Nutritional psychology is comprised of the following sciences:¹

• Psychological: mood, emotions, feelings, well-being
• Behavioral: craving, conditioning, availability, homeostatic and hedonic eating
• Cognitive: decision making, attention, memory, reward, learning
• Sensory-perceptual: sight, smell, taste, touch, palatability
• Interoceptive: hunger, satiety, craving
• Psychosocial: environment, social norms, social modeling, social facilitation

Because nutrition and psychological health are intertwined, it is important to consider how nutritional psychology and food choice architecture can effect positive change and positive health outcomes and to what extent individuals can be nudged toward healthy eating.

Nudging Attention toward Healthy Food

In a recent study examining the role of attention and health goals (N = 95; Mage = 35.96; SD = 12.79),⁵ researchers found that bringing one’s attention to a nudge did not diminish the nudge’s effect and that individuals with strong healthy eating goals made healthier food choices when nudged. Those individuals who had weak or no healthy eating goals were not influenced by the nudge.

Participants were recruited as they entered a grocery store and then assigned to a nudge condition or a control condition. In the nudge condition, there was a picture of a healthy snack on the bottom of the shopping basket, and in the control condition there was a neutral picture in the bottom of the basket.

Participants wore mobile eye tracking glasses to measure implicit (out of conscious awareness) and explicit (conscious awareness) attention and were instructed to select a snack from the store. Implicit attention was measured by fixations, i.e., time spent looking at the image on the image in the shopping basket, and explicit attention was a self-reported measure related to the picture. Healthy eating goals were also assessed by measuring participants’ responses to the following statement, “I think it is important to eat healthy (1 = totally disagree / 7 = totally agree). BMI, general snacking habits, store familiarity, and hunger were also assessed.

Results suggest that participants in the nudge condition paid more explicit attention but not implicit attention to the picture compared to counterparts in the control condition. It should be noted that there was no main effect of nudging on snack choice (healthy vs not healthy) irrespective of attention to the nudge. However, for those participants in the nudge condition who had strong healthy goals, the nudge did lead to a healthy snack choice.

Participants in the nudge condition who did not have healthy eating goals were not more likely to select a healthy snack. This result is interesting because it speaks to the debate on nudges and whether they could be used to manipulate behavior and restrict a person’s autonomy or agency in decision making. This study provides some evidence for autonomy and agency in the context of food choice architecture such that participants did select a non-healthy snack despite being in the nudge condition. It appears that nudging individuals to select a healthy food option might work only when there is some commitment to eating healthy.

Implications for Clinical Practice

Nutritional psychology may help patients with obesity or diabetes better understand their relationship with food and their food choices. Working with patients to help them understand how their food behavior (e.g., craving, conditioning, availability, homeostatic and hedonic eating) and cognitions (e.g., decision making and attention) influence food choices may shed light on where some disconnects lie and subsequently help patients calibrate their healthy eating goals with their behaviors. Supplementing weight loss efforts for patients with obesity with scientifically formulated meal replacements could provide the inroad some patients may need to align healthy eating goals with their food choices.

Source(s):

1 What is nutritional psychology?

2 Nudge: Improving decisions about health, wealth, and happiness

3 Nudge: The final edition

4 Campus food service users’ support for nudge strategies for fruit and vegetable-rich items: Findings from a large Canadian national sample

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