Applying the principle of small subtle changes in the food environment to ‘nudge’ people to healthier food choices has been found to be an effective way to promote a healthy workplace cafeteria.

Nudge theory is a fascinating development in the area of health research. Simply put, it is based on small, indirect suggestions or changes to the environment (nudges) that help to reinforce positive changes in human behaviour in a beneficial way. The great thing about small nudges is that they do their work all without a person feeling they’re being coerced, lectured or ‘nannied’ into it and often times, without even being aware of the subtle behaviour change signals.

Food choices are one area where the food environment has a big role to play. The availability of tempting highly kilojoule dense and palatable food combined with heavy food advertising can make a strong will to eat healthily hard to achieve. Researchers are applying nudge theory to the food environment and one of the first randomised controlled trials in the field has used the real-world workplace cafeteria as the testing ground

Over 12 weeks, 30 different workplace cafeterias in the Netherlands were studied. Fourteen of the workplaces underwent a ‘nudge makeover’ that involved 14 small changes to the food service environment. Some of the changes included having fruit and vegetables always offered, ‘better choices’ always available in every food category, cash register food displays always having some healthier options and offering water for free. The other 16 workplaces served as the control group.

The key outcomes monitored were sales of healthier foods, the change in the food environment, and employee questionnaires on their thoughts of their cafeteria.

By the end of 12 weeks, sales of healthier sandwiches, healthier cheese as sandwich fillings, and fruit all went up and stayed constant over the study time. About three-quarters of the planned 14 nudges were implemented at each of the sites making the changes feasible to do. Surprisingly, there was little change in the overall employee satisfaction with their cafeteriae that underwent a nudge makeover.

Implications

Small changes to the food environment are not a magic bullet for healthier eating, but the results from this study show that they can make small positive changes that appear to stick, all without making a change to a person’s autonomy in making food choices.

Last Reviewed: 15/11/2018

© Norman Swan Medical Communications.



References

Velema E et al. Nudging and social marketing techniques encourage employees to make healthier food choices: a randomized controlled trial in 30 worksite cafeterias in The Netherlands. American Journal of Clinical Nutrition 2018;107:236-246.