High BMI Predicts Attention to Less Healthy Product Sets: Can a Prompt Lead to Consideration of Healthier Sets of Products?

Abstract

While the food environment has been implicated in diet-related health disparities, individuals’ ability to shape the food environment by limiting attention to a subset of products has not been studied. We examine the relationship between BMI category and consideration set—the products the individual considers before making a final choice—in an online hypothetical shopping experiment. Specifically, we focus on the healthiness of the consideration set the individual selected. Secondly, we examined the interaction of a health prompt (versus a no-prompt control) with BMI category on the healthiness of the consideration set. We used linear probability models to document the relationship between weight status and consideration set, between prompt and consideration set, and the effect of the interaction between prompt and weight status on consideration set. We found that (1) obese individuals are 10% less likely to shop from a consideration set that includes the healthy options, (2) viewing the prompt increased the probability of choosing a healthy consideration set by 9%, and (3) exposure to the prompt affected individuals in different BMI categories equally. While obese individuals are more likely to ignore healthier product options, a health-focused prompt increases consideration of healthy options across all BMI categories.

Active Consideration of Future Health Can Be Prompted by Simple Health Messages and Improves Nutritional Quality of Food Choices

“…Reminders sent to gym members increase gym attendance, with an effect that lasts beyond the end of the intervention (38,39). Recent work on primes or prompts encountered by individuals in food choice and physical activity environments finds increases in healthy behaviors, suggesting that these interventions draw attention to the health attributes of choices (16,17,28,(40)(41)(42). In this work, results show that participants who spend at least 3 sec on the prompt message are significantly more likely to consider future health impacts and that the effect size of the prompt message increases as participants spend more time processing the information.…”

Eating contexts determine the efficacy of nutrient warning labels to promote healthy food choices

“…In the unrestricted context, participants were instructed to choose as if nothing was stopping them, which aimed to reflect situations where health concerns are minimized (i.e., dining out for pleasure). The healthy context was included to facilitate interpreting choice data, as this context drives healthier food choices compared to other contexts (26)(27)(28)(29)(30)(31). Using different sets of food images in each context, we measured the probability of a healthy choice and conflict during food choice first without showing NWL for all pairs of food images and then showing NWL for the same pairs.…”

“…As such, an experimental healthy eating context can be created by prompting participants to consider the healthiness of food or its health consequences. This intervention reduces the portion size and probability of choosing unhealthy foods compared to participants prompted to select foods based on taste or desire (26)(27)(28)(29)(30)(31)(32). The effects of a health context on food choice include increasing the value of health-related food attributes over others like taste (27,33).…”

Comparing the impact of subsidies and health prompts on choice process variables and food choice: The case of dietary fiber

“…Using a health prompt focused on dietary fiber, a multiple mediation analysis of the pathways through which the prompt operated showed that exposure to the health message increased the likelihood that consumers considered a healthier set of products, increased the likelihood that they used nutrition information during choice, and additionally directly promoted healthier food choices, resulting in significantly healthier (and higher fiber) food choices. Using a similar framework, but focusing on the set of products considered during choice, (Gustafson et al, 2021) showed that individuals with high body mass index (BMI) scores were significantly more likely to only include lower nutritional quality products in their consideration sets. These consideration sets omitted higher nutritional quality foods that many policies or interventions target, suggesting that-in the absence of efforts to draw their attention to the presence of the policy or intervention-these individuals would not be exposed to the intervention.…”

“…Evidence suggests that segments of the population that are highest priority for health promotion interventions, such as individuals with obesity, direct their attention to systematically different types of products than normal weight individuals (Werthmann et al, 2011). In an online shopping experiment, individuals with obesity were significantly less likely to consider healthier items while making food choices than normal weight participants (Gustafson et al, 2021).…”