Stealth Health For Kids

What's the best way to make sure a kid eats an apple? Ask him if he wants one. It's really that simple, according to a recent Yale University study in which cafeteria workers asked students if they wanted fruit with their meal, and raised consumption of the good stuff from 40 to 70 percent. Want her to eat her veggies, too? Rename them. When a Cornell researcher told kindergartners they were eating "X-ray vision carrots" rather than plain old vegetables, the kids ate 50 percent more.

Despite years of junk-food bans and stringent nutrition standards in the nation's school cafeterias, childhood obesity hasn't dropped. Now researchers are testing simpler strategies designed to "nudge" students toward healthier decisions. Lisa Mancino of the U.S. Department of Agriculture, which oversees school-meal programs, calls the new approach "stealth health," getting kids to eat healthy without even realizing it. As it turns out, the problem may not be the presence of junk food after all; it's that the good food just isn't appealing enough.

Stealth health is an application of behavioral economics, an academic field that studies the role of environmental factors in decision making. "The general principle is finding changes that push people in the right direction without limiting their choices," says David Just, a behavioral economist at Cornell University who has worked with the USDA. In the cafeteria, that means using environmental cues to make the most nutritious decision the most desirable one. The school lunch provides lots of opportunities for increasing the appeal of healthy foods; verbal encouragement while ordering (asking the fruit question), descriptive labels ("rich vegetable medley soup" sounds a lot better than "vegetable soup") and improved access (a cafeteria, for example, where the "grab and go" section is the healthiest) can all help sway a student's decision. Even the method of payment matters. One USDA-sponsored study found that students who pay for a meal with cash make significantly healthier decisions than those who use a prepaid card. David Just thinks such changes, which help kids make healthy decisions even when unhealthy options are available, better prepare students for the real world than flat-out bans on junk food. "Removing food choices is a good solution until they graduate or until they go to 7-Eleven on Saturday," he says.

Not all nutrition experts are thrilled with Just's suggestion that schools back off on bans and bring back cookies. "We don't expose kids to cigarettes in schools, we don't teach them comic books in English class, so why would we provide unhealthy options in the cafeteria?" says Tracy Fox, vice president of the Society for Nutrition Education. She likes the idea of cafeteria workers suggesting fruit, but is skeptical that kids, if given the choice, would pick bananas over brownies. (The Yale study didn't offer junk food as an alternate.)

X-ray vision carrots are far from becoming a kindergarten staple. Although the USDA has shown interest in behavioral economics and sponsored research, there are no plans to revamp federal school-lunch guidelines. For now, Cornell's Just and others continue to push the research forward (often with federal funding). Just is currently working with three school districts, and more than a dozen others have expressed interest. In February, he and fellow Cornell food researcher Brian Wansink launched SmarterLunchrooms.org, a site for administrators to swap strategies. Not all changes, however, have had positive outcomes. Putting veggies on every lunch tray in a Utah school increased trash volume but not vegetable consumption. Labeling a dish "food of the day" slightly decreased its appeal. "I guess that's like mystery meat," says Just, "too nondescript to be exciting." Worse yet, no superpowers.      

© 2009