What we think about a label may be as important as the label itself

What believe about a food's ingredients may have a biological effect on our bodies above and beyond the actual nutrient content.

That is the conclusion from a study published in the journal Health Psychology, which was recently covered by Alix Spiegel at the NPR Health blog.

The authors conducted an experiment in which they fed the same 380 calorie milk shake to two different groups of subjects.  The first group was lied to, and were told (via a label) that the shake was a "sensible" 140 calories.  The second group was also lied to, but in the opposite manner: they were told (via a label) that the shake was an "indulgent" 620 calories.  

The researchers measured the levels of a hormone, ghrelin, before during and after the label experiment.  Ghrelin levels are particularly interesting to monitor because they regulate metabolism and help signal hunger or satiety.  After eating a big meal, ghrelin levels fall, signalling us to stop eating.  Eat a light meal, and ghrelin levels remain high, signaling us to eat more.

The authors found that people consuming the "indulgent" labeled shake experienced a significant increase in ghrelin just before consumption (in anticipation) and then a significant decline in ghrelin after consumption.  The change, the authors argue, is consistent with that typically observed after eating a big meal.  By contrast, the level of ghrelin was flat before and after eating the "sensible" shake.   All this is in spite of the fact that the two shakes were exactly the same in every way except for the labels!  

The authors were quoted as saying:

Labels are not just labels; they evoke a set of beliefs

and that labels might

actually affect the body's physiological processing of the nutrients that are consumed.

One way to interpret the results is to place them in the category with other "behavioral biases" in the behavioral economics literature: another piece of evidence that people do not behave rationally.  I see it a bit differently.  The results suggest a kind of "extra" rationality.  Mind over matter.  What we think might well trigger how our body responds.  Marketers might influence what we think about foods, but we have some control over the process too.  

Now, if I can just fool myself into believing that small lunch salad is actually one of the Carl's Jr. "Indulgent Salads", I'll feel fuller and lose more weight! 

The study's sample size was small (N=46), probably because to measure ghrelin they had to insert an intravenous catheter to draw blood at repeated intervals.  So one proceed with caution until more work of this sort is done.  Still, very interesting nonetheless.

Want to legalize dope but outlaw transfats?

An editorial in Politico by William Bennett and Christopher Beach highlights the irony of the policy positions held by many people on the progressive left (something I also point out in the Food Police).

They write:

The very same year, for example, that Colorado legalized marijuana, the Colorado Senate passed (without a single Republican vote) a ban on trans fats in schools. Are we to believe eating a glazed donut is more harmful than smoking a joint? California has already banned trans fats in restaurants statewide, but now is on the brink of legalizing marijuana statewide come November. Former New York City Mayor Michael Bloomberg supported New York Gov. Andrew Cuomo’s effort to decriminalize marijuana in New York State, while at the same time supporting a ban on extra-large sodas. A 32-ounce Mountain Dew is bad for you, but pot isn’t?

The logic is dumbfounding. For many years, health-conscious liberals have waged a deafening, public war against cigarettes. Smoking bans in public places like restaurants and bars have been enacted in states all over the country. Recently, New York City, New Jersey and several other cities and states have extended those bans to include the newest tobacco fad—e-cigarettes. Yet, when it comes to smoking marijuana? Crickets.

What explains this obvious paradox?

They don't actually answer their own question - later saying simply that "The answer is not clear, and there may not be a good answer at all."  I think there is an answer.

One way to think about these sorts of issues is to turn to ideology scales.  A common view is that people's ideologies can be explained by where they fall on two dimensions related to views about economic freedom and personal freedom and willingness to use government force in these two areas.  In this framework, a "liberal" wants personal freedom (abortion, gay rights, etc.) but wants to restrict economic freedom (by, e.g., setting minimum wages).  Conversely, a "conservative" wants to restrict personal freedom (outlaw abortion and prohibit gay rights) but wants economic freedom (e.g., no minimum wage).  I think one has to augment this model to provide an account of what's going on in this case.   

Here we have two health-related issues: smoking marijuana and eating transfats.  What would possibly rationalize supporting the legalization of one and the prohibition of the other?  I think it has to with people's heuristic thinking about whether companies are good or bad and whether government is good or bad - or stated differently whether businesses or government is more likely to be corrupt.  I think many on the left see transfats as bad because they're sold by big-bad food companies who will kill us just to make a buck, whereas marijuana (at least at present) doesn't have ties to big business.  Thus, it is interpreted as a personal freedom issue by many on the left.  Conservatives, by contrast, are probably less likely to want to ban transfats because it is seen as an intrusion of "bad" government into the economics sphere.  Conservative's support for marijuana prohibition likely comes about from their willingness to use government force to regulate personal/social issues.

Interestingly, Bennett and Beach attempt to resolve their paradox in the Politico piece by seemingly arguing both transfats and marijuana should be banned.  The other seemingly logically consistent stance is to suggest both should be legal, which is the position of many libertarians. 

I suppose the economist could logically support one and oppose the other based on the results of a cost-benefit analysis or considerations of the extent of externalities, etc.  Stated differently, a consistent utilitarian (or the economist who will use cost-benefit analysis as the final word on whether a policy is "good") could very well end up supporting one of these issues and opposing another.  

The challenge, from the economic standpoint, is that many of these policies are advocated on paternalistic grounds - arguing that somehow people don't know what is in their own self interest, which seems to degrade the ability to know what is "best" from the consumers perspective, and thus the ability to even do a legitimate cost-benefit analysis.

My own view is that there is a legitimate role for government to play in researching and informing the public of the risks of smoking marijuana, eating transfats, etc.  But, to step in and decide which choice should be made goes too far.  It supplants the judgement of "experts" and politicians for the judgement of each person.  If we are willing to dismiss people's ability to decide whether to smoke dope or eat transfats, it seems a short step to say that they also can't be trusted to make their own health care choices, or decide where they should live or what job they should take.  Heck, why even allow these people to vote?  That might seem a bit extreme, but I'm simply following the chain of paternalistic thinking to its logical conclusion.

Food Conspiracies

This past weekend, I was a guest on a radio show that is broadcast through a network to about 100 stations across the US.  I was talking about my book, The Food Police.  Having done dozens of these kinds of shows over the past six or seven months since the book release, I figured that I've heard just about every question there was to ask.  I was wrong.  

After some standard back-and-forth questions with the host, the line was opened to callers.  Here are a few of the claims I heard - each from a different caller: 

• Adding fluoride to water doesn't prevent cavities and causes joint pain, teeth browning, cancer, and Alzheimers   
• Canola oil is an "unnatural" newly created synthetic product that causes cardiac problems and high blood pressure
• Organic farmers are small farmers; small farmers treat their soil better than large farmers
• With GMOs the genes they inject into DNA.  They are unnatural and become free floating in the soil; 70% of babies have the Bt toxin in their blood as a result of GMOs; the implication is that GMOs are very dangerous
• A new wave of cancer patients are successful fighting cancer by moving to a diet of organic produce 

Some of these are more grounded in reality than others but overall I think I lost a little bit of faith in my fellow man.  I don't mean that in a belittling way.  But it makes me wonder what it is in human nature or what incentives exist in media/internet that would take a little grain of truth and turn it into some of these beliefs that are so at odds with the evidence.  

The Paternalist Meets His Match

That is the title of a new paper that I co-authored with Bailey Norwood and Stephan Marette that was just released by the journal  Applied Economic Perspectives and Policy.  It will be coming out in their special issue on Nudge.

Here are a few excerpts from the paper: 

As illustrated by Nancy Reagan’s “Just Say No,” and Michelle Obama’s “Let’s Move!” campaigns, public figures are often interested in the choices made by others. Indeed, concern for other’s food and health choices is often manifested in public policy, from America’s 1920s-era prohibition on alcohol, all the way to today’s bans on trans fats. Some form of altruism is often indicated as the prime motivator for such paternalism (e.g., Arrow 1963; Jacobsson et al. 2007). Developments in behavioral economics have added fuel to the fire by suggesting that people’s health and food choices may not actually promote their own long-term well-being.

and

Yet, the conclusion that paternalism is warranted in light of the evidence of behavioral biases is typically a logical extrapolation, rather than a direct observation that paternalistic policies actually maximize efficiency or enhance welfare, however conceived. . . . The purpose of this paper is to study paternalism from both the perspective of the paternalist and the recipient of the paternalism (the person whom we refer to as the paternalee). That is, rather than taking evidence of decision-making biases as prima fascia justification for paternalism, we study how paternalists make decisions for others and how paternalees respond to decisions made for them.

From the abstract: 

Using data from over 300 people recruited from two cities in the United States and France, we study how choices between a relatively healthy item (apples) and a relatively unhealthy item (cookies) are influenced by one’s role as either the paternalist or the paternalee. We find that after being provided information on nutritional content, but not before, paternalists make healthier choices for the paternalees than for themselves. Surprisingly, prior to being provided information, paternalees desire healthier choices than they expect the paternalists to give, a phenomenon that seems to arise from a type of egotism where individuals believe they make healthier choices than everyone else. Results in both locations reveal that more than 75% of paternalees prefer their own choices compared to the ones made for them by the paternalists, and are willing to pay nontrivial amounts to have their own choices. Any intrinsic value people place on the freedom of choice must be weighed against whatever benefits might arise from paternalistic policies, and consequently the scope for paternalism may be narrower than is often purported.

Mirrors in Grocery Carts

One of my colleagues forwarded me this article in the New York Times on some research published in an agricultural economics journal on the effects of "nudges" on consumer purchases of vegetables and produce.  

One part of the authors' research program is looking at how placing a mirror in the cart affects sales (I suppose it is supposed to encourage you to think more about the effects of your purchases on your long term self).  They don't yet know what effects the mirrors will have, but what they have found is the following: 

the scientists tinkered again with the cart, creating a glossy placard that hung inside the baskets like the mirrors. In English and Spanish, the signs told shoppers how much produce the average customer was buying (five items a visit), and which fruits and vegetables were the biggest sellers (bananas, limes and avocados) — information that, in scientific parlance, conveys social norms, or acceptable behavior.

By the second week, produce sales had jumped 10 percent, with a whopping 91 percent rise for those participating in the government nutrition program called Women, Infants and Children. 

This research is being facilitated by a grocery chain, which is interesting.  I find it interesting because this research and the author's article (Michael Moss) position this as research into the "Nudge" phenomenon advocated by many behavioral economists:

Mr. Payne and Mr. Niculescu are pursuing a strategy that behavioral scientists call nudge marketing, an idea popularized by the 2008 book “Nudge,” by the former Obama administration regulatory affairs administrator Cass R. Sunstein and the University of Chicago professor Richard H. Thaler.

Nudge marketing calls for applying just the right amount of pressure to persuade: not too little, not too much.

Here's my beef.  The Sunstein and Thaler book is primarily about government "nudges".  This research is about a grocery store's "nudge".  Retailers try to nudge us all the time - it's called advertising.  And I suspect this store will not continue with the mirrors and special carts if it ultimately hurts sales in the long run. The difference between a store nudge and a government nudge is important: if we don't like what a store is doing, we can leave and shop elsewhere.  Stores have an incentive to only adopt those nudges that consumers actually want, as revealed in their purchase behavior.  Governments, by contrast, have no such accountability or rapid feedback mechanisms.  For these reasons, I think it is important to draw a distinction between marketing and advertising on the one hand and nudging on the other.