Rewarding teens for healthier snack choices can help improve dietary habits

2017 Alpro Foundation Award for best scientific publication

Nathalie De Cock, University Ghent, Belgium

Adolescence is a critical time for the development of eating behaviour. Despite most young people being aware that healthy nutrition is important, few follow healthy eating patterns. Adolescents seldom manage to consume enough fruit and vegetables and many favour high-calorie low nutrient dense foods. Such habits will impact on both short and long-term health outcome. More importantly, childhood and teen years are when dietary habits develop and shape eating behaviour in adulthood.

The consumption of high-calorie snacks with high fat and sugar content tends to be driven by a desire for pleasure, rather than by hunger or energy depletion. High-calorie snacks therefore have a more "rewarding" effect than low-calorie foods such as fruit and vegetables. Linking a different form of reward to healthy snacks could be a promising strategy for encouraging healthy food choices.

Study design and key findings

The aim of this study was to encourage young people to ultimately choose healthier snacks through a novel reward framework. The reward framework combines the principles of behavioural choices, rewarding desirable behaviour and reinforcing the value of healthy snacks by associating them with a class competition.

165 14–16-year-olds from five different schools in Belgium took part in study. The students performed computer assignments, where they would earn points, which they could then exchange for snacks: the more points they earned, the more snacks they received. The class groups were divided into three parts:

• Group 1 could earn points to exchange for fruit: grapes, apples, pears, plums or mandarin oranges

• Group 2 could earn points to exchange for unhealthy snacks: candy bars, chocolate, marshmallows, biscuits or crisps

• Group 3 could earn points to exchange for fruit in combination with an intangible reward

The student with the highest number of points would be the class winner.

Group 3 had a higher motivation to win fruit compared to Group 1, who could only earn fruit. The addition of a competitive aspect generated an increase in the reinforcing value of the fruit. Group 3 was similarly motivated to win the fruit as Group 2 was to win points for unhealthy snacks.

Conclusion

This study indicates that, in an experimental setting, rewarding healthy choices could be more effective than encouraging healthier snack choices alone.

"If we would repeatedly reward young people for choosing healthy snacks, they could ultimately associate healthy snacking in their minds with positive consequences, and make this behaviour more frequent."

Nathalie De Cock

Although reward-based strategies might be a promising strategy to promote healthy food choices, this concept will need to be confirmed through more large-scale real-life studies.

The final aim of this PhD was to combine all of the above findings to develop an intervention in adolescents. A dual process model integrating control theory with behavioural choice theory, learning theory and reinforcement sensitivity theory was used as theoretical framework.

"If further studies confirm the effectiveness of this method of rewarding, these methods could easily be applied at school or at the individual level, and could have a positive impact on the dietary habits and the current and future health of these young people", concludes De Cock.

Dietary choices in adults are often based on habits learned at a young age. Alpro Foundation wants to spread knowledge about the health and sustainability benefits of plant-based eating and how different target groups, such as young people, can be encouraged to increase their intake of plant foods. This study provides new knowledge on the subject that can provide effective routes to achieving such dietary change.

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