Highlighting Food Products as ‘Less Healthy’ Prompts Purchase of Healthier Items

By Robert Polner

To entice consumers to buy mini-bags of carrot sticks instead of potato chips and bottled water instead of jumbo sodas, some policymakers have suggested imposing a special tax on less-than-wholesome food choices. Another idea: in-store signage alerting purchasers to calorie-rich snacks perhaps best to pass up.

But the potential of such policies to change consumer behaviors is not yet known. Prior studies, including several in Western Europe, have produced inconsistent findings to date.

Enter a quintet of NYU medical and health policy researchers led by Brian Elbel of the School of Medicine’s Department of Population Health and the Robert F. Wagner Graduate School of Public Service. To test the proposition that taxation and labels, as for cigarettes, might influence consumer choices, the researchers set up a small store in the busy outpatient area of Bellevue Hospital Center, the largest public hospital in New York City, and operated it during the last three months of 2011.

The concession looked like any standard snack shop. Healthier and less-healthy food items were placed near to each other—the baked potato chips right next to the greasier variety—so customers could readily see the healthier alternatives. In all, 34 healthier items were offered at an average pretax price of 90 cents, while 45 less-healthy foods were available for an average pretax cost of 98 cents.

At different times during the store’s daily hours of 8 am to 4 pm, the researchers staged one of five conditions: a scenario in which food offerings had no special labeling or tax; another situation in which “Less Healthy” highlighting appeared on the price tags of the less-healthy food items, in red capital letters with a red box drawn around it; a 30 percent non-itemized tax placed on all food items marked “Less Healthy”; a 30 percent itemized tax placed on foods identified as “Less Healthy”; and, finally, a 30 percent itemized tax levied with the signage “30 percent less-healthy tax = $0.33.”

This controlled field experiment (consumers were asked to fill out a short survey in return for $2 after leaving the store) is detailed in the article “Promotion of Healthy Eating Through Public Policy,” published in the June 2013 edition of the American Journal of Preventive Medicine. In addition to Elbel, the authors of the article include Glen B. Taksler and Courtney B. Abrams of the School of Medicine’s Department of Population Health and Tod Mijanovich and L. Beth Dixon of the Steinhardt School of Culture, Education, and Human Development.

In other studies, Elbel has examined the impact of recent municipal policies requiring fast-food restaurants to post calorie counts with their menu offerings. He found little indication that consumer choices were affected by this much-publicized measure.

But the snack-shop inquiry found that highlighting the words “less healthy” in large red letters on the price tag was associated with some consumer behavior change: There was a 7 percent increase in purchases of healthier items—an indication, perhaps, that consumers found the short-hand label more helpful than detailed nutrition labeling traditionally appended to foods and beverages. At the same time, the taxing of less-healthy items had a greater impact than labeling did alone, under the experiment. Purchases of healthful food choices rose by 12 percentage points when a hefty 30 percent tax existed for less-than-healthful snacking alternatives.

“Although taxes and labeling are not the single answer to influence obesity, these public policies may induce consumers to purchase healthier foods and beverages,” the authors write.

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