As humans, we have a genetic predisposition to crave foods high in fat and salt. The natural instinct to satisfy taste and palatability is an evolutionary trait that once fueled the survival of our ancestors. Yet, in the age of sedentary lifestyles, fast food and Starbucks, this instinct has now become de-evolutionary with rising rates of obesity, diabetes and heart disease.
Television, video games and giant, fast food conglomerates are often easy targets for this new age epidemic; however the cause is much more complex than we realize. Urban sprawl, decreased access to outdoor recreation, sedentary work and home lives, and increased access and availability of unhealthy foods are just some of the major contributing factors to our obesogenic environment. Underlying issues such as disparities in income and education can further explain geographic trends in obesity hot zones (1). While many of these societal issues are difficult to address, we can still effect some change in our immediate environment.
Brian Wansink, PhD, author of Mindless Eating: Why We Eat More Than We Think, merges psychology, nutrition and consumer behaviour in identifying environmental factors that influence our eating behaviours. The intention is to teach the reader how to “re-engineer” their environment to help counteract influences that promote over consumption. This recent popularization of practical food psychology has caught the attention of many, including health conscious consumers, the media, health professionals and policy makers. Mindless eating has quickly become a movement among health promoters and has offered a fresh, new focus for anti-obesity campaigns. The food industry has even jumped on board the opportunity to supply the growing demand of portion controlled 100 calorie snack packs.
Guidance on how to make small but important changes in our eating habits and lifestyles is the main appeal of mindless eating. By slightly changing your environment to avoid an unhealthy habit, you can mindfully make a permanent, healthy behaviour change that will allow you to mindlessly eat less. Emphasizing volume consumption also provides an alternate focus for those who are trying to achieve or maintain a healthy weight, but find it difficult to make changes around food choice. Wansink’s book, which stems from his extensive research, uncovers numerous obesogenic habits that are common to our everyday routines, many of which we are completely unaware. In quantifying these effects on consumption patterns, he illustrates the magnitude of difference small changes can make. Through evidence based principles, consumers learn simple solutions that make eating less, less daunting.
This is a topic that applies to both patients and healthcare professionals. Obesity continues to be a growing concern as the health and economic implications become more and more apparent. Our efforts in nutrition promotion are continuously challenged by our environment and the incongruence is becoming increasingly frustrating. It is time to shift some focus from strengthening our ability to self-regulate our eating, to shaping our environment to address the autonomic nature of eating (2). It is important that we have a thorough understanding of our food environment and acquire the knowledge to finally make it work for us, rather than against us.
Minding Portion Distortion
Over the past 20 years, consumption norms have undoubtedly grown to enormous proportions. Interestingly, our appetites have evolved to mirror this upward trend. Portions that used to satiate us 20 years ago appear meager in comparison to the inflated choices we have today. Reference tools such as Eating Well with Canada’s Food Guide, the hand jive and the CDA plate model are designed to guide consumers back to healthy portions and stifle growing consumption norms; however, these tools are noticeably disjointed from what we consider to be the norm. According to Eating Well with Canada’s Food Guide, one serving of meat and alternatives is 21/2 oz (3). This is miniscule compared to a typical restaurant portion of 6 to12 oz. Our food choices and behaviours are modeled from what we see, and it is often difficult to break away from portions with which we are accustomed.
Part of the difficulty comes from estimating portion size according to visual cues (4). What we consider to be acceptable is often influenced by the size of food items; plates, drinking glasses and utensils, as well as jumbo sized packaging and super-sized options (5). Wansink has found that doubling the size of a container leads to an 18% increase in consumption for meal related foods and 30% to 45% in snack related foods (6). Such external influences can easily challenge those who not only have trouble estimating, but are unaware of their energy needs and portions that are appropriate.
While the size of food items is a concern, we must also consider our perception of size. We have a natural tendency to overestimate height and underestimate width (7). According to his infamous elongation bias study, Wansink found that even professional bartenders were not immune to the illusions of a short wide glass. We perceive short wide glasses as containing less fluid and as a result, we consume more than we anticipate. In this study, bartenders consistently poured more fluid into the short wide glass, versus a tall, slender glass (8). We can use this to our advantage by using tall, slender glasses to consume less than we perceive. This way, we feel more satiated and satisfied with the portions we serve ourselves.
Efforts to help counteract these influences can be as simple as replacing larger plates and glassware with smaller or slender versions and repackaging jumbo packages into smaller containers (5). This promotes smaller consumption norms and makes estimating portions easier (4). While these external influences can have an effect on how much we eat, there are others that signal when we start and finish.
Hunger and Satiety
We seldom draw on physiological hunger signals to initiate and terminate eating. We often let time, sight and the salience of food dictate when we eat, as these food cues have been found to increase reported hunger, salivation and gastric secretion (5). Increased stomach distention, hormone responses and overall satisfaction in taste, palatability and mouth feel are just some of the factors behind satiety (9). Similar to hunger, we often use external food cues to signal our satiety (10). We do not eat until we are full or no longer hungry; we frequently eat until our plates, bowls and glasses are empty (5). Atmospheric and social factors also influence our pace of eating, which can cause us to eat faster than our physiological feedback can tell us we are full (4).
We can gather part of the solution from an age old saying, “out of sight, out of mind”. Having a large inventory of food, including jumbo sized, family packs can increase consumption volumes. The trick here is to repackage food items into smaller containers and hide the rest out of sight (5). Moreover, eating at a slower pace may help increase our responsiveness to physiological satiety signals and increase our overall satisfaction from ingested food (11). Chewing thoroughly and pausing between smaller sized bites can help achieve more pleasure from food with fewer calories (11). It is also important to be conscious of the effects on volume consumption when eating in a social environment. Studies have shown a linear increase in consumption as the amount of eating companions increase (4). Wansink’s advice here is to keep pace with the person who is taking their time. While there are many changes we can make for ourselves, we must also recognize our role in influencing the dietary habits and choices of others.
Nutritional Gatekeepers… Keeping junk out
A nutritional gatekeeper is the person responsible for acquiring and preparing meals within a household (12). A survey conducted by Wansink in 2005, found that nutritional gatekeepers controlled a whopping 72% of a household’s dietary intake (12). This offers the nutritional gatekeeper a significant opportunity to make healthy choices for the family. The idea is to make healthy choices with the assumption that the alternative, being junk food, will involve too much effort for others in the household to pursue.
Wansink also suggests that parents decide serving sizes for their children. Children ages one to three are able to eat just until they are no longer hungry; however, beyond the age of four they are likely to eat whatever they are given (5). Children are unaware of appropriate serving sizes and proper nutrition and rely on parents and caregivers to make these decisions for them.
Nutritional gatekeepers are not only able to regulate the flow of food from their pantries, but they have the ability to shape behaviours and attitudes toward food. The eating patterns and behaviours of children are often modeled by their parents. Studies show that having at least one overweight parent increases the likelihood of children being overweight (13). This can partly be attributed to both genetics, as well as adopted eating behaviours. While there are many behaviours that are difficult to address, there are ways of improving a child’s perception of healthy eating. Presentation, availability and variety are key issues in encouraging children to adopt positive attitudes toward healthy foods. It is also important not to use guilt, fear, or rewards in getting children to finish their food, no matter how engrained these traditions are from previous generations (5). Not only will these tactics promote negative associations, it may also desensitize their physiological response (13). It is important that parents understand their role in modeling food behaviours, choices and attitudes. Like all life lessons, children need guidance when it comes to food and nutrition. Setting the stage for optimal nutrition at an early age is crucial in the development of healthy habits and attitudes.
Eating is often viewed in terms of what and how much; however, eating is a multidimensional behaviour and there are a number of factors within our environment that promote over consumption (4). Despite the strong influences of an obesogenic environment, it is not entirely deterministic of our health. In understanding our food environment we can actively shape it in a way that benefits us. Mindless eating offers a fresh, new perspective on promoting a healthy environment that facilitates healthy food behaviours and attitudes. Minding actual and perceived portion sizes, listening to internal food cues and recognizing opportunities to influence others are just some of the elements of mindless eating you can integrate into practice for your patients, yourself and for your household.
As health professionals we often struggle with the irony, what is best is not what always works. We can only guide the steps that people are willing to take, in the direction where they are prepared to go. Mindless eating offers the practical knowledge to help people make small but important changes that cater to their food environment, making personal goals more achievable.
Mindless Eating Tips
Simple tips based on the book Mindless Eating: Why We Eat More Than We Think by Dr. Brian Wansink:
- Use smaller bowls, plates and utensils to help you control portion sizes and eat less.
- “Jumbo” packages aren’t always a steal of a deal. You just might find yourself eating more than you want to just to finish it!
- Don’t eat straight from the package. Repackage snack items into smaller bags, bowls or plates. Otherwise, you may eat more than you are aware of.
- Don’t let food descriptions fool you. Belgian chocolate, is still just chocolate.
- Listen to internal cues like “fullness”, instead of external cues like how much food is left on your plate. Listening to external cues leads to overeating.
- When eating with others, make sure to pace yourself with the person who is taking their time.
For more information, visit www.mindlesseating.org.
- Walsh, B. (2008, June 23) It’s not just genetics. Time Magazine, pp. 56 – 63.
- Cohen, D., Farley, T. (2008). Eating as an automatic behavior. Preventing Chronic Disease. 5(1):A23.
- Health Canada. (2007). Eating well with Canada’s food guide. Ottawa: Heath Canada.
- Wansink, B. (2004). Environmental Factors that Increase the Food Intake and Consumption Volume of Unknowing Consumers. Annual Review of Nutrition. 24: 455–479.
- Wansink, B. (2006). Mindless Eating: Why We Eat More Than We Think. New York: Bantam.
- Wansink, B. (1996). Can Package Size Accelerate Usage Volume? Journal of Marketing. 60(3): 1–14.
- Wansink, B., van Ittersum, K., Painter, J. (2006). Ice cream illusions: bowl size, spoon size, and self-served portion sizes. American Journal of Preventive Medicine. 31(3): 240–243.
- Wansink, B., van Ittersum, K. (2005). Shape of glass and amount of alcohol poured: comparative study of effect of practice and concentration. British Medical Journal. 331(7531): 1512–1514.
- Romijin, J et al. (2008). Gut-brain axis. Current Opinion in Clinical Nutrition and Metabolic Care. 11(4):518-21.
- Wansink, B., Painter. J, North, J. (2005). Bottomless Bowls: Why Visual Cues of Portion Size May Influence Intake. Obesity Research. 13:1 (January), 93–100.
- Andrade, M et al. (2008). Eating slowly led to decreases in energy intake within meals in healthy women. Journal of the American Dietetic Association. 108(7): 1186-1191.
- Wansink, B. (2006). Nutritional gatekeepers and the 72% solution. Journal of the American Dietetic Association, 106(9):1324–1327.
- Ogden, K et al. (2008). The role of parental control practices in explaining children’s diet and BMI. Appetite. 50: 252-259.