Cognitive and environmental interventions to encourage healthy eating: evidence-based recommendations for public health policy.

Lindsay A Walker,Harm Veling,Christopher D Chambers,Natalia S Lawrence

doi:10.1098/rsos.190624

Abstract

Policymakers are focused on reducing the public health burden of obesity. The UK average percentage of adults classified as obese is 26%, which is double that of the global average. Over a third of UK adults report using at least one weight management aid. Yet, many people still struggle to change their diet-related behaviour, despite having the awareness, intention and capability to do so. This ‘intention–behaviour gap’ may be because most existing dietary-choice interventions focus on individual decision-making, ignoring the effects of environmental cues on human behaviour. Behaviour change interventions that ‘nudge’ people into making healthier choices by modifying the food environment have been shown to be effective. However, this type of intervention is typically challenging for policymakers to implement for economic, ethical and public accessibility reasons. To overcome these concerns, policymakers should consider ‘boosting’ interventions. Boosting involves enhancing competences that help people make decisions consistent with their goals. Here, we outline cognitive training as a boosting intervention to tackle obesity. We synthesize the evidence for one type of cognitive training (go/no-go training) that may be effective at modifying food-related decisions and reducing body weight. We offer evidence-based recommendations for an obesity-focused Public Health Wales behaviour change programme.

Highlights

Obesity is a global public health threat
The focus of UK public health policy ranges from fiscal incentives and disincentives to the local built environment, almost all with the primary aim of altering dietary choice [6]
We learn to approach and consume energy-dense foods associated with neural reward responses more strongly than low-calorie foods that do not elicit such a response. For these reasons, healthrelated behaviour change interventions typically have limited effects [13], and we argue that addressing the public health threat of obesity will require interventions that focus on targeting automatic cognitive processes

Summary

Introduction

Obesity is a global public health threat. The World Health Organization estimated that in 2016, around 13% of the world’s adult population were obese [1]. For these reasons, healthrelated behaviour change interventions typically have limited effects [13], and we argue that addressing the public health threat of obesity will require interventions that focus on targeting automatic cognitive processes.

Results

Conclusion