Healthy Theme Park Meals?

Healthy Side Dish and Beverage Alternatives are Embraced by Disney World Visitors

John C. Peters, Jimikaye Beck, Jan Lande, Zhaoxing Pan, Michelle Cardel, Keith Ayoob, and James Hill (2016). Using Healthy Defaults in Walt Disney World Restaurants to Improve Nutritional Choices. The Journal of the Association for Consumer Research, 1. 

JOHN.C.PETERS@ucdenver.edu

When meals at Disney World restaurants came with a fruit or vegetables instead of fries, about half of diners opted to keep the healthier option!   A new study published in the Journal of the Association for Consumer Research shows that nutritionally improved kid’s meals at the 145 restaurants located at Walt Disney World, Orlando, Florida were embraced by diners. 

Starting in 2006 the Walt Disney Company began improving the nutritional quality of kid’s meals by replacing the default sides and beverages of French Fries and regular soda with healthy defaults of low fat milk or water and either fruit or vegetables.  Customers could still request soda and fries if they chose to “opt out” of the healthy default items.  To better understand the acceptability and nutritional impact of making these dramatic changes Disney recently provided kid’s meal sales data for the years 2010-2012 to the University of Colorado Anschutz Health and Wellness Center for detailed analysis.  The results were dramatic and showed that across all restaurants, 48% and 66% of guests accepted healthy default sides and beverages, respectively.  The healthy defaults reduced calories (21.4%), fat (43.9%) and sodium (43.4%) for kid’s meal sides and beverages.  Disney further reported that improving the nutritional quality of the meals did not affect the consumer cost of the meals.

This research is important because it highlights a voluntary and bold move by a large company to make changes that can help improve nutrition for their customers but that doesn’t restrict choice and doesn’t increase cost.  It makes purchasing the healthier item the easy choice in a way that is a win-win for both consumer and restaurant.  “While these results were obtained in a theme park setting they may have broader applicability and may encourage other restaurants to try the opt-out approach for making healthier choices easier for consumers.” Says lead author, John C. Peters. 

This article is published in the inaugural issue of the Journal of the Association for Consumer Research entitled "The Behavioral Science of Eating." This issue has been edited by Brian Wansink of Cornell University and Koert van Ittersum of the University of Groningen.

 


Response by Marion Nestle:

Dietary nudges for obesity prevention: They work, but additional policies are also needed

Marion Nestle, PhD

PDF of this commentary

In 2006, the Walt Disney Company announced a new initiative to improve the nutritional quality of meals served to children at its theme parks. The company would be changing the default kids’ meals—the components that come without having to be ordered separately--to include low-fat milk, juice, or water rather than soft drinks, and sides such as apple sauce or carrots rather than French fries. Parents who wanted sodas or fries for their children would have to ask for them, something many might not bother to do. Health groups had long advocated for this policy change (Wootan 2012).

As I commented to a reporter at the time, "going to Disney World is an excuse for eating junk food…Disney or its advisers must be feeling they have some responsibility” (Horovitz and Petrecca 2006). Indeed, the healthier defaults were part of a larger effort by Disney to deal with its contribution to obesity in America. After ticket prices, food is the second greatest source of revenue at Disney World. Although reducing the amount of food consumed at the parks might help create a less “obesogenic” food environment, revenues might fall. But the default change might be revenue neutral. By 2008, Disney could report that two-thirds of U.S. customers ordering kids’ meals had accepted the default, with no loss in sales. In Hong Kong Disney parks, nearly all customers accepted the default. The report, however, did not include data on the numbers or proportions of customers ordering kids’ meals (Walt Disney Company 2008).

Disney’s more recent summary of its child health initiatives states that it is funding investigators at the University of Colorado to conduct a more formal evaluation of use of the default options (Walt Disney Company 2015). The paper by Peters et al. (2016) in this issue of the Journal presents the results of that research. Their work confirms the ongoing effectiveness of the strategy. Nearly half the customers ordering kids’ meals accepted the healthy default side dishes and two-thirds accepted the healthier beverages. These choices resulted in significant reductions in the calories, fat, and sodium in purchased kids’ meals, but not sugar (Peters et al 2016).

The authors argue that gentle nudges changes like these are preferable to more coercive policies that smack of nanny statism. Such reductions help, but are they enough to make a real difference? To answer this question, it would help to know what else the children were eating along with the drink and side dishes. Although the authors were given raw sales data, Disney did not permit them to use this information as part of the overall analysis. The company also refused to provide information about the number of children who visited the park or the number of kids’ meals sold.

These missing pieces raise red flags because this is a Disney-funded study that produced results that Disney can use to advertise itself as a company that cares about kids’ health, and to deflect attention from Disney World’s’ reputation as a junk-food paradise. Corporate funding of research introduces conflicts of interest and reduces the credibility of the results, not least because the biases inherent in such research are largely unconscious, unintentional, and unrecognized (Moore et al 2005) The results of this study merit especially careful scrutiny. Taking them at face value, the default strategy worked well for the drink, but the sides are still a problem, and so are the sugars. They do not reveal much about what kids eat in a day at Walt Disney World

Nudges like this default are an important part of strategies to counter childhood obesity. But are they enough to deal with the public health problem? To make a real difference, they need to be accompanied and supported by a range of policy approaches. Current thinking about such approaches recommends combining insights from behavioral research, economics, and public health to establish a food environment far more conducive to making the healthy choice not only easy choice, but also the preferred choice. Doing so is likely to require multiple actions—for example, regulation of nutrient content and marketing; incentives such as subsidies of healthier foods; disincentives such as taxes, warning labels, and nutritional rating systems for unhealthier foods; and education of adults and children (Hawkes et al 2015). Disney’s voluntary default is a small step in the direction of such policies, but many more are needed if we are to make real progress in reducing the prevalence of childhood obesity.

References

  1. Margo G. Wootan. Children’s meals in restaurants: families need more help to make healthy choices.   Childhood Obesity 2012;8(1):31-33. 

  2. Bruce Horovitz and Laura Petrecca.  Disney to make food healthier for kids.  USA Today, October 17, 2006..

  3. Walt Disney Company. Walt Disney Company—2008 Corporate Responsibility Report. 2008. 

  4. Walt Disney Company.  Magic of Healthy Living brochure.  2015. https://thewaltdisneycompany.com/sites/default/files/MOHL_Brochure.pdf.

  5. John C. Peters, Jimikaye Beck, Jan Lande, Zhaoxing Pan, Michelle Cardel, Keith Ayoob, and James Hill. Using healthy defaults in Walt Disney World restaurants to improve nutritional choices.  J Assoc Consumer Res., 2016;1:1, forthcoming.

  6. Don A. Moore, Daylian M. Cain, George Loewenstein, and Max H. Bazerman, editors.  Conflicts of Interest: Challenges and Solutions in Business, Law, Medicine, and Public Policy.  Cambridge University Press, 2005. 

  7. Corinna Hawkes, Trenton G Smith, Jo Jewell, Jane Wardle, Ross A Hammond, Sharon Friel, Anne Marie Thow, Juliana Kain.  Smart food policies for obesity prevention. The Lancet 2015;385:2410–2421.  

 


Rebuttal:

Response to “Dietary nudges for obesity prevention: They work, but additional policies are also needed” by Marion Nestle, PhD.

John C. Peters, PhD &  James O. Hill, PhD

We read with some encouragement and also some disappointment Dr. Nestle’s commentary about our article describing the positive effects of healthy defaults on kid’s meal nutritional composition at Walt Disney World theme park (1). 

On the positive side, Dr. Nestle acknowledged that healthy defaults for kid’s side dishes and beverages actually worked to alter meal selection behavior resulting in lower calories, fat and sodium.  Furthermore, she noted that behavioral nudges like defaults are an important strategy for combatting childhood obesity.  And, we agree with her that other strategies and policies that compliment and support each other are needed to fully deal with the problem of obesity.  Our paper never stated nor intimated that default nudges would singlehandedly solve the childhood obesity problem.  We even carefully pointed out that the work presented is relevant to the somewhat unique context of a theme park and may not be applicable to other restaurant settings.  However, given that Dr. Nestle described going to Disney World as “an excuse for eating junk food”, we would think the positive results of this study would have gotten even stronger words of encouragement.

We were disappointed by Dr. Nestle’s assertion that Disney’s decision to not allow publication of kid’s park attendance numbers or raw kid’s meal sales numbers (because of their proprietary nature in the competitive business of theme parks) and the fact that Disney funded the study raises “red flags” about the veracity of the data presented.  First of all, academic researchers are rarely ever given access to any kind of consumer data.  The public health community has been advocating for years that industry should share more of their data about consumer behavior in order to inform better strategies and tactics for improving public health.  Disney should be commended for being leaders in this respect.  We find Dr. Nestle’s comment about potential bias in the analysis because of the funding source curious given that the findings about default acceptance rates reported in the present paper are less favorable than data reported in another reference cited by Dr. Nestle (2) written by a prominent industry critic.  While we disagree with the premise that the funding source had any influence on the study, clearly, the potential for “bias” raised by Dr. Nestle concerning the data we reported did not favor the funding sponsor, Disney. 

It is unfortunate that when the industry does share important data with public health stakeholders the reaction from one of the most oft quoted voices is one weighted by suspicion and distrust rather than a focus on the learning and encouragement to continue the work.  Given this reception it is perhaps not surprising that more major companies do not share consumer information with outside parties which likely inhibits more rapid progress in reversing childhood obesity.  However, such strident anti-industry opinions are not uniform throughout the scientific and public health communities.  Many investigators are willing to work with industry to apply their data and insights toward promoting healthier consumer behavior.  While we believe caution and transparency are always key ingredients when working with industry we also believe that solving the obesity problem will require finding a productive model for working together that can channel everyone’s energy toward finding solutions.  The Disney study is a good example of why partnering with industry can help move the field forward.

  1. John C. Peters, Jimikaye Beck, Jan Lande, Zhaoxing Pan, Michelle Cardel, Keith Ayoob, and James Hill. Using healthy defaults in Walt Disney World restaurants to improve nutritional choices.  J Assoc Consumer Res., 2016;1:xx-xx.

  2. Margo G. Wootan. Children’s meals in restaurants: families need more help to make healthy choices.   Childhood Obesity 2012;8(1):31-33. 


Response to rebuttal

Marion Nestle, PhD

The response from Peters and Hill still fails to acknowledge the severity of the problems posed by Disney’s sponsorship of their research—the company’s failure to produce data essential for proper interpretation of study results, and the level to which sponsorship by food companies biases such interpretations.  At one point, Disney boasted of the results of this research, confirming its benefit to marketing goals.  The threat of industry sponsorship to research credibility has received considerable press attention in recent months, as must surely be known to these authors.1,2 

  1. Anahad O’Connor.  Coca-Cola funds scientists who shift blame for obesity away from bad diets.  New York Times, August 9, 2015. http://well.blogs.nytimes.com/2015/08/09/coca-cola-funds-scientists-who-...

  2. Candice Choi.  AP Newsbreak: Emails reveal Coke’s role in anti-obesity group.  US News, November 24, 2015.  http://www.usnews.com/news/business/articles/2015/11/24/apnewsbreak-emai....