Area man still not eating his veggies

Despite pleading and prodding from the feds, kids still won’t eat their veggies. A New York school district has decided to forgo federal funding for school lunches because of complaints about mandated smaller portion sizes and because new rules requiring kids to be served fruits and vegetables was resulting in massive waste:

The school district has decided to not participate in the National School Lunch program, saying recent changes requiring more fruits and vegetables on each tray has resulted in kids throwing the lunches away….

As part of the federal Healthy Hunger-Free Kids Act of 2010, school lunches now must meet strict federal guidelines to address the epidemic of childhood obesity. Some of the rules include: serving larger portions of fruits and vegetables, offering dark green and deep orange vegetables and legumes every week, using whole grains in half the grains served and reducing salt by 10 percent….

[Superintendent Kay] Salvaggio said in her letter that “our school meals will continue to be nutritious and well-rounded” and that while kids can take a fruit and a vegetable, they won’t be required to do so. Portion sizes will also increase, a reaction to the reduced amount of food allowed under the new federal guidelines.

This would be news, I guess, except that the USDA has been telling Americans to eat their veggies for ninety-six years, and we haven’t listened yet. Did we really think putting them on kids’ trays unasked would work? (Especially if they look like the vegetables the school cafeteria served when I was a kid?)

The thing is, the USDA knows, or at least claims to know, what makes a successful nutrition education program, and they’ve known since the Second World War. Here’s what the Food and Nutrition Service says such a program must do:

  1. Target specific behaviors or practices
  2. Focus on the interests and motivations of targeted population
  3. Devote sufficient time and intensity: There appears to be a generally positive association between the intensity of the intervention and dietary improvement.
  4. Deliver coherent and clearly focused curricula
  5. Involve multiple components using a social ecological approach
  6. Provide professional development to staff1

Two-thirds of these points (no. 1, 3, 4, and 6) are really about consistency of message and programming: pick a message, stick with it, and make sure everybody’s on board. That’s good advice for practically any sort of campaign. The other two are the interesting ones.

No. 5, that business about a social ecological approach, means that “An approach that uses multiple components — like classroom-based strategies, cafeteria interventions, and home and community components to focus on specific positive behaviors — is more likely to result in change.” In other words, you can’t just stick food on kids’ plates and expect them to eat it. By contrast, if you teach kids about nutrition in the classroom, serve them healthy food at school, and offer programming to parents, you might get somewhere — at least in theory.

The problem is that an approach like this assumes a sort of rational economic actor who will always behave in accordance with his best interests. If we could just get Americans to recognize what’s best for them, goes this thinking, they’ll surely do it. Economists like to imagine that rational actor exists. People who design public intervention programs have to assume he exists. But there’s just no evidence that he’s out there. Even if you assume that people have complete free choice about what they eat — which is questionable, given the existence of food deserts and new theories that sugar is physically addictive — this model doesn’t take into account the complex psychological and cultural factors behind what people eat. Often we don’t even know why we eat the things we eat or like the things we like. Historically, if a particular food or type of food has certain positive or negative associations for people in a given culture, it’s extraordinarily difficult to change them. It has been done — exactly once in the U.S. by a public program, in World War II, when the federal government convinced people (amid meat rationing) that organ meats were good eating. (That story probably deserves a separate post.) But on the whole, over time, Americans have been likelier to do the opposite of what government nutritionists have told them.

No. 2 in that list — “Focus on the interests and motivations of targeted population” — gets at this point.

Research indicates that in developing and implementing interventions, it is important to recognize the motivations of the target audience and to develop appropriate strategies based on those mediators. For elementary school children, preference and availability are primary motivators, meaning that nutrition education efforts should focus on helping children become familiar with and offering opportunities to taste healthy foods. As children become older, and in efforts aimed at adults, other mediators are important, like peer influences, behavioral choices, sense of competence and autonomy, and health outcomes.

It sounds easy enough when you put it in sociological language. But it isn’t. To say that “preference” is a “primary motivator” almost begs the question of motivation; the question is why. “Availability” means putting fruits and vegetables in the cafeteria, but we’ve seen that doesn’t work: by the time kids get to school they’ve already made strong associations about various foods. And even if you get them to eat their veggies at school, they’re not the ones doing the cooking at home. The school cafeteria simply isn’t the influence that family and friends are. Which gets us back to no. 5, of course. The point is, it’s incredibly complicated.

What you have to do, I think, is normalize the desired behavior, so that it becomes the behavior that people fall back on unthinkingly. That’s simple, but incredibly difficult. If you point out a behavior, you’ve defined it as not normal: if it were the norm, you wouldn’t have to point it out! Kids know this intuitively, and once you’ve defined the behavior as not-normal you have to count on their ethics or their rational self-interest to make them do it — both far weaker motivators than simply relying on convention. Which means that even if you have the opportunity to deeply influence kids, you have to work indirectly. And you have to make your normalcy somehow dominant over everybody else’s.

It isn’t that the kind of change we want can’t happen. There have, obviously, been cultures that ate lots of fruits and vegetables — including particular American cultures at various times in our history. But this is, I think, why it hasn’t happened yet, and why the latest government initiatives aren’t likely to work any better than the others.