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Study Shows Scare Tactics Won't Encourage Clients to Eat Healthfully

By Leesha Lentz

When offering nutrition advice to clients and patients, RDs may want to convey positive messages that promote what they should be doing rather than fear-based messages that focus on what they should not be doing, according to a study by researchers at Cornell University's Food and Brand Lab. The study, "When Do Gain-Framed Health Messages Work Better Than Fear Appeals?," is published in the January 2015 issue of Nutrition Reviews.

"There's been a big mystery over past years as to whether fear appeals or positive messages work best," says study author Brian Wansink, PhD, director of Cornell's Food and Brand Lab, and author of Slim by Design: Mindless Eating Solutions for Everyday Life. "In other words, is it better to say, 'Don't eat a candy bar or you'll get fat' or 'Eat an apple and stay healthy'?"

Study Findings
To answer this question, Wansink, along with study coauthor Lizzy Pope, PhD, a former postdoctoral researcher at the Food and Brand Lab who's now with the University of Vermont, analyzed 43 published international studies that involved what the researchers termed as "loss-framed" or "gain-framed" messages.

Loss-framed messages focus on what an audience may lose, either positive or negative, if they choose to either ignore or adhere to a health directive. An example of a loss-based message would be "Go outside without your sunscreen and lose your healthy skin," according to the study authors. Negative loss-framed messages are fear-based appeals, which suggest negative consequences if the health message is ignored and instills fear in individuals.

Gain-framed messages focus on what an audience will gain, either positive benefits or negative consequences, if they choose to either adhere to the health message or ignore it. The study authors offer the following example of a gain-framed message: "By using sunscreen, people can attain healthy skin."

According to their findings, negative loss-framed health messages are most effective on an audience of nutrition experts, such as dietitians and physicians. Wansink says these experts are risk-averse, knowledgeable in the topic, and highly involved in the health field—three main characteristics that can predict a better response to loss-framed messages. However, nonexperts respond better to positive gain-framed health messages in which they're told what to do for a healthful lifestyle and why it's important.

"They need a positive reason as to why they should eat healthfully," Wansink says. "That's what works for most people, because most people don't think that much about nutrition or their weight or care about how many milligrams of protein are in a food item. For them, just saying 'Look, if you eat a lot more apples, you'll be a lot skinnier and happy' is what resonates."

What RDs Should Know
According to the researchers, the nutrition-related messages should be "audience centered," suggesting that those delivering the messages, such as nutrition experts, need to think about how they relay those messages to their audience, Wansink says.

The study findings suggest a way to bridge that divide and create better communication between clients and nutrition professionals. "Gain-framed messages are likely to be the most successful type for encouraging adherence and compliance," the study authors wrote. Therefore, as in the previous example Wansink provides, it's better to present the health benefits of eating an apple, instead of the negative effects of eating something less healthful.

In conclusion, Wansink offers two important tips for dietitians. "The biggest tip is scare tactics will not work on most of their patients, because they really aren't that concerned or involved and those messages may scare them away," he says. "The second thing is that telling them what gives them a better life and more of what they want is the way to change their behavior. If you're telling them the positives and not the negatives—that's the way to do it."

— Leesha Lentz is a freelance writer based in Pottstown, Pennsylvania.