The Health Policy Division’s Psychology of Eating And Consumer Health (PEACH) lab studies public health policies and interventions designed to improve the world’s diet and prevent and reduce obesity and eating disorders. The goal of PEACH lab’s research is to provide policymakers and institutions with science-based guidance. The lab’s Director is Christina Roberto, PhD.

Food Policies to Encourage Healthier Eating Habits

Dr. Roberto has written a number of papers discussing food policies to improve diet. In a special Lancet issue on obesity, she and her colleagues describe the biological, psychological, social, and environmental forces that encourage over eating of unhealthy foods. Dr. Roberto has argued that environmental policies are necessary to reverse the obesity epidemic.

She has also co-authored another recent paper on public health policies to encourage healthier eating habits and has written about these ideas in popular media.

Food and Drink Labeling

In a recent PEACH lab study led by Dr. Roberto, PEACH lab found that health warning labels may influence parents to purchase fewer sugary drinks for their children and may be an impactful way to educate parents about the health harms of over consuming sugary drinks. More than half of children under the age of 11 drink sugary drinks including soft drinks and juices that contain as many as seven teaspoons of sugar per 6.5 ounces—on a daily basis.

In a review paper, we examined and summarized all the studies that have evaluated menu labeling in the real-world. We concluded that the evidence of calorie labeling’s impact on consumer purchases is mixed so far. It seems to encourage some consumers, some of the time, at some restaurants to order fewer calories. Our research revealed that only 6 out of 4,311 people looked for nutrition information in restaurants, suggesting that the existing approach to sharing information was ineffective.

In a separate study we then demonstrated that, after viewing menus with calorie counts, adults both ordered and ate less. However, there was an important influence of providing people with contextual information to understand the calorie amounts. A menu containing a label that adults should consume 2,000 calories per day had an impact that lasted beyond the meal: it prevented participants from eating more later that day, an effect that was absent without the contextual anchoring statement. These findings highlight the importance of putting calorie information in the context of a full day’s calorie requirements.

Overall, our research finds that nutrition labels that are easier to understand and convey nutrition information in more meaningful ways beyond simply providing numbers, are likely to be more effective at informing people and changing behavior.

Food Marketing

Food marketing to youth is pervasive and the foods most heavily marketed towards children are nutrient-poor and calorie-dense.  In one of our studies, we gave pre-school children a choice between two snacks that were identical except for one thing: one snack was in a plain package, the other had a licensed character like Dora the Explorer on its packaging. We found that not only do children overwhelmingly choose the snack with the character, they actually say it tastes better. These findings show the powerful influence such characters have on children and suggest the need for more stringent guidelines on how characters can be used to market nutrient-poor foods to children. We have also replicated and expanded this study in Guatemala.

The PEACH lab is interested in understanding how food companies use sports to market their products, whether through endorsements, team sponsorships, or sports references on food packaging. In collaboration with Marie Bragg we found that food companies use these sports references to market foods of poor nutritional quality and children are more likely to see commercials for these products than adults.

Eating Disorders 

In the last four versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a diagnosis of anorexia nervosa required a female to have an absence of menses (amenorrhea) for three months. In collaboration with colleagues at the Columbia Center for Eating Disorders, we conducted a study on whether this was an important diagnostic criterion and found that there were not meaningful clinical differences between those who did and did not meet the amenorrhea diagnostic criteria. In a paper for the DSM-5 task force, our research-based recommendation to remove amenorrhea as a diagnostic criterion was subsequently implemented in the new version of DSM-5.

In a study led by Jennifer Thomas, we examined the inconsistent application of the DSM-IV diagnostic criterion for weight loss for anorexia nervosa, which revealed that researchers were using a range of body weight percentage or body mass index cut offs to diagnosis anorexia nervosa and these cut-offs lead to dramatically different prevalence estimates for the illness. In another study led by Robyn Sysko, we demonstrated adequate test-retest reliability of the new proposed criteria for binge eating disorder, which became an official eating disorder diagnosis in DSM-5.

In collaboration with colleagues at the Yale Program for Obesity, Weight, and Eating Research, we conducted research demonstrating that the proposed DSM-5 change to reduce the required binge eating and/or purging frequency criteria from twice weekly to once weekly would capture clinically significant cases.

The PEACH lab has also developed an assessment tool, in collaboration with Kerstin Blomquist and colleagues at the Yale Program for Obesity, Weight, and Eating Research,  called the Eating Loss of Control Scale. This tool measures loss of control eating on a continuous scale. For a long time, the eating disorders field measured this construct, which is required for the diagnosis of bulimia nervosa and binge eating disorder, as the presence or absence of loss of control when eating, but we believe this new tool will shed light on this complicated clinical experience with which many patients struggle.