Courtesy of Hayden Peek

A designer’s plan to curb the obesity epidemic, one piece of paper at a time.

The link between grocery stores and health is a complicated one. As Vicky Gan noted in a CityLab story about a rural Wisconsin town’s effort to encourage healthy food choices: “Any healthy eating initiative has to start with access to healthy food, but it can’t end there.”

It can’t end there because, as numerous studies have shown, access to healthy choices does not guarantee that shoppers will bring those items from the shelf into their kitchens. And although we live in an age when the nutritional value of individual food items is obsessively tracked and qualified, there are far fewer ways to account for the totality of a purchase.

But could it be as simple as tallying it all up at the bottom of a receipt?

The U.K.-based designer Hayden Peek had watched people in various fields “try to combat the obesity epidemic, with little or no effect,” he explains. “I thought it was time a designer stepped into the ring.”

On his website this month, Peek floated a solution: color-coded labels at the bottom of a receipt showing the total calories, fat, sugar, saturated fat, and salt for the whole purchase. The categories mirror the Facts Up Front labels seen on individual food items. But Peek’s labels, instead of showing just a number or daily value percentage, would apply the traffic light system to each total: green for healthy, yellow for moderate, and red indicating that changes need to be made.

Courtesy of Hayden Peek

For now, Peek’s idea remains conceptual. He tells CityLab that the response has been overwhelmingly positive; he hopes to partner with a grocery store in the future to implement his design.

It would be beneficial for stores to do so, says Christina Roberto, a professor of medical ethics at the University of Pennsylvania. “We’re at a place where information needs to get out there in ways that are easy to understand,” she tells CityLab.

The effectiveness of traffic-light coding in food choice, she adds, has previously been proven. A 2014 study published in The American Journal of Preventative Medicine tracked how labeling options with green, yellow, and red influenced patrons’ selections in a large hospital cafeteria. After two years, the researchers found that sales of red (unhealthy) items decreased from 24 percent to 20, while sales of green items increased from 41 percent to 46.

This mode of “choice architecture” is similar to that of the Guiding Stars program, which rates items in select grocery store chains (among them Food Lion and Hannaford) with anywhere from one to three stars, which are affixed to the items’ price labels. A 2013 study documented a shift toward healthier, three-star items over 20 months, the Huffington Post reports.

Yet these strategies differ in in a crucial way from Peek’s idea, Roberto says: they influence decision making while the shopper is still selecting items, while Peek’s offers an after-the-fact assessment. The impact of the latter on its own, Roberto says, may not be that great; without in-store guidance, the tallies have the potential to read as a retroactive slap on the wrist.

Instead, she says, Peek’s idea points to a need for supermarkets to implement uniform, storewide guidance policies. “There are so many customers that are interested in making healthier choices,” she says, but the onslaught of information in food labels is often difficult to navigate.

Given that people respond so intuitively to traffic-light coding, Roberto says, it would make sense for stores to combine the choice-architecture model seen in programs like Guiding Stars with Peek’s tally system.

“There’s absolutely a space for supermarkets to intervene and help customers make healthy choices,” Roberto says. What’s crucial, she adds, is that they find a way to do so that provides the necessary information alongside what to do with it.

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