#196 Making Deliveroo Healthy

Ageing Health

Obesity is a growing problem. On average 300Kcal per day of the average persons intake comes from the “Out of Home” sector. Can consumers be induced to order less calories?

A Five-Minute Read

The incidence of obesity is more than twice as high in older people as a 16-24 year old. Obesity is related to an increased risk of disability. Obesity is a major cause of many chronic diseases. It impacts heart failure, heart attacks and strokes. It is a major cause of diabetes. It causes many cancers such as colon, breast and prostate. It has been estimated that obesity costs the UK £54BN per year. Obesity in old age is often the result of eating habits acquired when much younger. Two thirds of the UK population live with excess weight.

Reducing Obesity

The UK’s Innovation Agency for Social Good is called NESTA. It has calculated that obesity could be cut in half if average calorie intake for the obese was reduced by only 8.5%. That is equivalent to 216 Cal per day. NESTA has looked at various ways to achieve this. They have proposed new regulations for retailers and manufacturers. They have looked at new ways of formulating processed food. They have working on filling information gaps.

A growing source of our daily calorie intake is coming from “food out of the home”. This is a much broader category that simply fast food. It includes sandwiches bought in the supermarket and even the coffees we buy every day. NESTA has calculated that those “coffees” contribute 4% of our daily calorie intake. Non-alcoholic drinks of all kinds contribute 12% of our average daily calories. In total, the sector contributes 300 calories per person per day to our diets. Out of home purchases are known to be more calorie dense. Making the same meal at home would mean less calories.

Each out of home “trip” on average means 1027 Kcal. This compares to the Governments recommendation of 600 Kcal per meal. Two thirds of meals exceed this target. A fifth of such meals exceed half of the daily calorie target. The biggest sources of calories are fast food and supermarket sandwiches. Together they contribute over half of all “out of home” calories. Sandwiches are not calorie intense but are the most common food purchased out of the home. Fast food is bought much less often but a single pizza can contain nearly a days’ worth of calories. Fast food contributes over a third of the nations “out of home” calories. Burgers are the biggest part of this. There are massive variations in the use of this food sector food. In Scotland it contributes a quarter of the total calorie uptake. It is also associated with more deprived parts of the UK.

Promoting an 8.5% cut in Calorie Intake.

One focus of NESTA has been the part of that food which is now being delivered to our homes. A whole infrastructure has now exists to get “out of home” food delivered to home! Nearly a quarter of all out of home food is now delivered in some way. Sixty percent of the UK population use such services on average once a week. Eleven percent use it on average every day.

NESTA have looked at whether users can be “nudged” into making lower calorie choices. To do this they created a simulated delivery website. They could then change many things and test the impact on people’s food choices. Minor changes can have a significant impact. Their base case is a simulation of the most common delivery websites today. When asked to order a meal respondents will amass 1382kcal. That is close to 60% of the recommended daily calories in a single meal.

NESTA have experimented with calorie labelling. Moving such labels around on the screen to get the biggest impact. Just including a calorie label of any kind reduced the calories ordered by nearly 5%. Adding a “basket total” before the final order increased this by another 3%. Customers were given control of whether the calories were shown. This reduced the total by the same amount. It seems that sometimes we are prepared to calorie count. At other times we are not. Giving control has been shown to be a consumer benefit in many other areas.

They manipulated the order in which the meals and the restaurants were presented. In one case they arranged for low-calorie foods to be presented first. In another the restaurants were ordered in increasing calorie count of their menu. In the final case both were organized to promote lower calorie eating. Prioritizing lower calorie meals or restaurants produced a 6% decline in the orders. Prioritizing lower calories in both generated a 12% reduction. Well above the 8.5% target.

In their final set of nudges, they attempted to apply social pressure. They manipulated the respondents need to conform to “social norms”. In the simplest manipulation they prepopulated the order form. If the respondent was choosing (say) pizza size, between small, medium and large. The “small box” was pre-ticked. In a second variation the Pizzas were relabeled. “Small” became “regular”, “Medium” “large” and “large”“Extra Large”. It is known that people tend to choose the middle item in a list. The site was therefore adjusted to put “small” in the middle by adding a “super small”. All these manipulations reduced the calories ordered. Together they reduced the calories by 177Kcal. Interestingly the average price was reduced as well.

Medicine or Behaviour

In other Newsletters I have discussed whether it is better to use medicine or behaviour change to tackle issues like obesity. The advent of “obesity drugs” appears to offer a miracle cure. Unfortunately many people do not continue to take the drugs and the weight returns quickly. Exortations to eat healthily do not seem to work unless backed up with the support of organizations like Weightwatchers. These NESTA studies suggest a third way. Simple “nudges” could often have a big impact.

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