Impact of presenting images of foods with images of health consequences on attitudes and choices

Abstract

Background: The existing evidence base for the impact of affective imagery on health-related behaviour is most plentiful in relation to graphic picture warnings and smoking, with few experimental studies focused on food products. Our aim was to examine the impact of presenting images of food products paired with images of positive and negative health consequences, on food choice and implicit attitudes. Methods: Participants (N=711) were randomly allocated in a 2 x 3 factorial design (food type x affective valence) to one of six conditioning procedures that paired images of either energy-dense snack foods or fruit, with: (a) images of negative health outcomes, (b) images of positive health outcomes, or (c) a no image control. The primary outcome was food choice assessed post-intervention with a behavioural choice task. Secondary outcomes were implicit attitudes (assessed pre- and post-intervention) and explicit attitudes (assessed post-intervention). Findings: Presenting images of negative health outcomes led to more healthy food choices relative to control and positive image conditions, irrespective of whether they were paired with images of energy-dense snack foods or fruit. This relationship was partially mediated by changes in implicit attitudes, and also by explicit attitudes. Images of positive health outcomes did not alter food choices. Discussion: This study replicates and extends previous research showing that presenting images of negative health consequences increases healthy food choices. Because effects were elicited by manipulating affective valence irrespective of paired food type, these results appear more consistent with an explanation based on priming than on evaluative conditioning.