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The Tempest project came to an end

Final newsletter March, 2013

After having run for four years, the TEMPEST project on adolescent self-regulatory competence for dealing with the obesogenic environment came to an end in January 2013. This final newsletter informs you about the main research findings of the TEMPEST project, its health policy implications, and the potential for dissemination. These issues were addressed at the international TEMPEST conference in Utrecht, the Netherlands, as well as during pre-conference workshops for professionals and scientists in January 2013. This newsletter also informs you about the TEMPEST handbook for increasing self-regulatory competence in youth, which is available in eight languages (of each of the participating countries). The handbook aims to inform health professionals, teachers, and parents about opportunities for encouraging self-regulation strategies in adolescents that may help them to regulate their food intake. Finally, this newsletter publishes some highlights from the TEMPEST website. On this website (www.tempestproject.eu), that will remain on air for the next few years, all scientific publications on TEMPEST findings will be available.

tempest.fsw@uu.nl

www.tempestproject.eu

Tempest Highlights Identifying and assessing self-regulation strategies to ensure healthy eating Our research reveals that adolescents recognize and employ six distinct strategies for self-regulating their food intake four relating to food temptations (avoiding or controlling temptations; suppression; distraction) and two relating to healthy eating goals (goal and rule setting; goal deliberation) - implying that they have the skills to navigate the obesogenic environment successfully. Interventions should take account of this and speak to the self-regulatory competence adolescents possess. To assess the use of self-regulation strategies and to evaluate interventions, the Tempest Self regulation Questionnaire for Eating (TESQ-E) questionnaire was developed and validated in the nine European countries. The instrument is available in eight different languages (www.tempestproject.eu). Macro- and meso level environmental influences on self-regulation and eating Our research suggests that young people’s use of self-regulation strategies is critical in understanding the role of environmental factors on their eating behaviours. Specifically, the use of self-regulation strategies was shaped by and attenuated the influence of a diversity of factors in young people’s environment, including the eating-related practices and norms of parents and peers, family food cultures, and exposure to food-related advertising. The use of selfregulation also attenuated the influence of access to unhealthy foods on young people’s eating behaviours, illustrating that health promotion should not solely focus on the complex task of changing the food environment, but that young people also need to be taught strategies to effectively deal with today’s access to excess. Social images of food among adolescents Sweets and snacks have a great positive social value, which may unintentionally promote the consumption of these products. For example, young boys assumed that popular in comparison to unpopular peers have a pronounced preference for sweets and snacks but that they chose only rarely fruits when given the choice. Complementing this picture, young girls also assumed that popular boys in comparison to unpopular ones show a pronounced tendency to choose sweets and snacks rather than fruits. Children who ascribed popular peers a greater consumption of unhealthy food items reported a greater consumption of these snacks. Importantly, our research also demonstrated that the valence of the foods’ social image can be successfully adjusted, which may in turn affect the spontaneous intake of these foods. Pre-exposure to food temptations to enhance self-regulation of eating In a series of controlled studies it was demonstrated that pre-exposure to food temptations may help to build selfregulation. By pre-exposing youngsters to sweet temptations (while they do not consume the sweets), they seem to alter their perceptions of these foods. Youngsters subsequently ate less from foods from the same food category they were pre-exposed to. Schools that allow unhealthy food at school but encourage healthy consumption (by for instance providing healthy alternatives or price discrimination of unhealthy foods) appear to produce similar behavioral effects as the lab situation. The effect of temptation appears to cumulate across occasions and over time. We found preliminary evidence that this pre-exposure effect may be implemented into a “behavioral vaccination” program.


Tempest: Call to action During the Tempest conference, the possibilities for dissemination of TEMPEST findings in various settings were explored. These discussions resulted in this call to action. The following recommendations were given for each of the parties influencing adolescent eating behavior.

Final newsletter page 2 March, 2013

Parents: Family meals, which (amongst other important functions) facilitate communication about eating behavior, are quintessential and should continue right through adolescence. Schools: Concrete strategies for school-based interventions should be developed, including increasing self-regulatory competence and creating a health-supportive choice architecture. These interventions will then need to be rigorously tested to build evidence of their long-term effectiveness in promoting healthy eating using a range of appropriate indicators (e.g. use of self-regulation strategies, eating practices, weight). This evidence building should also address whether beneficial effects generalize to other health domains. Prevention and health promotion: The evidence-base needs to be strengthened and more research is required. Testing of interventions in real-life settings should be done in a multi-disciplinary way, taking into account the local and cultural context, and should be included in ongoing initiatives (such as EPODE, JOGG, healthy schools network). Promising venues for research are: pre-exposure to food temptations; social images and food advertising; negative effects of restrictions; and training self-regulation capacities and transfer of these capacities in different domains (food, being active, alcohol use, studying). Industry: In order to be more appealing to industry, TEMPEST findings (especially regarding social images and focusing on healthy choices rather than unhealthy options) need to be replicated in a professional manner in a joint effort with industry. Government: Based on TEMPEST findings, the government should invest in finding ways to promote selfregulatory competence in a variety of manners, especially in underprivileged groups.

Tempest Handbook Written by Marijn Stok, Denise de Ridder, Emely de Vet and John de Wit, Utrecht University and translated by country-specific research teams The research conducted in the Tempest project resulted in a book which appeared in eight languages. The handbook aims to inform health professionals, teachers, and parents about opportunities for encouraging self-regulation strategies in adolescents that may help them to regulate their food intake. The book describes the six self-regulation strategies that are also central to the Tempest Self-regulation Questionnaire for Eating (TESQ-E). Each of the following six strategies is covered in a chapter, that is avoiding temptations, controlling temptations, distraction, suppression, goal and rule setting, and goal deliberation. For each of the six strategies, it is discussed what the strategy entails, what is known from scientific research, what adolescents say about it, and how the use of the strategy could be improved.

I enjoyed reading the Tempest handbook. It is written in an attractive style, combining results of scientific research with examples of how adolescents themselves say they deal with food temptations. Six different self regulation strategies are explained clearly in practical and positive terms, giving readers confidence that they will be able to apply these strategies in real life situations. I expect that many readers will be tempted to try out one or more of these self regulation tools in their own family’s ‘chocolate factory’. Alet Wijga PhD , Senior scientist (epidemiology) National Institute for Public Health and the Environment Center for Nutrition, Prevention and Health Services


Review TEMPEST Invitational Conference: Highlights from a food industry perspective

Final newsletter page 3 March, 2013

End January, I attended the TEMPEST Invitational Conference in Utrecht, The Netherlands. The conference was the grand finale of the large-scale EU TEMPEST project that investigates different approaches to encourage young people to adopt a healthy lifestyle. For example, by helping children to make effective plans to eat healthily and by offering self-regulatory tools for dealing with (unhealthy) food temptations in an obesogenic environment. The conference started with a fascinating keynote lecture by Pierre Chandon,(director of INSEAD Social Science Research Center) on the underestimation of large portion sizes, entitled ’How food marketing distorts portion size perceptions and preferences’. Chandon presented evidence that showed that people tend to underestimate the increase in the size of portions. For example, when you double the size of a bottle or a cup, it looks just 50 to 70% bigger, not twice as big. In addition, he showed many examples of how package design and package-based communication (such as health claims) can lead to overeating. This has important implications as these relative small errors in portion perception can really add up over time. The rest of the day was devoted to presentations of findings that have arisen from the TEMPEST project. The work presented at the meeting was impressive and demonstrated some of the novel findings that can help adolescents to make and maintain healthy food choices. The presentations focused on the newly developed youth-specific Self-Regulatory Competence (SRC) Scale for dealing with weight-related temptations, the impact of temptations, new incentive schemes and different social contexts on SRC and weight-related behaviors. The focus on adolescents is undoubtedly unique. The latter has also been recognized by the Dutch Nutrition Centre that published the main findings in a practical handbook for health professionals, teachers, and parents (available in eight languages). From a food industry perspective, the novel insights from the TEMPEST are very valuable, but in order to implement them in an industrial context, additional research is required to translate the scientific findings into specific product applications. All in all, this was a very successful and well organized conference. Clearly there is much more to learn about self-regulation processes in healthy food choice behavior of adolescents. Nonetheless, this conference showed that the EU TEMPEST consortium have been building up a level of insight that holds promises for the future. Dr. Liesbeth Zandstra Unilever R&D Vlaardingen

“It is not the overwhelming presence of unhealthy foods that makes the environment obesogenic, but the lack of norms about appropriate intake” Of the conference audience 73% agree, 27% disagree


Workshop social Images of Food: We are what others eat

Final newsletter page 4 March, 2013

Workshop Food cultures in the family environment: Meals as social events or TV dinners John de Wit, Utrecht University & Fiona Johnson, University College London Review by Floor Kroese, Utrecht University Do you typically eat your (probably unhealthy) dinner in front of the TV, while your family members eat something else or might not even be there? Or do you enjoy healthy family meals, sitting together, and seeing dinner as a good opportunity to catch up with your family members? These negative and positive stereotypes of food cultures at home turn out to be important in terms of health: having family meals together – as opposed to TV dinners - is related to positive outcomes such as lower BMI and higher vegetable consumption. In this workshop we discussed factors that may influence ‘communal eating’, including cultural differences. With a highly culturally diverse audience it was very interesting to have small group discussions on different national traditions. Whereas families in Luxembourg may not always have dinner together as it’s often difficult for both parents to be home at 6pm, in Italy they have an easy solution: just have dinner later at night and don’t worry too much about children’s bedtimes. Altogether, the workshop was inspiring and appealed to parents as well as policy makers to think of ways to promote family dinners.

“It is primarily the responsibility of governments to create a healthy food environment” Of the conference audience 46% agree, 54% disagree

Britta Renner and Harald Schupp, University of Konstanz Review by Fiona Johnson, University College London I was delighted to be at this enjoyable and thought-provoking workshop that focused on the way our perceptions of food are influenced by our cultural expectations and social aspirations, and how this is manipulated by food advertisers to increase the desirability of foods. A lighthearted competition between the two sides of the room exposed an impressive knowledge of food advertising characters among the workshop attendees, alongside a rather woeful ability to identify world politicians. Cultural differences in the type and quantity of foods eaten were then brought to life with eye-opening images of the foods eaten by a family in the course of a week across countries around the world (…anyone for scorpion sticks, jellyfish or guineapig?). The presenters then moved on to discuss the findings of the TEMEST project, showing in experimental studies how children’s perceptions of healthy and unhealthy foods can be manipulated by pairing the foods with either a popular or unpopular fictional peer, and how this can influence children’s consumption of snack foods. These studies provide a very neat demonstration of the power of social image in eating behaviour, and raise further questions about how this knowledge can be applied to help promote a generation of children with greater resilience to the obesogenic environment. “Health promotion should support adolescents in using strategies to deal with unhealthy food environments rather than aiming to change the food environment itself” Of the conference audience 74% agree, 26% disagree

Workshop Protection from Food Temptations: Behavioral Inoculation in Schools Siegfried Dewitte, Catholic University of Leuven, Floor Kroese, Utrecht University Review by Helge Giese, University of Konstanz Because children are surrounded by many delicious food temptations, the question arises how they could possibly deal with this situation. One might think simply eradicating those temptations by banning them would be an adequate solution to the problem. However, this appears sometimes to be unfeasible and difficult to handle. Another solution might be to let the children simply hold back and control themselves. Yet, after a while, this might become increasingly difficult. Floor Kroese and Siegfried Dewitte proposed another potential solution to this problem. In an illustrative experiment they let their audience experience how a task, in which food was not used as comestible and, therefore, gently prevented from being eaten, helped later on to withstand other food temptations. Inspired by the idea that similar tasks might behaviorally “vaccinate” children to overcome tempting foods, Floor Kroese and Siegfried Dewitte presented data that creatively tested these assumptions in children’s everyday school settings with some promising results. Interestingly, for this task to work, it was better to nudge children not to eat instead of directly prohibiting eating. Moreover, another focus of the discussion was how the quality of a temptation might influence the reaction to it. Surprisingly, Floor Kroese and Siegfried Dewitte presented evidence that more tempting foods lead to lower consumption than mildly tempting foods, because strong food temptations directly confront people with their dietary goals.


Final newsletter page 5 March, 2013

“A healthy food environment in schools is useless, if the neighborhood surrounding the school is unhealthy” Of the conference audience 50% agree, 50% disagree

Workshop Implementation Intentions Marijn Stok and Charlotte Vinkers, Utrecht University Review by Liliya Nureeva, Aarhus University Being motivated for health behavior change is a good start but not always sufficient when one wants to succeed. The gap between the intention to eat healthier and actual eating behavior was the central topic of the workshop on implementation intentions. The very finding that snacking behavior (as a special case of unhealthy eating) often is habitual and performed more or less automatically, makes it even more difficult to change such a behavior. In that case, simple but structured if-then plans (implementation intentions) may be helpful: “If (describing a particular situation)… then (describing a particular action)” has proven to be an effective tool for installing healthy habits. Participants of the Workshop had a chance to elaborate on specific if-then plans in four different cases, allowing them to familiarize with the dynamics of formulating good plans. A compelling illustration of new insights provided by the facilitators of this workshop is that making one plan at a time will work better than having several plans.

Workshop Nudging in School Cafeterias: Placing Foods at a Distance Emely de Vet & Josje Maas, Utrecht University Review by Rita Juhasz, University of Konstanz, Germany The aim of this workshop was to introduce the concept of nudging, a useful strategy that might help us to cope with the obesogenic environment. Emely de Vet and Josje Maas provided the audience with a thorough overview of nudging, including different types of nudges. Furthermore, they presented their own research results on this topic and demonstrated several examples of nudges both in the eating and the physical activity domain. It was great that there were lots of opportunities for interaction throughout the workshop. The audience was encouraged to discuss which kind of interventions could be considered a nudge and, by doing so, realize how difficult it actually is to identify nudges that influence our behavior while not restricting freedom of choice. The last part of the session was devoted to brainstorming in small groups about nudges that could eventually be applied in school cafeteria settings, which was a very fruitful activity. All in all, I think this was an excellent workshop that brought us all closer to the understanding of how we could more effectively shape our environment in a way that facilitates a healthy lifestyle.

“Marketing of unhealthy foods to children should be completely forbidden” Of the conference audience 50% agree, 50% disagree

Responsible Food Industry Liesbeth Zandstra and Monique Smeets, Unilever R&D Review by Tracy Cheung, Utrecht University The Food Industry workshop at the TEMPEST Conference highlighted the value of stimulating discussion from experts from both the academic community and the food industry. Unilever representatives, Monique Smeets and Liesbeth Zandstra, invited academic opinions on the role and involvement of the food industry in consumers’ healthy food consumption. By presenting a brief and yet informative overview of Unilever’s corporate goals and values, as well as their products and services offered in the food sector, Smeets provided insight into how the food industry is responding and adapting to the current landscape where there in ongoing debate on whether healthy food consumption should be an exclusive or shared responsibility between the government, food industries, or consumers. Furthermore, Zandstra discussed the current research interests and ongoing research activities conducted by Unilever as efforts to promote healthier food consumptions, while giving an honest account of the challenges and obstacles encountered. Academic participants in the workshop were encouraged to ask questions and provide critique regarding Unilever’s current research activities and findings. Overall, the workshop was highly interactive and demonstrated that research in the promotion of healthy food consumption was valuable and relevant for both the interests of academia and the food industry.


Final newsletter page 6 March, 2013

Posted in 2012 at www.tempestproject.eu Be smart and don’t use your willpower! By Denise de Ridder, Utrecht University When talking with adolescents about the things they do to eat more healthily, they often tell us that they "just need to be strong and resist unhealthy foods". Being strong means that you use your willpower to override an urge to do what you really would like to do but better shouldn't. Relying on willpower is a popular strategy for regulating your behavior. However, psychological research has repeatedly demonstrated that willpower is a scarce resource and that you should save it for situations when you have no other strategies available. So if you really want to eat more healthily, the best thing to do is to prepare yourself by thinking of smart strategies that help you to not eat from foods you would want to avoid. Do like the Dutch who cherish the saying "If you are not strong, you should be smart". These are wise words that I agree with. Why, then, do I find myself thinking "Show Some Willpower!" when I see someone eating a whole bag of chips or an XL portion of ice cream? Probably because it is difficult to be smart while it is so easy to keep hoping that willpower will help you.

Adolescents: A special case By Marijn Stok, Utrecht University Regulating their own eating behavior poses considerable challenges for many adolescents. Resisting the many temptations of tasty but unhealthy food products in favor of maintaining long-term health is something that many adolescents will frequently fail to do. While this is of course also true for many adults, adolescents especially are at a disadvantage because several brain areas involved in the selfregulation of behavior are not yet fully developed during adolescence. This means that, while adolescents like to be trusted with responsibility and to feel independent, they will still need a little help here and there to ensure that they eat healthily. Many parents and health professionals fear that their input will not be of any influence. These parents should realize that what adolescents are looking for, rather than explicit prohibitions or rules, is just a little bit of guidance. One important way of providing such guidance is through modeling, even if many people do not realize the power of modeling. A parent who eats a piece of fruit for dessert every day will model this as standard, normal behavior to their adolescent child. Conversely, a teacher who tells her students about the importance of healthy eating, but who eats a hamburger for lunch herself should realize that the implicit unhealthy message she is sending through her behavior may just stick with her students more than the explicit health message she tried to convey. Adolescents do not just do what you say, they do what you do. Modeling healthy eating habits is a powerful way to provide adolescent children with that bit of guidance they need to maintain healthy eating behavior themselves.

How to survive Christmas and other feasts of abundance. By John de Wit, Utrecht University For many of us, Christmas and New Year centre around food, family, friends and more food; lots of food (and drinks). ‘I really can’t have any more’ you’ll hear yourself and others say, at more than one occasion. To be sure, we also regularly overeat at other times during the year, but over the December holidays it can be particularly difficult to eat in moderation. Here’s a couple of tips to help you enjoy the festivities, without putting on the pounds. • Value quality over quantity. At festive meals we typically serve way too much food that we throw out later. Why not spend your money on less but better food? Your meal will taste all the better and you’ll also do some good for the planet by conserving scarce resources (and buying organic). • Focus on the people rather than the food. The holidays are about spending quality time with the ones we love, right? Then why spend our time eating, rather than doing some other fun things together and (finally) take the time to play, talk and catch-up? For best results, it’s wise to organize ahead of time for some weatherproof alternatives. • Plan to manage the inevitable. Most of us know quite well what the holidays have in store for us, which means we can plan how doing it differently. That holds for organizing fun, active things to do, but also for how much we want to eat and when. Consider eating just a bit of every lovingly cooked (or bought) meal, course, or cake is served. Have some and tell them how much you enjoy it; make sure they know you really appreciate what you’re being served. But also let them know that can’t have more. And why have seconds if another treat is coming up?


Final newsletter page 7 March, 2013

Posted in 2012 at www.tempestproject.eu

Healthy or tasty? By Milou Andriessen (16 years old), The Netherlands It’s the choice that everybody considers each day. Everyone knows how to eat well; breakfast, snack, lunch, snack, dinner. Two pieces of fruit, 200 grams of vegetables and a lot of water. Also practicing a sport or another way to move your body is healthy! But what does it take to actually practice these things? In my case I often have a cookie with my tea and sometimes I sin. But I go to the gym twice a week so that makes up for the sins. If you look around you see people in all kinds of shapes: really thin people but also obese people. Both of them are really sad. I think people have to be conscious about your body and take good care of it.

Sinterklaas: a candy feast By Emely de Vet, Utrecht University

At school we can buy all kinds of high caloric foods; cookies, chips and chocolate. For a week a friend of mine and I did a small test: we decided to sell fruit and healthy sandwiches. We prepared them ourselves and we sold these things next to all the unhealthy stuff. The sandwiches were much loved but we did not sell many fruits because students bring fruit from their homes. The tricky thing with healthy food is that is has an expiration date. Therefore, in the end our school didn’t follow up on our small test to sell more healthy foods.

Sinterklaas, the Dutch equivalent of Santa Claus, is back in town again. Sinterklaas, a very old saint who is supposed to live in Madrid, pays yearly visits to the Netherlands to celebrate his birthday at December 5. He arrives by steamboat packed with gifts for all children who behaved well that year. Traditionally, the Sinterklaas feast is accompanied with lots of candies and chocolates. Special candies - chocoladeletters and pepernoten - can be bought only around this time of year. The shops are filled with these special treats. The Sinterklaas party actually makes an interesting case for studying self-regulation of eating behavior in a food-rich environment. Typical Sinterklaas treats are easily accessible in these few weeks before Sinterklaas’s birthday. Foods that are typically unavailable through the year round become widely available. Parents often find themselves balancing between restricting the amount of candy their children eat these days, and allowing indulgence because it is part of the festivities which last only a few weeks. It is often questioned whether it is smart to restrict children’s access to unhealthy foods. Our TEMPEST research tells no. Imposing strict rules may make the forbidden option more attractive. And the more attractive, the harder it is to resist. Further evidence for this idea might be found in the Sinterklaas celebrations. The finding that parents and children alike indulge to special treats that are only available for a limited amount of time, may be regarded as evidence that limited availability increases attractiveness. Compared to ten years ago, the treats are nowadays sold earlier. But did this truly increase sales? If our hypothesis is correct, then earlier sales of the treats should not necessarily lead to more sales. It would be interesting to investigate if the period during which the special treats are available is related to sales and consumption of these treats over time.

Tempest Consortium Department of Psychology, Utrecht University, Netherlands (coordinator) Department of Marketing and Organization, Catholic University of Leuven, Belgium MAPP – Centre for Research on Customer Relations in the Food Sector, Aarhus School of Business, Aarhus University, Denmark Finnish National Institute of Health and Welfare, Finland Department of Psychology, Psychological Assessment, Personality & Health Psychology, University of Konstanz, Germany Warsaw School of Social Psychology, University of Warsaw, Poland Faculty of Human Kinetics, Project Aventura Social, Technical University of Lisboa, Portugal Department of Psychology, Babes-Bolyai University, Rumania Department of Epidemiology and Public Health, University College London, United Kingdom


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