Healthy sections in menus to guide customers to healthier and more profitable food choices

Healthy sections in menus to guide customers to healthier and

more profitable food choices

Self-control as a moderator on the moderating effect of goal to eat healthy on the

interaction between healthy section menu to healthy food choice.

M.T. (MAARTEN) PREUSTERINK

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Healthy sections in menus to guide customers to healthier and

more profitable food choices

Self-control as a moderator on the moderating effect of goal to eat healthy on the

interaction between healthy section menu to healthy food choice.

M.T. (MAARTEN) PREUSTERINK

Valeriaanweg 161

3541 TR Utrecht

+31(0)657283854

m.t.preusterink@student.rug.nl

s3170551

January 2019

University of Groningen

Faculty of Economics and Business

MSc. Marketing Management

1st supervisor: M.T. (Martine) van der Heide

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ABSTRACT

Obesity is a continuing global health problem. People are eating out of home and in restaurants more frequently. This is becoming a larger aspect of people’s food consumption. Considering this, people are more likely to order unhealthy food in restaurants since they allow themselves to base their food choices on taste rather than on health. One way to guide people to healthier food choices, is to modify the menu designs. This study investigates the effect of a menu design featuring a healthy section on healthy food choices in restaurants. The extent to which people have the goal to eat healthy is used as a moderator, which will be influenced by a person’s level of self-control. A digital experiment was conducted in order to test the relations. The results show no significant relations between these variables. Nevertheless, this study gives a good overview of the existing theoretical knowledge and the importance of this topic. It also provides new insights and suggestions that can help marketers, governments and restaurant owners increase healthiness and profitability.

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TABLE OF CONTENTS

Factor analysis and reliability analysis ... 14

Multicollinearity ... 15 Descriptive statistics ... 15 Excluded cases ... 15 Descriptive statistics ... 16 Data analysis ... 17 Hypotheses testing ... 17 DISCUSSION ... 20 Theoretical implications ... 20 Practical implications ... 22 Limitations ... 22 Future research ... 23 CONCLUSION ... 24 REFERENCES ... 25 APPENDICES ... 32

Appendix A: Menu that was used ... 32

Appendix B: Survey ... 33

Appendix C: Factorial and reliability analysis ... 38

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INTRODUCTION

Overconsumption and an excessive intake of sugars and saturated fats contribute heavily to the increasing prevalence of non-communicable diseases. These non-communicable diseases include obesity. Obesity continues to be a global health problem. It increases the risk of chronic diseases (e.g. type 2 diabetes, cardiovascular disease, and hypertension). Obesity can broadly be defined as an excess of body weight for a given height (Gadde et al., 2018). According to Afshin et al. (2017), more than 600 million adults were obese in 2015, with high BMI accounting for 4 million deaths worldwide. Society’s health may be influenced by shifting its consumption to healthy foods. In this way, obesity and associated healthcare costs may be reduced (Bublitz & Peracchio, 2015).

"Away-from-home food" has become increasingly popular in recent years (Binkley, 2006; Frazao and Guthrie, 1999). There are several reasons for this increase: more women are working outside the home; two-earners; higher incomes; smaller households; and more convenient and affordable restaurants have become available. This increase in away-from-home food consumption is one of the reasons for unhealthy food consumption. According to Ayala et al. (2008), away-from-home food can be defined as “full meals and single ready-to-eat items (including takeaway food) purchased at restaurants, prepared-food counters at grocery stores, and other outlets.” Numbers in the study from Frazao and Guthrie (1999) suggest that when eating away from home, people eat larger quantities or higher calorie foods (or both) than when eating at home. Ayala et al. (2008) also state that away-from-home foods are higher in fat and lower in fiber. Cohen and Bhatia (2012) validate this by saying that away-from-home foods have more calories, sugar, fat and salt. Therefore, away-from-home foods contain fewer fruits and vegetables than recommended by national nutrition guidelines. Kant and Graubard (2004) state that from 1999 to 2000, 41% of U.S. adults reported eating away-from-home foods at least weekly. These trends have created an increased interest in research for ways to promote healthier eating in an out-of-home setting.

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"Menu psychology" can be defined as the way in which people perceive, interpret, and react to different elements of a menu. Many restaurants have already used menu psychology to increase profit (Feldman & Mahadevan, 2011; Panitz, 2000). Wansink and Love (2014) studied how to guide customers to healthier decisions by shifting attention, enhancing taste expectations, and increasing perception of value by engineering the menu. They tested the ways in which different menu designs can increase the healthfulness of what customers order. Kershaw (2009) suggested that consumer attention can be drawn by separating the items from the rest of the menu. Bacon and Krpan (2018) tested this, focusing on vegetarian food. They conducted a study to determine whether consumers would order more vegetarian food when a separate vegetarian section with vegetarian dishes was available. The literature suggests that merging a group of dishes in a separate section on the menu might have an effect on consumers’ food choice. A similar research study in the domain of healthy food is still missing.

A menu design incorporating a healthy section may not influence all consumers in the same way. One relevant difference may be in the individual health goals of consumers. Shilts et al. (2004) state that goal setting (e.g., dietary) can influence adults’ food choices. We can expect that people with healthy eating goals are more likely to choose healthy food. Additionally, the effects of a menu featuring a healthy section may depend on the person’s goal to eat healthy. Not only healthy food choices may depend on healthy eating goal, but also the effect of menu section design may depend on the persons’ goal to eat healthy.

According to Haws et al. (2016), self-control is an important and influential individual difference that affects a wide variety of consumer decisions including food choices. Extensive literature sources about self-control state that a multitude of situational influences, including portion and plate size, affect eating behaviour (Scott et al. 2008; Wansink, 2006) and emotions (Fedorikhin and Patrick 2010; Garg, Wansink, and Inman 2007; Winterich and Haws 2011). Although a consumer’s food choice is influenced by different factors, the choice is often based on automatic decision making (Bacon & Krpan, 2018). People with high self-control are better able to inhibit this kind of decision making than people with low self-control (Baumeister, Bratslavsky, Muraven, & Tice, 1998). The effect of a healthy section on the menu may depend on self-control as well. This research paper will investigate this effect.

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restaurants? (3) What is the effect of the goal to eat healthy on the relation between the healthy section menu design and choosing healthy food in restaurants? (4) What is the effect of self-control on the relation between the goal to eat healthy and choosing healthy food in restaurants? (5) What is the effect of self-control on the moderating effect of the goal to eat healthy on the relation between healthy section menu design and choosing healthy food in restaurants? This research paper is structured as follows. The theoretical framework presents a brief overview of the knowledge about promoting healthy food decisions in restaurants and discuss the role of healthy eating goals and self-control. Following this, the research design illustrates a procedure by which restaurants can target the healthy high-margin dishes on their menu. In specific, an online experiment will be conducted to answer the research questions that compares the impact of two menu designs on healthy food choices. The first menu design is the "healthy section menu" which involves a separate healthy food section. The second menu design is the regular control menu where no sections were used. An online survey asks participants to pick a main dish and answer questions to test the other measurements (e.g., self-control). Lastly, implications and suggestions outline future research in this domain that can guide promising future actions in this key area.

In conclusion, the investigated model sheds new light on the literature of promoting healthy food. It provides new insights into the effects that menu design has on customers’ healthy food choices. The practical contribution this study provide illustrates what the impact of the menu design will be on consumers’ healthy food choices, which also has implications for restaurants’ profits.

THEORETICAL FRAMEWORK

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nutritional value, it has a higher level of essential micronutrients, or because it has a better composition of macronutrients (e.g., lower levels of fats) compared to alternatives (Ditlevsen, Sandøe & Lassen, 2019). In this research, Bouwman et al. (2009)'s description of "healthful eating" is used. They explain that healthful eating consists of following a varied diet with many vegetables, fruit, and fish and avoiding too much fats, sugars, calories, and salt.

Away-from-home food generally contains more of the overconsumed nutrients and less of the under-consumed nutrients (Lin et al. 1999). This issue is even more relevant considering that expenditures on away-from-home food are increasing worldwide (Drichoutis, 2009). Some studies have found that most consumers underestimate the nutrient content of restaurant foods (Burton et al. 2006), which can be twice as much as compared to their expectations (Burton & Creyer, 2004). Instead of nutrient content, many people's choices regarding what they eat are shaped by other factors with different degrees of importance (e.g., taste, health, cost, mood, culture, competence; Bacon, Krpan, 2018). However, Wansink & Love (2014) state that design changes to restaurant menus can influence food consumption based on the principles of behavioral science. Several studies have been conducted about the design features. Dayan & Bar-Hillel (2011) and Duke (2013), for example, concluded that dishes placed at the beginning or at the end of the menu of their category were chosen up to twice as much than when they were placed in the middle of the list. This can be explained by the primacy and recency effects, which in this case means that people are most likely to remember the first and last things they see (Bowen & Morris, 1995).

Another option to guide consumers to healthy food choices is to modify the visual design of the menu. This can be done by using symbols (Feldman, Mahadevan, Su, Brusca, & Ruzsilla, 2011). According to Visschers & Siegrist (2015), the inclusion of additional information is also a main design feature. Dishes can become more attractive when the menu states they are climate-friendly meal choices. Another feature is the dish's description. For example, "Grandma’s homemade chocolate pudding" instead of "chocolate pudding". If the description is used appropriately, it can improve sales and the perceptions of the restaurant and the meals (Wansink et al. 2001).

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will increase the likelihood of healthy food choices because people might be more willing to order a healthy dish since it is placed in an outstanding section. As Kershaw (2009) mentioned, the eyes of a consumer tend to be drawn on that area that stands out and will therefore increase the likelihood of choosing something of that separated and outstanding part of the menu. In addition, there is no question of an excluded group of people like there was for the non-vegetarians in Bacon and Krpan (2018)'s study.

Hypothesis 1: A healthy section on the menu increases healthy food choices.

The effects of a healthy section on the menu may depend on the importance a person places on eating healthily. Health goals represent desired future states and are accessible during individuals' decision making (Schultheiss & Brunstein, 1999). According to McCarthey et al. (2017), eating behavior can be motivated by many goals. The interplay between individual, social, and interpersonal factors describe these goals (Köster, 2009; Randall & Sanjur, 1981; Sobal, Bisogni, Devine, & Jastran, 2006). The interactions between these factors shape food choices and consumption patterns (McCarthy & Collins, 2008). Goals represent desired outcomes to which people are committed (Fishbach & Ferguson, 2007; Fujita & MacGregor, 2011). Good health may be highly valued without actually adopting a health goal to guide the behavior of a person. A person may, for example, think that health is important without actually decreasing their consumption of unhealthy food. Goal setting motivates people to actually act toward their desired outcomes (Carver & Scheier, 1982). A high extent of the goal to eat healthy should therefore increase the likelihood of choosing a healthy dish. Therefore, a person's goal to eat healthy probably influences the person's healthy food choice. This is confirmed by Selmon et al. (2014), who state that healthy choices are related to healthy eating goals. Therefore, people who have a high extent of goal to eat healthy are probably more likely to choose a healthy dish.

Hypothesis 2: Goal to eat healthy increases healthy food choice.

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Hypothesis 3: Goal to eat healthy strengthens the relation between healthy section menu and healthy food choice.

The positive effect of goal to eat healthy on the relation between healthy section menu and healthy food might be moderated by self-control. Individuals with high self-control might pursue healthy eating goals to ensure that a healthy eating habit is supported if not maintained in its entirely (Baumeister, 2002). Self-control is a central function of the self and an important factor for success in a person's life (Baumeister, Vohs and Tice, 2007). Self-control is an essential predictor, especially in a healthy life (Tangney, Baumeister & Boone, 2004; De Ridder, Lensvelt-Mulders, Finkenauer, Stok & Baumeister, 2012). Self-control can be defined as the ability to override or change one’s inner responses, as well as to interrupt undesired behavioral tendencies (such as impulses) and refrain from acting on them (Hofmann, Luhmann, Fisher, Vohs & Baumeister, 2013).

There are two types of self-control. The first type of self-control is "state self-control" (Gillebaart, Schneider & de Ridder, 2015). This type can fluctuate over time and is an exhaustible behavior (Baumeister, 2002). According to Baumeister (2002), this type of self-control is affected by emotions. It is harder to keep your long-term goal when you feel sad. State self-control is not an unlimited source of inhibition. Therefore, when you feel sad you will eat more unhealthy food (Baumeister, 2002; Mick, 1996).

The other type of self-control is "trait self-control." Trait self-control is a part of an individual's personality and is stable (Gillebaart, Schneider & De Ridder, 2015). Individuals with more inherent self-control can better control their thoughts, impulses, and behaviors and are less influenced by temptations (Friese & Hofmann, 2009). This study only focuses on trait self-control because it is part of one's character and is therefore a stable item. For the remainder of this study, self-control will refer to "trait self-control."

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(Cohen & Farley 2008). Individuals with a high level of self-control are therefore more likely to resist unhealthy food. In addition, several studies state that a high level of self-control is a prerequisite for healthy food choices (Hofmann, Friese & Wiers, 2008, Schwarzer, 2008), while individuals with low self-control are often unable to exert the effort to warrant a well-considered, balanced food decision (Bargh, 2002; Wansink & Sobal, 2007). Individuals often set goals for themselves. Those with high self-control are more likely to achieve those goals and resist temptations (Baumeister, 2002; Fishbach & Shah, 2006; Tangney et al., 2004). This moderating effect of self-control on the relation between goal to eat healthy and healthy food choices will be tested in the fourth hypothesis.

Hypothesis 4: Self-control strengthens the relation between goal to eat healthy and healthy food choice.

These decisions are influenced by factors including salience, priming, defaults, and social norms (Bacon, Krpan. 2018). Placing healthy dishes in a separate section in the menu can be seen as an example of salience. When focusing on salience, most models of health behavior assume that a high level of self-control is a prerequisite for making healthy food decisions (e.g., Hofmann, Friese & Wiers, 2008; Schwarzer, 2008). In addition, food choices are, most of the time, made mindlessly and impulsively when consumers have low self-control and are unable to make a well-considered, balanced decision (Bargh, 2002; Wansink & Sobal, 2007). Therefore, high self-control is expected to strengthen the moderating effect of healthy eating goals on the positive relationship between healthy section and healthy choice. Therefore, the fifth hypothesis is:

Hypothesis 5: The effect of goal to eat healthy on the relation between healthy section menu on healthy food choice will be stronger when self-control is high.

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Figure 1 Conceptual model

Hypothesis 1: A healthy section on the menu increases healthy food choice. Hypothesis 2: Goal to eat healthy increases healthy food choice.

Hypothesis 3: Goal to eat healthy strengthens the relation between healthy section

menu and healthy food choice.

Hypothesis 4: Self-control strengthens the relation between goal to eat healthy and healthy food choice.

Hypothesis 5: The effect of goal to eat healthy on the relation between healthy section menu on healthy food choice will be stronger when self-control is high.

RESEARCH DESIGN

To test the hypotheses, a between-subject design was applied. In an online scenario, participants were randomly assigned to one of the two conditions. The first condition group was shown the control menu, which means the dishes were presented in the usual manner without any sections. The second group was shown an adjusted menu wherein the healthy dishes were presented in a separate section of the menu titled "healthy main dishes." Respondents were asked to choose one of the main dishes they would like to eat.

Method

Participants were recruited using e-mail and social-media. All participants were residents of the Netherlands. The participants who could not choose freely from the menu items due to restricted diets were identified with a question at the end of the study so they could be excluded from the analysis. To test the hypotheses, a factorial between-subject design was used. This means that the respondents of the survey served in only one condition (Malhotra, 2010). In our study, they received either the control menu or the menu with a separate healthy section.

Healthy section

menu Healthy food choice

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The menus used were based on the menus that were used in the research of Lowe (2012), in which the meals were selected from the menu of a full-service restaurant chain that included nutrition information (Appendix A). The three most healthy options were moved together under the heading "Healthy Main Dishes." According to Wisdom et al. (2010), the daily calorie recommendation appears, on average, to decrease calorie intake. Therefore, the three dishes with the fewest calories were merged into the healthy food section. To increase its visibility, the healthy section is placed at the top of the menu. According to Liu et al. (2012) people may be more likely to order from this part of the menu.

The menu was adjusted to make it as simple as possible for participants to make a single choice without needing further information. Making the menu as clear as possible minimized the possibility of ambiguities about the dishes. In addition, to increase the likelihood that all respondents would understand each menu item, each item included a Dutch translation. Both menus used are shown in Figure 2.

Main measures

To measure healthy food choices, three healthy dishes were merged together in the healthy section in one of the menus. As mentioned previously, the menu was based on Lowe (2012). The healthy dishes were the ones containing the lowest number of calories. These dishes were the healthy food choices, while the other dishes were the non-healthy meals. The research asked participants to select one of the dishes. The healthy food choice variable is a binary variable. To test the importance that participants placed on healthy eating, goal to eat healthy was included as a moderating variable. This variable is based on Salmon et al. (2014) and tested using the following question: “To what extent do you have the goal to eat healthily?” on 5-point scales ranging from 1 ("not at all") to 5 ("very much").

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Figure 2

The control menu versus the healthy section menu

Control measures

The participants' hunger was measured on a five-point scale ranging from 1 ("not hungry at all") to 5 ("very hungry") using the question “How hungry do you feel at this moment?” Since age (Drewnowski & Shultz, 2001) and gender (Wardle et al. 2004) are known to play a role in food choices, the participants were asked to report theirs.

Gardner (2014) states that negative and positive moods may lead to preferences for different types of foods. Therefore, the participant's mood is included as a control measure, which is tested on a five-point scale ranging from 1 ("very negative") to 5 ("very positive") using the question “How do you feel at this moment?”

To test to what extent the respondent paid attention to the healthiness of the dish when picking a main dish, attention to healthiness was measured. This variable was tested on a five-point scale ranging from 1 ("not at all") to 5 ("very great extent") using the question “To what extent have you paid attention to the healthiness of dishes during your choice?”

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Exploratory measures

Exploratory variables were measured to gain additional insights into the impact of menu design on healthy food choices. The participants’ future intentions regarding eating a healthier diet was measured using Bacon & Krpan (2018) survey questions. Participants were asked how strongly they intended to eat a healthier diet over the next three months. This was measured on a scale from 0 ("no intention") to 10 ("very strong intention").

Subjective nutritional knowledge is also used as an exploratory measure. According to Moorman et al. (2004), subjective knowledge affects choice because consumers are motivated to behave consistently with their subjective knowledge. Therefore, subjective knowledge is a stronger driver of the behavior of an individual compared to objective knowledge (House et al. 2004, Pienak et al. 2006). Subjective knowledge will be measured using Moorman et al. (2004) by asking participants to rate the following questions: "Rate your knowledge of nutrition information compared to the average consumer" on a 7-point scale from 1 ("much less") to 7 ("much more"); "Rate your confidence in using nutrition information compared to the average consumer" on a 7-point scale from 1 ("much less") to 7 ("much more"); and "I feel confident about my ability to comprehend nutrition information on product labels" on a 7-point scale from 1 ("disagree") to 7 ("agree").

Procedure

Participants completed the study online. They were first presented with an image of a "cozy" restaurant and were asked to imagine as if they were going to have evening dinner there with a friend. Subsequently, they were presented with one of the two menus and were asked to select a main dish. Following that, participants were presented with the questions about self-control and the other items described under the measures in the materials section. Finally, they were asked if they were restricted in some way (e.g., a diet). This was done in order to identify the participants' level of freedom to choose from the menu items and whether they should be excluded from the analysis. The complete survey can be found in Appendix B.

RESULTS

Factor analysis and reliability analysis

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needs to be significant at a significance level below .05 (p < .05) (Malhotra, 2010). The results show that the dimensions pass the conditions of these tests. The results can be seen in Appendix C.

The factor analysis is tested to determine the number of components that will be extracted from the data. The determination is based on the scree plot, which is one of the options to determine the number of factors (Malhotra, 2010). This is a plot of eigenvalues against the number of factors in order of extraction. The scree plot indicates that the "break" occurs at item number 2. Only components above this "break" are retained for further testing (Costello & Osborne, 2005). Therefore, it can be assumed that variables are unidimensional. To test the reliability, the Cronbach’s alpha score is calculated. Since a Cronbach’s alpha score above .60 is commonly acceptable (Malhotra, 2010), the scores in Table 1 satisfy the criteria.

According to the factor analysis and reliability analysis, the items can be combined into new variables. Therefore, self-control and subjective nutrition knowledge will be used in further analysis. The complete output can be found in Appendix C.

Table 1

Results factor analysis and reliability analysis

Construct

Number of

combined items Eigen value

Cronbach's alpha score

Self-control 13 4,191 0,819 Subjective knowledge 3 2,320 0,848

Multicollinearity

Regression is complicated by the presence of multicollinearity. Multicollinearity arises when intercorrelations among predictors are very high (Malhotra, 2010). To test our data set for multicollinearity, the widely-used variance inflation factor (VIF) will be used. The VIF scores in both tables indicate they are all between 1 and 1.5 (Appendix C). This is far below 10, which is the condition (Griffith and Harvey, 2010). Thus, it can be concluded that there is no reason to worry about multicollinearity.

Descriptive statistics

Excluded cases

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menu. The responses from the remaining 143 participants, composed of 97 (67.8%) males and 46 (32.2%) females, were included in the main analysis: 70 participants were in the control menu condition, and 73 participants were in the healthy menu section condition.

Descriptive statistics

The descriptive statistics are presented in Table 2. The statistics include means, standard deviations, and bivariate correlations for the variables used in this study. As shown in Table 2, not all variables were significantly related to our conceptual model and were therefore excluded from further analysis (Becker, 2005). Therefore, the analyses to test hypotheses one, two, and three contain the following variables: attention to healthiness, subjective knowledge, and fluency English. For hypotheses four and five, hungry, age, gender, and mood were included.

Table 2

Means, Standard Deviations, and Correlations

Variables Mean SD 1 2 3 4 5 6 7 8 9 10

1. Healthy section menu .51 .502

2. Healthy food choice .44 .498 -.089

3. Goal to eat healthy 3.59 .980 .037 -.050

4. Self-Control 3.22 .599 .046 .122 .250** 5. Attention to healthiness 2.36 1.201 .093 .053 .279** .255** 6. Subjective knowledge 4.78 1.144 .059 -.038 .263** .114 .237** 7. Fluency English 5.64 1.302 -.140 .233* .013 .113 .019 .268** 8. Hungry 2.29 1.119 0.001 -.108 0.010 -.246** -.013 .057 .053 9. Age 32.6 13.937 -.73 .131 .114 .240** .188* .036 -.062 -.284** 10. Gender 1.32 .469 .105 -.038 .148 .214* .170* -.054 -.122 -.154 -.001 11. Mood 3.76 .789 -.002 .008 1.162 .335* .033 .200* -.140 -.150 .089 .062

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Data analysis

Since the dependent variable (i.e., healthy food choice) is binary, a logistic regression was conducted to analyze the data (Malhotra, 2010). To analyze the data, PROCESS-analysis (Hayes, 2013) was used. Hayes (2013) offers several models to test data. Model 1 will be used to test the first three hypotheses. These results will be shown in Table 3. Hayes’ (2013) model 3 will be used to test the fourth and fifth hypotheses and these results will be displayed in Table 4. Since the two menu conditions will be compared to each other, the healthy section menu variable will be coded as effect codes during the hypotheses testing (Mayhew & Simonoff, 2015). Therefore, the control menu will be coded as -1, and the healthy section menu still as 1.

Hypotheses testing

The first hypothesis predicted that a separate health section in the menu increases healthy food choices. A logistic regression was conducted, using healthy section menu as an independent variable and healthy food choices as a dependent variable. Participants’ food choices in each menu condition are shown in Figure 3. The control menu provided a higher percentage of healthy food choices compared to the menu with the health section. The results in Table 3 reveal a nonsignificant relationship between the appearance of a healthy section and healthy food choice (B = .0792, SE = .6777, P = .9070). Hence, Hypothesis 1 was not supported.

The second hypothesis predicted that a high extent of the goal to eat healthy increases healthy food choices. To test this hypothesis, a logistic regression analysis was conducted using self-control as an independent variable and healthy food choice as a dependent variable. As displayed in Table 3, the results revealed a nonsignificant relationship between self-control and healthy food choice (B = -.1125, SE = .1913, P = .5565). Hence, Hypothesis 2 was not supported.

18 51% 60% 49% 40% 0% 20% 40% 60% 80% 100% 120%

Control menu Health section menu Non-healthy choice Healthy choice

variable, and self-control as moderating variable. As displayed in Table 4, the results revealed a nonsignificant interaction of self-control on the relation between goal to eat healthy and healthy food choice (B = .2201, SE = .3258, P = .4993). Hence, Hypothesis 4 was not supported.

The fifth hypothesis predicted that a high degree of self-control would strengthen the moderating effect of goal to eat healthy on the positive relationship between healthy section menu on healthy food choice. A logistic regression analysis is conducted using healthy section menu as independent variable, healthy food choice as dependent variable, and goal to eat healthy and self-control as moderating variables. As shown in Table 4, results revealed a nonsignificant relationship between self-control that would increase the moderating effect of goal to eat healthy on the positive relation between the sectional menu design and healthy food choice (Interaction 2: B = .2201, SE = .3258, P = .4993). Hence, Hypothesis 5 was not supported.

Also the control measures are not significant, except fluency English. This variable have a significant effect in both first three hypotheses (B = .4692, SE = .1682, P = .0053), as well as hypothesis four and five (B = .5392, SE = .1852, P = .0036). A higher degree of fluency English seem to increase healthy food choices. The complete output of the results are included in Appendix D.

Figure 3

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Table 3

Regression model of predictors of healthy food choice (self-control not included)

B SE B T P

Constant -1.8376 1.1657 -1.5764 .1149 Goal to eat healthy -.1125 .1913 -.5881 .5565 Healthy section menu .0792 .6777 .1169 .9070 Interaction -.0538 .1817 -.2963 .7670 Attention to healthiness .1620 .1560 1.0388 .2989 Subjective knowledge -.2212 .1713 -1.2914 .1966 Fluency English .4692 .1682 2.7888 .0053 p= .0683 Conditional effect of IV on DV at different values of goal to eat healthy

95 % Confidence Interval LLCI ULCI - 1SD -.5559 .4329 M -.4627 .2340 + 1SD -.6592 .3249 Note. N = 143. *_{p < .05,} **_{p < .01, p} ***_{< .001} Table 4

Regression model of predictors of healthy food choice (self-control included)

B SE B T P

Constant -5.9433 3.8964 -1.5253 .1272 Goal to eat healthy .8801 1.0047 .8760 .3810 Healthy section menu 1.8983 3.7726 .5032 .6148 Interaction 1 -.3387 .3196 -1.0599 .2892 Interaction 2 .2201 .3258 .6756 .4993 Attention to healthiness .1116 .1721 .6482 .5168 Subjective knowledge -.2741 .1852 -14.803 .1388 Fluency English .5395 .1852 29.123 .0036 Hungry -.1821 .1716 -10.612 .2886 Age .0186 .0144 12.903 .1969 Gender -.0922 .4250 -.2169 .8283 Mood .0285 .2608 .1094 .9129 p= .1445 Conditional effect of IV on

DV at different values of self-control

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DISCUSSION

The purpose of this research is to expand the current knowledge of the promotion of healthy food in an out-of-home setting. It was expected that a separate healthy section on the menu would increase the likelihood of people choosing healthy dishes. The extent to which a person has a goal to eat healthily might strengthen that relation. In addition, the level of self-control may increase that interaction. After conducting the analysis, these relations were found to be nonsignificant. Nevertheless, this research still provides insights into healthy food choices.

Theoretical implications

The findings suggest that there is not a significant relation between healthy section menu and healthy food choices. A possible explanation might be in the moral licensing phenomenon. According to this phenomenon, an action that is perceived to be healthy can influence a person to subsequently make a less healthy or morally-desirable choice (Chiou et al., 2011; Fishbach & Dhar, 2005; Messner & Brügger, 2015). In this case, participants may have made a healthy or morally-desirable choice earlier that day or week, and therefore have allowed themselves to choose a less-healthy food dish. In addition to licensing, Wilcox et al. (2010) reasoned in their study on vicarious goal fulfillment that the merepresence of a healthy option can already cause licensing. This could be the case in this study: with the presence of a healthy section on the menu, people are more likely to make indulgent food choices.

Also, the limited number of healthy options people could choose from may play an important role. Many factors shape people's food choices, including taste and cost (Sobal & Bisogni, 2011). It may have been the case that respondents didn’t think the healthy food options were appealing. Since there were only three dishes labeled as healthy in this study, it is possible that the respondents considered these dishes to be unappetizing. Another option in this case is that the respondents may have expected the non-healthy dishes to be more appetizing. This may also be due to the descriptions of the dishes. Non-healthy dishes may have appeared to be more appealing in the expectations of the respondent. However, to minimize the possibility of this occurring, menu design effects such as those discussed in the literature review were deliberately excluded from both survey menus.

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imagine that they were going to eat in a restaurant with a friend. The friend they had in mind could have unconsciously influenced their own food choices.

The results of this study show that individuals with healthy eating goals do not necessarily act to reach these goals by choosing healthy food. An explanation can be provided by Bayuk et al. (2010). They suggest that goal setters are less likely to consider an alternative when their goals cannot be reached. These finding suggest that individuals who set goals for themselves but cannot meet them will stop trying to reach those goals. The relationship between the goal and the action may differ in the difficulty of the goals (Bayuk and Laran, 2014). Relating to this study, individuals who fail (or seem to fail) to eat healthy may rather give up on their healthy eating goals and therefore base their food choices less on healthiness. According to David and Haws (2016), another reason might be that the healthiest goals focus on avoiding the unhealthy foods that they favor the most. They stated that this kind of healthy eating strategy is unlikely to be successful in making food choices.

The effect of healthy section menu on healthy choices with an moderating effect of goal to eat healthy is not supported in this study. A reason might be that individuals are not considering to be eating healthy when they are consuming away-from-home food (Kyureghian et al. 2007). Consumers have a different attitude about away-from-home food than food at home. They may consider it as an occasional threat. They only stick to their health goals when eating at home (Lin, Frazao and Guthrie, 1999). These consumers may not realize the extent to which away-from-home food has become a regular occasion in their lives (Kyureghian et al. 2007).

22

healthy menu section. However, according to the results in Table 4, a lower level of self-control does not lead to significant evidence for this in the current study.

Practical implications

A healthy section on the menu does not seem to increase healthy food choices by itself. Restaurant owners who want to guide customers to more healthy dishes should therefore try other menu strategies as mentioned in the theoretical framework.

According to Frazao and Guthrie (1999), consumers seem to be ignorant about the extent to which away-from-home food has become a more regular occasion in their daily lives. Thus, by not adhering to their health goals when eating away-from-home food, it has a bigger effect on their health than they may believe. To decrease societal health problems, the government could make consumers more aware of their away-from-home food consumption and the corresponding health problems it might deliver.

Customers may be seeking more healthy food options, but they still demand appetizing food or their favorite items when eating out. Both are likely be less healthy. Restaurants can support healthy food consumption by offering smaller portion sizes or using lean protein. These are subtle and effective ways to provide a more healthful menu (Hoffman, 2007).

Restaurant menu health sections are not expected to reduce unhealthy products in order to address obesity on their own, but it might be a place to start. With a problem as complicated as obesity, no one policy will be enough. More strategies need to be implemented to address the obesity problem.

Limitations

The first limitation is that the research was conducted online instead of at a real restaurant. The first question in the study asked participants to imagine a restaurant scenario. This restaurant scenario was created to minimize the disadvantages of an online survey and to make the food choice more authentic. Comparable studies have used similar approaches (Brunstrom & Shakeshaft, 2009; Haws & Liu, 2016). Prior impactful menu studies which also not used a real restaurant setting have indicated that the online survey should not be considered as a disadvantage (e.g. Liu, Roberto, Liu, & Brownell, 2012).

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The consumer may value a different focus on healthiness in his or her own goal to eat healthily. For example, the consumer's healthy eating goal values a healthy supply chain (e.g. locally, organically grown, fresh) instead of nutritional value as used in this study (vanEpps et, al. 2016). In addition to this limitation, goal to eat healthy was measured using a one-item scale in this study. To gain a more precise insight into a more specific domain of the goal to eat healthy, a multi-item scaled would have been better.

Another limitation for this research might be the sample size. Although it is possible to draw conclusions based on the size of the respondent sample, a better and more-representative conclusion could have been drawn from a larger sample size.

The present study used self-report measures for self-control variables. More objective measures may increase the validity of this study. Examples of more objective measures are peer ratings or supervisor ratings (Chan, 2009).

Future research

Future research should consider a case study approach in which all respondents come to the same restaurant (Sulek and Hensley, 2004). Therefore, a real restaurant instead of an online survey should be considered. In this online survey, respondents may (despite the restaurant picture which was shown) imagine different kinds of restaurants.

Also interesting for future research might be a combination of restaurant menu section and calorie labeling to increase awareness and change consumer and restaurant behavior. Findings from studies that tested calorie labeling have provided mixed results so far. Some studies state that it is an excuse for overconsumption, while others suggest that it helps consumers in making healthy choices (Bates et al., 2011; Chandon & Wansink, 2007; Roberto, Schwartz, & Brownell, 2009; Tandon, Wright, Zhou, Rogers, & Christakis, 2010). Restaurants have been found hesitant to provide calorie labeling, possibly due to worries for sales (Story, Kaphingst, Robinson O’Brien, & Glanz, 2008). Therefore, the combination of calorie labeling and a health section may result in new, interesting findings to guide customers to healthy (and commercially-profitable) choices. In addition, the effects of a combination of the health section design with other visual designs or descriptive designs as discussed in the literature review can be an interesting topic for future research as well.

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communication about healthiness will help customers' choices in restaurants. Future research should investigate whether informing customers about why the items in the healthy section are healthy may increase the effectiveness of the healthy section design.

Ordering online is becoming more and more popular (Kimes, 2011). The menu's health section may show different results about healthy food choices when ordering online at home instead of in a restaurant. This might be an interesting domain to investigate in future research. Lastly, future research is needed to find out which strategies may raise consumers' awareness of healthy products and encourage their consideration when eating in restaurants. The effect of communication campaigns might be one of them (vanEpps et, al. 2016).

CONCLUSION

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APPENDICES

Appendix A: Menu that was used

Figure A1

Menu that was used by Lowe (2012)

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Appendix C: Factor and reliability analysis

Figure C1

Scree plot Subjective knowledge

Component

Table C2

Eigen values Self-control Initial Eigenvalues

Total % of Variance Cumulative %

1 4,191 32,235 32,235 2 1,360 10,461 42,696 3 1,208 9,292 51,989 4 1,023 7,868 59,857 5 ,970 7,461 67,318 6 ,829 6,380 73,698 7 ,703 5,405 79,103 8 ,617 4,745 83,849 9 ,543 4,179 88,028 10 ,466 3,581 91,609 11 ,409 3,144 94,753 12 ,372 2,859 97,612 13 ,310 2,388 100,000 Component Table C1

Eigen values Subjective knowledge Initial Eigenvalues

Total % of Variance Cumulative %

1 2,320 77,328 77,328

2 ,481 16,037 93,365

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Figure C2 Scree plot Self-control

Table C3 Coefficients (Model 1) Unstandardized coefficients Standardized coefficients

Beta Collinearity Statistics

B Std. Error t Sig. Tolerance VIF

(Constant) 0,148 0,258 0,573 0,567 Section -0,053 0,083 -0,054 -0,643 0,521 0,965 1,036 Attention to healthiness 0,039 0,036 0,093 1,072 0,286 0,887 1,127 Healthy eat goal -0,024 0,045 -0,048 -0,542 0,588 0,879 1,138 Subjective knowledge -0,049 0,039 -0,112 -1,245 0,215 0,828 1,208 Fluency English 0,097 0,033 0,255 2,94 0,004 0,9 1,111

40 Table C4 Coefficients(Model 2) Unstandardized coefficients Standardized coefficients

Beta Collinearity Statistics

B Std. Error t Sig. Tolerance VIF

(Constant) -0,068 0,389 -0,174 0,862 Section -0,04 0,084 -0,47 0,639 0,943 1,061 Attention to healthiness 0,028 0,038 -0,04 0,742 0,46 0,81 1,234 Healthy eat goal -0,034 0,046 0,068 -0,736 0,463 0,831 1,204 Subjective knowledge -0,053 0,041 -0,066 -1,296 0,197 0,769 1,3 Fluency English 0,101 0,035 -0,122 2,888 0,005 0,809 1,236 Self-control 0,051 0,081 0,264 0,621 0,536 0,706 1,416 Hungry -0,028 0,037 0,061 -0,752 0,453 0,846 1,182 Age 0,004 0,003 -0,067 1,192 0,235 0,842 1,188 Gender -0,038 0,093 0,107 -0,407 0,684 0,879 1,138 Mood 0,025 0,059 -0,036 0,426 0,671 0,787 1,271

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Appendix D: SPSS output regression analysis

Model 1

Outcome: Healthy food choice Coding of binary DV for analysis: Healthy food choice Analysis .00 .00 1.00 1.00

Logistic Regression Summary

-2LL Model LL p-value McFadden CoxSnel Nagelkrk n 184.4837 11.7306 .0683 .0598 .0788 .1055 143.0000

coeff se Z p LLCI ULCI

constant -1.8376 1.1657 -1.5764 .1149 -4.1224 .4472 Goal to eat healthy -.1125 .1913 -.5881 .5565 -.4875 .2625 Healthy section menu .0792 .6777 .1169 .9070 -1.2491 1.4075 int_1 -.0538 .1817 -.2963 .7670 -.4100 .3023 Attention to healthiness .1620 .1560 1.0388 .2989 -.1437 .4678 Subjective knowledge -.2212 .1713 -1.2914 .1966 -.5570 .1145 Fluency English .4692 .1682 2.7888 .0053 .1394 .7989 Product terms key:

int_1 Healthy section menu X Goal to eat healthy

Conditional effect of Healthy section menu on Healthy food choice at values of the moderator(s): Goal to eat

healthy Effect se Z p LLCI ULCI 2.6141 -.0615 .2522 -.2440 .8072 -.5559 .4329 3.5944 -.1143 .1777 -.6432 .5201 -.4627 .2340 4.5748 -.1671 .2511 -.6657 .5056 -.6592 .3249 Level of confidence for all confidence intervals in output: 95.00

Model 2

Outcome: Healthy food choice Coding of binary DV for analysis: Healthy food choice Analysis .00 .00 1.00 1.00

Logistic Regression Summary

42

coeff se Z p LLCI ULCI

constant -5.9433 3.8964 -1.5253 .1272 -13.5800 1.6934 Goal to eat healthy .8801 1.0047 .8760 .3810 -1.0891 2.8493 Healthy section menu 1.8983 3.7726 .5032 .6148 -5.4959 9.2926 Self-Control 1.3325 1.2000 1.1103 .2669 -1.0196 3.6845 int_3 -.3387 .3196 -1.0599 .2892 -.9652 .2877 int_4 .2201 .3258 .6756 .4993 -.4184 .8586 Attention to healthiness .1116 .1721 .6482 .5168 -.2257 .4489 Subjective knowledge -.2741 .1852 -1.4803 .1388 -.6371 .0888 Fluency English .5395 .1852 2.9123 .0036 .1764 .9025 Hungry -.1821 .1716 -1.0612 .2886 -.5184 .1542 Age .0186 .0144 1.2903 .1969 -.0097 .0469 Gender -.0922 .4250 -.2169 .8283 -.9252 .7408 Mood .0285 .2608 .1094 .9129 -.4826 .5396 Product terms key:

int_3 Goal to eat healthy X Self-control

int_4 Healthy section menu X Goal to eat healthy X Self-control

Conditional effect of Healthy section menu on Healthy food choice at values of the moderators:

Self-control Goal to eat healthy Effect se Z p LLCI ULCI 2.6168 2.6141 -.0822 .3313 -.2482 .8040 -.7316 .5672 2.6168 3.5944 -.2496 .2926 -.8532 .3936 -.8231 .3238 2.6168 4.5748 -.4170 .4260 -.9791 .3275 -1.2519 .4178 3.2157 2.6141 -.0888 .2804 -.3166 .7516 -.6383 .4607 3.2157 3.5944 -.1269 .1906 -.6660 .5054 -.5005 .2467 3.2157 4.5748 -.1651 .2699 -.6119 .5406 -.6941 .3638 3.8146 2.6141 -.0953 .4630 -.2058 .8369 -1.0027 .8121 3.8146 3.5944 -.0043 .2827 -.0150 .9880 -.5583 .5498 3.8146 4.5748 .0868 .3597 .2413 .8093 -.6182 .7918

Conditional effect of Healthy section menu on Goal to eat healthy interaction at values of Self-control: