Nudge interventions to reduce fish sauce consumption in Thailand

Abstract

High sodium consumption is one of the four major risk factors contributing to non-communicable diseases around the world. Thailand has one of the highest rates of sodium consumption, with fish sauce being one of the main sources. The aim of this study was to examine whether changes in the micro-environment factors can affect fish sauce consumption behavior in a university setting in Thailand. We implemented four interventions (with one control) in five canteens across a Thai university. The study design was a Latin square, where the five canteens were randomized over five weeks to implement four interventions plus a control. Our interventions included behavior-oriented, cognitive-oriented, and affective-oriented nudges aimed to reduce the amount of fish sauce people add to their noodles during lunchtime at the university canteens. Results indicate that a simple change in how fish sauce was served can reduce fish sauce consumption. Serving fish sauce in a bowl with a spoon reduced the amount of fish sauce used per noodle bowl by 0.25 grams, compared to the normal condition where fish sauce is served in a bottle. Using a specially-designed spoon with a hole induced a larger reduction of 0.58 grams of fish sauce used per bowl. The other two interventions, cognitive-and affective-oriented nudges, also showed reductions of fish sauce usage, but the differences were not statistically significant. The findings can be used for policy implementation to advocate the use of a smaller sized spoon and a bowl to serve fish sauce instead of a bottle to reduce sodium consumption among Thai people.

Effects of Using a Perforated Spoon on Salt Reduction When Consuming Ramen Noodles: A Randomized Crossover Study of Japanese Male University Students

“…The test meal was a ramen noodle dish that contained wheat noodles, sliced pork, seaweed, bean sprouts, and other ingredients in the soup. It was selected because it is frequently consumed in Japan [ 15 ]. According to a study examining the food-based dietary patterns of Japanese people for breakfast, lunch, and dinner, “ramen” is frequently consumed for during lunch [ 16 ].…”

“…According to a study examining the food-based dietary patterns of Japanese people for breakfast, lunch, and dinner, “ramen” is frequently consumed for during lunch [ 16 ]. This study showed that 1504 lunches from the 4-day dietary records of 392 Japanese adults aged 20–69, of which 99 were observed to contain ramen [ 15 ]. Generally, ramen has a high salt content [ 17 ].…”

“…This study suggested that ease of eating affects the amount of food eaten. A study conducted in Thailand [ 15 ] on fish sauce consumption reported that using a specially designed spoon with a hole induced a larger reduction (0.58 g) in the fish sauce used per bowl compared to the normal condition where fish sauce is served in a bottle.…”

Being unconventional: The impact of unconventional packaging messages on impulsive purchases

“…Nudge theory, grounded in dual-system principles (Kahneman & Frederick, 2002), proposes that consumer decision making comprises reflective and automatic systems (Thaler & Sunstein, 2008). The reflective system is conscious, controlled, and logical; the automatic system is unconscious, emotional, and heuristic (Kanchanachitra et al, 2020). The automatic system is more susceptible to external stimuli, but the reflective system considers different alternatives in decision making.…”

Food Choices and Hypertension Among Rural Thais: Evidence From a Discrete Choice Experiment

“…In fact, 22% of Thai respondents, compared to 9% of global respondents, reported eating away from home at least once a day [12]. Moreover, 38% of Thai respondents who eat away from home reported eating street foods [12], which are a popular choice for out-of-home dining in Thailand and are commonly high in sodium [13].…”