Elsevier

Appetite

Volume 155, 1 December 2020, 104831
Appetite

Front-of-pack images can boost the perceived health benefits of dietary products

https://doi.org/10.1016/j.appet.2020.104831Get rights and content

Abstract

Images on dietary supplement packaging can help identify the products' supposed function. However, research shows that these images can also lead people to infer additional health benefits of consuming the products. The present research investigated the extent to which front-of-pack imagery affects people's perceptions of the health risks and benefits of fictional products. In three randomized experiments, participants saw fictitious dietary supplement packages. Some of the packages included a health-related image (e.g. a heart), whereas others did not. Participants were asked to infer the products' intended purpose and then to rate the perceived risks and benefits of consuming the product. In Experiment 1 (N = 546), the inclusion of a health-related image increased the perceived benefits of consuming the product, with minimal effect on the perceived risks. This finding was replicated in Experiment 2 (N = 164), but was contingent on whether each product's assumed health function was confirmed or disconfirmed. In Experiment 3 (N = 306), which used a pre-registered design and analysis plan, the inclusion of a health-related image increased the perceived benefits and decreased the perceived risks of consuming the product. Again, these effects were contingent on whether the assumed health functions were confirmed or disconfirmed. These findings indicate that health-related imagery could lead consumers to infer additional health properties from non-diagnostic information featured on a product's packaging, perhaps as a consequence of increased processing fluency. This research underscores the importance of regulating the use of imagery in health marketing, to protect consumers from the effects of potentially misleading claims.

Introduction

Visual imagery can offer an effective way for marketers to inform consumers and to capture their interest. However, images can also sometimes convey subtle or even unintended meanings (Gil-Pérez, Rebollar, Lidón, Martín, et al., 2019). In 2010, for example, regulators forced the Dannon Company to alter their product packaging and advertisements, which had claimed—without scientific evidence—that eating their probiotic yogurts would reduce digestive transit time (Federal Trade Commission, 2010). Not only did Dannon ultimately abandon these written health claims from their packaging, but gone too was a downwards-pointing yellow arrow that had previously been superimposed over an image of a svelte woman's waist. This arrow, it was claimed, constituted a more subtle kind of health claim. As one commentator put it, “The arrow is code for ‘This will go right through you’” (cited in Sandler, 2008; see also; Singer, 2011).

Dannon's yellow arrow aptly illustrates how easily health-related imagery can be used in product marketing to imply—in valid or misleading ways—supposed health benefits. In this paper we ask whether adding a simple health-related image to a dietary supplement's packaging could unduly boost its apparent health benefits and reduce its apparent risks.

Many countries legally regulate the appropriate use of health claims on the packaging of food and dietary supplements, including probiotic yogurts, to ensure that consumers are well-informed and not misled (European Commission, 2006; Food and Drugs Act, 1985, n.d.; Food and Drug Administration, 2019). From a sizeable research literature in health and consumer psychology, we know a lot about the effects of written health claims on people's appraisals of products. For example, when a short written claim—such as “Calcium may reduce the risk of osteoporosis”—is added to a product's packaging, prospective consumers typically judge the product more favorably (Kozup, Creyer, & Butron, 2003), giving higher ratings of its perceived healthiness (Wills, Bonsmann, Kolka, & Grunert, 2012) and of their intent to purchase it (Roe, Levy, & Derby, 1999). Recent work into promoting healthier food choices showed that a written health claim increased older adults' self-reported likelihood of consuming beans (Farrell, Doma, Leith-Bailey, Soucier, & Duncan, 2019), and that participants perceived drinks carrying a written health claim as healthier than those without the claim, irrespective of the products' actual healthiness (Franco-Arellano, Vanderlee, Ahmed, Oh, & L'Abbé, 2020). However, whereas written claims communicate information about health functions explicitly, some countries' laws acknowledge that images can convey similar kinds of information, and therefore demand that the use of such imagery is also regulated (e.g., European Commission, 2006). In contrast with the sizeable literature on written health claims, relatively few studies have explored the comparable effects of health imagery on people's appraisals of products.

In one study, researchers found that adding a ‘natural’ or ‘medical’ graphic to a product's package led participants to infer that it was healthier (Saba et al., 2010). Similarly, Carrillo, Fiszman, Lähteenmäki, and Varela (2014) used a word association task to demonstrate that even ambiguous health-related images—including an image of a person running, some olives, or a heart and stethoscope—can increase the overall appeal and trustworthiness of the product. In another study, participants categorized a product's attributes (e.g. this product is spicy) more rapidly when the name of the product was accompanied by a relevant image (e.g. ‘Tabasco sauce’ accompanied by a fire graphic; Gil-Pérez, Rebollar, Lidón, Piqueras-Fiszman, & van Trijp, 2019). Other research shows that health-related images can lead people to believe they saw health claims, which in fact they only inferred (Klepacz, Nash, Egan, Hodgkins, & Raats, 2016). In three experiments, Klepacz et al.‘s participants saw pictures of fictional product packages—some of which contained a health-related image such as a heart-shaped graphic—and also read written facts about each product. Afterwards participants were tested on their memory for the details about the various products. When products' packages had featured health-related images, participants often falsely recalled having read positive health claims about them—such as that the product was beneficial to heart health. Participants made these memory errors even when explicitly warned to disregard the health-related images; a finding that suggests participants formed their inferences implicitly and automatically, rather than with conscious awareness.

However, Klepacz et al.’s (2016) data cannot tell us whether the participants actually believed their inferences were true. For example, they might believe that a product is marketed to benefit heart functioning, but not necessarily believe that it would truly have this benefit. From a legislative and health psychology perspective, this is an important issue to address, especially as frameworks such as the Theory of Planned Behaviour predict that people's behavioral intentions—such as their intent to purchase or consume a product—are governed not by their inferences per se but by their beliefs in those inferences (Ajzen, 1991). Moreover, in all of the studies described above, the health images were the only relevant cue that signalled information to participants about the products' health properties. It therefore makes sense that participants inferred health functions when seeing these health function images. We know less about whether images affect people's inferences about a product only when they have no other information to inform their understanding, or instead, whether images would guide people's inferences even when they are given written information about the product's health properties.

There are at least two reasons to predict that health-related images would indeed shape people's appraisals of products' benefits and risks, even when they receive other, more relevant written information. The first reason is that imagery may simply make the product package more aesthetically appealing, leading people to think more positively in general about the qualities of the product. There are many examples in the psychological literature wherein people afford globally positive attributions to an object or individual, on the basis of observing a single positive yet non-diagnostic characteristic. For example, these so-called ‘halo effects’ lead us to assume that more-attractive defendants are less likely to be guilty of criminal acts (Mazzella & Feingold, 1994), and lead to essays being marked more favorably when attributed to an attractive author (Landy & Sigall, 1974). These kinds of overgeneralizations arise, too, when we judge health products. For instance, people assume that a product carrying an ‘organic’ claim will contain fewer calories than an equivalent product without the claim (Schuldt & Schwarz, 2010); that products marketed by socially responsible corporations are healthier (Peloza, Ye, & Montford, 2015); and that products whose names contain a nutritive term (e.g. protein bar) will contain higher levels of other, unrelated nutrients, such as fiber and iron (Fernan, Schuldt, & Niederdeppe, 2018). We might therefore expect that people would judge a dietary supplement as more appealing when its packaging uses imagery, and in turn, that people would anticipate such products to have other positive features, such as being beneficial and posing a low-risk to health.

A second, related reason to make this same prediction comes from the literature on processing fluency, which demonstrates that when we process information in ways that subjectively feel ‘quick and easy’, we are more likely to experience a (sometimes mistaken) sense of comprehending the information well, and to consequently make positive appraisals of the information's target (Schwarz, 1998). For example, Dohle and Montoya (2017) demonstrated that people were willing to administer higher doses of imaginary drugs that had easy-to-pronounce, fluent names, than of drugs with difficult-to-pronounce, dysfluent names. In a related study, people perceived food additives with hard-to-pronounce names as significantly more harmful than additives with fluent names (Song & Schwarz, 2009). Crucially, we know that images—just like easily-processed text— afford feelings of processing fluency that can shape people's judgments of information. For instance, Cardwell, Lindsay, Förster, and Garry (2017) showed participants statements about complex natural or mechanical processes—such as how a rainbow forms—some of which were preceded by a related yet uninformative photo, such as an image of a rainbow. Participants then rated the extent to which they felt they understood how each process worked. In six experiments, viewing uninformative images led participants to believe they had a greater understanding of these complex processes. Similarly, a simple nonprobative photograph (i.e., one that provides no relevant evidence) can make people more likely to believe that a claim is true (Newman et al., 2015; Newman, Garry, Bernstein, Kantner, & Lindsay, 2012), and when added to a wine bottle, can even make the wine seem better tasting (Cardwell, Newman, Garry, Mantonakis, & Beckett, 2017). In a similar vein, we would predict that the addition of a health-related image to a product's package could provide a sense of perceptual and conceptual fluency that affects people's judgments of its health properties.

In short, the aesthetic and processing fluency accounts both lead us to predict that adding a health-related image to a dietary supplement's packaging would increase people's positive evaluations of the product, such that they would judge its health benefits to be more likely, and the risks less likely. Here we tested this prediction in three experiments. Participants saw images of fictitious dietary supplement packages, some of which contained a health-related image. For each product, participants were then explicitly told the product's ‘real’ health function, and were informed about two health benefits and two health risks of consuming the product. They then made judgements about the likelihood that someone with the specific target health concern would benefit from, and be at risk from, consuming the product.

Section snippets

Method

The studies reported in this paper received approval from the University of Surrey (Experiments 1 & 2) and Aston University (Experiment 3) Ethics Committees.

Experiment 2

Above we described two theoretical accounts of why health-related images might lead people to make more positive appraisals of a product's health benefits and (in principle, although this was not the case in Experiment 1) their risks. In Experiment 2 we attempted to tease apart these two different interpretations of the data from Experiment 1. To do this, we manipulated the written information that people received about each product after they guessed its intended function. Specifically, people

Experiment 3

Both Experiments 1 and 2 generally show that health images on products' packaging increased people's perceptions of those products' health benefits, but not their risks. Importantly, our analysis of Experiment 2 also lends support to the processing fluency-based account, in that people's appraisals of a product's health benefits were only enhanced when their initial expectations about the products prove to be correct. Our findings do not fit well, though, with the aesthetic account, which would

Discussion

Taken together, the results of these three experiments indicate that front-of-pack imagery can shape how people appraise the health properties of dietary supplements. Specifically, in all three experiments we found that the addition of a function image to a product's packaging increased participants' perceptions of the likelihood that somebody experiencing the target health concern would benefit from consuming the product. Similarly, we found evidence that function images led participants to

Ethical statement

All of the studies reported in this paper received full approval from an institutional ethics committee; Experiments 1 and 2 received ethical approval from the University of Surrey Ethics Committee (application number: EC/2012/105/FAHS); Experiment 3 was approved by Aston University Ethics Committee (application number: 1410). All participants gave informed consent prior to participation, and were fully debriefed upon completing the study.

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    This research was funded in part by funding from the European Commission's Seventh Framework Programme, within the PlantLIBRA project (Plant Food Supplements: Levels of Intake, Benefit and Risk Assessments). The European Commission had no role in the experimental design, analysis, or writing of this paper. The content of this paper reflects only the views of the authors; the European Commission is not liable for any use that may be made of the information contained in this paper. N.A.K. and M.M.R.‘s research center provides consultancy to, and received travel funds to present research results from, organizations supported by food and drink companies. The authors acknowledge the input from the PlantLIBRA project team at the University of Surrey (Bernadette Egan, Charo E. Hodgkins, Lada Timotijevic, Adrian P. Banks, Matthew Peacock) who contributed to research design discussions for Experiment 1. They are also grateful to staff and students at King Edward VI College, Stourbridge, for their involvement in Experiment 2.

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