Pairing Images of Unhealthy and Healthy Foods With Images of Negative and Positive Health Consequences: Impact on Attitudes and Food Choice

Objective: To examine the impact of presenting images of foods paired with images of positive and negative health consequences of their consumption on food choice and attitudes. Method: Participants (N = 711) were randomly allocated in a 2 × 3 factorial design (Food Type × Affective Valence) to 1 of 6 conditioning procedures that paired images of either energy-dense snack foods or fruit, with (a) images of negative health outcomes, (b) images of positive health outcomes, or (c) a no image control. The primary outcome was food choice assessed postintervention with a behavioral choice task. Secondary outcomes were implicit attitudes (assessed pre- and postintervention) and explicit attitudes (assessed postintervention). Results: Presenting images of negative health outcomes led to more healthy food choices relative to control and positive image conditions, irrespective of whether they were paired with images of energy-dense snack foods or fruit. This relationship was partially mediated by changes in implicit and explicit attitudes. Images of positive health outcomes did not alter food choices. Conclusions: This study replicates and extends previous research showing that presenting images of negative health consequences increases healthy food choices. Because effects were elicited by manipulating affective valence irrespective of paired food type, these results appear more consistent with an explanation based on priming than on evaluative conditioning.