According to the World Health Organization, over 340 million children and adolescents (ages 5 to 10) were classified as overweight or obese in 2016, a statistic that has risen by 14% since 1975. Child obesity is associated with a range wide range of serious health complications and an increased risk of premature onset of diseases including diabetes and heart disease. Without intervention, children and young adolescents classified as obese are likely to remain so throughout adolescence and adulthood.

A new study conducted in the UAE investigates whether research by early adolescents to evaluate peer food choices triggers controversial thinking that improves their food choices, even when peer choices about food are unhealthy. The findings suggest that including the health assessments of others’ food choices may be a tool to combat unhealthy lifestyles. This study is the first to ask early adolescents to evaluate the food choices of “distant peers” (real or fictional children of the same age who are not physically present). In this case, distant peers were fictitious students of the same age identified as coming from another school, whose various food choices (healthy or unhealthy) were shared in writing before the young teenagers who participated in the study to choose their food.

The findings were published in a Child development article, written by researchers at the American University of Sharjah, the University of Granada, Zayed University, the University of St. Gallen, New York University Abu Dhabi, Center for Institutional Behavioral Design, and Luxembourg Institute for Socio-Economic Research.

“We initially hypothesized that early adolescents evaluating the health choices of distant peers would make healthier decisions, regardless of the health choices chosen by distant peers,” said Ernesto Reuben, lead researcher and professor at the Center for Institutional Design of Behavior at New York University Abu Dhabi. “Our second hypothesis suggested that the search for young adolescents to assess the health of distant peer choices will cause more controversial decision-making among 6th graders compared to 5th graders because cognitive development even in the short span of a year can result in greater reliance on reasoned decisions made more slowly and thoughtfully than intuitive decisions made impulsively.Increase in support of controversial decision-making with age during adolescence “early will mean that the requirement to evaluate the food choices of a distant colleague may have a higher impact on the health choices of older students compared to younger ones.”

Participants included 467 students (54.5% female) in 5th and 6th grades recruited from three international primary schools in Abu Dhabi, UAE. The sample was mainly of a medium to high socio-economic status.

One week before the experiment, the parents of the participating students were sent an email informing them that they would not need to bring a snack for one of the school holidays on study day. Participants were introduced to four different food trays each with five different food items with similar nutritional values ​​rated by a nutritionist at Burjeel Hospital in Abu Dhabi, UAE. Each teen was asked to select four food items from the tray. Before making their food choices, they were informed of four food items selected by an unknown distant colleague attending another school who was also participating in the experiment.

In each participating school, different classes were randomly assigned to one of four treatments (variables):

  • Healthy health: The food items of distant colleagues were relatively healthy: an apple, a banana, a pear, and water.
  • Sick colleague: distant colleague items were relatively unhealthy: gummy bears, a lollipop, chips, and chocolate milk.
  • Healthy Peer with Assessment: after receiving information about the choices of distant colleagues, but before choosing the food themselves, participants had to evaluate the decisions of distant colleagues regarding health and explain their assessment. Peer choices were the same as in the healthy treatment of peers (apples, bananas, pears and water).
  • Sick colleague with evaluation: reflects the treatment of healthy colleagues with evaluation, but uses the choices of colleagues to treat sick colleagues (gummy bears, a lollipop, chips and chocolate milk).

Participants were also asked to rate the health of peer elections as “very sick”, “sick”, “healthy” or “very healthy”. Participants ’knowledge of food item health was also measured (how they thought parents from their school would rank different food pans from the most unhealthy to the healthiest).

The findings showed that the mere fact that he was asked to evaluate the choices of a distant peer led young teens to choose significantly healthier food, regardless of whether or not their peers’ choice of food was healthy. Moreover, even the small age difference between 5th and 6th graders was significant. Peer-to-peer assessment improved the health choices of 6th graders’s food choices more than those of 5th graders.

“These findings show that making individuals think more influences their decision-making – moreover, the stage of their cognitive development matters,” said Francisco Lagos, professor of economics at Zayed University and the University of Granada. “The findings also have important implications for public health: having a better understanding of how young teens develop, evaluate and then make food choices can help us design effective strategies to improve people’s eating habits while they are young. “

The authors acknowledge that the adolescents in the study made their decisions without social interaction, while food choices are often made by adolescents in social contexts. Furthermore, study participants were provided with familiar, familiar items of healthy eating such as fruits, but not healthy options that are sometimes considered less attractive, such as green vegetables. Participants were also from relatively wealthy and educated families in which adults may be more likely to emphasize the benefits of healthy eating. The findings are based on age-specific age groups and may not apply to younger teens with less questionable thinking skills. Finally, one of the main challenges in improving eating habits is finding effects that last for a long time and this study assessed only short-term effects.


This research was supported by a grant from the College of Business at Zayed University as part of a project in Remedies against obesity in childhood.

Summarized by Child development, Early adolescent food selection after health assessment of food choices of distant peers from Cobo-Reyes, R. (American University of Sharjah), Lacomba, JA (University of Granada), Lagos, F. (Zayed University and University of Granada), Zenker, C. (University of St. Gallen), Reuben, E. (New York University Abu Dhabi, Center for Institutional Design of Behavior and Luxembourg Institute for Socio-Economic Research). Copyright 2021 Association for Research in Child Development, Inc. All rights reserved.

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