Selection Does Not Equate Consumption

To the Editor We applaud Turnwald et al¹ for their experimental design to test inexpensive interventions to increase healthy food consumption within the Stanford University dining hall. In a Research Letter published in a recent issue of JAMA Internal Medicine, Turnwald et al¹ reported that indulgent descriptors of healthy vegetables dramatically increased “consumption” compared with alternatively labeling the same food. The assumption that measuring the quantity of a vegetable selected equates to consumption is flawed and may misrepresent the results and overstate the conclusions. The authors cited a review by Wansink and Johnson² that found that on average 92% of foods selected are consumed.