You’ve probably heard the saying, “You are what you eat”, to encourage healthier eating behaviours. This is a ‘mental model’ that simplifies the relationship between diet and health – a heuristic when we make choices around food. Another prevalent mental model views the body as a ‘calorie-container’, where the difference between input ie. calories consumed and output ie. work done, is stored as fat. Individuals going on a narrow calorie-deficit diet to lose weight may end up ignoring other nutritional aspects in the bargain, leading to potential health risks. So what are mental models, and are they helpful? Can they also be harmful, and what could we do to correct this? Mental models are internal representations of an external reality that shape how we understand the world, make decisions, and act. In 1943, Scottish psychologist Kenneth Craik proposed that the mind constructs “small-scale models” of reality, which are used to reason, anticipate events, and underlie explanation. Mental models can provide pragmatic and effective shortcuts in thinking, especially for complex concepts and situations! For example, physics concepts such as escape velocity, catalysts, inertia, friction, leverage, etc., when thinking of change in a system; the Pareto Principle that states that roughly 80per cent of outcomes come from 20per cent of causes; Occam’s Razor to keep things simple, etc. In being representations, mental models are bound to miss out on information. Even if popular, they can be inaccurate and incorrect! For instance, the ‘calorie-container’ view of the body represents energy input and work done from a thermodynamic perspective but insufficiently represents nutritional requirements from a dietary perspective. Our research at
the Centre for Social and Behaviour Change on adherence to Exclusive Breastfeeding observed a common bias of viewing the infant’s system as a mini version of an adult’s. Parents incorrectly believe that providing supplements beneficial to adults, such as water, honey, and dal water, would similarly benefit the infant, inadvertently harming them. This intuition goes against medically recommended practices: water, although hydrating could fill an instant’s stomach and not leave sufficient space for nutritious milk, it could also be contaminated, resulting in diarrhoea; although honey is considered immunity boosting and dal-water strengthening for adults, an infant’s system may not be equipped to digest this yet, resulting in health complications. Another stark example of inaccurate mental models is the widespread belief about diarrhoea treatment in India, which sees the body as a “leaky pipe”, leading parents to reduce a sick child’s fluid intake – in opposition to the medical recommendation of providing ORS and further liquids. Sendhil Mullainathan observed that 35-50per cent of poor Indian women incorrectly believed that decreasing fluid intake was the best course of action, revealing their misperception that feeding a child liquids will only make the child more sick, and that keeping the child ‘dry’ would be better.This could result in dehydration, the infection not being flushed out of the system soon enough. Diarrhoea is one of the leading causes of mortality in children under five years of age in India, and the treatment of diarrhoea can be improved by not only ensuring an accessible supply of ORS, but also correcting this flawed mental model.
In cases of inaccurate models, effort must be made to replace or correct them to develop effective solutions. Commenting on Complementary feeding behaviours for children aged 6-24 months, Dr. VK Paul (Member, NITI Aayog) said, “Children have to eat more often — twice a day between six to nine months, thrice between nine and twelve months and four times a day beyond twelve months. They also must eat diverse foods, which should include cereals, protein, fat, sugar or jaggery, milk and fruits. Both meal frequency and diverse diets together make an acceptable diet.” There are two kinds of mental models at play -relating to quality, and diet diversity. Families may underfeed children due to biases in miscalculating how much food a child needs in their growing stage. A 2018 narrative synthesis found that the portion sizes parents serve vary substantially and are influenced by amounts parents serve themselves, perceived child hunger, and parent and child body size. Additionally, young children are often fed child-versions of adult diets that are typically carbohydrate-heavy and contain insufficient nutrients, thus hampering their development. One way to replace the mental model regarding diet diversity is the using the ‘Tiranga Thaali,’ ie. the inclusion of foods of three different colours in the daily diet – encouraging the provision of a more diverse diet such as white carbohydrates, yellow/orange pulses and vegetables and green leafy vegetables. This concept is now being used in many geographies as part of counselling efforts to improve nutrition indicators.
It is valuable to investigate underlying mental models that influence behaviours while designing effective interventions, programmes, and policies. They may not be a hundred per cent accurate, but we expect them to provide utility within their respective contexts. When they are flawed, well-intentioned actions can have harmful consequences. However, since mental models can provide useful tools in decision-making, we must not throw the baby with the bathwater. In cases where these are inaccurate, effort must be made to replace them with correct models. Take the example of the Tiranga Thaali – it is easy to remember, is a quick decision-making tool, and effectively represents complex knowledge about the system!
This article is written by Nymphea Noronha, Senior Programme Manager, Centre for Social and Behaviour Change, Ashoka University.
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