A new study from the Journal of Consumer Research addresses a modern health crisis: the so-called “American obesity paradox” — the rise in obesity rates despite the growing popularity of healthier food.

In a series of four studies, the researchers reveal that the public tends to over-generalize “healthy” claims. In fact, consumers chose beverages, side dishes, and desserts containing up to 131% more calories when the main dish was labelled as “healthy”.

“In [the consumers] black and white view, most food is good or not good,” explained co-author Brian Wansink of Cornell University. “When we see a fast-food restaurant like Subway advertising its low-calorie sandwiches, we think, ‘It’s OK: I can eat a sandwich there and then have a high-calorie dessert,’ when, in fact, some Subway sandwiches contain more calories than a Big Mac.”

In one study, Wansink and his team had consumers guess how many calories are in sandwiches from two restaurants. The consumers estimated that sandwiches from restaurants claiming to be healthy contain around 35% fewer calories than when prepared from restaurants that don’t make this claim.

The result of this calorie underestimation? “Consumers then chose beverages, side dishes, and desserts containing up to 131% more calories when the main course was positioned as “healthy” compared to when it was not—even though, in the study, the “healthy” main course already contained 50% more calories than the “unhealthy” one,” according to the study.

“These studies help explain why the success of fast-food restaurants serving lower-calorie foods has not led to the expected reduction in total calorie intake and in obesity rates,” the authors write.

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