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Bennett R, Driessen C, Zorbas C, Sacks G, Gupta A, Cameron A, Gomez-Donoso C, Peeters A, Backholer K. ' Healthier options tend to get lost in the noise of online' - Australian shoppers' experiences with online grocery platforms. Public Health Nutr 2024; 27:e134. [PMID: 38742445 DOI: 10.1017/s1368980024001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE We aimed to understand what influences parents' purchasing behaviours when shopping for groceries online and potential ways to improve the healthiness of online grocery platforms. DESIGN We conducted semi-structured interviews, guided by the Marketing Mix framework. Reflexive thematic analysis was used to analyse data. SETTING Online interviews were conducted with primary grocery shoppers. PARTICIPANTS Parents (n 14) or caregivers (n 2) using online grocery platforms at least every 2 weeks. RESULTS Most participants perceived purchasing healthy food when shopping for groceries online to be more challenging compared to in physical stores. They expressed concerns about the prominence of online marketing for unhealthy food. Participants from lower socio-economic backgrounds often depended on online supermarket catalogues to find price promotions, but healthy options at discounted prices were limited. Across socio-economic groups, fresh items like meat and fruit were preferred to be purchased instore due to concerns about online food quality.Participants believed online grocery platforms should make healthy foods more affordable and supported regulations on supermarket retailers to promote healthy options and limit unhealthy food promotion online. CONCLUSIONS Participants had varied experiences with online grocery shopping, with both positive and negative aspects. Efforts to improve population diets need to include mechanisms to create health-enabling online grocery retail platforms. Government interventions to restrict marketing of unhealthy foods and promote marketing of healthy options on these platforms warrant investigation.
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Affiliation(s)
- Rebecca Bennett
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Christine Driessen
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Adyya Gupta
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | | | - Clara Gomez-Donoso
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
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2
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Woodall S, Hollis JH. The Difference between PC-Based and Immersive Virtual Reality Food Purchase Environments on Useability, Presence, and Physiological Responses. Foods 2024; 13:264. [PMID: 38254565 PMCID: PMC10814356 DOI: 10.3390/foods13020264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Computer simulations used to study food purchasing behavior can be separated into low immersion virtual environments (LIVE), which use personal computers and standard monitors to display a scene, and high immersion virtual environments (HIVE) which use virtual reality technology such as head-mounted displays to display a scene. These methods may differ in their ability to create feelings of presence or cybersickness that would influence the usefulness of these approaches. In this present study, thirty-one adults experienced a virtual supermarket or fast-food restaurant using a LIVE system or a HIVE system. Feelings of presence and cybersickness were measured using questionnaires or physiological responses (heart rate and electrodermal activity). The participants were also asked to rate their ability to complete the set task. The results of this study indicate that participants reported a higher sense of presence in the HIVE scenes as compared to the LIVE scenes (p < 0.05). The participant's heart rate and electrodermal activity were significantly higher in the HIVE scene treatment when compared to the LIVE scene (p < 0.05). There was no difference in the participant's ability to complete tasks in the different scenes. In addition, feelings of cybersickness were not different between the HIVE and LIVE scenes.
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Affiliation(s)
| | - James H. Hollis
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50312, USA;
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3
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Chuvileva YE, Manangan A, Chew A, Rutherford G, Barillas-Basterrechea M, Barnoya J, Breysse PN, Blanck H, Liburd L. What North American retail food environment indices miss in Guatemala: Cultural considerations for the study of place and health. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2024; 164:10.1016/j.apgeog.2024.103204. [PMID: 38532832 PMCID: PMC10964928 DOI: 10.1016/j.apgeog.2024.103204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
We evaluated the cross-context validity and equivalence of the US- and Canada-originated Retail Food Environment Index (RFEI) and modified RFEI (mRFEI) against a retail food environment dataset from the indigenous-majority city of Quetzaltenango (Xela), Guatemala. The RFEI/mRFEI failed to identify 77% of retailers and misclassified the healthiness of 42% of the remaining retailers in Xela, inaccurately labeling the city a food swamp. The RFEI/mRFEI are not currently suitable for mapping retail food environments in places like Quetzaltenango. Alternative functional and temporal classifications of retail food environments may provide measures with greater contextual fit, highlighting important cultural considerations for the study of place and dietary health.
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Affiliation(s)
- Yulia E. Chuvileva
- Division of Adolescent and School Health (DASH), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), USA
| | - Arie Manangan
- Division of Environmental Health Science and Practice (DEHSP), National Center for Environmental Health (NCEH), CDC, Atlanta, GA, USA
| | - Aiken Chew
- Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - George Rutherford
- University of California San Francisco (UCSF), San Francisco, CA, USA
| | | | - Joaquín Barnoya
- Unidad de Cirugía Cardiovascular de Guatemala and Universidad Rafael Landivar, Guatemala City, Guatemala
| | - Patrick N. Breysse
- NCEH/Agency for Toxic Substances and Disease Registry (ATSDR), CDC, Atlanta, GA, USA
| | - Heidi Blanck
- Division of Nutrition, Physical Activity, and Obesity (DNPAO), NCCDPHP, CDC, Atlanta, GA, USA
| | - Leandris Liburd
- Office of Minority Health and Health Equity (OMHHE), CDC, Atlanta, GA, USA
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4
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Rosin M, Young L, Jiang Y, Vandevijvere S, Waterlander W, Mackay S, Ni Mhurchu C. Product promotional strategies in supermarkets and their effects on sales: A case study of breakfast cereals and drinks in New Zealand. Nutr Diet 2023; 80:463-471. [PMID: 36843241 DOI: 10.1111/1747-0080.12800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 02/28/2023]
Abstract
AIMS To examine the frequency of promotions on breakfast cereals and drinks in a major New Zealand supermarket chain, determine the healthiness of promoted versus non-promoted products, and quantify the effects of promotions on sales. METHODS Weekly data on product promotions and sales were collected in six Auckland supermarkets for 198 breakfast products over 12 weeks. The healthiness of products was determined using the Health Star Rating system, and the effect of promotions on sales was estimated using linear mixed models. RESULTS On average, 47% of breakfast products in a given week were promoted using on-shelf tickets, 12% in weekly mailers, and 9% via promotional displays. The healthiness of promoted and non-promoted breakfast products was comparable. In relation to weekly sales of non-promoted products, all three promotional strategies had substantial (2 to 2.5 times higher sales) and statistically significant (P < 0.001) effects on product sales. CONCLUSION Promotions are frequently used and effective at increasing sales. Marketing strategies focusing solely on promoting healthier products could be an important nudging strategy to improve the healthiness of supermarket food purchases.
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Affiliation(s)
- Magda Rosin
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Leanne Young
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Stefanie Vandevijvere
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Department of Public Health and Epidemiology, Scientific Institute of Public Health (Sciensano), Brussels, Belgium
| | - Wilma Waterlander
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sally Mackay
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
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5
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Wallis LW, Moore SG. Product promotions in online supermarkets: prevalence of 'High Fat Sugar Salt' (HFSS) products and labelling characteristics. Public Health Nutr 2023; 26:2607-2618. [PMID: 37606051 DOI: 10.1017/s1368980023001787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
OBJECTIVE To evaluate the prevalence of 'High Fat Sugar Salt' (HFSS) products and front-of-pack nutrition labelling (FOPNL) characteristics across promoted products in UK online supermarkets. DESIGN A cross-sectional survey conducted (December 2021-January 2022) on promoted products. Data on ingredients, nutritional composition and display of FOPNL were collected from product webpages. The UK's Nutrient Profiling Model and Multiple Traffic Light criteria were used to determine HFSS status and possession of inherent red traffic lights (iRTL), respectively. Data analysis determined the prevalence (i.e. percentage of products of the total number of products sampled) of HFSS; FOPNL and possession of iRTL. Chi-squared tests explored associations between these. SETTING Three major UK online supermarket retailer websites. PARTICIPANTS Product 'multibuy' and 'entrance' promotions, from selected product categories. RESULTS Among the sampled 625 promoted products, the prevalence of HFSS was greater in entrance (73 %) compared with multibuy (41 %) promotions (χ2 (1) = 34, P < 0·05), with variations in the former across retailers (49-92 %). The prevalence of HFSS products in multibuy promotions offered by two retailers varied by category (i.e. Confectionery 94-97 %, Yogurts 20-20 %, Soft Drinks 16-33 %, Ready Meals 1·4-18 %). Not all promoted products displayed FOPNL on webpages (70 %) or images (52 %). A number of iRTL were found to be possessed by both HFSS and non-HFSS-promoted products. CONCLUSIONS Prior to the 2022 implementation of Regulations restricting these, HFSS products were promoted in online supermarkets with varying display of FOPNL and possession of iRTL. Findings support future policy evaluation and mandatory digital FOPNL.
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Affiliation(s)
- Lewis W Wallis
- School of Food Science and Nutrition, University of Leeds, LeedsLS3 9JT, UK
| | - Sally G Moore
- School of Food Science and Nutrition, University of Leeds, LeedsLS3 9JT, UK
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6
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Chen YJM, Haynes A, Scully M, Gascoyne C, McAleese A, Dixon H, Morley B, Wakefield M. Food purchasing practices in various retail settings and dietary intake: A cross-sectional survey of Australian adolescents. Health Promot J Austr 2023; 34:784-790. [PMID: 36625434 DOI: 10.1002/hpja.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 12/20/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND/AIMS Discretionary, energy-dense, nutrient-poor food and drinks are heavily marketed and readily available in retail settings frequented by adolescents. This study examines associations between food purchasing practices in various retail settings and dietary intake among Australian adolescents. METHODS Participants were students in years 8 to 11 (ages 12-17 years) who completed the 2009-10 (n = 13 790), 2012-13 (n = 10 309) or 2018 (n = 9102) National Secondary Students' Diet and Activity (NaSSDA) cross-sectional survey. Multistage stratified random sampling was used. An online survey completed at school assessed self-reported frequency of food purchasing practices in various retail settings and consumption of discretionary food, sugary drinks, fruit and vegetables. Generalised linear regression models examined associations between food purchasing practices and dietary behaviour. RESULTS Relative to students who brought lunch from home, those who purchased lunch from school or nearby outlets reported higher intake of discretionary food and sugary drinks and lower fruit intake. Buying lunch from school was also associated with lower vegetable intake. Buying food or drinks on the school commute, outside school grounds during school hours, from supermarket checkouts, and using mobile phone apps were each associated with higher discretionary food and sugary drink intake (all P < .01). CONCLUSIONS Purchasing food or drink in various retail settings is associated with higher intake of discretionary food and drink among Australian adolescents, and some purchasing practices appeared to displace fruit and vegetable intake. SO WHAT?: These findings highlight a need to improve the accessibility and promotion of healthier food and drink options in schools and other retail settings.
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Affiliation(s)
- Yan Jun Michelle Chen
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Ashleigh Haynes
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Claudia Gascoyne
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Alison McAleese
- Prevention Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
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7
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Guan V, Zhou C, Wan H, Zhou R, Zhang D, Zhang S, Yang W, Voutharoja BP, Wang L, Win KT, Wang P. A Novel Mobile App for Personalized Dietary Advice Leveraging Persuasive Technology, Computer Vision, and Cloud Computing: Development and Usability Study. JMIR Form Res 2023; 7:e46839. [PMID: 37549000 PMCID: PMC10442736 DOI: 10.2196/46839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/23/2023] [Accepted: 05/10/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND The Australian Dietary Guidelines (ADG) translate the best available evidence in nutrition into food choice recommendations. However, adherence to the ADG is poor in Australia. Given that following a healthy diet can be a potentially cost-effective strategy for lowering the risk of chronic diseases, there is an urgent need to develop novel technologies for individuals to improve their adherence to the ADG. OBJECTIVE This study describes the development process and design of a prototype mobile app for personalized dietary advice based on the ADG for adults in Australia, with the aim of exploring the usability of the prototype. The goal of the prototype was to provide personalized, evidence-based support for self-managing food choices in real time. METHODS The guidelines of the design science paradigm were applied to guide the design, development, and evaluation of a progressive web app using Amazon Web Services Elastic Compute Cloud services via iterations. The food layer of the Nutrition Care Process, the strategies of cognitive behavioral theory, and the ADG were translated into prototype features guided by the Persuasive Systems Design model. A gain-framed approach was adopted to promote positive behavior changes. A cross-modal image-to-recipe retrieval model under an Apache 2.0 license was deployed for dietary assessment. A survey using the Mobile Application Rating Scale and semistructured in-depth interviews were conducted to explore the usability of the prototype through convenience sampling (N=15). RESULTS The prominent features of the prototype included the use of image-based dietary assessment, food choice tracking with immediate feedback leveraging gamification principles, personal goal setting for food choices, and the provision of recipe ideas and information on the ADG. The overall prototype quality score was "acceptable," with a median of 3.46 (IQR 2.78-3.81) out of 5 points. The median score of the perceived impact of the prototype on healthy eating based on the ADG was 3.83 (IQR 2.75-4.08) out of 5 points. In-depth interviews identified the use of gamification for tracking food choices and innovation in the image-based dietary assessment as the main drivers of the positive user experience of using the prototype. CONCLUSIONS A novel evidence-based prototype mobile app was successfully developed by leveraging a cross-disciplinary collaboration. A detailed description of the development process and design of the prototype enhances its transparency and provides detailed insights into its creation. This study provides a valuable example of the development of a novel, evidence-based app for personalized dietary advice on food choices using recent advancements in computer vision. A revised version of this prototype is currently under development.
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Affiliation(s)
- Vivienne Guan
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Chenghuai Zhou
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Hengyi Wan
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Rengui Zhou
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Dongfa Zhang
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sihan Zhang
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Wangli Yang
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Bhanu Prakash Voutharoja
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lei Wang
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Khin Than Win
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Peng Wang
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
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8
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Yin E, Cameron AJ, Schultz S, White CM, Vanderlee L, Hammond D, Sacks G. Public Support for Nutrition-Related Actions by Food Companies in Australia: A Cross-Sectional Analysis of Findings from the 2020 International Food Policy Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4054. [PMID: 36901060 PMCID: PMC10002083 DOI: 10.3390/ijerph20054054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Unhealthy food environments contribute to unhealthy population diets. In Australia, the government currently relies on voluntary food company actions (e.g., related to front-of-pack labelling, restricting promotion of unhealthy foods, and product formulation) as part of their efforts to improve population diets, despite evidence that such voluntary approaches are less effective than mandatory policies. This study aimed to understand public perceptions of potential food industry nutrition-related actions in Australia. An online survey was completed by 4289 Australians in 2020 as part of the International Food Policy Study. The level of public support was assessed for six different nutrition-related actions related to food labelling, food promotion, and product formulation. High levels of support were observed for all six company actions, with the highest support observed for displaying the Health Star Rating on all products (80.4%) and restricting children's exposure to online promotion of unhealthy food (76.8%). Findings suggest the Australian public is strongly supportive of food companies taking action to improve nutrition and the healthiness of food environments. However, given the limitations of the voluntary action from food companies, mandatory policy action by the Australian government is likely to be needed to ensure company practices align with public expectations.
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Affiliation(s)
- Ebony Yin
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, Deakin University, Burwood 3125, Australia
| | - Adrian J. Cameron
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, Deakin University, Burwood 3125, Australia
| | - Sally Schultz
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, Deakin University, Burwood 3125, Australia
| | - Christine M. White
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Lana Vanderlee
- School of Nutrition, Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC G1V 0A6, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Gary Sacks
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, Deakin University, Burwood 3125, Australia
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9
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Davies T, Coyle D, Shahid M, Pettigrew S, Wu JH, Marklund M. Packaged foods purchased on price promotion in Australia. Appetite 2023; 180:106352. [PMID: 36272544 DOI: 10.1016/j.appet.2022.106352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 09/16/2022] [Accepted: 10/15/2022] [Indexed: 12/15/2022]
Abstract
We examined the prevalence and magnitude of price promotions among purchases of packaged foods and beverages in Australia, as well as the contribution of price-promoted foods and beverages to apparent energy intake. We utilized grocery purchase data from a nationally representative panel of 10 000 households in 2019 (NielsenIQ Homescan panel), combined with a food nutrition dataset (FoodSwitch). Nutritional quality was defined using the Australian and New Zealand Health Star Rating (HSR), where products with an HSR <3.5 were classified as 'less healthy' and products with an HSR ≥3.5 were classified as 'healthy'. Apparent energy intake was expressed as the total energy content of all purchased products per day per capita. Price promotions were claimed by panel members. Overall, four-in-ten packaged products (41%) were purchased on price promotion. Compared to 'healthy' products, 'less healthy' products were more frequently purchased on price promotion (33% vs 48%, respectively, p < 0.001), but had a similar mean magnitude of price discount (both 22%). Low socio-economic status (SES) households consumed 18% more energy from 'less healthy' packaged products on price promotion than high SES households (1141 vs 970 kJ/day/capita, p < 0.001). In conclusion, restricting price promotions for 'less healthy' packaged foods and beverages could potentially improve diet quality and dietary inequalities in Australia.
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Affiliation(s)
- Tazman Davies
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia.
| | - Daisy Coyle
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Maria Shahid
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Jason Hy Wu
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Matti Marklund
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia; Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA; Department of Public Health and Caring Sciences, Uppsala University, 75122, Uppsala, Sweden
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10
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Zorbas C, Browne J, Chung A, Peeters A, Booth S, Pollard C, Allender S, Isaacs A, Hawkes C, Backholer K. Shifting the social determinants of food insecurity during the COVID-19 pandemic: the Australian experience. Food Secur 2023; 15:151-170. [PMID: 36160693 PMCID: PMC9483265 DOI: 10.1007/s12571-022-01318-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 08/31/2022] [Indexed: 01/21/2023]
Abstract
We aimed to explore experiences of government-led actions on the social determinants of food insecurity during Australia's COVID-19 pandemic response (which included novel, yet temporary, social protection measures to support Australians facing hardship during state-wide lockdowns). During November-December 2020, we conducted in-depth interviews with 24 Victorians who received government income support (prior to COVID-19) and the temporary COVID-19 specific payments. Interviews were guided by a theoretical understanding of the social determinants of health and health inequities, which we aligned to the social policy context. Data were audio-recorded, transcribed, inductively coded, categorised and thematically analysed. Our sample included mostly women (n = 19) and single parents (n = 13). Interviews reflected four key themes. Firstly, participants described 'battles all around them' (i.e., competing financial, health and social stressors) that were not alleviated by temporary social policy changes and made healthy eating difficult to prioritise during the pandemic. Secondly, housing, income, job, and education priorities rendered food a lower and more flexible financial priority - even with 18 participants receiving temporary income increases from COVID-19 Supplements. Thirdly, given that food remained a lower and more flexible financial priority, families continued to purchase the cheapest and most affordable options (typically less healthful, more markedly price discounted). Finally, participants perceived the dominant public and policy rhetoric around income support policies and healthy eating to be inaccurate and shaming - often misrepresenting their lived experiences, both prior to and during COVID-19. Participants reported entrenched struggles with being able to afford basic living costs in a dignified manner during COVID-19, despite temporary social protection policy changes. To reduce inequities in population diets, a pre-requisite to health, all stakeholders must recognise an ongoing responsibility for adopting long-term food and social policies that genuinely improve lived experiences of food insecurity and poverty. Supplementary Information The online version contains supplementary material available at 10.1007/s12571-022-01318-4.
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Affiliation(s)
- Christina Zorbas
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Jennifer Browne
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Alexandra Chung
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Anna Peeters
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Sue Booth
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Christina Pollard
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Steven Allender
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Anna Isaacs
- Centre for Food Policy, School of Health Sciences, Division of Health Services Research and Management, City, University of London, London, United Kingdom
| | - Corinna Hawkes
- Centre for Food Policy, School of Health Sciences, Division of Health Services Research and Management, City, University of London, London, United Kingdom
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
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11
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Miguel-Berges ML, Jimeno-Martínez A, Larruy-García A, Moreno LA, Rodríguez G, Iguacel I. The Effect of Food Vouchers and an Educational Intervention on Promoting Healthy Eating in Vulnerable Families: A Pilot Study. Nutrients 2022; 14:nu14234980. [PMID: 36501009 PMCID: PMC9739317 DOI: 10.3390/nu14234980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Cost has been reported as the main barrier to healthy eating in vulnerable groups. We aimed to evaluate the effect of a nutrition education intervention on adherence to Mediterranean Diet and health when providing food vouchers. This pilot study has a randomized control trial design. We included 66 vulnerable users from the Red Cross of Zaragoza (Spain). Intervention and control group individuals received 120 euros/month of food vouchers over 3 months to be spent in supermarkets (60 euros/month if under 12 y) plus a 10-week nutrition education program for the intervention group. Family food purchases were assessed using electronically recorded supermarket-obtained transactions. During and at the end of the intervention the percentage of healthy food was higher in the intervention than in the control group. Once the nutrition education was over, differences between groups dissipated. In the intervention group, health parameters improved, particularly weight-status, lipids, and liver enzymes. Control participants gained weight, although lipid and liver enzymes improved. Blood pressure and HbA1c did not improve in either the intervention or the control group. In conclusion, providing unrestricted food vouchers to vulnerable groups to increase healthy food consumption appears to be insufficient and should be accompanied by medium-long term nutrition education.
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Affiliation(s)
- María L. Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 50009 Zaragoza, Spain
| | - Andrea Jimeno-Martínez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
| | - Alicia Larruy-García
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 50009 Zaragoza, Spain
| | - Gerardo Rodríguez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Isabel Iguacel
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 50009 Zaragoza, Spain
- Correspondence: ; Tel.:+34-(97)-6761749
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Keeble M, Adams J, Burgoine T. Investigating experiences of frequent online food delivery service use: a qualitative study in UK adults. BMC Public Health 2022; 22:1365. [PMID: 35842625 PMCID: PMC9287535 DOI: 10.1186/s12889-022-13721-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/27/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Food prepared out-of-home is typically energy-dense and nutrient-poor. This food can be purchased from multiple types of retailer, including restaurants and takeaway food outlets. Using online food delivery services to purchase food prepared out-of-home is increasing in popularity. This may lead to more frequent unhealthy food consumption, which is positively associated with poor diet and living with obesity. Understanding possible reasons for using online food delivery services might contribute to the development of future public health interventions, if deemed necessary. This knowledge would be best obtained by engaging with individuals who use online food delivery services as part of established routines. Therefore, we aimed to investigate customer experiences of using online food delivery services to understand their reasons for using them, including any advantages and drawbacks. METHODS AND RESULTS In 2020, we conducted telephone interviews with 22 adults living in the UK who had used online food delivery services on at least a monthly basis over the previous year. Through codebook thematic analysis, we generated five themes: 'The importance of takeaway food', 'Less effort for more convenience', 'Saving money and reallocating time', 'Online food delivery service normalisation' and 'Maintained home food practices'. Two concepts were overarching throughout: 'Place. Time. Situation.' and 'Perceived advantages outweigh recognised drawbacks'. After considering each of the accessible food purchasing options within the context of their location and the time of day, participants typically selected online food delivery services. Participants reported that they did not use online food delivery services to purchase healthy food. Participants considered online food delivery service use to be a normal practice that involves little effort due to optimised purchasing processes. As a result, these services were seen to offer convenient access to food aligned with sociocultural expectations. Participants reported that this convenience was often an advantage but could be a drawback. Although participants were price-sensitive, they were willing to pay delivery fees for the opportunity to complete tasks whilst waiting for delivery. Furthermore, participants valued price-promotions and concluded that receiving them justified their online food delivery service use. Despite takeaway food consumption, participants considered home cooking to be irreplaceable. CONCLUSIONS Future public health interventions might seek to increase the healthiness of food available online whilst maintaining sociocultural values. Extending restrictions adopted in other food environments to online food delivery services could also be explored.
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Affiliation(s)
- Matthew Keeble
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Jean Adams
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Thomas Burgoine
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
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Cameron AJ, Brown A, Orellana L, Marshall J, Charlton E, Ngan WW, Ananthapavan J, Isaacs J, Blake M, Sacks G. Change in the Healthiness of Foods Sold in an Australian Supermarket Chain Following Implementation of a Shelf Tag Intervention Based on the Health Star Rating System. Nutrients 2022; 14:nu14122394. [PMID: 35745125 PMCID: PMC9229209 DOI: 10.3390/nu14122394] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 12/10/2022] Open
Abstract
Introduction: Most people in Australia buy most of their food in supermarkets. Marketing techniques promoting healthy foods in supermarkets can be important to encourage healthy eating at a population level. Shelf tags that highlight the healthiness of products have been identified as one such promising initiative. The aim of this study was to assess changes in the healthiness of foods sold in an Australian supermarket chain following implementation of a shelf tag intervention based on the Australian Health Star Rating (HSR) system. Methods: A controlled, non-randomised trial was undertaken in seven supermarkets (intervention: n = 3; control: n = 4) of a single chain in Victoria, Australia, over 12 weeks (4 weeks baseline, 8 weeks intervention period) between August and November 2015. The intervention involved provision of a shelf tag indicating the HSR of all packaged products that scored 4.5 or 5 stars (‘high-HSR products’) using the Australian HSR system. Posters indicating the healthiness of fresh fruits and vegetables (not eligible for an HSR rating, as they are not packaged) were also installed. Weekly per store sales data were provided by the retailer. In an intention-to-treat analysis (with intervention status of individual products based on their eligibility to be tagged), the proportion (%) of all ‘high-HSR’ packaged food sold and the volume of key nutrients (saturated fat, total fat, sodium, total sugar, protein, carbohydrates and energy) per 100 g sold were assessed. Difference-in-difference analyses were conducted to determine the difference between intervention and control stores in terms of mean outcomes between baseline and intervention periods. Customer exit surveys (n = 304) were conducted to evaluate awareness and use of the shelf tags and posters. Results: The proportion of ‘high-HSR products’ sold increased in the intervention period compared to the baseline period in each of the three intervention stores (average increase of 0.49%, 95% CI: −0.02, 0.99), compared to a decrease of −0.15% (−0.46, 0.15) in control stores (p = 0.034). The overall increase in intervention compared to control stores (difference-in-difference) of 0.64% represents an 8.2% increase in the sales of ‘high-HSR products’. Sales of total sugar, total fat, saturated fat, carbohydrates, sodium, protein and total energy in packaged food all decreased significantly more in intervention stores compared to control stores. Sales of fresh fruits and vegetables decreased in intervention stores compared to control stores. Customer surveys found that 34.4% noticed the shelf tags. Of those who noticed the tags, 58% believed the shelf tags influenced their purchases. Conclusions: With this study, we found that the use of shelf tags that highlight the healthiest packaged foods in a supermarket setting showed promise as a mechanism to improve the healthiness of purchases. Opportunities to scale up the intervention warrant exploration, with further research needed to assess the potential impact of the intervention on overall population diets over the longer term.
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Affiliation(s)
- Adrian J. Cameron
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
- Correspondence: ; Tel.: +61-39-2517-741
| | - Amy Brown
- City of Greater Bendigo Council, Bendigo, VIC 3550, Australia;
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC 3550, Australia;
| | - Josephine Marshall
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Emma Charlton
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Winsfred W. Ngan
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Jaithri Ananthapavan
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Jasmine Isaacs
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Miranda Blake
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Gary Sacks
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
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Mackenbach JD, Hobbs M, Pinho MG. Where do Dutch adults obtain their snack foods? Cross-sectional exploration of individuals' interactions with the food environment. Health Place 2022; 75:102802. [PMID: 35462182 DOI: 10.1016/j.healthplace.2022.102802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/28/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022]
Abstract
We investigated frequency of consumption and location of obtaining snack foods and sociodemographic differences therein. Data: cross-sectional survey data (N = 1784 Dutch adults 18-65 years) on the frequency of consumption of 10 snack foods and where they obtained them. Adjusted logistic regression analyses revealed notable differences in the frequency of snack food consumption between younger and older adults and between those with low vs. high socioeconomic position (SEP). The location of obtaining snack foods also differed between sociodemographic groups with supermarkets forming an important point-of-purchase for snack foods, especially for those with low SEP and with children in their household.
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Affiliation(s)
- Joreintje D Mackenbach
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, the Netherlands; Upstream Team, www.upstreamteam.nl, Amsterdam, UMC, the Netherlands.
| | - Matthew Hobbs
- Health Sciences, College of Education, Health and Human Development, University of Canterbury, Christchurch, Canterbury, New Zealand; GeoHealth Laboratory, University of Canterbury, Christchurch, Canterbury, New Zealand.
| | - Maria Gm Pinho
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, the Netherlands; Upstream Team, www.upstreamteam.nl, Amsterdam, UMC, the Netherlands.
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Driessen C, Kelly B, Sing F, Backholer K. Parents' Perceptions of Children's Exposure to Unhealthy Food Marketing: a Narrative Review of the Literature. Curr Nutr Rep 2022; 11:9-18. [PMID: 35278205 PMCID: PMC8942884 DOI: 10.1007/s13668-021-00390-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 12/20/2022]
Abstract
Purpose of Review A key driver of unhealthy diets in children is the marketing of unhealthy foods and beverages. Attempts to regulate children’s exposure to unhealthy food marketing through government-led policies are challenged by commercial interests. Parents shoulder the responsibility of counteracting the effects of omnipresent unhealthy food marketing that children are exposed to within the food environment. In this narrative review we aimed to synthesise the evidence over the last 10 years on parents' perceptions of children’s exposure to unhealthy food marketing and parents support for policies to restrict this marketing. Recent Findings The evidence indicates that unhealthy food marketing leads parents to feel undermined in their ability to provide healthy foods to their children. Despite this concern, parents tend to underestimate the levels of exposure to, and impacts of, unhealthy food marketing to their children, especially in the digital ecosystem. Summary The voices and support of parents represent a significant opportunity to accelerate policy action on food marketing. Increasing awareness among parents and caregivers to the high levels and harmful impacts of children’s exposure to unhealthy food marketing, focusing on their right not to be undermined by such action, may drive support for policy change. Further research is needed to understand parents’ attitudes and perceptions related to their children’s exposure to contemporary unhealthy food marketing, specifically in digital environments, and the perspectives of fathers and parents from low and middle-income countries.
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Affiliation(s)
- Christine Driessen
- Deakin University, Institute for Health Transformation, Global Obesity Centre, Geelong, Australia.
| | - Bridget Kelly
- Early Start, School of Health & Society, University of Wollongong, Wollongong, Australia
| | - Fiona Sing
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Kathryn Backholer
- Deakin University, Institute for Health Transformation, Global Obesity Centre, Geelong, Australia
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Luongo G, Tarasuk V, Yi Y, Mah CL. Feasibility and measurement error in using food supply data to estimate diet costs in Canada. Public Health Nutr 2022; 25:1-33. [PMID: 35260223 PMCID: PMC9991605 DOI: 10.1017/s1368980022000532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 02/17/2022] [Accepted: 03/06/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The cost of food is a key influence on diet. The majority of diet cost studies match intake data from population-based surveys to a single source of food supply prices. Our aim was to examine the methodological significance of using food supply data to price dietary intakes. METHODS Nationally representative 24-hour dietary recall data from the 2015 Canadian Community Health Survey-Nutrition (CCHS-N) was matched to the 2015 Canadian Consumer Price Index (CPI) food price list. Proportions and means of reported intakes covered by the 2015 CPI price list were used to compare reported intakes of food groups and food components of interest and concern overall, and by quartile of CPI coverage. SETTING Canada. PARTICIPANTS 20,487 Canadians ages one and older. RESULTS The CPI covered on average 76.3% of total dietary intake (g) without water. Staple food groups that were more commonly consumed had better CPI price coverage than those less commonly consumed. Yet some food groups (vegetables, additions, sweets) that were also commonly consumed by Canadians were not well covered by price data. Individuals in the poorest CPI coverage quartile reported consuming significantly greater fibre (g), gram weight (g), dietary fibre (g), and energy (kcal) as compared to those with the best coverage. CONCLUSIONS Differential CPI price coverage exists among food components and commonly consumed food groups; additionally dietary intake differs significantly in the population by CPI coverage. Methodological refinements are needed to better account for error when using prices from food supply data to estimate diet costs.
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Affiliation(s)
- Gabriella Luongo
- School of Health Administration, Faculty of Health, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, PO Box 15000, Halifax, NSB3H 4R2, Canada
| | - Valerie Tarasuk
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Yanqing Yi
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, Newfoundland and Labrador, Canada
| | - Catherine L Mah
- School of Health Administration, Faculty of Health, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, PO Box 15000, Halifax, NSB3H 4R2, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Neighbourhood food typologies, fast food outlet visitation and snack food purchasing among adolescents in Melbourne, Australia. Public Health Nutr 2022; 25:729-737. [PMID: 34629138 PMCID: PMC9991780 DOI: 10.1017/s1368980021004298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Despite the increased attention on neighbourhood food environments and dietary behaviours, studies focusing on adolescents are limited. This study aims to characterise typologies of food environments surrounding adolescents and their associations with fast food outlet visitation and snack food purchasing to/from school. DESIGN The number of food outlets (supermarket; green grocers; butcher/seafood/deli; bakeries; convenience stores; fast food/takeaways; café and restaurants) within a 1 km buffer from home was determined using a Geographic Information System. Adolescents' self-reported frequency of fast food outlet visitation and snack food purchasing to/from school. Latent Profile Analysis was conducted to identify typologies of the food environment. Cross-sectional multilevel logistic regression analyses were conducted to examine the relationships between food typologies, fast food outlet visitations and snack food purchasing to/from school. SETTING Melbourne, Australia. PARTICIPANTS Totally, 410 adolescents (mean age= 15·5 (sd = 1·5) years). RESULTS Four distinct typologies of food outlets were identified: (1) limited variety/low number; (2) some variety/low number; (3) high variety/medium number and (4) high variety/high number. Adolescents living in Typologies 1 and 2 had three times higher odds of visiting fast food outlets ≥1 per week (Typology 1: OR = 3·71, 95 % CI 1·23, 11·19; Typology 2: OR = 3·65, 95 % CI 1·21, 10·99) than those living in Typology 4. No evidence of association was found between typologies of the food environments and snack food purchasing behaviour to/from school among adolescents. CONCLUSION Local government could emphasise an overall balance of food outlets when designing neighbourhoods to reduce propensity for fast food outlet visitation among adolescents.
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Maganja D, Miller M, Trieu K, Scapin T, Cameron A, Wu JHY. Evidence Gaps in Assessments of the Healthiness of Online Supermarkets Highlight the Need for New Monitoring Tools: a Systematic Review. Curr Atheroscler Rep 2022; 24:215-233. [PMID: 35138570 PMCID: PMC9023389 DOI: 10.1007/s11883-022-01004-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Online grocery shopping is increasingly popular, but the extent to which these food environments encourage healthy or unhealthy purchases is unclear. This review identifies studies assessing the healthiness of real-world online supermarkets and frameworks to support future efforts. RECENT FINDINGS A total of 18 studies were included and 17 assessed aspects of online supermarkets. Pricing and promotional strategies were commonly applied to unhealthy products, while nutrition labelling may not meet regulated requirements or support consumer decision-making. Few studies investigated the different and specific ways online supermarkets can influence consumers. One framework for comprehensively capturing the healthiness of online supermarkets was identified, particularly highlighting the various ways retailers can tailor the environment to target individuals. Comprehensive assessments of online supermarkets can identify the potential to support or undermine healthy choices and dietary patterns. Common, validated instruments to facilitate consistent analysis and comparison are needed, particularly to investigate the new opportunities the online setting offers to influence consumers.
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Affiliation(s)
- Damian Maganja
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW, 2042, Australia.
| | - Mia Miller
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW, 2042, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW, 2042, Australia
| | - Tailane Scapin
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia
| | - Adrian Cameron
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia
| | - Jason H Y Wu
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW, 2042, Australia
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Needham C, Strugnell C, Allender S, Orellana L. Beyond food swamps and food deserts: exploring urban Australian food retail environment typologies. Public Health Nutr 2022; 25:1-13. [PMID: 35022093 PMCID: PMC9991784 DOI: 10.1017/s136898002200009x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/21/2021] [Accepted: 01/05/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE 'Food deserts' and 'food swamps' are food retail environment typologies associated with unhealthy diet and obesity. The current study aimed to identify more complex food retail environment typologies and examine temporal trends. DESIGN Measures of food retail environment accessibility and relative healthy food availability were defined for small areas (SA2s) of Melbourne, Australia, from a census of food outlets operating in 2008, 2012, 2014 and 2016. SA2s were classified into typologies using a two-stage approach: (1) SA2s were sorted into twenty clusters according to accessibility and availability and (2) clusters were grouped using evidence-based thresholds. SETTING The current study was set in Melbourne, the capital city of the state of Victoria, Australia. SUBJECTS Food retail environments in 301 small areas (Statistical Area 2) located in Melbourne in 2008, 2012, 2014 and 2016. RESULTS Six typologies were identified based on access (low, moderate and high) and healthy food availability including one where zero food outlets were present. Over the study period, SA2s experienced an overall increase in accessibility and healthiness. Distribution of typologies varied by geographic location and area-level socio-economic position. CONCLUSION Multiple typologies with contrasting access and healthiness measures exist within Melbourne and these continue to change over time, and the majority of SA2s were dominated by the presence of unhealthy relative to healthy outlets, with SA2s experiencing growth and disadvantage having the lowest access and to a greater proportion of unhealthy outlets.
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Affiliation(s)
- Cindy Needham
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong3220, Australia
| | - Claudia Strugnell
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong3220, Australia
| | - Steven Allender
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong3220, Australia
| | - Liliana Orellana
- Deakin University, Biostatistics Unit, Faculty of Health, Geelong, Australia
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Tawfiq E, Bradbury KE, Ni Mhurchu C. Does the prevalence of promotions on foods and beverages vary by product healthiness? A population-based study of household food and drink purchases in New Zealand. Public Health Nutr 2021; 25:1-9. [PMID: 34924088 PMCID: PMC9991816 DOI: 10.1017/s1368980021004936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 10/29/2021] [Accepted: 12/13/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess the prevalence of promotions on foods and non-alcoholic drinks purchased by New Zealand households and to determine if they vary according to healthiness of products. DESIGN We undertook a cross-sectional analysis of Nielsen New Zealand Homescan® 2018/19 panel data. We conducted multivariate analyses to examine the variability in quantities of healthy v. unhealthy food and beverage products purchased on promotion. Promotion was self-reported by the panellist. Healthiness of products was measured by the Health Star Rating (HSR) system. We also carried out a subgroup analysis for beverages according to the threshold of < 5 g v. ≥ 5 g sugar per 100 ml content of products. SETTING The Nielsen New Zealand Homescan® data were linked with two New Zealand Food Composition Databases (Nutritrack and the FOODfiles). PARTICIPANTS Food and beverage purchases data by 1800 panel households were used. RESULTS Overall, 46 % (1 803 601/3 940 458) of all purchases made were on promotion. Compared with purchases of food and beverage products with HSR < 3·5 (unhealthy), food and beverage products with HSR ≥ 3·5 (healthy) were significantly less likely to be on promotion (OR = 0·78, 95 % CI 0·77, 0·79). The subgroup analysis for beverages shows that products with < 5 g sugar per 100 ml were significantly less likely to be on promotion than those with ≥ 5 g sugar per 100 ml (OR = 0·77, 95 % CI 0·75, 0·79). CONCLUSIONS Policies to improve healthy food retailing should focus on increasing the promotion of healthier food and drink options in stores and supermarkets.
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Affiliation(s)
- Essa Tawfiq
- National Institute for Health Innovation, Faculty of Medical and Health Sciences, The University of Auckland, Auckland1010, New Zealand
| | - Kathryn E Bradbury
- National Institute for Health Innovation, Faculty of Medical and Health Sciences, The University of Auckland, Auckland1010, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, Faculty of Medical and Health Sciences, The University of Auckland, Auckland1010, New Zealand
- The George Institute for Global Health, Sydney, Australia
- University of New South Wales, Sydney, Australia
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How healthy and processed are foods and drinks promoted in supermarket sales flyers? A cross-sectional study in the Netherlands. Public Health Nutr 2021; 24:3000-3008. [PMID: 33843554 PMCID: PMC9884785 DOI: 10.1017/s1368980021001233] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate to what extent promotions in Dutch supermarket sales flyers contribute to a healthy diet and whether there are differences between supermarket types. DESIGN A cross-sectional study investigating promotions on foods and beverages (n 7825) in supermarket sales flyers from thirteen Dutch supermarket chains (8-week period), including ten traditional, two discount and one organic supermarket chain(s). Promoted products were categorised by food group (e.g. bread), contribution to a healthy diet (yes/no), degree of processing (e.g. ultra-processed), promotion type (temporary reduction in price, volume-based promotions or advertised only) and percentage discount of price promotions. Differences between supermarket chains in the degree of healthiness and processing of products and the types of price promotions were investigated. RESULTS In total, 70·7 % of all promoted products in supermarket sales flyers did not contribute to a healthy diet and 56·6 % was ultra-processed. The average discount on less healthy products (28·7 %) was similar to that of healthy products (28·9 %). Less healthy products were more frequently promoted via volume-based promotions than healthy products (37·6 % v. 25·4 %, P < 0·001). Discount supermarket chains promoted less healthy (80·3 %) and ultra-processed (65·1 %) products more often than traditional supermarket chains (69·6 % and 56·6 %, respectively). CONCLUSIONS The majority of promoted products via supermarket sales flyers do not contribute to a healthy diet. As promotions are an important determinant of food purchasing decisions, supermarkets do not support healthy choices. Future studies should identify barriers that withhold supermarket chains from promoting more healthy foods in supermarket sales flyers.
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Dhuria P, Lawrence W, Crozier S, Cooper C, Baird J, Vogel C. Women's perceptions of factors influencing their food shopping choices and how supermarkets can support them to make healthier choices. BMC Public Health 2021; 21:1070. [PMID: 34090410 PMCID: PMC8178895 DOI: 10.1186/s12889-021-11112-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/13/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To examine women's perceptions of factors that influence their food shopping choices, particularly in relation to store layout, and their views on ways that supermarkets could support healthier choices. DESIGN This qualitative cross-sectional study used semi-structured telephone interviews to ask participants the reasons for their choice of supermarket and factors in-store that prompted their food selections. The actions supermarkets, governments and customers could take to encourage healthier food choices were explored with women. Thematic analysis was conducted to identify key themes. SETTING Six supermarkets across England. PARTICIPANTS Twenty women customers aged 18-45 years. RESULTS Participants had a median age of 39.5 years (IQR: 35.1, 42.3), a median weekly grocery spend of £70 (IQR: 50, 88), and 44% had left school aged 16 years. Women reported that achieving value for money, feeling hungry, tired, or stressed, and meeting family members' food preferences influenced their food shopping choices. The physical environment was important, including product quality and variety, plus ease of accessing the store or products in-store. Many participants described how they made unintended food selections as a result of prominent placement of unhealthy products in supermarkets, even if they adopted more conscious approaches to food shopping (i.e. written or mental lists). Participants described healthy eating as a personal responsibility, but some stated that governments and supermarkets could be more supportive. CONCLUSIONS This study highlighted that in-store environments can undermine intentions to purchase and consume healthy foods. Creating healthier supermarket environments could reduce the burden of personal responsibility for healthy eating, by making healthier choices easier. Future research could explore the interplay of personal, societal and commercial responsibility for food choices and health status.
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Affiliation(s)
- Preeti Dhuria
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
| | - Wendy Lawrence
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Sarah Crozier
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Janis Baird
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Christina Vogel
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
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Vandevijvere S, Van Dam I. The nature of food promotions over one year in circulars from leading Belgian supermarket chains. ACTA ACUST UNITED AC 2021; 79:84. [PMID: 34011377 PMCID: PMC8132025 DOI: 10.1186/s13690-021-00591-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022]
Abstract
Background To examine the proportion of healthier and less healthy food promotions in circulars of major Belgian supermarket chains. Methods Food promotions were collected from all circulars over 1 year from the five largest Belgian supermarket chains. Foods promoted were classified according to the World Health Organization Europe nutrient profile model categories and the level and purpose of processing as per the NOVA classification. In addition, promotional characters (i.e. cartoons, licensed characters, celebrities) and premium offers within the promotions were analysed. Results In total, 15,271 food promotions were analyzed. The most frequently promoted foods in circulars were processed meat, poultry and fish (11.8%); fresh and frozen fruit, vegetables and legumes (9.5%); soft drinks and sweetened beverages (9.0%); fresh and frozen meat, poultry, fish and eggs (8.6%); cakes, sweet biscuits and pastries (8.1%); ready-made and convenience foods (8.0%); chocolate and sugar confectionery; energy bars and sweet toppings (7.7%) and cheeses (5.7%). About 52.2% of food promotions across all circulars were for ultra-processed foods, with considerable variation across chains (42.9–61.6%). Promotional characters and premium offers were found within 5.3 and 19.5% of promotions respectively. For all chains, circular covers were healthier compared to entire circulars, with a lower proportion of ultra-processed foods and a higher proportion of fresh fruit and vegetables promoted. Conclusions Food promotions in circulars were most frequently for ultra-processed foods, with considerable variation across chains. Circular covers were healthier than entire circulars. Policies to reduce less healthy food promotions could contribute to improving the healthiness of supermarket food purchases.
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Affiliation(s)
- Stefanie Vandevijvere
- Sciensano (Scientific Institute of Public Health), J.Wytsmanstraat 14, 1050, Brussel, Belgium.
| | - Iris Van Dam
- Sciensano (Scientific Institute of Public Health), J.Wytsmanstraat 14, 1050, Brussel, Belgium.,INRA (Institut National de la Recherche Agronomique), Paris, France
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Zhong Y, Auchincloss AH, Stehr MF, Langellier BA. Are price discounts on sugar-sweetened beverages (SSB) linked to household SSB purchases? - a cross-sectional study in a large US household and retail scanner database. Nutr J 2021; 20:29. [PMID: 33740986 PMCID: PMC7980678 DOI: 10.1186/s12937-021-00673-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background Price promotions on sugar-sweetened beverages (SSBs) are commonly used by retailers to provide economic incentives for purchasing. Surprisingly, there is a lack of high-quality articles that examine the frequency and magnitude of sugary beverage discounting and consumer responses to discounts. The objective of this study is to quantify the association between exposure to price discounts and SSB purchases. Methods This cross-sectional study linked 2016 SSB consumption data from a U.S. household consumer panel (analytic sample N = 11,299 households) and weekly prices at stores where they shopped. We derived percent of the time SSBs were discounted (annual promotion frequency) and the amount of the discount (annual promotion magnitude) and assessed their association with household annual per capita SSB purchase ounces. Linear regression models adjusted for household size, income per capita, age, education, presence of children, race, occupation, region, and urbanicity. We also evaluated whether the association between promotion and purchase varied by socioeconomic status and race subgroups. Data were analyzed in 2019–2020. Results On average, households were exposed to SSBs price promotions 44% of the time. A 10-percentage point increase in annual SSB promotion frequency was associated with 13.7% increase in annual per capita purchasing (P < 0.0001), and a 1-percentage point increase in annual SSB promotion magnitude was associated with 15.3% increase in annual per capita purchasing (P < 0.0001). These associations did no vary significantly across socioeconomic status and race subgroups (Interaction P > 0.2). Conclusions More frequent and deeper price promotion was associated with higher annual per capita SSB purchases. Restricting SSB price promotions may be effective at reducing SSB consumption. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00673-w.
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Affiliation(s)
- Yichen Zhong
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Mark F Stehr
- School of Economics, LeBow College of Business, Drexel University, Philadelphia, PA, 19104, USA
| | - Brent A Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
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Zenk SN, Li Y, Leider J, Pipito AA, Powell LM. No long-term store marketing changes following sugar-sweetened beverage tax implementation: Oakland, California. Health Place 2021; 68:102512. [PMID: 33517072 DOI: 10.1016/j.healthplace.2021.102512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/05/2020] [Accepted: 01/08/2021] [Indexed: 11/30/2022]
Abstract
Globally, more than 45 countries have implemented sugar-sweetened beverage (SSB) taxes; however, little is known about effects on marketing practices. For the 2017 Oakland, California, 1 cent per ounce SSB tax, this study evaluated long-term changes in beverage price promotions, depth of sale, and interior and exterior advertising at stores, collected via in-person audits at two time points (pre-tax and 24-months post-tax). Overall, based on difference-in-differences estimation, relative to the comparison site, no significant pre-post tax changes were found in the odds of price promotions, exterior or interior advertising, or sale depth for SSBs or untaxed beverages. As additional SSB taxes are considered these findings suggest that SSB taxes may not have long-term effects on store marketing practices.
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Affiliation(s)
- Shannon N Zenk
- National Institute of Nursing Research, National Institutes of Health, 9000 Rockville Pike, Building 31, Room 5B05, Bethesda, MD, USA.
| | - Yu Li
- Health Policy and Administration Division, School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA.
| | - Julien Leider
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
| | - Andrea A Pipito
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
| | - Lisa M Powell
- Health Policy and Administration Division, School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA; Institute for Health Research and Policy, University of Illinois Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
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The Healthiness of Food and Beverages on Price Promotion at Promotional Displays: A Cross-Sectional Audit of Australian Supermarkets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239026. [PMID: 33287395 PMCID: PMC7729449 DOI: 10.3390/ijerph17239026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 12/22/2022]
Abstract
Supermarket environments can strongly influence purchasing decisions. Price promotions are recognised as a particularly persuasive tactic, but the healthiness of price promotions in prominent in-store locations is understudied. This study compared the prevalence and magnitude of price promotions on healthy and unhealthy food and beverages (foods) displayed at prominent in-store locations within Australian supermarkets, including analyses by supermarket group and area-level socio-economic position. A cross-sectional in-store audit of price promotions on foods at key display areas was undertaken in 104 randomly selected stores from major Australian supermarket groups (Woolworths, Coles, Aldi and independents) in Victoria, Australia. Of the display space dedicated to foods with price promotions, three of the four supermarket groups had a greater proportion of display space devoted to unhealthy (compared to healthy) foods at each promotional location measured (end of aisles: 66%; island bins: 53%; checkouts: 88%). Aldi offered very few price promotions. Few measures varied by area-level socio-economic position. This study demonstrated that price promotions at prominent in-store locations in Australian supermarkets favoured unhealthy foods. Marketing of this nature is likely to encourage the purchase of unhealthy foods, highlighting the need for retailers and policy-makers to consider addressing in-store pricing and placement strategies to encourage healthier food environments.
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Huitink M, Poelman MP, Seidell JC, Kuijper LDJ, Hoekstsra T, Dijkstra C. Can Healthy Checkout Counters Improve Food Purchases? Two Real-Life Experiments in Dutch Supermarkets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228611. [PMID: 33228189 PMCID: PMC7699573 DOI: 10.3390/ijerph17228611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/10/2020] [Accepted: 11/16/2020] [Indexed: 11/16/2022]
Abstract
Most snacks displayed at supermarket checkouts do not contribute to a healthy diet. We investigated the effects of introducing healthier snack alternatives at checkouts in supermarkets on purchasing behavior. In Study 1, we investigated the effect of completely substituting less healthy with healthier snacks (one supermarket). In Study 2, we investigated the effect of placing and discounting healthier snacks while the less healthy snacks remain in place (two supermarkets). In both studies, the number of purchased snacks (per 1000 customers) was used as the outcome variable. Results for Study 1 showed that the absolute number of purchased checkout snacks was 2.4 times lower (95% confidence interval (CI): 1.9-2.7) when healthier snacks instead of less healthy snacks were placed at the supermarket checkouts. Results for Study 2 showed that when additional healthier snacks were placed near the checkouts, the absolute number of healthier purchased snacks increased by a factor of 2.1 (95% CI: 1.3-3.3). When additional healthier snacks were placed near the checkouts and discounted, the absolute number of healthier purchased snacks increased by a factor of 2.7 (95% CI: 2.0-3.6), although this was not statistically significant higher than placement only (ratio: 1.1, 95% CI: 0.7-1.9). Purchases of less healthy snacks did not decline, and even slightly increased, during the intervention period (ratio: 1.3, 95% CI: 1.1-1.5). If supermarkets want to promote healthier snack purchases, additional healthier products can be positioned near the checkouts. However, this does not discourages the purchase of less healthy snacks. Therefore, to discourage unhealthy snack purchases at supermarket checkouts, a total substitution of less healthy snacks with healthier alternatives is most effective.
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Affiliation(s)
- Marlijn Huitink
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
- Correspondence:
| | - Maartje P. Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN Wageningen, The Netherlands;
| | - Jacob C. Seidell
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
| | - Lothar D. J. Kuijper
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
| | - Trynke Hoekstsra
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
| | - Coosje Dijkstra
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
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Are food and drink available in online and physical supermarkets the same? A comparison of product availability, price, price promotions and nutritional information. Public Health Nutr 2020; 24:819-825. [PMID: 33109282 DOI: 10.1017/s1368980020004346] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Online supermarkets are increasingly used both by consumers and as a source of data on the food environment. We compared product availability, nutritional information, front-of-pack (FOP) labelling, price and price promotions for food and drink products between physical and online supermarkets. DESIGN For physical stores, we collected data on price, price promotions, FOP nutrition labels and nutrition information from a random sample of food and drinks from six UK supermarkets. For online stores, we used foodDB, a research-ready dataset of over 14 million observations of food and drink products available in online supermarkets. SETTING Six large supermarket stores located near Oxford, UK. PARTICIPANTS General sample with 295 food and drink products, plus boost samples for both fruit and vegetables, and alcohol. RESULTS In the general sample, 85 % (95 % CI 80, 90 %) of products found in physical stores could be matched with an online product. Nutritional information found in the two settings was almost identical, for example, concordance correlation coefficient for energy = 0·995 (95 % CI 0·993, 0·996). The presence of FOP labelling and price promotions differed between the two settings (Cohen's kappa = 0·56 (95 % CI 0·45, 0·66) and 0·40 (95 % CI 0·26, 0·55), respectively). Prices were similar between online and physical supermarkets (concordance correlation coefficient > 0·9 for all samples). CONCLUSIONS Product availability, nutritional information and prices sourced online for these six retailers are good proxies of those found in physical stores. Price promotions and FOP labelling vary between the two settings. Further research should investigate whether this could impact on health inequalities.
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Hecht AA, Perez CL, Polascek M, Thorndike AN, Franckle RL, Moran AJ. Influence of Food and Beverage Companies on Retailer Marketing Strategies and Consumer Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7381. [PMID: 33050424 PMCID: PMC7600709 DOI: 10.3390/ijerph17207381] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 01/20/2023]
Abstract
The retail food environment plays an important role in shaping dietary habits that contribute to obesity and other chronic diseases. Food and beverage manufacturers use trade promotion-incentives paid to retailers-to influence how products are placed, priced, and promoted in stores. This review aims to: (1) catalogue trade promotion practices that manufacturers use to influence retailer marketing strategies, and (2) describe how these retailer marketing strategies affect consumer purchasing behavior and attitudes. Researchers searched five databases, Academic Search Ultimate, Business Source Ultimate, PsycINFO, PubMed, and Web of Science, to identify literature from industry and academic sources published in English through November 2019. Twenty articles describing manufacturer trade promotion practices were synthesized and provided insight into four types of trade promotion practices: category management, slotting allowances, price discounts, and cooperative advertising. Fifty-four articles describing the impact of retailer marketing on consumers were synthesized and graded for quality of evidence. While comparison across studies is challenging, findings suggest that retailer marketing strategies, such as price promotions and prominent placement, lead to increased sales. Results can guide efforts by policymakers, public health practitioners, and food retailers to design retail environments that improve healthy eating while maintaining retailer financial interests. Additional research should measure the impact of retailer marketing strategies on consumer diet quality and retailer outcomes (e.g., return-on-investment).
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Affiliation(s)
- Amelie A. Hecht
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (C.L.P.); (A.J.M.)
| | - Crystal L. Perez
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (C.L.P.); (A.J.M.)
| | - Michele Polascek
- Westbrook College of Health Professions, University of New England, Portland, ME 04103, USA;
| | - Anne N. Thorndike
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA;
| | - Rebecca L. Franckle
- Program in Global Public Health and the Common Good, Department of Biology, Boston College, Chestnut Hill, MA 02467, USA;
| | - Alyssa J. Moran
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (C.L.P.); (A.J.M.)
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Availability and placement of healthy and discretionary food in Australian supermarkets by chain and level of socio-economic disadvantage. Public Health Nutr 2020; 24:203-214. [PMID: 32792022 DOI: 10.1017/s1368980020002505] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The current study aimed to investigate availability and placement of healthy and discretionary (less healthy) food in supermarkets in Victoria, Australia, and examine variation by supermarket chain and area-level socio-economic disadvantage. DESIGN Cross-sectional supermarket audit. Measures included: (i) proportion of shelf space (in square metres) allocated to selected healthy and discretionary food and beverages; (ii) proportion of end-of-aisle, checkout and island bin displays containing discretionary food and beverages and (iii) proportion of space within end-of-aisle, checkout and island bin displays devoted to discretionary food and beverages. SETTING Metropolitan areas of Melbourne and Geelong, Australia. Assessment: June-July 2019. PARTICIPANTS Random sample of 104 stores, with equal numbers from each supermarket group (Coles, Woolworths, Aldi and Independent stores) within strata of area-level socio-economic position. RESULTS Proportion of shelf space devoted to selected discretionary foods was greater for Independent stores (72·7 %) compared with Woolworths (65·7 %), Coles (64·8 %) and Aldi (63·2 %) (all P < 0·001). Proportion of shelf space devoted to selected discretionary food for all Coles, Woolworths and Aldi stores was 9·7 % higher in the most compared with the least disadvantaged areas (P = 0·002). Across all stores, 90 % of staff-assisted checkout displays and 50 % of end-of-aisle displays included discretionary food. Aldi was less likely to feature discretionary food in end-of-aisle and checkout displays compared with other supermarket groups. CONCLUSIONS Extensive marketing of discretionary food in all Australian supermarket chains was observed, which is likely to strongly influence purchasing patterns and population diets. Findings should be used to inform private and public sector policies to reduce marketing of discretionary food in supermarkets.
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Energy-dense, nutrient-poor food and beverage sales in Australia: where and when products are sold, and how sales are changing over time. Public Health Nutr 2020; 24:193-202. [PMID: 32782045 DOI: 10.1017/s1368980020002347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To quantify sales trends for key energy-dense, nutrient-poor (EDNP) foods and beverages over 5 years in Australia. DESIGN The Euromonitor Global Market Information Database and linear regression models were used to estimate average annual change in sales per capita of thirteen EDNP food categories and two EDNP beverage categories (defined using Australian Dietary Guidelines) over 5 years (2012-2017 for foods and 2011-2016 for beverages). The average annual change in sales was divided by the observed sales in 2012 (foods) or 2011 (beverages) to estimate the average percentage-change in sales per capita per annum. SETTING All major retail outlets in Australia. PARTICIPANTS Euromonitor Global Market Information Database sales data. RESULTS Between 2012 and 2017, sales per capita per annum of frozen pizza (6 %), pastries (5 %), potato chips (crisps) (5 %), tortilla chips (3 %), chocolate confectionery (2 %), frozen processed potatoes (2 %), ice cream (2 %) and sugar confectionery (0·2 %) increased. There were no changes in sales of sweet biscuits, chocolate spreads and cakes, and sales of savoury biscuits and processed meat decreased (-2 and -1 %, respectively). Between 2011 and 2016, sales per capita per annum of sports and energy drinks increased (4 %), sales of regular (sugar-sweetened) cola (-6 %) and all non-cola soft drinks (-1 %) decreased and sales of diet cola did not change. CONCLUSIONS Sales of EDNP foods and beverages generally increased or remained stable relative to population growth. Our results demonstrate the need for public health policies to reduce sales of EDNP foods and beverages.
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McMahon EJ, Jaenke R, Brimblecombe J. A Mobile App to Rapidly Appraise the In-Store Food Environment: Reliability, Utility, and Construct Validity Study. JMIR Mhealth Uhealth 2020; 8:e16971. [PMID: 32706683 PMCID: PMC7407248 DOI: 10.2196/16971] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/20/2020] [Accepted: 03/24/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Consumer food environments are increasingly being recognized as influential determinants of food purchasing and subsequent intake and health. We developed a tool to enable efficient, but relatively comprehensive, appraisal of the in-store food environment. The Store Scout mobile app facilitates the evaluation of product (availability and range), placement (visibility, accessibility, proximity to high-traffic areas, and location relative to other products), price (price promotion), and promotion (displays and advertising) across 7 categories of food products, with appraisal given immediately as scores (0-100, where a higher score is more in line with best practice). Primary end users are public health nutritionists and nutritionists employed by store organizations; however, store managers and staff are also potential end users. OBJECTIVE This study aims to evaluate the reliability (interrater reliability and internal consistency), utility (distribution of scores), and construct validity (score by store type) of measurements using the Store Scout mobile app. METHODS The Store Scout mobile app was used independently by 2 surveyors to evaluate the store environment in 54 stores: 34 metropolitan stores (9 small and 11 large supermarkets, 10 convenience stores, and 4 petrol stations) in Brisbane, Australia, and 20 remote stores (19 small supermarkets and 1 petrol station) in Indigenous Australian communities in Northern Australia. The agreement between surveyors in the overall and category scores was evaluated using intraclass correlation coefficients (ICCs). Interrater reliability of measurement items was assessed using percentage agreement and the Gwet agreement coefficient (AC). Internal consistency was assessed by comparing the responses of items measuring similar aspects of the store environment. We examined the distribution of score values using boxplots and differences by store type using the Kruskal-Wallis test. RESULTS The median difference in the overall score between surveyors was 4.4 (range 0.0-11.1), with an ICC of 0.954 (95% CI 0.914-0.975). Most measurement items had very good (n=74/196, 37.8%) or good (n=81/196, 41.3%) interrater reliability using the Gwet AC. A minimal inconsistency of measurement was found. Overall scores ranged from 19.2 to 81.6. There was a significant difference in score by store type (P<.001). Large Brisbane supermarkets scored highest (median 77.4, range 53.2-81.6), whereas small Brisbane supermarkets (median 63.9, range 41.0-71.3) and small remote supermarkets (median 63.8, range 56.5-74.9) scored significantly higher than Brisbane petrol stations (median 33.1, range 19.2-37.8) and convenience stores (median 39.0, range 22.4-63.8). CONCLUSIONS These findings suggest good reliability and internal consistency of food environment measurements using the Store Scout mobile app. We identified specific aspects that can be improved to further increase the reliability of this tool. We found a good distribution of score values and evidence that scoring could capture differences by store type in line with previous evidence, which gives an indication of construct validity. The Store Scout mobile app shows promise in its capability to measure and track the health-enabling characteristics of store environments.
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Affiliation(s)
- Emma Joy McMahon
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Rachael Jaenke
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Julie Brimblecombe
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Streamlined data-gathering techniques to estimate the price and affordability of healthy and unhealthy diets under different pricing scenarios. Public Health Nutr 2020; 24:1-11. [PMID: 32662385 DOI: 10.1017/s1368980020001718] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine the reliability of streamlined data-gathering techniques for examining the price and affordability of a healthy (recommended) and unhealthy (current) diet. We additionally estimated the price and affordability of diets across socio-economic areas and quantified the influence of different pricing scenarios. DESIGN Following the Healthy Diets Australian Standardised Affordability and Pricing (ASAP) protocol, we compared a cross-sectional sample of food and beverage pricing data collected using online data and phone calls (lower-resource streamlined techniques) with data collected in-store from the same retailers. SETTING Food and beverage prices were collected from major supermarkets, fast food and alcohol retailers in eight conveniently sampled areas in Victoria, Australia (n 72 stores), stratified by area-level deprivation and remoteness. PARTICIPANTS This study did not involve human participants. RESULTS The biweekly price of a healthy diet was on average 21 % cheaper ($596) than an unhealthy diet ($721) for a four-person family using the streamlined techniques, which was comparable with estimates using in-store data (healthy: $594, unhealthy: $731). The diet price differential did not vary considerably across geographical areas (range: 18-23 %). Both diets were estimated to be unaffordable for families living on indicative low disposable household incomes and below the poverty line. The inclusion of generic brands notably reduced the prices of healthy and unhealthy diets (≥20 %), rendering both affordable against indicative low disposable household incomes. Inclusion of discounted prices marginally reduced diet prices (3 %). CONCLUSIONS Streamlined data-gathering techniques are a reliable method for regular, flexible and widespread monitoring of the price and affordability of population diets in areas where supermarkets have an online presence.
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Lee AJ, Kane S, Herron LM, Matsuyama M, Lewis M. A tale of two cities: the cost, price-differential and affordability of current and healthy diets in Sydney and Canberra, Australia. Int J Behav Nutr Phys Act 2020; 17:80. [PMID: 32571334 PMCID: PMC7309977 DOI: 10.1186/s12966-020-00981-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 06/08/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The perception that healthy foods are more expensive than unhealthy foods has been reported widely to be a key barrier to healthy eating. However, assessment of the relative cost of healthy and unhealthy foods and diets is fraught methodologically. Standardised approaches to produce reliable data on the cost of total diets and different dietary patterns, rather than selected foods, are lacking globally to inform policy and practice. METHODS This paper reports the first application, in randomly selected statistical areas stratified by socio-economic status in two Australian cities, of the Healthy Diets Australian Standardized Affordability and Pricing (ASAP) method protocols: diet pricing tools based on national nutrition survey data and dietary guidelines; store sampling and location; determination of household incomes; food price data collection; and analysis and reporting. The methods were developed by the International Network on Food and Obesity/NCD Research, Monitoring and Action Support (INFORMAS) as a prototype of an optimum approach to assess, compare and monitor the cost and affordability of diets across different geographical and socio-economic settings and times. RESULTS Under current tax policy in Australia, healthy diets would be 15-17% less expensive than current (unhealthy) diets in all locations assessed. Nevertheless, healthy diets are likely to be unaffordable for low income households, costing more than 30% of disposable income in both cities surveyed. Households spent around 58% of their food budget on unhealthy food and drinks. Food costs were on average 4% higher in Canberra than Sydney, and tended to be higher in high socioeconomic locations. CONCLUSIONS Health and fiscal policy actions to increase affordability of healthy diets for low income households are required urgently. Also, there is a need to counter perceptions that current, unhealthy diets must be less expensive than healthy diets. The Healthy Diets ASAP methods could be adapted to assess the cost and affordability of healthy and unhealthy diets elsewhere.
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Affiliation(s)
- Amanda J Lee
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia.
| | - Sarah Kane
- Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Lisa-Maree Herron
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia
| | - Misa Matsuyama
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia
| | - Meron Lewis
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia
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Dickie S, Woods JL, Baker P, Elizabeth L, Lawrence MA. Evaluating Nutrient-Based Indices against Food- and Diet-Based Indices to Assess the Health Potential of Foods: How Does the Australian Health Star Rating System Perform after Five Years? Nutrients 2020; 12:nu12051463. [PMID: 32443570 PMCID: PMC7284529 DOI: 10.3390/nu12051463] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 12/25/2022] Open
Abstract
Nutrient-based indices are commonly used to assess the health potential of individual foods for nutrition policy actions. This study aimed to evaluate the nutrient profile-informed Australian Health Star Rating (HSR), against NOVA and an index informed by the Australian Dietary Guidelines (ADGs), to determine the extent of alignment. All products displaying an HSR label in the Australian marketplace between June 2014 and June 2019 were extracted from the Mintel Global New Product Database, and classified into one of four NOVA categories, and either as an ADG five food group (FFG) food or discretionary food. Of 4451 products analysed, 76.5% were ultra-processed (UP) and 43% were discretionary. The median HSR of non-UP foods (4) was significantly higher than UP foods (3.5) (p < 0.01), and the median HSR of FFG foods (4) was significantly higher than discretionary foods (2.5) (p < 0.01). However, 73% of UP foods, and 52.8% of discretionary foods displayed an HSR ≥ 2.5. Results indicate the currently implemented HSR system is inadvertently providing a ‘health halo’ for almost ¾ of UP foods and ½ of discretionary foods displaying an HSR. Future research should investigate whether the HSR scheme can be reformed to avoid misalignment with food-and diet-based indices.
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Huitink M, Poelman MP, Seidell JC, Pleus M, Hofkamp T, Kuin C, Dijkstra SC. Can unhealthy food purchases at checkout counters be discouraged by introducing healthier snacks? A real-life experiment in supermarkets in deprived urban areas in the Netherlands. BMC Public Health 2020; 20:542. [PMID: 32316936 PMCID: PMC7171819 DOI: 10.1186/s12889-020-08608-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 03/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The checkout area in supermarkets is an unavoidable point of purchase where impulsive food purchases are likely to be made. However, the product assortment at the checkout counters is predominantly unhealthy. The aim of this real life experiment was to investigate if unhealthy food purchases at checkout counters in supermarkets in deprived urban areas in the Netherlands can be discouraged by the introduction of the Healthy Checkout Counter (HCC). In addition, we examined customers' perceptions towards the HCC. METHODS The HCC was an initiative of a leading supermarket chain in the Netherlands that consisted of displays with a selection of healthier snacks that were placed at the checkouts. We used a real life quasi-experimental design with 15 intervention and 9 control supermarkets. We also performed a cross-sectional customer evaluation in 3 intervention supermarkets using oral surveys to investigate customers' perceptions towards the HCC (n=134). The purchases of unhealthy and healthier snacks at checkouts were measured with sales data. RESULTS During the intervention period, customers purchased on average 1.7 (SD: 0.08) unhealthy snacks per 100 customers in the intervention supermarket and 1.4 (SD: 0.10) in the control supermarket. Linear regression analyses revealed no statistically significant difference in the change during the control and intervention period of sales of unhealthy snacks between the control and intervention supermarkets (B = - 0.008, 95% CI = - 0.15 to 0.14). The average number of healthier snacks purchased was 0.2 (SD: 0.3) items per 100 customers in the intervention supermarkets during the intervention period. Of the intervention customers, 41% noticed the HCC and 80% of them were satisfied or very satisfied with the intervention. CONCLUSIONS This real life experiment in supermarkets showed that the placement of healthier snacks at checkouts did not lead to the substitution of unhealthy snack purchases with healthier alternatives. Although supermarket customers positively evaluated the HCC, future studies are needed to investigate other strategies to encourage healthier food purchases in supermarkets.
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Affiliation(s)
- Marlijn Huitink
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands
| | - Maartje P Poelman
- Chairgroup Consumpion and Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706, KN, Wageningen, the Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands
| | - Milan Pleus
- Nederlandse Zorgautoriteit, Newtonlaan 1, 3584, BX, Utrecht, The Netherlands
| | - Tom Hofkamp
- Sustainability Department, Ahold Delhaize, Provincialeweg 11, 1506 MA, Zaandam, The Netherlands
| | - Carlijn Kuin
- Department of Healthy living, Diabetes Fonds, Amersfoort, The Netherlands
| | - S Coosje Dijkstra
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands.
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Food Retail Environments in Greater Melbourne 2008-2016: Longitudinal Analysis of Intra-City Variation in Density and Healthiness of Food Outlets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041321. [PMID: 32092853 PMCID: PMC7068484 DOI: 10.3390/ijerph17041321] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/05/2020] [Accepted: 02/07/2020] [Indexed: 11/16/2022]
Abstract
Obesity prevalence is inequitably distributed across geographic areas. Food environments may contribute to health disparities, yet little is known about how food environments are evolving over time and how this may influence dietary intake and weight. This study aimed to analyse intra-city variation in density and healthiness of food outlets between 2008 and 2016 in Melbourne, Australia. Food outlet data were classified by location, type and healthiness. Local government areas (LGAs) were classified into four groups representing distance from the central business district. Residential population estimates for each LGA were used to calculate the density of food outlets per 10,000 residents. Linear mixed models were fitted to estimate the mean density and ratio of ‘healthy’ to ‘unhealthy’ food outlets and food outlet ‘types’ by LGA group over time. The number of food outlets increased at a faster rate than the residential population, driven by an increasing density of both ‘unhealthy’ and ‘healthy’ outlets. Across all years, ratios of ‘unhealthy’ to ‘healthy’ outlets were highest in LGAs located in designated Growth Areas. Melbourne’s metropolitan food environment is saturated by ‘unhealthy’ and ‘less healthy’ food outlets, relative to ‘healthy’ ones. Melbourne’s urban growth areas had the least healthy food environments.
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Zorbas C, Grigsby-Duffy L, Backholer K. Getting the Price Right: How Nutrition and Obesity Prevention Strategies Address Food and Beverage Pricing Within High-Income Countries. Curr Nutr Rep 2020; 9:42-53. [PMID: 31953676 DOI: 10.1007/s13668-020-00300-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Food and beverage prices are major influences on dietary intakes. International health bodies recommend leveraging food prices to create healthier food environments. A policy review was conducted to understand the extent to which national nutrition and obesity prevention policy strategies within high-income countries (i) consider food price as a determinant of health and (ii) propose and implement policies to rebalance food pricing towards healthier options. RECENT FINDINGS Policy strategies were inconsistent and fragmented in their inclusion of food prices as determinants of diet-related health. The equity benefits of pricing policies were often indicated. Fiscal measures and food subsidies in schools were the most commonly proposed and implemented pricing policies, predominantly used in Europe. Price is a pertinent but underutilized policy lever in nutrition policy. Comprehensive food and beverage pricing strategies need to be identified, adopted and implemented to improve population diets for everyone.
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Affiliation(s)
- Christina Zorbas
- Geelong, Australia, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Lily Grigsby-Duffy
- Geelong, Australia, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Geelong, Australia, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
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Bennett R, Zorbas C, Huse O, Peeters A, Cameron AJ, Sacks G, Backholer K. Prevalence of healthy and unhealthy food and beverage price promotions and their potential influence on shopper purchasing behaviour: A systematic review of the literature. Obes Rev 2020; 21:e12948. [PMID: 31633289 DOI: 10.1111/obr.12948] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/26/2019] [Accepted: 08/26/2019] [Indexed: 12/11/2022]
Abstract
Policies to restrict unhealthy food and beverage price promotions have been recommended, as part of a broader strategy to reduce obesity, but little evidence underpins such recommendations. We aimed to synthesize the literature on the prevalence of healthy and unhealthy food and beverage price promotions and their potential influence on purchasing behaviour. Eight scientific databases (covering health, business, and marketing) and grey literature were systematically searched using search terms related to "food and beverage price promotions" up until July 2019. Articles were included if they examined prevalence of, and/or consumer response to, food and non-alcoholic beverage price promotions, from a nutritional perspective. Of the 16 included studies, eight examined the prevalence of price promotions and eight examined the potential influence of price promotions on purchasing behaviour. Seven of the "prevalence" studies found that price promotions were more common for unhealthy foods and beverages. Seven "influence" studies found a greater proportion of price-promoted purchases were for unhealthy compared with healthy products. Policies that reduce the prevalence and/or influence of price promotions on unhealthy foods and beverages may shift consumer purchasing away from unhealthy foods and beverages. Empirical studies are required to better understand how consumers and industry may respond to such policies.
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Affiliation(s)
- Rebecca Bennett
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Christina Zorbas
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Oliver Huse
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Anna Peeters
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Adrian J Cameron
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Kathryn Backholer
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
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Zorbas C, Eyles H, Orellana L, Peeters A, Mhurchu CN, Riesenberg D, Backholer K. Do purchases of price promoted and generic branded foods and beverages vary according to food category and income level? Evidence from a consumer research panel. Appetite 2020; 144:104481. [DOI: 10.1016/j.appet.2019.104481] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/11/2019] [Accepted: 10/03/2019] [Indexed: 11/25/2022]
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