In this study, over one-fifth (22%) of the sample (n = 37) visited convenience stores on 62 occasions during their 4-day data collection period. They encountered, on average, 300 non-core food and drink item/child, at a rate 8.3 times that of core food and drink items (mean 36 core food and drink items/child). Most of the non-core food and drink available was confectionary items, especially single-serve confectionary, chocolate and sugary drinks. Snack foods, including potato crisps and packaged single-serve cookies were also widely available. These findings are consistent with previous research that has found the product assortment in convenience stores is dominated by non-core food and drinks (10, 32).
Sanders-Jackson et al, found half the US adolescents (13-16y) in their sample visited a convenience store at least once a week (9). Our study did not include data collection over the week, and the participants in our study were younger. However, it is concerning that more than one in five (22%) children in our sample visited a convenience store during a 4-day period, some more than once. Moreover, we also know that the children in Kids’Cam NZ study visited other stores where non-core food is sold, such as fast food outlets, and do so regularly (26).
The non-core foods and drinks the children in this study encountered were promoted through a variety of mechanisms, including placement, price promotions, packaging, branded displays and signage (30, 33, 34). The placement of single-serve confectionary directly on the counter top, or immediately underneath or beside the counter, was especially conspicuous. When children were paying for a food item, they often had to reach over single-serve confectionary food items placed on the counter top. In addition, the confectionary displayed underneath the counter top featured prominently in the images, being proximal to a child’s chest height and therefore could be easily reached.
In a previous analysis of the Kids’Cam data that measured marketing to children, it was found children were exposed to 27 non-core and 12 core marketing exposures per day (22). Exposures in convenience stores and supermarkets were excluded from the analysis as the marketing examples were too numerous to count (22). In the current study, children who visited a convenience store had a mean of 7.9 exposures to packaged non-core products, 4.8 exposures to non-core branded displays, and 6.8 exposures to non-core signs. There was a significant difference across all marketing mediums between exposure to non-core and core food and drink marketing in convenience stores. Therefore, the children in the Kids’Cam study who visited convenience stores had greater overall marketing exposure to non-core food and drinks.
Non-core food and drink items were also the dominant food and drinks promoted by pricing, at a mean rate of 2.8 items per child. For example, single-serve confectionary was often promoted at low prices (at NZ$1 or less), as seen in Fig. 3. International evidence shows that the low price of food at convenience stores is appealing to children (35, 36).
Almost all of the food purchased (n = 70) and all the food consumed by the participants (n = 33), was non-core, which in turn substantially contributes to children’s overall energy intake (35) This finding is consistent with other studies (16, 37, 38) that have associated convenience stores with unhealthy food purchase and consumption. Although we did not determine the motivation behind children’s food purchasing decisions, it is possible that the prominent marketing and availability of non-core food and drink in convenience stores was a contributing factor.
To our knowledge, this is the first study to objectively measure the food and drink available and marketed to children in convenience stores in their everyday life, and with the children’s food and drink purchase and consumption. The use of wearable cameras overcame previous methodological limitations, such as the use of food diaries or dietary recall, to measure consumption, or the collection of receipts to measure food purchase. The methodology enabled the food and drink available and marketed to children in a convenience store to be measured, from their perspective, and to observe their subsequent behaviour.
While this research provides evidence on the food and drink available to children in convenience stores, and their food and drink purchase and consumption, it has some limitations. The study was cross-sectional in design, therefore only associations can be drawn the data. The method could not determine if a child saw the food and drink that was available in the image. It is possible that they were looking in a different direction. However, given the amount of non-core food and drinks available in convenience stores, it is likely the children could see non-core food and drinks not captured in the images. It is also likely that the amount of food and drink available was underestimated, as some items were unable to be coded. For example, iced-confectionary in freezers was not visible unless a child was directly standing over a freezer, likewise single-serve confectionary stacked underneath other items in a box on a counter. Future research could use the FoodSee methodology to describe children’s interaction with other food settings supermarkets or takeaway outlets. Future research could also focus on specific ethnic or socioeconomic groups in the sample to describe any differences by those factors.
This research focuses on the convenience store setting as a source of unhealthy food and drink in children’s lives that contributes to unhealthy food and drink consumption. To reduce and prevent childhood obesity, strategies to limit the impact of convenience stores need to be considered. Policy options include limiting the density and proximity of convenience stores located near schools such as in South Korea where green food zones, which ban convenience stores within 200 m of a school, have been implemented (39, 40).
There is international evidence on programmes that involve working with convenience store owners to improve the range of healthy food and drinks that are available and promoted (32, 41), and reduce the availability and promotion of unhealthy food and drink products, such as removing them from counter tops (42). Other such strategies could include limiting price promotion of unhealthy food and drinks and reducing branded displays (41). However, these strategies would be challenging in the NZ environment as convenience stores are mostly independently owned. National policies, such as introducing plain packaging (43) or the introduction of a tax on sugary drinks, would likely impact purchasing and dietary intakes (44). Confectionary was the major non-core food and drink category available and purchased. Policy makers should also consider strategies to limit its availability and promotion alongside those that limit sugary drinks
Convenience stores are located centrally within communities and are an important food source for people with limited mobility due to age, income or disability (41). Given that substantial changes to the in-store environment would need to occur in order to impact food and drink purchasing behaviour of children (38), future research could also explore the role of convenience stores in the community. Communities have the right to a local source of healthy food options and it is time to question if the current model is delivering this.