This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Marlijn Huitink
Vrije Universiteit Amsterdam Faculteit der Aard- en Levenswetenschappen
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5303-9668
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Most foods displayed at supermarket checkouts are unhealthy and do not support healthy purchases. This study investigates the sales effects of introducing healthier alternatives at supermarket checkouts.
Methods
We performed two real-life quasi-experimental studies in supermarkets located in a disadvantaged urban area in the Netherlands. In Study 1, we examined the impact of substituting healthier options for all the unhealthy snacks at checkouts (n = 1 supermarket). In Study 2, we investigated the impact of placing healthier snacks at checkouts (placement intervention), as well as the impact of offering a discount on healthier checkout snacks (placement + price intervention), while continuing to display unhealthy snacks for sale (n = 2 supermarkets). Supermarket sales data were used to measure purchases.
Results
In Study 1, median weekly sales/1000 customers of checkout snacks were 2.3 times lower (SE: 1.1, 95% CI: 1.9–2.7) during the intervention period – when healthier options were substituted for the entire unhealthy snack assortment – (median: 10, IQR: 2.8), as compared to the control period (median: 24, IQR: 2.8). In Study 2, median daily sales/1000 customers of healthier snacks were 2.1 times higher (SE: 1.3, 95% CI: 1.3–3.3) during the placement-intervention period (median: 7.8, IQR: 4.6), as compared to the control period (median: 4.2, IQR: 4.6). Similarly, median daily sales/1000 customers of healthier snacks were 2.7 times higher (SE: 1.2, 95%CI: 2.0–3.6) during the placement + price-intervention period (median: 5.8, IQR: 2.2), as compared to the control period (median: 2.2, IQR: 4.7). There was no difference between the effect of the placement intervention and that of the placement + price intervention (ratio: 1.1, SE: 1.3, 95% CI: 1.7–1.9). Neither did we observe a decline in purchases of unhealthy snacks (ratio: 1.3, SE: 1.1, 95% CI: 1.1–1.5).
Conclusions
This study showed that if we want to promote healthier food purchases at supermarket checkouts the substitution of the unhealthy snacks with healthier alternatives is an effective intervention, which is not the case if the unhealthy snacks remain in place at the checkouts, even with discounts on the healthier snacks. Future research should assess the feasibility and willingness of eliminating unhealthy checkout snacks in supermarkets.
Keywords
supermarkets, checkout counter, purchase behavior, food purchases, snacks, impulsive behavior, food environment
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Marlijn Huitink
Vrije Universiteit Amsterdam Faculteit der Aard- en Levenswetenschappen
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5303-9668
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 18 May, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Most foods displayed at supermarket checkouts are unhealthy and do not support healthy purchases. This study investigates the sales effects of introducing healthier alternatives at supermarket checkouts.
Methods
We performed two real-life quasi-experimental studies in supermarkets located in a disadvantaged urban area in the Netherlands. In Study 1, we examined the impact of substituting healthier options for all the unhealthy snacks at checkouts (n = 1 supermarket). In Study 2, we investigated the impact of placing healthier snacks at checkouts (placement intervention), as well as the impact of offering a discount on healthier checkout snacks (placement + price intervention), while continuing to display unhealthy snacks for sale (n = 2 supermarkets). Supermarket sales data were used to measure purchases.
Results
In Study 1, median weekly sales/1000 customers of checkout snacks were 2.3 times lower (SE: 1.1, 95% CI: 1.9–2.7) during the intervention period – when healthier options were substituted for the entire unhealthy snack assortment – (median: 10, IQR: 2.8), as compared to the control period (median: 24, IQR: 2.8). In Study 2, median daily sales/1000 customers of healthier snacks were 2.1 times higher (SE: 1.3, 95% CI: 1.3–3.3) during the placement-intervention period (median: 7.8, IQR: 4.6), as compared to the control period (median: 4.2, IQR: 4.6). Similarly, median daily sales/1000 customers of healthier snacks were 2.7 times higher (SE: 1.2, 95%CI: 2.0–3.6) during the placement + price-intervention period (median: 5.8, IQR: 2.2), as compared to the control period (median: 2.2, IQR: 4.7). There was no difference between the effect of the placement intervention and that of the placement + price intervention (ratio: 1.1, SE: 1.3, 95% CI: 1.7–1.9). Neither did we observe a decline in purchases of unhealthy snacks (ratio: 1.3, SE: 1.1, 95% CI: 1.1–1.5).
Conclusions
This study showed that if we want to promote healthier food purchases at supermarket checkouts the substitution of the unhealthy snacks with healthier alternatives is an effective intervention, which is not the case if the unhealthy snacks remain in place at the checkouts, even with discounts on the healthier snacks. Future research should assess the feasibility and willingness of eliminating unhealthy checkout snacks in supermarkets.
Figure 1
Figure 2
Figure 3
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