Can Healthy Checkout Counters Improve Food Purchases? Two Real-Life Experiments in Dutch Supermarkets

Huitink, Marlijn; Poelman, Maartje P.; Seidell, Jacob C.; Kuijper, Lothar D. J.; Hoekstsra, Trynke; Dijkstra, Coosje

doi:10.3390/ijerph17228611

Cited by 9 publications

(9 citation statements)

References 51 publications

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“…The increase in micro-pack sales in group 1 stores remained significantly higher than the pre-intervention period during the second phase of the intervention, demonstrating a sustained effect of the intervention in those stores. These results are similar to other studies that have examined the impact of healthy checkout interventions, which found that healthy purchases increased during the intervention period (21,(29)(30)(31)(32)(33)(34)(35) .…”

Section: Discussionsupporting

confidence: 90%

“…Interventions have ranged in duration from 4 d to 6 months, substituting unhealthy items like candy and soda with fresh fruits and vegetables, dried fruit, cereal bars, nuts, dried fish and bottled water or removing unhealthy items altogether. Five studies added healthy items to checkout aisles and found that sales of healthier items increased (21,(29)(30)(31) , but there was no reduction in the sales of less healthy items (29)(30)(31) . Three studies substituted unhealthy foods with healthier options at checkout aisles and reported mixed results.…”

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confidence: 99%

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The impact of a healthy checkout intervention on fruit and vegetable ‘micro-pack’ purchases in New Mexico

Rogus

Guthrie

Niculescu

et al. 2022

Public Health Nutr.

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Objective: Produce sold as plastic-wrapped packs of two to four individual items (i.e., produce micro-packs) that are low-cost and placed at checkout may appeal to shoppers with budget constraints and provide a second chance to purchase items available elsewhere in the store. This study examined the impact of an intervention that placed produce micro-packs at checkout and promoted them in grocery stores across New Mexico, United States of America (USA). Design: This quasi-experimental study placed produce micro-packs at checkout end-caps in 13 stores (group 1), with eight stores serving as controls (group 2) from July 1, 2019 through January 31, 2020 (first phase). The intervention was extended to group 2 stores from February 1, 2020 through June 30, 2020 (second phase). Cashiers were directed to upsell the micro-packs to Special Supplemental Nutrition Program for Women, Infants, and Children recipients who had unspent cash value benefits for produce purchases. Setting: Twenty-one grocery stores across New Mexico. Participants: Twenty-one produce items sold as micro-packs in stores from July 2019 through June 2020. Results: A random effects model showed that the daily sales of micro-packs increased by 47% during each intervention period. Group 2 stores had lower sales than group 1 stores during the first phase of the intervention. Once extended to group 2 stores, sales of micro-packs in those stores increased and sales in group 1 stores continued at the higher level. Conclusions: Placing produce micro-packs at checkout may increase produce sales and support health promotion efforts by public and private stakeholders.

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Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

The impact of a healthy checkout intervention on fruit and vegetable ‘micro-pack’ purchases in New Mexico

Rogus

Guthrie

Niculescu

et al. 2022

Public Health Nutr.

View full text Add to dashboard Cite

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“…One study carried out in the United States found that more healthy items were purchased from the checkout only offering healthy foods compared with the standard checkout, but purchasing was generally low (Adjoian et al, 2017). Another study which used a pre‐post design, in The Netherlands, found that the total number of snacks sold was 2.4 times lower when all less healthy foods were removed and replaced with healthier options (Huitink, Poelman, Seidell, Kuijper, Hoekstsra, et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…For example, experimental studies manipulating the availability of snack foods at supermarket checkouts have had mixed findings. Some studies have found limited impact on purchasing of less healthy foods (Huitink, Poelman, Seidell, Pleus et al, 2020; Winkler et al, 2016), while others found reduced sales of less healthy foods (Sigurdsson et al, 2014), a decrease in absolute number of snack foods purchased (Huitink, Poelman, Seidell, Kuijper, et al, 2020) or an increase in healthier foods purchased (Adjoian et al, 2017; Payne & Niculescu, 2018; Sigurdsson et al, 2014). In a different setting, sales data from a hospital canteen indicated purchasing of healthier snacks increased when a greater proportion of healthier snacks were displayed at the checkout, but there was no impact on less healthy snack purchasing (Van Kleef et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Impact on purchasing behaviour of implementing ‘junk free checkouts’: A pre‐post study

et al. 2022

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Background Removing unhealthy products from checkouts will arguably reduce impulse purchasing, but evidence is lacking. In 2015, Tesco Express stores implemented so-called healthy checkouts; products high in sugar, fat, or salt (defined by national Nutrient Profiling Model criteria) were removed from in-queue areas. We aimed to compare the purchasing of unhealthy foods before and after its introduction.

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“…In high-income countries, nutrition-focused interventions in supermarkets are common, including experimental work altering food positioning Huitink et al, 2020;Hyseni et al, 2017) and food labeling (Andreyeva and Luedicke, 2013;Campos et al, 2011;Cecchini and Warin, 2016;Hyseni et al, 2017;Just and Gabrielyan, 2018), both of which show some evidence of impact. However, their applicability to lower-income consumers and rural populations in East Africa is questionable, except for targeting higher-income consumers.…”

Section: Other Information-based Interventionsmentioning

confidence: 99%

Understanding the demand for “protective foods” in East Africa: An economic analysis with policy recommendations

Headey¹,

Ecker²,

Comstock³

et al. 2021

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Suboptimal diets are a major risk factor for avoidable death and disease in low-and middle-income countries.n Evidence shows that some foods or food components (e.g., processed red meat, saturated fat, salt, sugar) significantly elevate the risk of noncommunicable diseases and mortality, while others protect health (e.g., vegetables, fruits, pulses, nuts/seeds, fish, whole grains-referred to in this document as "protective foods") n We used household surveys to compare dietary patterns in Ethiopia, Kenya, Tanzania, and Uganda to the EAT-Lancet healthy reference diet and to quantify and explain consumption gaps for nutritious foods.n Compared to the EAT-Lancet healthy reference diet, consumption gaps for pulses and nuts/seeds, vegetables, and fruits are large for both poor and rich consumers in rural and urban areas in the four countries studied, while consumption gaps for meat, fish, and eggs and dairy foods are much larger for lower income groups.n Food expenditures of most households in these four countries are far too low to allow consumption of the healthy reference diet; animal-source foods and vegetables are the largest cost components of food expenditures, although quantities consumed of both food groups are much lower than the EAT-Lancet healthy reference diet.n Income elasticities of demand for pulses and nuts/seeds and vegetables are often low or moderate, suggesting weak consumer preference for these foods, while income elasticities for fruits and animal-source foods are relatively high.n Income growth alone will not solve dietary problems in East Africa; in addition to supply-side interventions to improve affordability, special interventions are required to increase consumer demand for underappreciated protective (nutritious) foods such as pulses and nuts/seeds and vegetables. Are average diets in East Africa meeting the intake levels of the EAT-Lancet healthy reference diet?The EAT-Lancet healthy reference diet includes a balanced mix of vegetables, fruits, pulses, nuts/seeds, dairy foods, and (white or red) meat, fish, and eggs, and allows only a third of total calories to come from starchy staples and very limited quantities of added fats and sugars. Figure 1 reports average calorie consumption amounts and composition by main food groups for the populations in four East African countries and compares these averages to the midpoints of the possible calorie intake ranges of the healthy reference diet. 2 Note that the food groupings used here are driven by the datasets used, which combine into single groups pulses and nuts and meat, fish, and eggs, respectively.The contrast between the actual diets of consumers in these four LMICs and the EAT-Lancet healthy reference diet is stark. Many people are consuming far too many calories from starchy staples, which account for 59%-77% of total calories consumed at home, on average. These nutrient-poor but caloriedense diets may explain why all four countries still have high rates of preschooler stunting (>30%) and rapidly rising rates of adult overweight and...

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Can Healthy Checkout Counters Improve Food Purchases? Two Real-Life Experiments in Dutch Supermarkets

Cited by 9 publications

References 51 publications

The impact of a healthy checkout intervention on fruit and vegetable ‘micro-pack’ purchases in New Mexico

The impact of a healthy checkout intervention on fruit and vegetable ‘micro-pack’ purchases in New Mexico

Impact on purchasing behaviour of implementing ‘junk free checkouts’: A pre‐post study

Understanding the demand for “protective foods” in East Africa: An economic analysis with policy recommendations

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