Price discounts significantly enhance fruit and vegetable purchases when combined with nutrition education: a randomized controlled supermarket trial

Waterlander, Wilma; Boer, Michiel R. de; Schuit, Albertine J.; Seidell, Jacob C.; Steenhuis, I.H.M.

doi:10.3945/ajcn.112.041632

Cited by 131 publications

(196 citation statements)

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“…This finding is echoed in findings that dietary variety is significantly associated with caloric availability from staples, but more strongly associated with caloric availability from non-staples (Hoddinott and Yohannes 2002). Furthermore, interventions that have deflated fruit and vegetable prices generally have found that consumption increases (Powell et al 2009;Waterlander et al 2013;Eyles et al 2012;French 2003;An et al 2013). …”

Section: Affordabilitymentioning

confidence: 99%

The food environment, its effects on dietary consumption, and potential for measurement within agriculture-nutrition interventions

Herforth¹,

2015

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The food environment in markets constrains and signals consumers what to purchase. It encompasses availability, affordability, convenience, and desirability of various foods. The effect of income on dietary consumption is always modified by the food environment. Many agricultural interventions aim to improve incomes, increase food availability and reduce food prices. Their effects on nutrition could be better understood if food environment measures helped to explain how additional income is likely to be spent, and how food availability and prices change as a result of large-scale interventions. Additionally, measurement of the food environment could elucidate food access gaps and inform the design of nutrition-sensitive interventions. This paper reviews existing measures of the food environment, and then draws from these tools to suggest ways the food environment could be measured in future studies and monitoring.

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Section: Affordabilitymentioning

confidence: 99%

The food environment, its effects on dietary consumption, and potential for measurement within agriculture-nutrition interventions

Herforth¹,

2015

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“…The baseline period was two weeks and the intervention period lasted three weeks, which are standard time periods that have been shown to be sufficient for price intervention research (9,34,35) .…”

Section: Methodsmentioning

confidence: 99%

Buying health: assessing the impact of a consumer-side vegetable subsidy on purchasing, consumption and waste

Smith-Drelich

2015

Public Health Nutr.

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Objective: To measure the impact of a reimbursement-based consumer subsidy on vegetable expenditures, consumption and waste. Design: Two-arm randomized controlled trial; two-week baseline observation period, three-week intervention period. Participants' vegetable expenditures, consumption and waste were monitored using receipts collection and through an FFQ. During the intervention period, the treatment group received reimbursement of up to 50 US dollars ($) for purchased vegetables. Setting: Participants were solicited from Palo Alto, CA, USA using materials advertising a 'consumer behavior study' and a small participation incentive. To prevent selection bias, solicitation materials did not describe the specific behaviour being evaluated. Subjects: One hundred and fifty potential participants responded to the solicitations and 144 participants enrolled in the study; 138 participants completed all five weekly surveys. Results: Accounting for the control group (n 69) and the two-week baseline period, the intervention significantly impacted the treatment group's (n 69) vegetable expenditures (+ $8·16 (SD 2·67)/week, P < 0·01), but not vegetable consumption ( +1·3 (SD 1·2) servings/week, P = 0·28) or waste (−0·23 (SD 1·2) servings/week, P = 0·60). Conclusions: The consumer subsidy significantly increased participants' vegetable expenditures, but not consumption or waste, suggesting that this type of subsidy might not have the effects anticipated. Reimbursement-based consumer subsidies may therefore not be as useful a policy tool for impacting vegetable consumption as earlier studies have suggested. Moreover, moderation analysis revealed that the subsidy's effect on participants' vegetable expenditures was significant only in men. Additional research should seek to determine how far reaching genderspecific effects are in this context. Further research should also examine the effect of a similar consumer subsidy on high-risk populations and explore to what extent increases in participants' expenditures are due to the purchase of more expensive vegetables, purchasing of vegetables during the study period that were consumed outside the study period, or a shift from restaurant vegetable consumption to grocery vegetable consumption.

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“…Nonetheless, strong evidence for supermarket interventions, particularly those that provide nutrition education only at point of purchase, is somewhat lacking (8) , although interventions with a price intervention show more promise (13,45,46) . Nutrition education alone may not be adequate to drive real and sustained change to the household food supply.…”

Section: Discussionmentioning

confidence: 99%

“…BMI was categorised into three weight status groups consistent with the World Health Organization (20) cut-offs. Age was categorised into three groups consistent with those used in the latest Australian Health Survey (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50) and 51-70 years).…”

Section: Methodsmentioning

confidence: 99%

Feasibility of a Healthy Trolley Index to assess dietary quality of the household food supply

et al. 2015

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Supermarket receipts have the potential to provide prospective, objective information about the household food supply. The aim of this study was to develop an index to estimate population diet quality using food purchase data. Supermarket receipt data of 1 month were available for 836 adults from a corporate office of a large retail chain. Participants were aged 19-65 years (mean 37·6 (SD 9·3) years), 56 % were female and 63 % were overweight or obese. A scoring system (Healthy Trolley Index (HETI)) was developed to compare food expenditure with the Australian Guide to Healthy Eating. Monthly expenditure per food group, as a proportion of total food expenditure, was compared with food group recommendations, and a HETI score was calculated to estimate overall compliance with guidelines. Participants spent the greatest proportion on discretionary foods, which are high in fat/sugar (34·8 %), followed by meat including beef and chicken (17·0 %), fresh and frozen vegetables (13·5 %) and dairy foods (11·3 %). The average HETI score ranged from 22·6 to 93·1 (out of 100, mean 58·8 (SD 10·9)). There was a stepwise decrease in expenditure on discretionary foods by increasing HETI quintile, whereas expenditure on fruit and vegetables increased with HETI quintile (P < 0·001). The HETI score was lower in obese compared with normal-weight participants (55·9 v. 60·3; P < 0·01). Obese participants spent more on discretionary foods (38·3 v. 32·7 %; P < 0·01) and less on fruits and vegetables (19·3 v. 22·2 %; P < 0·01). The HETI may be a useful tool to describe supermarket purchasing patterns and quality of the household food supply with application for consumer feedback to assist improved quality of foods purchased.Key words: Diet quality: Supermarkets: Food supply Poor eating habits are one of the key drivers of overconsumption of energy, weight gain and obesity. Australians consume inadequate amounts of fruit, vegetables and whole grains and, on average, get about 35 % of their energy from energy-dense, nutrient-poor discretionary food and beverage items (1,2) . As a result, improving the food supply to support healthy food choices has been identified as a priority for Australian health promotion efforts and internationally (3,4) .About 60 % of Australian food retail expenditure is in the supermarket, indicating its potential as a key setting to influence the food supply (5) . Previously, supermarket purchases have been found to relate to dietary intakes, particularly at the household level (6,7) . For example, when compared with 4 d of weighed food record data, 1 month of shopping purchase information produced reasonable estimates about energy and fat intake (7) . Many nutrition interventions promoting the purchase of healthier foods have been trialled in the supermarket setting. Although the evidence is equivocal for the effectiveness of supermarket interventions focused on point-of-purchase dietary education and information provision (8,9) , the potential for success using an innovative approach in this setting has ...

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Price discounts significantly enhance fruit and vegetable purchases when combined with nutrition education: a randomized controlled supermarket trial

Cited by 131 publications

References 50 publications

The food environment, its effects on dietary consumption, and potential for measurement within agriculture-nutrition interventions

The food environment, its effects on dietary consumption, and potential for measurement within agriculture-nutrition interventions

Buying health: assessing the impact of a consumer-side vegetable subsidy on purchasing, consumption and waste

Feasibility of a Healthy Trolley Index to assess dietary quality of the household food supply

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