A real-life supermarket experiment shows that moving fresh produce to discount store shelves can lead to healthier shopping carts, but the effect is small and increases in food waste show that policy design still matters.
Evaluating supermarket location strategies to encourage healthier eating habits: Overview of the WRAPPED study. Image credit: Itxu / Shutterstock
In a recent study published in the journal public health researchresearchers investigated whether supermarket location strategies could improve eating habits, store sales, and household purchases at UK discount supermarkets.
Inadequate diet is a major modifiable risk factor for non-communicable diseases. Supermarkets are a major food source and their marketing strategies influence food choices. Healthy foods are more than twice as expensive per calorie as unhealthy foods, and fruits and vegetables are promoted less than 1% of the time. Furthermore, fresh fruit and vegetables are less prominently positioned in small and discount supermarkets.
This is concerning as such stores are often used by disadvantaged families and people with poor eating habits. In October 2022, legislation will be introduced in the UK that will ban foods high in fat, salt and sugar from being placed at store entrances, checkout registers and at the end of aisles in retail chains. Research prior to the law’s implementation supported these new rules and indicated that restrictions could be further expanded to support healthier food choices.
About research
In this study, researchers investigated whether expanding fresh fruit and vegetable sections at discount supermarket store entrances improved diet quality, store sales, and household purchases. The study included 36 discount supermarkets across the UK. In addition, female shoppers who owned a loyalty card from a supermarket chain were also recruited. Online-only shoppers were excluded.
The intervention included expanding and installing fresh food corners near store entrances for six months. The control store did not change its layout, with a limited range of fresh produce placed near the back of the store. Participants provided data on their ethnicity, age, marital status, education, employment, weekly grocery spending, and whether the surveyed supermarket was their primary grocery store.
Household purchasing data and store sales data were obtained from stores. The survey collected data on participants’ diets, shopping habits, and household fruit and vegetable waste patterns. Intervention costs at societal, individual, and retailer levels were estimated. A process evaluation was conducted to assess the implementation and impact of the intervention. Linear regression models examined the effect of the intervention on changes in diet quality from baseline to 3 and 6 months post-intervention.
Survey results
The study included 580 shoppers, 280 from 18 intervention stores and 300 from 18 control stores. Of these, 475 participants provided purchase data and 360 provided information on household fruit/vegetable waste and dietary patterns. There were small differences in participant characteristics between intervention and control stores. Specifically, shoppers at intervention stores were more likely to live in poorer neighborhoods and less likely to be white.
For 31% of study participants, supermarkets were the main source of household groceries. Participants with available purchasing data made 5,077 store visits during the intervention. Although the proportion of shoppers purchasing fruits and vegetables decreased from baseline to months 3 and 6, the decrease was less pronounced among shoppers at intervention stores. Fruit and vegetable purchases showed suggestive increases among intervention store shoppers with low education, but results for this subgroup were inconclusive.
Intervention stores experienced significant increases in fresh fruit/vegetable sales, especially early after implementation, but these effects diminished over time. Furthermore, although the intervention had a positive effect on women’s diet quality at 6-month follow-up, this effect was small and not consistently observed at earlier time points. The intervention had little effect on household fruit and vegetable disposal frequency at 1 and 3 months post-intervention. However, at 6 months, intervention store participants were discarding fruits and vegetables more frequently at home, with a clear increase in vegetable waste compared to fruit waste.
From an individual (household) perspective, the intervention had a positive effect on the amount of fruit and vegetables purchased over a 6-month period. At the retailer level, in addition to the initial capital costs of moving fruits and vegetables, there were additional costs to maintain a wider range and quantity of produce, but the overall financial impact was difficult to quantify. Before the intervention, approximately 41% of intervention stores and 27% of control stores had their fresh food section located in the front half of the first aisle.
One month after implementation of the intervention, all intervention stores placed the fresh food section in the front half of the first aisle, compared to only 23% of control stores. After implementation of the intervention, the distance between the store entrance and the fresh food section was significantly shorter in intervention stores than in control stores. Intervention stores also had more different fruit/vegetable items than control stores after implementation.
conclusion
Placing fresh fruit and vegetable sections near store entrances may improve the nutritional profile of supermarket sales and improve household purchasing and women’s diet quality, but purchasing effects are modest and sometimes uncertain. After 6 months, the net intervention effect was positive at the individual level, with no increase in shopping time or spending. However, the study was not randomized, was carried out amidst Brexit, Covid-19 and cost of living pressures, and found an increase in household fruit and vegetable waste at six months.
Overall, the findings provide evidence to support improvements to the UK Food (Promotion and Placement) Regulations in force in the UK to include fresh food corners near store entrances to improve health outcomes.
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Reference magazines:
- Vogel C, Crozier S, Dhuria P, et al. Evaluating supermarket location strategies to encourage healthier eating habits: Overview of the WRAPPED study. Public health research. 2026;14(14). Doi: 10.3310/KSDT8756. https://www.journalslibrary.nihr.ac.uk/phr/KSDT8756
