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Petimar J, Moran AJ, Grummon AH, Anderson E, Lurie P, John S, Rimm EB, Thorndike AN. In-Store Marketing and Supermarket Purchases: Associations Overall and by Transaction SNAP Status. Am J Prev Med 2023; 65:587-595. [PMID: 36878416 PMCID: PMC10475490 DOI: 10.1016/j.amepre.2023.02.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION In-store placement promotions are used widely in supermarkets, but their effects on customer purchases remain largely unknown. This study examined associations of supermarket placement promotions with customer purchases overall and by Supplemental Nutrition Assistance Program (SNAP) benefit use. METHODS Data on in-store promotions (e.g., endcaps, checkout displays) and transactions (n=274,118,338) were obtained from a New England supermarket chain with 179 stores from 2016 to 2017. Product-level analyses examined multivariable-adjusted changes in products' sales when they were promoted (versus not) across all transactions and stratified by whether the transaction was paid for with SNAP benefits. Food group-level analyses examined the extent to which a 20% increase from the mean number of weekly promotions for a food group (e.g., increasing the number of candy promotions from 17.0 to 20.4) was associated with total food group sales. Analyses were conducted in 2022. RESULTS Across stores, the mean (SD) number of promotions per week was highest for sweet/salty snacks (126.3 [22.6]), baked goods (67.5 [18.4]), and sugar-sweetened beverages (48.6 [13.8]) and lowest for beans (5.0 [2.6]) and fruits (6.6 [3.3]). Product sales were between 16% (low-calorie drinks) and 136% (candy) higher when promoted versus not promoted. In 14 of 15 food groups, associations were stronger among transactions made with SNAP benefits than among those not made with SNAP benefits. The number of in-store promotions was generally not associated with total food group sales. CONCLUSIONS In-store promotions, which were mostly for unhealthy foods, were associated with large product sales increases, particularly among SNAP purchasers. Policies limiting unhealthy in-store promotions and incentivizing healthy promotions should be explored.
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Affiliation(s)
- Joshua Petimar
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Alyssa J Moran
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Anna H Grummon
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emma Anderson
- Department of Population Health Management, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Peter Lurie
- Center for Science in the Public Interest, Washington, District of Columbia
| | - Sara John
- Center for Science in the Public Interest, Washington, District of Columbia
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Anne N Thorndike
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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El-Sayed OM, Powell LM. The impact of the Oakland sugar-sweetened beverage tax on price promotions of sugar-sweetened and alternative beverages. PLoS One 2023; 18:e0285956. [PMID: 37294798 PMCID: PMC10256178 DOI: 10.1371/journal.pone.0285956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/05/2023] [Indexed: 06/11/2023] Open
Abstract
The goal of sugar-sweetened beverage (SSB) taxes is to raise the prices of SSBs to decrease consumption. Price promotions play an important role in the sales of SSBs and could potentially be used by manufacturers to weaken the impact of such taxes. The purpose of this study is to determine how price promotions changed after the introduction of the 2017 Oakland SSB tax. A difference-in-differences study design was used to compare changes in prices and the prevalence and amount of price promotions for beverages in Oakland, California, relative to Sacramento, California, using two different datasets. Nielsen Retail Scanner data included price promotions for beverages sold and store audit data included price promotions offered by retailers. Changes were analyzed for SSBs, noncalorically sweetened beverages, and unsweetened beverages. After the implementation of the tax, the prevalence of price promotions for SSBs did not change significantly in Oakland relative to the comparison site of Sacramento. However, the depth of price promotions increased by an estimated 0.35 cents per ounce (P<0.001) based on the Nielsen retail scanner data and by 0.39 cents per ounce (P<0.001) based on the store audit data. This increase in the amount by which SSBs were price promoted following the introduction of the Oakland SSB tax may reflect a strategy by manufacturers to weaken the tax and/or retailers to bolster demand.
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Affiliation(s)
- Osama M. El-Sayed
- Division of Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Lisa M. Powell
- Division of Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, Illinois, United States of America
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Lovasi GS, Boise S, Jogi S, Hurvitz PM, Rundle AG, Diez J, Hirsch JA, Fitzpatrick A, Biggs ML, Siscovick DS. Time-Varying Food Retail and Incident Disease in the Cardiovascular Health Study. Am J Prev Med 2023; 64:877-887. [PMID: 36882344 PMCID: PMC10200742 DOI: 10.1016/j.amepre.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 03/08/2023]
Abstract
INTRODUCTION Natural experiments can strengthen evidence linking neighborhood food retail presence to dietary intake patterns and cardiometabolic health outcomes, yet sample size and follow-up duration are typically not extensive. To complement natural experiment evidence, longitudinal data were used to estimate the impacts of neighborhood food retail presence on incident disease. METHODS The Cardiovascular Health Study recruited adults aged 65+ years in 1989-1993. Analyses conducted in 2021-2022 included those in good baseline health, with addresses updated annually through the year of death (restricted to 91% who died during >2 decades of cohort follow-up). Baseline and annually updated presence of 2 combined food retail categories (supermarkets/produce markets and convenience/snack focused) was characterized using establishment-level data for 1-km and 5-km Euclidean buffers. Cox proportional hazards models estimated associations with time to each incident outcome (cardiovascular disease, diabetes), adjusting for individual and area-based confounders. RESULTS Among 2,939 participants, 36% with baseline supermarket/produce market presence within 1 km had excess incident cardiovascular disease (hazard ratio=1.12; 95% CI=1.01, 1.24); the association was attenuated and no longer statistically significant after adjustment for sociodemographic characteristics. Adjusted associations were robustly null for time-varying supermarket/produce market or convenience/fast food retail presence across analyses with outcomes of cardiovascular disease or diabetes incidence. CONCLUSIONS Food environment changes continue to be studied to provide an evidence base for policy decisions, and null findings in this longitudinal analysis add literature that casts doubt on the sufficiency of strategies targeting food retail presence alone of an elderly cohort for curtailing incident events of clinical importance.
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Affiliation(s)
- Gina S Lovasi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
| | - Sarah Boise
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Siddharth Jogi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Philip M Hurvitz
- Center for Studies in Demography & Ecology, University of Washington, Seattle, Washington; Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle, Washington
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Julia Diez
- Department of Surgery, Medical and Social Sciences, Universidad de Alcalá, Madrid, Spain
| | - Jana A Hirsch
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Annette Fitzpatrick
- Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington; Department of Global Health, School of Medicine, University of Washington, Seattle, Washington; Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Mary L Biggs
- Department of Biostatistics, School Public Health, University of Washington, Seattle, Washington
| | - David S Siscovick
- Research, evaluation and policy, New York Academy of Medicine, New York, New York
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Davies T, Coyle D, Shahid M, Pettigrew S, Wu JH, Marklund M. Packaged foods purchased on price promotion in Australia. Appetite 2023; 180:106352. [PMID: 36272544 DOI: 10.1016/j.appet.2022.106352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 09/16/2022] [Accepted: 10/15/2022] [Indexed: 12/15/2022]
Abstract
We examined the prevalence and magnitude of price promotions among purchases of packaged foods and beverages in Australia, as well as the contribution of price-promoted foods and beverages to apparent energy intake. We utilized grocery purchase data from a nationally representative panel of 10 000 households in 2019 (NielsenIQ Homescan panel), combined with a food nutrition dataset (FoodSwitch). Nutritional quality was defined using the Australian and New Zealand Health Star Rating (HSR), where products with an HSR <3.5 were classified as 'less healthy' and products with an HSR ≥3.5 were classified as 'healthy'. Apparent energy intake was expressed as the total energy content of all purchased products per day per capita. Price promotions were claimed by panel members. Overall, four-in-ten packaged products (41%) were purchased on price promotion. Compared to 'healthy' products, 'less healthy' products were more frequently purchased on price promotion (33% vs 48%, respectively, p < 0.001), but had a similar mean magnitude of price discount (both 22%). Low socio-economic status (SES) households consumed 18% more energy from 'less healthy' packaged products on price promotion than high SES households (1141 vs 970 kJ/day/capita, p < 0.001). In conclusion, restricting price promotions for 'less healthy' packaged foods and beverages could potentially improve diet quality and dietary inequalities in Australia.
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Affiliation(s)
- Tazman Davies
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia.
| | - Daisy Coyle
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Maria Shahid
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Jason Hy Wu
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Matti Marklund
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia; Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA; Department of Public Health and Caring Sciences, Uppsala University, 75122, Uppsala, Sweden
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Gomes Cordeiro N, Mendes LL, Jardim MZ, Claro RM, Pessoa MC, Granado FS, Cristina de Souza Andrade A, de Lima Costa BV. Do Food and Nutrition Public Establishments Influence Availability to Healthy Food in Neighborhood? JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2155095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Larissa Loures Mendes
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mariana Zogbi Jardim
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Rafael Moreira Claro
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Fernanda Serra Granado
- Public Health Postgraduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Sugar-sweetened beverage purchases and intake at event arenas with and without a portion size cap. Prev Med Rep 2022; 25:101661. [PMID: 35127348 PMCID: PMC8800009 DOI: 10.1016/j.pmedr.2021.101661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 12/03/2022] Open
Abstract
This real-world study examined sugar-sweetened beverage (SSB) and food purchases and consumption during basketball games at sporting arenas with and without a voluntary 16-ounce portion size cap. A portion-size cap at an event arena was associated with customers’ purchasing and consuming fewer SSB oz. This study provides some of the first real-world evidence that an SSB portion-size cap policy may decrease SSB ounces purchased and consumed.
This is the first real-world study to examine the association between a voluntary 16-ounce (oz) portion-size cap on sugar-sweetened beverages (SSB) at a sporting arena on volume of SSBs and food calories purchased and consumed during basketball games. Cross-sectional survey data from adults exiting a Brooklyn, NY, USA arena (Barclays, n = 464) with a 16-oz portion-size restriction and a Manhattan, NY, USA arena with no portion-size restriction (Madison Square Garden, control, n = 295) after the portion cap policy was put in place from March through June 2014 were analyzed. Linear regression models adjusting for sex, age, BMI, ethnicity, race, marital status, education, and income were used to compare the two arenas during the post-implementation period. The survey response rate was 45.9% and equivalent between venues. Among all arena goers, participants at Barclays purchased significantly fewer SSB oz (−2.24 oz, 95% CI [−3.95, −0.53], p = .010) and consumed significantly fewer SSB oz (−2.34 oz, 95% CI[−4.01, −0.68], p = .006) compared with MSG after adjusting for covariates. Among those buying at least one SSB, Barclays’ participants purchased on average 11.03 fewer SSB oz. (95% CI = [4.86, 17.21], p < .001) and consumed 12.10 fewer SSB oz (95% CI = [5.78, 18.42], p < .001). There were no statistically significant differences between arenas in food calories and event satisfaction. In addition, no one reported not ordering a drink due to small size. An SSB portion-size cap was associated with purchasing and consuming fewer SSB oz. without evidence of decreasing satisfaction with the event experience.
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Laframboise NA, Seabrook JA, Matthews JI, Dworatzek PDN. Sixty Percent of Foods Advertised in Grocery Store Flyers are Not In-line with Canada's Food Guide. CAN J DIET PRACT RES 2022; 83:1-7. [PMID: 35014540 DOI: 10.3148/cjdpr-2021-035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose: To evaluate foods advertised in discount and premium grocery flyers for their alignment with Canada's 2007 Food Guide (CFG) and assess if alignment differed by food category, season, page location, and price.Methods: Weekly flyers (n = 192) were collected from discount and premium grocery chains from each of 4 seasons. Health Canada's Surveillance Tool was used to assess food items as in-line or not in-line with CFG.Results: Of 35 576 food items, 39.7% were in-line with CFG. There were no differences in proportions of foods not in-line in discount versus premium flyers (60.9% and 60.0%, respectively). Other Foods and Meat & Alternatives were advertised most (28.0% and 26.3%, respectively; P < 0.001). Milk & Alternatives were the least advertised food group (10.3%). Vegetables & Fruit (19.6%), Grains (21.6%), Milk & Alternatives (20.6%), and Meat & Alternatives (20.2%) were promoted least in Fall (P < 0.001). A higher proportion of foods advertised on middle pages were not in-line (61.0%) compared with front (56.6%) and back (58.8%) pages (P < 0.001). Not in-line foods were more expensive ($3.49, IQR = $2.82) than in-line foods ($3.28, IQR = $2.81; P < 0.001).Conclusions: While there was no difference in healthfulness of foods advertised in discount versus premium flyers, grocers advertised more foods not in-line with CFG. Government policies to improve the food environment should consider grocery flyers.
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Affiliation(s)
- Natalie A Laframboise
- School of Food and Nutritional Sciences, Brescia University College, Western University, London, ON
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, Western University, London, ON
- Department of Paediatrics, Western University, London, ON
- Department of Epidemiology and Biostatistics, Western University, London, ON
- Children's Health Research Institute, London, ON
- Lawson Health Research Institute, London, ON
- Human Environments Analysis Laboratory, London, ON
| | - June I Matthews
- School of Food and Nutritional Sciences, Brescia University College, Western University, London, ON
| | - Paula D N Dworatzek
- School of Food and Nutritional Sciences, Brescia University College, Western University, London, ON
- Schulich Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, Western University 1285 Western Road, London, ON N6G 1H2
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Wu YH, Moore S, Ma Y, Dube L. Longitudinal geo-referenced field evidence for the heightened BMI responsiveness of obese women to price discounts on carbonated soft drinks. PLoS One 2021; 16:e0261749. [PMID: 34965263 PMCID: PMC8716038 DOI: 10.1371/journal.pone.0261749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 12/09/2021] [Indexed: 11/18/2022] Open
Abstract
There is increasing interest in the effect that food environments may have on obesity, particularly through mechanisms related to the marketing and consumption of calorie-dense, nutrient-poor foods and sugary beverages. Price promotions, such as temporary price discounts, have been particularly effective in the marketing of carbonated soft drinks (CSDs) among consumers. Research has also suggested that the purchasing behavior of consumer groups may be differentially sensitive to price discounts on CSDs, with obese women particularly sensitive. In addition, the intensity of price discount in a person's food environment may also vary across geography and over time. This study examines whether the weight change of obese women, compared to overweight or normal BMI women, is more sensitive to the intensity of price discounts on CSDs in the food environment. This study used longitudinal survey data from 1622 women in the Montreal Neighborhood Networks and Health Aging (MoNNET-HA) Panel. Women were asked to report their height and weight in 2008, 2010 and 2013 in order to calculate women's BMI in 2008 and their change of weight between 2008 and 2013. Women's exposure to an unhealthy food environment was based on the frequency in which their neighborhood food stores placed price discounts on CSDs in 2008. The price discount frequency on CSDs within women's neighborhoods was calculated from Nielsen point-of sales transaction data in 2008 and geocoded to participant's forward sortation area. The prevalence of obesity and overweight among MoNNET-HA female participants was 18.3% in 2008, 19.9% in 2010 and 20.7% in 2013 respectively. Results showed that among obese women, exposure to unhealthy food environments was associated with a 3.25 kilogram (SE = 1.35, p-value = 0.02) weight gain over the five-year study period. Exposure to price discounts on CSDs may disproportionately affect and reinforce weight gain in women who are already obese.
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Affiliation(s)
- Yun-Hsuan Wu
- Department of Public Health, China Medical University, Taichung, Taiwan
- * E-mail:
| | - Spencer Moore
- Health & Society Group, Social Sciences Department, Wageningen University & Research, Wageningen, Netherlands
| | - Yu Ma
- Desautels Faculty of Management, McGill University, Montreal, Quebec, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, Quebec, Canada
| | - Laurette Dube
- Desautels Faculty of Management, McGill University, Montreal, Quebec, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, Quebec, Canada
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Tawfiq E, Bradbury KE, Ni Mhurchu C. Does the prevalence of promotions on foods and beverages vary by product healthiness? A population-based study of household food and drink purchases in New Zealand. Public Health Nutr 2021; 25:1-9. [PMID: 34924088 PMCID: PMC9991816 DOI: 10.1017/s1368980021004936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 10/29/2021] [Accepted: 12/13/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess the prevalence of promotions on foods and non-alcoholic drinks purchased by New Zealand households and to determine if they vary according to healthiness of products. DESIGN We undertook a cross-sectional analysis of Nielsen New Zealand Homescan® 2018/19 panel data. We conducted multivariate analyses to examine the variability in quantities of healthy v. unhealthy food and beverage products purchased on promotion. Promotion was self-reported by the panellist. Healthiness of products was measured by the Health Star Rating (HSR) system. We also carried out a subgroup analysis for beverages according to the threshold of < 5 g v. ≥ 5 g sugar per 100 ml content of products. SETTING The Nielsen New Zealand Homescan® data were linked with two New Zealand Food Composition Databases (Nutritrack and the FOODfiles). PARTICIPANTS Food and beverage purchases data by 1800 panel households were used. RESULTS Overall, 46 % (1 803 601/3 940 458) of all purchases made were on promotion. Compared with purchases of food and beverage products with HSR < 3·5 (unhealthy), food and beverage products with HSR ≥ 3·5 (healthy) were significantly less likely to be on promotion (OR = 0·78, 95 % CI 0·77, 0·79). The subgroup analysis for beverages shows that products with < 5 g sugar per 100 ml were significantly less likely to be on promotion than those with ≥ 5 g sugar per 100 ml (OR = 0·77, 95 % CI 0·75, 0·79). CONCLUSIONS Policies to improve healthy food retailing should focus on increasing the promotion of healthier food and drink options in stores and supermarkets.
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Affiliation(s)
- Essa Tawfiq
- National Institute for Health Innovation, Faculty of Medical and Health Sciences, The University of Auckland, Auckland1010, New Zealand
| | - Kathryn E Bradbury
- National Institute for Health Innovation, Faculty of Medical and Health Sciences, The University of Auckland, Auckland1010, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, Faculty of Medical and Health Sciences, The University of Auckland, Auckland1010, New Zealand
- The George Institute for Global Health, Sydney, Australia
- University of New South Wales, Sydney, Australia
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Houghtaling B, Holston D, Szocs C, Penn J, Qi D, Hedrick V. A rapid review of stocking and marketing practices used to sell sugar-sweetened beverages in U.S. food stores. Obes Rev 2021; 22:e13179. [PMID: 33331094 PMCID: PMC7988563 DOI: 10.1111/obr.13179] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/28/2020] [Accepted: 11/15/2020] [Indexed: 12/29/2022]
Abstract
Sugar-sweetened beverages (SSBs) are a primary source of added sugars in the American diet. Habitual SSB consumption is associated with obesity and noncommunicable disease and is one factor contributing to U.S. health disparities. Public health responses to address marketing-mix and choice-architecture (MMCA) strategies used to sell SSB products may be required. Thus, our goal was to identify original research about stocking and marketing practices used to sell SSB in U.S. food stores. We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the World Health Organization (WHO) protocol for rapid reviewing. We searched six databases and Google Scholar using key terms focused on store type and SSB products. We characterized results using an MMCA framework with categories place, profile, portion, pricing, promotion, priming or prompting, and proximity. Our search resulted in the identification of 29 articles. Most results focused on profile (e.g., SSB availability) (n = 13), pricing (e.g., SSB prices or discounts) (n = 13), or promotion (e.g., SSB advertisements) (n = 13) strategies. We found some evidence of targeted MMCA practices toward at-risk consumers and differences by store format, such as increased SSB prominence among supermarkets. The potential for systematic variations in MMCA strategies used to sell SSB requires more research. We discuss implications for public health, health equity, and environmental sustainability.
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Affiliation(s)
- Bailey Houghtaling
- School of Nutrition and Food Sciences, Louisiana State University (LSU) and LSU Agricultural Center, Baton Rouge, LA, USA
| | - Denise Holston
- School of Nutrition and Food Sciences, Louisiana State University (LSU) and LSU Agricultural Center, Baton Rouge, LA, USA
| | - Courtney Szocs
- E.J. Ourso College of Business, Louisiana State University, Baton Rouge, LA, USA
| | - Jerrod Penn
- Agricultural Economics and Agribusiness, Louisiana State University (LSU) and LSU Agricultural Center, Baton Rouge, LA, USA
| | - Danyi Qi
- Agricultural Economics and Agribusiness, Louisiana State University (LSU) and LSU Agricultural Center, Baton Rouge, LA, USA
| | - Valisa Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
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Mamiya H, Moodie EEM, Schmidt AM, Ma Y, Buckeridge DL. Price discounting as a hidden risk factor of energy drink consumption. Canadian Journal of Public Health 2021; 112:638-646. [PMID: 33725331 DOI: 10.17269/s41997-021-00479-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/25/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Global consumption of caffeinated energy drinks (CED) has been increasing dramatically despite increasing evidence of their adverse health effects. Temporary price discounting is a rarely investigated but potentially powerful food marketing tactic influencing purchasing of CED. Using grocery transaction records generated by food stores in Montreal, we investigated the association between price discounting and purchasing of CED across socio-economic status operationalized by education and income levels in store neighbourhood. METHODS The outcome, log-transformed weekly store-level sales of CED, was modelled as a function of store-level percent price discounting, store- and neighbourhood-level confounders, and an interaction term between discounting and each of tertile education and income in store neighbourhood. The model was separately fit to transactions from supermarkets, pharmacies, supercentres, and convenience stores. RESULTS There were 18,743, 12,437, 3965, and 49,533 weeks of CED sales from supermarkets, pharmacies, supercentres, and convenience stores, respectively. Percent price discounting was positively associated with log sales of CED for all store types, and the interaction between education and discounting was prominent in supercentres: -0.039 [95% confidence interval (CI): -0.051, -0.028] and -0.039 [95% CI: -0.057, -0.021], for middle- and high-education neighbourhoods relative to low-education neighbourhoods, respectively. Relative to low-income areas, the associations of discounting and log CED sales in supercentres for neighbourhoods with middle- and high-income tertile were 0.022 [95% CI: 0.010, 0.033] and 0.015 (95% CI: -0.001, 0.031), respectively. CONCLUSION Price discounting is an important driver of CED consumption and has a varying impact across community education and income.
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Affiliation(s)
- Hiroshi Mamiya
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1120 Ave Pine, Montreal, QC, H3G 1A1, Canada.
| | - Erica E M Moodie
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1120 Ave Pine, Montreal, QC, H3G 1A1, Canada
| | - Alexandra M Schmidt
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1120 Ave Pine, Montreal, QC, H3G 1A1, Canada
| | - Yu Ma
- Desautels Faculty of Management, McGill University, 1001 Ave Sherbrooke West, Montreal, QC, H3G 1G5, Canada
| | - David L Buckeridge
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1120 Ave Pine, Montreal, QC, H3G 1A1, Canada
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Zhong Y, Auchincloss AH, Stehr MF, Langellier BA. Are price discounts on sugar-sweetened beverages (SSB) linked to household SSB purchases? - a cross-sectional study in a large US household and retail scanner database. Nutr J 2021; 20:29. [PMID: 33740986 PMCID: PMC7980678 DOI: 10.1186/s12937-021-00673-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background Price promotions on sugar-sweetened beverages (SSBs) are commonly used by retailers to provide economic incentives for purchasing. Surprisingly, there is a lack of high-quality articles that examine the frequency and magnitude of sugary beverage discounting and consumer responses to discounts. The objective of this study is to quantify the association between exposure to price discounts and SSB purchases. Methods This cross-sectional study linked 2016 SSB consumption data from a U.S. household consumer panel (analytic sample N = 11,299 households) and weekly prices at stores where they shopped. We derived percent of the time SSBs were discounted (annual promotion frequency) and the amount of the discount (annual promotion magnitude) and assessed their association with household annual per capita SSB purchase ounces. Linear regression models adjusted for household size, income per capita, age, education, presence of children, race, occupation, region, and urbanicity. We also evaluated whether the association between promotion and purchase varied by socioeconomic status and race subgroups. Data were analyzed in 2019–2020. Results On average, households were exposed to SSBs price promotions 44% of the time. A 10-percentage point increase in annual SSB promotion frequency was associated with 13.7% increase in annual per capita purchasing (P < 0.0001), and a 1-percentage point increase in annual SSB promotion magnitude was associated with 15.3% increase in annual per capita purchasing (P < 0.0001). These associations did no vary significantly across socioeconomic status and race subgroups (Interaction P > 0.2). Conclusions More frequent and deeper price promotion was associated with higher annual per capita SSB purchases. Restricting SSB price promotions may be effective at reducing SSB consumption. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00673-w.
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Affiliation(s)
- Yichen Zhong
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Mark F Stehr
- School of Economics, LeBow College of Business, Drexel University, Philadelphia, PA, 19104, USA
| | - Brent A Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
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Zenk SN, Li Y, Leider J, Pipito AA, Powell LM. No long-term store marketing changes following sugar-sweetened beverage tax implementation: Oakland, California. Health Place 2021; 68:102512. [PMID: 33517072 DOI: 10.1016/j.healthplace.2021.102512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/05/2020] [Accepted: 01/08/2021] [Indexed: 11/30/2022]
Abstract
Globally, more than 45 countries have implemented sugar-sweetened beverage (SSB) taxes; however, little is known about effects on marketing practices. For the 2017 Oakland, California, 1 cent per ounce SSB tax, this study evaluated long-term changes in beverage price promotions, depth of sale, and interior and exterior advertising at stores, collected via in-person audits at two time points (pre-tax and 24-months post-tax). Overall, based on difference-in-differences estimation, relative to the comparison site, no significant pre-post tax changes were found in the odds of price promotions, exterior or interior advertising, or sale depth for SSBs or untaxed beverages. As additional SSB taxes are considered these findings suggest that SSB taxes may not have long-term effects on store marketing practices.
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Affiliation(s)
- Shannon N Zenk
- National Institute of Nursing Research, National Institutes of Health, 9000 Rockville Pike, Building 31, Room 5B05, Bethesda, MD, USA.
| | - Yu Li
- Health Policy and Administration Division, School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA.
| | - Julien Leider
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
| | - Andrea A Pipito
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
| | - Lisa M Powell
- Health Policy and Administration Division, School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA; Institute for Health Research and Policy, University of Illinois Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
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The Healthiness of Food and Beverages on Price Promotion at Promotional Displays: A Cross-Sectional Audit of Australian Supermarkets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239026. [PMID: 33287395 PMCID: PMC7729449 DOI: 10.3390/ijerph17239026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 12/22/2022]
Abstract
Supermarket environments can strongly influence purchasing decisions. Price promotions are recognised as a particularly persuasive tactic, but the healthiness of price promotions in prominent in-store locations is understudied. This study compared the prevalence and magnitude of price promotions on healthy and unhealthy food and beverages (foods) displayed at prominent in-store locations within Australian supermarkets, including analyses by supermarket group and area-level socio-economic position. A cross-sectional in-store audit of price promotions on foods at key display areas was undertaken in 104 randomly selected stores from major Australian supermarket groups (Woolworths, Coles, Aldi and independents) in Victoria, Australia. Of the display space dedicated to foods with price promotions, three of the four supermarket groups had a greater proportion of display space devoted to unhealthy (compared to healthy) foods at each promotional location measured (end of aisles: 66%; island bins: 53%; checkouts: 88%). Aldi offered very few price promotions. Few measures varied by area-level socio-economic position. This study demonstrated that price promotions at prominent in-store locations in Australian supermarkets favoured unhealthy foods. Marketing of this nature is likely to encourage the purchase of unhealthy foods, highlighting the need for retailers and policy-makers to consider addressing in-store pricing and placement strategies to encourage healthier food environments.
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15
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Streamlined data-gathering techniques to estimate the price and affordability of healthy and unhealthy diets under different pricing scenarios. Public Health Nutr 2020; 24:1-11. [PMID: 32662385 DOI: 10.1017/s1368980020001718] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine the reliability of streamlined data-gathering techniques for examining the price and affordability of a healthy (recommended) and unhealthy (current) diet. We additionally estimated the price and affordability of diets across socio-economic areas and quantified the influence of different pricing scenarios. DESIGN Following the Healthy Diets Australian Standardised Affordability and Pricing (ASAP) protocol, we compared a cross-sectional sample of food and beverage pricing data collected using online data and phone calls (lower-resource streamlined techniques) with data collected in-store from the same retailers. SETTING Food and beverage prices were collected from major supermarkets, fast food and alcohol retailers in eight conveniently sampled areas in Victoria, Australia (n 72 stores), stratified by area-level deprivation and remoteness. PARTICIPANTS This study did not involve human participants. RESULTS The biweekly price of a healthy diet was on average 21 % cheaper ($596) than an unhealthy diet ($721) for a four-person family using the streamlined techniques, which was comparable with estimates using in-store data (healthy: $594, unhealthy: $731). The diet price differential did not vary considerably across geographical areas (range: 18-23 %). Both diets were estimated to be unaffordable for families living on indicative low disposable household incomes and below the poverty line. The inclusion of generic brands notably reduced the prices of healthy and unhealthy diets (≥20 %), rendering both affordable against indicative low disposable household incomes. Inclusion of discounted prices marginally reduced diet prices (3 %). CONCLUSIONS Streamlined data-gathering techniques are a reliable method for regular, flexible and widespread monitoring of the price and affordability of population diets in areas where supermarkets have an online presence.
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Changes in Beverage Marketing at Stores Following the Oakland Sugar-Sweetened Beverage Tax. Am J Prev Med 2020; 58:648-656. [PMID: 32192801 DOI: 10.1016/j.amepre.2019.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION In July 2017, Oakland, California implemented a 1 cent/ounce sugar-sweetened beverage tax. This study examined changes in store marketing practices-advertising and price promotions-for sugar-sweetened beverages, artificially sweetened beverages, and unsweetened beverages following the introduction of the tax. METHODS The study employed a quasi-experimental research design and included Oakland as the intervention site and Sacramento, California as a comparison site. Based on data collected pretax (May-June 2017), 6 months post-tax (January 2018), and 12 months post-tax (June 2018) at 249 stores across the 2 sites, exterior and interior advertising for 4 taxed sugar-sweetened beverage subtypes and 6 untaxed artificially sweetened and unsweetened beverage subtypes, as well as price promotions for 59 specific taxed products and 69 untaxed products were examined. In 2019, difference-in-differences logistic regressions estimated pre-post changes in Oakland relative to Sacramento. RESULTS At 6 months post-tax, the odds of sugar-sweetened beverage price promotions fell 50% in Oakland but only 22% in Sacramento. Price promotions for regular soda in particular declined in Oakland post-tax, by 47% at 6 months and 39% at 12 months (versus no change in Sacramento). Moreover, the odds of artificially sweetened beverage price promotions fell by a similar magnitude as sugar-sweetened beverages in Oakland, 55% at 6 months and 53% at 12 months, which differed significantly from Sacramento. No significant post-tax changes were found in sugar-sweetened or artificially sweetened beverage exterior or interior advertising. CONCLUSIONS Rather than increasing marketing, retailers and manufacturers may have tried to offset revenue losses by reducing price promotions for sugar-sweetened beverages, particularly regular soda, and artificially sweetened beverages.
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17
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A systematic review, and meta-analysis, examining the prevalence of price promotions on foods and whether they are more likely to be found on less-healthy foods. Public Health Nutr 2020; 23:1281-1296. [PMID: 32209142 PMCID: PMC7196736 DOI: 10.1017/s1368980019004129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective: There are concerns that price promotions encourage unhealthy dietary choices. This review aims to answer the following research questions (RQ1) what is the prevalence of price promotions on foods in high-income settings, and (RQ2) are price promotions more likely to be found on unhealthy foods? Design: Systematic review of articles published in English, in peer-review journals, after 1 January 2000. Setting: Included studies measured the prevalence of price promotions (i.e. percentage of foods carrying a price promotion out of the total number of foods available to purchase) in retail settings, in upper-mid to high-income countries. Participants: ‘Price promotion’ was defined as a consumer-facing temporary price reduction or discount available to all customers. The control group/comparator was the equivalent products without promotions. The primary outcome for this review was the prevalence of price promotions, and the secondary outcome was the difference between the proportions of price promotions on healthy and unhealthy foods. Results: Nine studies (239 344 observations) were included for the meta-analysis for RQ1, the prevalence of price promotions ranged from 6 % (95 % CI 2 %, 15 %) for energy-dense nutrient-poor foods to 15 % (95 % CI 9 %, 25 %) for cereals, grains, breads and other starchy carbohydrates. However, the I-squared statistic was 99 % suggesting a very high level of heterogeneity. Four studies were included for the analysis of RQ2, of which two supported the hypothesis that price promotions were more likely to be found on unhealthy foods. Conclusions: The prevalence of price promotions is very context specific, and any proposed regulations should be supported by studies conducted within the proposed setting(s).
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Zorbas C, Eyles H, Orellana L, Peeters A, Mhurchu CN, Riesenberg D, Backholer K. Do purchases of price promoted and generic branded foods and beverages vary according to food category and income level? Evidence from a consumer research panel. Appetite 2020; 144:104481. [DOI: 10.1016/j.appet.2019.104481] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/11/2019] [Accepted: 10/03/2019] [Indexed: 11/25/2022]
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Leider J, Powell LM. Sugar-sweetened beverage prices: Variations by beverage, food store, and neighborhood characteristics, 2017. Prev Med Rep 2019; 15:100883. [PMID: 31193242 PMCID: PMC6522848 DOI: 10.1016/j.pmedr.2019.100883] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/12/2019] [Accepted: 04/28/2019] [Indexed: 01/03/2023] Open
Abstract
Sugar-sweetened beverage (SSB) consumption is associated with obesity, type 2 diabetes, and cardiovascular disease. A number of U.S. jurisdictions have levied volume-based specific SSB taxes. This study estimated baseline mean SSB prices across categories and sizes as this will help to determine the percentage increase in price resulting from the imposition of specific taxes. Data on food store SSB prices were collected in 2017 in Cook County, IL, St. Louis City/County, MO, Oakland, CA, and Sacramento, CA (N = 11,767 product-level observations from 581 stores). Data were weighted to represent volume sold by category and size. Mean prices per ounce were computed across categories and sizes. Linear regression models, clustered on store, were run to estimate associations between price per ounce and product characteristics, neighborhood (linked by census tract) characteristics, store type, and site. Weighted summary statistics show that the mean price of SSBs was 4.8 cents/oz. Soda was least expensive (3.4 cents/oz), followed by sports drinks (4.8 cents/oz), juice drinks (5.2 cents/oz), ready-to-drink tea/coffee (7.8 cents/oz), and energy drinks (19.9 cents/oz). Prices were higher for individual-sized (9.6 cents/oz) compared to family-sized drinks (>1 L/multi-pack; 3.5 cents/oz). Regression results revealed that prices were lower in stores in majority non-Hispanic black tracts and varied by beverage characteristics and store type but not tract-level socioeconomic status. Given substantial variation in prices by SSB category, a penny-per-ounce SSB tax, if fully passed through, would increase soda prices by 29% versus 5% for energy drinks, highlighting the potential importance of different specific tax rates across beverage categories.
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Affiliation(s)
- Julien Leider
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, M/C 275, Chicago, IL 60608-1264, USA
| | - Lisa M. Powell
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, M/C 275, Chicago, IL 60608-1264, USA
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor Street, M/C 923, Chicago, IL 60612-4394, USA
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20
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Riesenberg D, Backholer K, Zorbas C, Sacks G, Paix A, Marshall J, Blake MR, Bennett R, Peeters A, Cameron AJ. Price Promotions by Food Category and Product Healthiness in an Australian Supermarket Chain, 2017-2018. Am J Public Health 2019; 109:1434-1439. [PMID: 31415196 DOI: 10.2105/ajph.2019.305229] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To examine the prevalence and magnitude of price promotions in a major Australian supermarket and how they differ between core (healthy) and discretionary (less healthy) food categories.Methods. Weekly online price data (regular retail price, discount price, and promotion type) on 1579 foods were collected for 1 year (April 2017 to April 2018) from the largest Australian supermarket chain. Products audited were classified according to Australian Dietary Guidelines definitions of core and discretionary foods and according to their Health Star Rating (a government-endorsed nutrient profiling scheme).Results. On average, 15.1% (95% confidence interval [CI] = 14.7%, 15.3%) of core foods and 28.8% (95% CI = 28.6%, 29.0%) of discretionary foods were price promoted during a given week. Average discounts were -15.4% (95% CI = -16.4, -14.4) for core products and -25.9% (95% CI = -26.8, -25.1) for discretionary products. The percentage of products on price promotion and the size of the discount were larger for products with a lower Health Star Rating (P < .05).Conclusions. Price promotions were more prevalent and greater in magnitude for discretionary foods than for core foods. Policies to reduce the prevalence and magnitude of price promotions on discretionary foods could improve the healthiness of food purchased from supermarkets.
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Affiliation(s)
- Devorah Riesenberg
- The authors are with the Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Kathryn Backholer
- The authors are with the Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Christina Zorbas
- The authors are with the Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- The authors are with the Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Anna Paix
- The authors are with the Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Josephine Marshall
- The authors are with the Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Miranda R Blake
- The authors are with the Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Rebecca Bennett
- The authors are with the Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Anna Peeters
- The authors are with the Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Adrian J Cameron
- The authors are with the Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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21
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Mamiya H, Moodie EEM, Ma Y, Buckeridge DL. Susceptibility to price discounting of soda by neighbourhood educational status: an ecological analysis of disparities in soda consumption using point-of-purchase transaction data in Montreal, Canada. Int J Epidemiol 2019; 47:1877-1886. [PMID: 29939286 DOI: 10.1093/ije/dyy108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2018] [Indexed: 12/25/2022] Open
Abstract
Introduction Price discounting is a marketing tactic used frequently by food industries and retailers, but the extent to which education modifies the effect of discounting on the purchasing of unhealthy foods has received little attention. We investigated whether there was a differential association of price discounting of soda with store-level soda purchasing records between 2008 and 2013 by store-neighbourhood education in Montreal, Canada. Methods Using data on grocery purchase transactions from a sample of supermarkets, pharmacies, supercentres and convenience stores, we performed an ecological time-series analysis, modelling weekly store-level sales of soda as a function of store-level price discounting, store- and neighbourhood-level confounders and an interaction term between discounting and categorical education in the neighbourhood of each store. Results Analysis by store type (n = 18 743, 12 437, 3965 and 49 533 store-weeks for superstores, pharmacies, supercentres and convenience stores, respectively) revealed that the effect measure modification of discounting by neighbourhood education on soda purchasing was lower in stores in the more educated neighbourhoods, most notably in pharmacies: -0.020 [95% confidence interval (CI): -0.028, -0.012] and -0.038 (95% CI: -0.051, -0.025), for middle- and high-education categories, respectively). Weaker effect modification was observed in convenience stores. There was no evidence of effect modification in supercentres or superstores. Conclusions Price discounting is an important environmental risk factor for soda purchasing and can widen education inequalities in excess sugar intake across levels of education. Interventions to regulate price discounting warrant further investigation as a public health strategy to improve population nutrition, particularly in lower-education neighbourhoods.
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Affiliation(s)
- Hiroshi Mamiya
- Department of Epidemiology, Biostatistics, and Occupational Health.,Surveillance Laboratory, McGill Clinical and Health Informatics
| | - Erica E M Moodie
- Department of Epidemiology, Biostatistics, and Occupational Health
| | - Yu Ma
- Desautels Faculty of Management, McGill University, Montréal, QC, Canada
| | - David L Buckeridge
- Department of Epidemiology, Biostatistics, and Occupational Health.,Surveillance Laboratory, McGill Clinical and Health Informatics
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22
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Zorbas C, Gilham B, Boelsen-Robinson T, Blake MRC, Peeters A, Cameron AJ, Wu JHY, Backholer K. The frequency and magnitude of price-promoted beverages available for sale in Australian supermarkets. Aust N Z J Public Health 2019; 43:346-351. [PMID: 31180614 DOI: 10.1111/1753-6405.12899] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/01/2019] [Accepted: 03/01/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Price promotions are used to influence purchases and represent an important target for obesity prevention policy. However, no long-term contemporary data on the extent and frequency of supermarket price promotions exists. We aimed to evaluate the frequency, magnitude and weekly variation of beverage price promotions available online at two major Australian supermarket chains over 50 weeks. METHODS Beverages were categorised into four policy-relevant categories (sugar-sweetened beverages, artificially-sweetened beverages, flavoured milk and 100% juice, milk and water). The proportional contribution of each category to the total number of price proportions, the proportion of price promotions within the available product category, the mean discount, and weekly variation in price promotions were calculated. RESULTS For Coles and Woolworths respectively, 26% and 30% of all beverages were price promoted in any given week. Sugar-sweetened beverages made up the greatest proportion of all price promotions (Coles: 46%, Woolworths: 49%). Within each product category, the proportion of sugar-sweetened and artificially-sweetened beverages that were price promoted was similar, higher than the other categories and reasonably constant over time. Diet drinks and sugar-sweetened soft drinks were most heavily discounted (by 29-40%). CONCLUSIONS Beverage price promotions are used extensively in Australian supermarkets, undermining efforts to promote healthy population diets. Implications for public health: Policies restricting price promotions on sugar-sweetened beverages are likely to be an important part of strategies to reduce obesity and improve population nutrition.
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Affiliation(s)
- Christina Zorbas
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria
| | - Beth Gilham
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria
| | - Tara Boelsen-Robinson
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria.,School of Public Health and Preventive Medicine, Monash University, Victoria
| | - Miranda R C Blake
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria.,School of Public Health and Preventive Medicine, Monash University, Victoria
| | - Anna Peeters
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria
| | - Adrian J Cameron
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria
| | - Jason H Y Wu
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales
| | - Kathryn Backholer
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria
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23
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Olivan-Blázquez B, Montero-Marin J, García-Toro M, Vicens-Pons E, Serrano-Ripoll MJ, Castro-Gracia A, Sarasa-Bosque MC, Mendive-Arbeloa JM, López-del-Hoyo Y, Garcia-Campayo J. Facilitators and barriers to modifying dietary and hygiene behaviours as adjuvant treatment in patients with depression in primary care: a qualitative study. BMC Psychiatry 2018; 18:205. [PMID: 29921245 PMCID: PMC6008925 DOI: 10.1186/s12888-018-1779-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 06/07/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Major depression is a highly prevalent condition. Its pathogenesis is related to a wide variety of biological and psychosocial factors and among these is factors related to lifestyle. Lifestyle-based interventions seem to be appropriate strategies as coadjutant treatment. The objective of this study is to explore and identify expectations and experiences of both patients and healthcare professionals that can point to the main barriers and facilitators with regard to the promotion of healthy dietary and hygiene behaviours in patients suffering from major depression. METHODS A qualitative design was used to collect information from a wide range of purposefully and theoretically guided samples of depressed patients and health professionals from Primary Care (PC). Both in-depth interviews and discussion groups were used. A standardized protocol was designed to guide the interviews and groups, including the preparation of a topic list to be addressed, with previously tested, open suggestions that could be of interest. A thematic analysis was performed from grounded theory in order to explore, develop and define until saturation the emergent categories of analysis derived from the individual interview and group data. RESULTS Both patients as well as PC professionals noted a series of central aspects with respect to the implementation of a programme for the acquisition of healthy dietary and hygiene habits for depressive patients, which may be organized around 'personal', 'programmatic', and 'transversal' aspects. As for the personal aspects, categories regarding 'patient history', and 'disposition' were found; the programmatic aspects included categories such as 'presentation and monitoring', and modification of 'cognitive' and 'behavioural' habits; whereas the transversal aspects comprised the possibilities of 'social support' and defining categories of 'objectives'. CONCLUSION The implementation of intervention programmes that combine dietary and hygiene-related factors in patients with depression is complex, given the nature of the disorder itself, and its symptoms such as apathy and feelings of guilt or incompetence. Key issues exist for the success of the intervention, such as the simplicity of guidelines, tailoring through motivational interviewing, prolonged and intense monitoring throughout the different stages of the disorder, and the provision of adequate feedback and social support. PC could be an appropriate level in which to implement these interventions.
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Affiliation(s)
- B. Olivan-Blázquez
- Department of Psychology and Sociology, University of Zaragoza, Violante de Hungria 23, 50009 Zaragoza, Spain
- Research Network on Preventive Activities and Health Promotion (Red de Investigación en Actividades Preventivas y Promoción de la Salud - RedIAPP), Barcelona, Spain
- Promosam Network, Red de Excelencia PSI2014-56303-REDT PROMOSAM: (Investigación en procesos, mecanismos y tratamientos psicológicos para la promoción de la salud mental), Economy and Competitiveness Ministry, Madrid, Spain
| | - J. Montero-Marin
- Research Network on Preventive Activities and Health Promotion (Red de Investigación en Actividades Preventivas y Promoción de la Salud - RedIAPP), Barcelona, Spain
- Promosam Network, Red de Excelencia PSI2014-56303-REDT PROMOSAM: (Investigación en procesos, mecanismos y tratamientos psicológicos para la promoción de la salud mental), Economy and Competitiveness Ministry, Madrid, Spain
| | - M. García-Toro
- Research Network on Preventive Activities and Health Promotion (Red de Investigación en Actividades Preventivas y Promoción de la Salud - RedIAPP), Barcelona, Spain
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears (UIB), Palma de Mallorca, Spain
| | - E. Vicens-Pons
- Research Network on Preventive Activities and Health Promotion (Red de Investigación en Actividades Preventivas y Promoción de la Salud - RedIAPP), Barcelona, Spain
- Departamento de Psiquiatría, Parc Sanitari San Joan de Déu, Sant Boi de Llobregat, Spain
| | - M. J. Serrano-Ripoll
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears (UIB), Palma de Mallorca, Spain
| | - A. Castro-Gracia
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears (UIB), Palma de Mallorca, Spain
| | | | | | - Y. López-del-Hoyo
- Department of Psychology and Sociology, University of Zaragoza, Violante de Hungria 23, 50009 Zaragoza, Spain
- Research Network on Preventive Activities and Health Promotion (Red de Investigación en Actividades Preventivas y Promoción de la Salud - RedIAPP), Barcelona, Spain
- Promosam Network, Red de Excelencia PSI2014-56303-REDT PROMOSAM: (Investigación en procesos, mecanismos y tratamientos psicológicos para la promoción de la salud mental), Economy and Competitiveness Ministry, Madrid, Spain
| | - J. Garcia-Campayo
- Research Network on Preventive Activities and Health Promotion (Red de Investigación en Actividades Preventivas y Promoción de la Salud - RedIAPP), Barcelona, Spain
- Promosam Network, Red de Excelencia PSI2014-56303-REDT PROMOSAM: (Investigación en procesos, mecanismos y tratamientos psicológicos para la promoción de la salud mental), Economy and Competitiveness Ministry, Madrid, Spain
- Aragones Health Service, Zaragoza, Spain
- Department of Medicine and Psychiatry, University of Zaragoza, Zaragoza, Spain
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Kumanyika S. The Sociocultural Context for Obesity Prevention and Treatment in Children and Adolescents: Influences of Ethnicity and Gender. CONTEMPORARY ENDOCRINOLOGY 2018. [DOI: 10.1007/978-3-319-68192-4_40] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Glover M, Kira A, Kira G, McRobbie H, Breier BH, Kruger R, Stephen J, Funaki-Tahifote M. An innovative team-based weightloss competition to reduce cardiovascular and diabetes risk among Māori and Pacific people: rationale and method for the study and its evaluation. BMC Nutr 2017; 3:78. [PMID: 32153855 PMCID: PMC7050897 DOI: 10.1186/s40795-017-0199-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 10/03/2017] [Indexed: 11/18/2022] Open
Abstract
Background Obesity rates for New Zealand (NZ) Pacific and Māori (NZ indigenous people) are among the highest in the world. Long-term results of weight management programmes for adults have been modest but primarily focused on individuals. This paper describes the rationale and methodology for a trial of a culturally tailored team-based weightloss competition conducted online with community level support. Methods/Design A quasi-experimental design was used to compare an intervention and control group. Three six-month competitions with seven teams of seven Māori or Pacific people (N = 147) were run. Eligible participants were: Māori or Pacific, 16 years of age and above, obese (BMI ≥30 kg/m2) and either at risk of or already diagnosed with type 2 diabetes (HbA1c >50 mmol/mol) or cardiovascular disease. The intervention facilitated group use of an internet-based competition offering financial incentives, education and support. The primary outcome was percentage of individual weight lost at 12-months. Secondary outcomes were percentage reduced total cholesterol and glycated haemoglobin (HbA1c). Data collected at baseline, 6-months and 12-months included: height, body weight, blood lipids and HbA1c, eating and dieting habits, family support, food access, alcohol use, nutrition literacy, activity levels, perceptions of weight, stress and sleep, and, perceived contagion effect. Process evaluation tasks will inform acceptability. Discussion An attractive, easy to understand weight change programme that effectively reduces disease risk among Māori and Pacific is desperately needed. Web-based delivered support and information to largely self-directed teams could also ease exponential rises in costs to the health system. Trial registration Trial Id: ACTRN12617000871347.
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Affiliation(s)
- Marewa Glover
- 1School of Health Sciences, College of Health, Massey University, Albany Highway, Albany, Auckland, 0632 New Zealand
| | | | - Geoff Kira
- 1School of Health Sciences, College of Health, Massey University, Albany Highway, Albany, Auckland, 0632 New Zealand
| | | | - Bernhard H Breier
- 4School of Sport, Exercise and Nutrition, College of Health, Massey University, Private Bag 102904, North Shore, Auckland, 0745 New Zealand
| | - Rozanne Kruger
- 4School of Sport, Exercise and Nutrition, College of Health, Massey University, Private Bag 102904, North Shore, Auckland, 0745 New Zealand
| | - Jane Stephen
- 1School of Health Sciences, College of Health, Massey University, Albany Highway, Albany, Auckland, 0632 New Zealand
| | - Mafi Funaki-Tahifote
- Pacific Heartbeat, Heart Foundation, PO Box 17-160, Greenlane, Auckland, 1546 New Zealand
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Taillie LS, Ng SW, Xue Y, Harding M. Deal or no deal? The prevalence and nutritional quality of price promotions among U.S. food and beverage purchases. Appetite 2017; 117:365-372. [PMID: 28705473 PMCID: PMC5574185 DOI: 10.1016/j.appet.2017.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/27/2017] [Accepted: 07/08/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This study examines trends in the prevalence of price promotions among packaged food and beverage purchases, differences in prevalence by household race/ethnicity or income, and the association between price promotions and the nutritional profile of purchases. DESIGN This cross-sectional study utilizes a dataset of 90 million purchases from 38,744 (2008) to 45,042 (2012) US households in 2008-2012. Chi-square tests were used to examine whether the proportion of purchases with price promotions changed over time or differed by household race/ethnicity or income. T-tests were used to compare purchased products' nutritional profiles. RESULTS Prevalence of price promotions among packaged food and beverage purchases increased by 8% and 6%, respectively, from 2008 to 2012, with both reaching 34% by 2012. Higher-income households had greater proportions of purchases with price promotions than lower-income households. Asian households had the highest proportion of purchases with any price promotion, followed by non-Hispanic whites. While total price-promoted packaged food purchases had higher mean energy, total sugar, and saturated fat densities than purchases with no price promotions, absolute differences were small. CONCLUSIONS Prevalence of price promotions among US household purchases increased from 2008 to 2012 and was greater for higher-income households. No clear associations emerged between presence of price promotions and nutritional quality of purchases.
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Affiliation(s)
- Lindsey Smith Taillie
- Carolina Population Center, Dept. of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 137 E Franklin St, CB #8120, Chapel Hill, NC 27514, USA.
| | - Shu Wen Ng
- Carolina Population Center, Dept. of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 137 E Franklin St, CB #8120, Chapel Hill, NC 27514, USA
| | - Ya Xue
- Duke-UNC USDA Center for Behavioral Economics and Healthy Food Choice Research, 140 Science Drive, 230P Gross Hall, Duke University, Box 90989, Durham, NC 27708-0989, USA
| | - Matthew Harding
- Dept. of Economics, University of California, 3207 Social Science Plaza B, Irvine, CA 92697, USA
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Abstract
OBJECTIVE To assess the evidence of the impact of new food store (supermarket/grocery store) interventions on selected health-related outcomes. DESIGN A systematic review following the Effective Public Health Practice Project guidelines. All quantitative studies were assessed for their methodological quality. Results were synthesized narratively. SETTING Eight electronic databases - MEDLINE, EMBASE, CINAHL, ProQuest Public Health, Web of Science, Scopus, PsycINFO and Cochrane Library - were searched to identify relevant records. SUBJECTS Peer-reviewed scholarly journal articles on new grocery store/supermarket interventions with adult study populations, published in the English language after 1995. RESULTS Eleven records representing seven new grocery store interventions were identified. Six were assessed having 'weak' methodological quality, one as 'moderate' and two as 'strong'. All studies reported fruit and vegetable consumption but results were not consistent, some studies reporting significantly more and others no increase in consumption. BMI and self-rated health did not show significant improvements. Perceptions of food access, neighbourhood satisfaction and psychological health showed significant improvements. CONCLUSIONS Improved food access through establishment of a full-service food retailer, by itself, does not show strong evidence towards enhancing health-related outcomes over short durations. Presently the field is developing and the complex linking pathways/mechanisms are yet to be elucidated. Further evidence, in the form of high-quality research in different communities with longer follow-up periods, is needed to inform policy decisions.
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