Abstract
To investigate to what extent promotions in Dutch supermarket sales flyers contribute to a healthy diet and whether there are differences between supermarket types. A cross-sectional study investigating promotions on foods and beverages (n 7825) in supermarket sales flyers from thirteen Dutch supermarket chains (8-week period), including ten traditional, two discount and one organic supermarket chain(s). Promoted products were categorised by food group (e.g. bread), contribution to a healthy diet (yes/no), degree of processing (e.g. ultra-processed), promotion type (temporary reduction in price, volume-based promotions or advertised only) and percentage discount of price promotions. Differences between supermarket chains in the degree of healthiness and processing of products and the types of price promotions were investigated. In total, 70·7 % of all promoted products in supermarket sales flyers did not contribute to a healthy diet and 56·6 % was ultra-processed. The average discount on less healthy products (28·7 %) was similar to that of healthy products (28·9 %). Less healthy products were more frequently promoted via volume-based promotions than healthy products (37·6 % v. 25·4 %, P < 0·001). Discount supermarket chains promoted less healthy (80·3 %) and ultra-processed (65·1 %) products more often than traditional supermarket chains (69·6 % and 56·6 %, respectively). The majority of promoted products via supermarket sales flyers do not contribute to a healthy diet. As promotions are an important determinant of food purchasing decisions, supermarkets do not support healthy choices. Future studies should identify barriers that withhold supermarket chains from promoting more healthy foods in supermarket sales flyers.
Highlights
In comparison with traditional supermarket chains, discount supermarket chains promoted a higher proportion of less healthy products (80·3 % v. 69·6 %, χ2 = 53·40, P =< 0·001) and a lower proportion of healthy products (18·6 % v. 21·2 %, χ2 = 3·99, P = 0·046)
Organic supermarket chains promoted a lower proportion of less healthy products (56·2 % v. 69·6 %, χ2 = 18·41, P =< 0·001) and a higher proportion of healthy products (37·6 % v. 21·2 %, χ2 = 34·39, P =< 0·001), compared to traditional supermarket chains (Table 2)
Ultra-processed foods were significantly more often promoted by discount supermarket chains (65·1 %) compared to traditional supermarket chains (56·6 %) that in turn promoted more often ultraprocessed foods than the organic supermarket chain (13·3 %, χ2 = 340, P < 0·001) (Table 2)
Summary
Study design A cross-sectional study was conducted, examining the products promoted via weekly online supermarket sales flyers of thirteen supermarket chains in the Netherlands, issued between February and April 2018. These products were not available in the supermarket and the nutrition facts label of a similar product offered by the same supermarket chain was used as reference instead (exact numbers were not recorded, we estimate that this was the case at less than ten products) If both healthy and less healthy foods and drinks were promoted together in one promotion, this promotion was classified in a separate category (‘varying healthiness’). ANOVA analyses were performed to investigate differences between supermarket types in percentage discount of the promoted products per healthiness category and the degree of processing of the promoted products. To investigate whether there was a difference in types of promotions for the discounted food products per healthiness category, degree of processing and per supermarket type, chi-square analyses (Bonferroni adjusted) were performed. All analyses were conducted using the IBM SPSS statistical software package, version 25.0
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