Healthy Stores 2020
Restricting merchandising of discretionary food to improve health
Restricting merchandising of discretionary food to improve health
Healthy Stores 2020 celebrates a partnership between The Arnhem Land Progress Aboriginal Corporation (ALPA) and the research community to show a pathway for the food retail sector to support better health outcomes for communities. How food is promoted in food retail settings impacts what consumers purchase. Foods high in sugar, fat and/or salt are normally promoted by retailers to attract impulse purchases to stimulate sales. To combat the high burden of chronic disease and associated conditions confronting society, Healthy Stores 2020 aimed to reverse the promotion of these foods and restrict their merchandising (promotion and visibility). This website tells the story of Healthy Stores 2020.
In 2018, with funding from the National Health and Medical Research Council, Monash University partnered with The Arnhem Land Progress Aboriginal Corporation (ALPA) and a group of world experts in healthy food retail research from a number of universities in Australia and Canada to conduct the Healthy Stores 2020 study, a pragmatic randomised controlled trial.
Restricting merchandising of unhealthy foods can achieve both public health relevant and business relevant gains.
For the one health of people and the planet, we urge the food retail sector to follow the leadership of ALPA and remote communities to restrict the merchandising of unhealthy food and drinks and enable consumers to more easily choose the healthier options.
Healthy Stores 2020 was funded by an NHMRC project grant (1138629). This research is also linked to an NHMRC-funded Center of Research Excellence in Food Retail Environments for Health (APP1152968). The information and opinions contained in this paper do not necessarily reflect the views or policies of the supporting organizations. We acknowledge and pay respects to the Aboriginal and Torres Strait Islander communities that contributed to this research.
Healthy Stores 2020 was co-designed with ALPA to restrict the merchandising of discretionary products and subsequent desirability of these products, while allowing for substitute merchandising of healthy core foods. The overarching aim was to reduce the volume of targeted discretionary items purchased and hence the amount of free sugar purchased.
Of the 25 ALPA owned and/or managed stores in the Northern Territory and Northern Queensland, 20 stores agreed to participate and were allocated to the 12-week intervention (7-point Healthy Stores 2020 strategy) or to usual retail practice. Four intervention stores with retail competition implemented a modified 6-point strategy. A team helped with strategy set-up in each of the ten intervention stores. Store managers with their staff maintained the strategy thereafter.
Weekly sales data were used to assess intervention impact on free sugars (g) to energy (MJ) (our primary outcome) derived from all purchased food and beverages. Impact on gross profit and sales of targeted food and beverages was also assessed. Managers of intervention stores were interviewed to determine their views on customer response and impact on retail practice.
There were statistically significant reductions in free sugars from food and drinks purchased and no adverse impact on gross profit.
The public health and business relevant gains demonstrated by this novel study have resulted in ALPA converting their stores to the Healthy Stores 2020 strategy and integrating the strategy in to their nutrition policy. Retail competition impedes complete implementation of the 7-point strategy. Tackling this will require a collective agreement by retailers to implement the full strategy and/or government policy power.
Working with the Store Committees and ALPA board, the Healthy Stores 2020 strategy involves:
* Except in stores with close-by food retail competition
Healthy Stores 2020 positively impacted the healthiness of food and beverage purchasing while still providing the customer with choice and with no observed business risk to the retailer and with no substitution effect; customers did not switch to other less healthy food and drinks. Healthy Stores 2020 helped customers buy less sugary drinks and confectionery. An effect on sweet biscuits and table sugar purchases was not observed. The greatest impact observed in association with Healthy Stores 2020 overall was the reduction in targeted beverages, particularly soft drinks.
The volume of sugar purchased plummeted. In 12 weeks across 10 stores, 1.8 tonnes less free sugar was purchased through foods and drinks. That’s equivalent to the weight of a large car.
The impact on targeted soft drinks was even greater among stores where the Healthy Stores strategy was fully implemented. In stores that removed the large sized soft drink units from the fridges, there was a 21.5% reduction in free sugars (g/MJ) from soft drink purchased. These stores were those that did not have retail competition in or within close proximity to the store.
Sales didn’t drop off
Business performance was not affected and store managers were able to practically maintain the strategy.
The bottom line
The success of these results explains a clear correlation with store merchandising, and its influence on the purchase of specific goods. In the control stores without the Healthy Stores 2020 strategy, the merchandising of discretionary products greatly ‘edited’ the choice of consumers. Whilst when these merchandising strategies were restricted via the Healthy Stores 2020 strategy, there was a clear decrease in the sales of discretionary products, influencing consumers to shop far healthier. The decrease in sales of soft drink was much greater in stores where the strategy was fully implemented due to there not being retail competition within or in close proximity to the community.
Discretionary food and beverages currently provide over 40% of the calories purchased in remote community stores. This is similar for the rest of Australia. Free sugars contribute 2.6 times the percent to energy recommended by the World Health Organisation for the prevention of overweight and obesity and dental disease. Healthy Stores 2020 has demonstrated through a randomised controlled trial that the amount of free sugars purchased through the food supply in remote communities can be reduced significantly through a low cost intervention that requires Aboriginal and Torres Strait Islander leadership and the drive and commitment of retailers. It has also demonstrated that reducing merchandising can impact on customer purchases whilst still offering choice.
Healthy Stores 2020 is now part of the ALPA Health and Nutrition policy and store directors have identified further strategies to restrict merchandising of high sugar food/drinks. Healthy Stores 2020 demonstrates the boldness of an Aboriginal and Torres Strait Islander organisation in putting in place store policy to support the communities it serves to regain sovereignty of their food supply. Aboriginal and Torres Strait Islander leaders and retailers across remote Australia however must be supported by policy that enables such boldness in an increasingly competitive retail environment. Healthy Stores 2020 hopefully gives the confidence for Aboriginal and Torres Strait Islander leaders, retailers and policymakers to work towards finding a policy solution together to restrict the choice-editing currently occurring in the Australian retail sector with merchandising of discretionary food and drinks.
Healthy Stores 2020 as far as we understand is a world first to restrict merchandising of unhealthy food/drinks. Aboriginal and Torres Strait Islanders in Australia are fully aware of the impact of the environment on people's diets and health. We hope the boldness of ALPA and success of Healthy Stores 2020 will encourage the Australian retail sector to join ALPA and store directors to transform Australia's food retail sector to be health-enabling.
Healthy Stores 2020 provides robust evidence that co-design with retailers can result in a strategy that is effective, feasible and acceptable to customers.
Join us and support retailers and leaders in other remote communities to use this evidence for the benefit of their communities.
A/Prof Julie Brimblecombe
Department of Nutrition, Dietetics and Food