NUTRITION POLICY PROFILES:
EDUCATING CONSUMERS ABOUT HEALTHY FOOD CHOICES:
POINT-OF-SALE INTERVENTIONS

May 2002

Also available as PDF

This paper is part of a series of nutrition policy profiles prepared by Prevention Institute for the Center for Health Improvement (CHI).

Background

Point-of-sale interventions make nutrition information available at the places where people buy their food. Through strategies such as labeling items on store shelves and restaurant menus or offering free samples of healthy foods, grocery stores, cafeterias, and institutions that house vending machines can help consumers choose healthy foods. Although people receive nutrition information from a variety of sources, studies suggest nutrition education offered at the "point of sale" is more likely to influence their food purchasing behavior.¹

The U.S. Dietary guidelines recommend eating less fat, saturated fat, sodium, and cholesterol. By changing their diets, people can reduce their risk of cancer, heart disease, and other chronic diseases. Yet many people do not know which foods are high in fat, salt, and cholesterol. Because families cook at home less frequently than in the past, they eat more ready-made convenience foods, and are often unaware of how these foods have been prepared. Businesses can guide consumers to healthy cooking ingredients and pre-prepared foods by strategically placing nutrition information. Businesses benefit by winning the loyalty of their customers, while consumers gain by learning healthier purchasing habits.

Policy

Health organizations and businesses should encourage consumers to select healthy foods by making nutrition information available wherever people buy food (i.e., at restaurants and grocery stores).

The "Start with Your Heart" program, a partnership between Lowes Foods and the Surry County Health and Nutrition Center in North Carolina, assisted customers to shop for heart-healthy foods. Over a six-month period, the program was put into practice in nine Lowes Foods stores; it utilized bilingual shelf tags, window posters, hanging posters, and floor decals to help shoppers find healthy items. Shelf tags highlighted 24 food categories with an attention-grabbing yellow and red heart logo and easy-to-read text in Spanish and English. To demonstrate to customers that low-fat foods are not "low in taste," Lowes Foods offered samples of heart-healthy foods; Surry County Health and Nutrition Center nutritionists distributed the food.²

During a one-month campaign to educate customers about cholesterol, Detroit's Farmer Jack supermarkets implemented the "M-Fit Supermarket Shelf-Labeling Program" in 18 stores. They designed shelf tags to highlight foods that promote heart health (i.e., items low in fat, saturated fat, cholesterol, and sodium, and high in fiber). "Best Choice" foods were labeled with a green shelf tag, while "Acceptable Choice" foods had a yellow tag. Nearly 3,800 items were flagged with the M-Fit Label. Shoppers were notified of the program through promotional materials such as banners, posters, and an M-Fit shopping guide.

Effectiveness

Evaluation of the "Start with Your Heart" program assessed the change in volume of heart-healthy items purchased before and after the interventions. Item sales during the 52 weeks prior to the intervention were compared to sales during the 24 weeks of the program's duration. Perhaps unsurprisingly, sales of items that were highlighted in promotional materials rose; items that were promoted as food samples showed a further increase in sales. Interestingly, researchers found that sales of the 60 most-sold store products also improved during implementation of the program, as did sales of selected items such as milk, cereal, and juice. These results were achieved despite the program's short duration, and without paid advertising.³

The Society of Nutrition reviewed a variety of point-of-sale interventions, such as efforts to label meats and poultry as low or high-fat, restaurant interventions, and grocery store shelf-labeling programs, and concluded that strategically placed information about nutritious food choices can increase purchases of healthier items. Signs have a greater impact on consumer behavior when they compare brands based on harmful ingredients (such as sugar or fat) as opposed to health-promoting ingredients (such as vitamins and minerals).⁴

Contact

Frank Clawson, Coordinator Region III
Surry County Health and Nutrition Center
Tel: (336) 401-8459
E-mail: clawson@co.surry.nc.us

Acknowledgments

Frank Clawson, Coordinator Region III, Surry County Health and Nutrition Center, Dobson, NC

Holly Noble, RD, University of Michigan, Ann Arbor, MI

Advisory Committee:

Kate Clancy, Ph.D., Director of the Henry A. Wallace Center for Agriculture and Environmental Policy at WINROCK International, Rosslyn, VA

Andy Fisher, Executive Director, National Community Food Security Coalition, Venice, CA

Arnell Hinkle, RD, MPH, CHES, Executive Director, California Adolescent Nutrition and Fitness Program (CANFit), Berkeley, CA

Sheldon Margen, MD, Professor Emeritus, Public Health Nutrition, University of California at Berkeley, Berkeley, CA

Marion Nestle, MPH, Ph.D., Chair, Department of Nutrition and Food Studies, New York University, New York, NY

Margo Wootan, D.Sc., Director of Nutrition Policy, Center for Science in the Public Interest, Washington, DC

Prevention Institute's nutrition policy profile series is funded in part by a grant from The California Wellness Foundation (TCWF). Created in 1992 as an independent, private foundation, TCWF's mission is to improve the health of the people of California by making grants for health promotion, wellness education, and disease prevention programs.

References

¹ Lang JE, Mercer N, Tran D, Mosca L. Use of a supermarket shelf-labeling program to educate a predominately minority community about foods that promote heart health. Journal of the American Dietetic Association. 2000;100:804-809.

² Clawson F, Gregory S, Berryman S, Linz W, Silver C. Influencing consumer behavior in supermarkets regarding healthy food choices. Poster presented at: American Public Health Association Annual Meeting; November 12-16, 2000; Boston, Mass.

³ Clawson, Frank. Personal communication. February 2001.

⁴ Contento I, Balch GI, Bronner YL, et al. The effectiveness of nutrition education and implications for nutrition education policy, programs and research: a review of research. Journal of Nutrition Education. 1995;27:279-418.

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