Can supermarkets help turn the tide on obesity? - A report from one year of the Collaboration forHealthier Lives in the UK (CHL UK) - Impact on ...
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Can supermarkets
help turn the tide
on obesity?
A report from one year
of the Collaboration
for Healthier Lives in the
UK (CHL UK)
In partnership with
evaluators at the
University of Oxford
Impact on Urban Health 2
Can supermarkets help turn the tide on obestiy?
Impact on Urban Health
W: urbanhealth.org.uk
The places that we grow up, live and work impact how @ImpUrbanHealth
healthy we are. Urban areas, like inner-city London, have impact-on-urban-health
some of the most extreme health outcomes. Alongside
their vibrancy and diversity sit stark health inequalities.
At Impact on Urban Health, we want to change this. We believe that we can remove
obstacles to good health, by making urban areas healthier places for everyone to live.
From our home in the London boroughs of Lambeth and Southwark, we’re focused on
a few complex health issues that disproportionately impact people living in cities, and
we work with local, national and international organisations, groups and individuals
to tackle these. The partnership with Collaboration for Healthier Lives (CHL UK) is one
part of a larger group of projects in our childhood obesity programme; which aims to
tackle the inequality that exists for children and families in accessing nutritious diets.
Impact on Urban Health’s local insights and relationships in the community have enabled
CHL UK to run targeted interventions in Lambeth and Southwark, and use these areas
as a testing ground for the most effective ideas. These two boroughs are in many ways
typical of inner-city areas around the world, with significant inequalities between low-
income and more affluent neighbourhoods. As a partner in the Collaboration for Healthier
Lives, with a goal to share learnings for creating healthier food retail environments,
Impact on Urban Health has partnered with CGF to produce this report.
The Consumer Goods Forum
W: tcgfhealthierlives.com
The Consumer Goods Forum (“CGF”) is a global,
@CGF_Health
parity-based industry network that is driven by its
TheConsumerGoodsForum
members to encourage the global adoption of
the-consumer-goods-forum
practices and standards that serves the consumer
goods industry worldwide. It brings together the
CEOs and senior management of some 400 retailers,
manufacturers, service providers, and other stakeholders across 70 countries, and it
reflects the diversity of the industry in geography, size, product category and format.
The CGF’s Collaboration for Healthier Lives (CHL) Coalition is about making it easier
for people around the world to adopt healthier lives for themselves and their
families. It’s about making healthier decisions easier and habitual for people in every
community around the world. It is a global movement led by manufacturers, retailers,
public health authorities and local communities, delivering local movements in
communities worldwide. There are currently nine CHL initiatives running across 14
countries, including CHL UK.
3
Impact on Urban Health 4
Can supermarkets help turn the tide on obestiy?
Contents
Foreword ...................................................................................................................... 6
Executive summary ...................................................................................................... 8
Introduction ................................................................................................................. 10
CHL UK participating companies ................................................................................ 11
CHL UK collaborators, advisors and evaluators .............................................................. 11
The Collaboration for Healthier Lives Journey ........................................................... 12
Countries with CHL initiatives ..................................................................................... 12
CHL UK in numbers .................................................................................................. 14
Intervention tactics ..................................................................................................... 16
The trials ...................................................................................................................... 18
Pricing and promotional trials ..................................................................................... 20
Price promotion fruit & vegetable trial ...................................................................... 20
Price and family-focussed promotions for healthier purchases ..................................... 22
Availability trial........................................................................................................ 24
Introducing a healthier version of a product .............................................................. 24
Editing choice across a category ............................................................................. 26
Positioning trial ....................................................................................................... 28
In-aisle positional changes ...................................................................................... 28
Store location and availability trial ............................................................................ 30
Shelf labelling trial ................................................................................................... 32
Shelf labelling trial ................................................................................................. 32
Social feedback....................................................................................................... 34
Social norming ............................................................................................................................ 34
Other trials .................................................................................................................. 36
Price promotion snacking trial ................................................................................. 36
Promoting healthier children’s lunch items ................................................................ 36
Advertising healthier yogurt alternatives ................................................................... 37
Promotion and in-store engagement for improved oral care ......................................... 37
Change is on the horizon for the food sector ........................................................... 38
Conclusion .................................................................................................................. 40
5
Impact on Urban Health
Foreword
Every child has the right to grow up accessing the things they need to
be healthy. However, even in the UK, one of the world’s most developed
countries with a strong public health system, it’s not always easy.
The COVID-19 pandemic has highlighted the link to which we could find quick, easy solutions.
between good population health, and healthy Achieving meaningful collaboration amongst
weight in particular, with a thriving economy. The diverse stakeholders, leading to real change in a
healthier and more resilient people are, the more retail environment is a complex process. We are
they’re able to work and shop, contributing to gathering useful data and learnings which we
economic growth. The pandemic has highlighted are convinced will unlock new, creative ways of
the important role that food manufacturers and encouraging healthier lives.
retailers can play in ensuring that all consumers
have access to the food and non-food products An honest assessment of our first year is that
they need to lead healthy lives. whilst some initiatives have been scaled across
the UK, we won’t achieve the full potential
In 2018, we came together as a collective with of our unique collaboration unless we do
public health bodies, charities and academics to more to incorporate health goals into the
pioneer new ways of facing the health challenges business planning process between and within
of the nation. We aimed to apply what was known manufacturers and retailers. These discussions
in theory through international evidence about are underway and greater regulation of the
what is effective to improve consumer diets, in a industry could help to set an even playing field.
real-world practical setting. This report details the
approach we took and preliminary results from So while we are proud of our first year, we are clear
the independent evaluation by the University of that this is just the beginning. We need to learn from
Oxford. They evaluated some of the interventions the preliminary evaluation and adapt to a changing
that have been tested so far by The Consumer consumer. As co-chairs, we need to listen to the
Goods Forum (CGF) members in the London challenges that some CGF members have faced
Boroughs of Lambeth and Southwark. and make it easier for them to participate more fully.
Looking back over our first year of Collaboration We hope this report about our first year of
for Healthier Lives UK (CHL UK), we’re certainly collaboration will be thought-provoking reading.
proud of what has been achieved. Our ambition for If your company is already a CHL UK member, we
this initiative was to go much further than we can thank you for supporting this collaboration, and
deliver as individual organisations and to deliver hope it will inspire you to go even further, faster. If
significant impact on the healthiness of shopping your company is not, then we’d love to talk about
baskets. We can see that many of the interventions you becoming more involved. Together, we can go
our members have run so far in Lambeth and further - and together, we can support healthier
Southwark have had a positive impact on lives in the UK and beyond.
individuals, and either a neutral or positive financial
impact on business. There are also examples of
Richard Hall, VP and General Secretary UK &
interventions being rolled out nationwide.
Ireland, Danone. CHL UK Co-Chair
But we were clear from the start that the Judith Robinson, Head of Health, Tesco and CHL
challenges we had set ourselves were not ones UK Co-Chair. CHL UK Co-Chair
6
7
Impact on Urban Health
Executive summary
Retailers and manufacturers came together to improve the health of
their consumers, a collaboration facilitated through their membership
with The Consumer Goods Forum. They ran a series of trials over the
course of a year, starting in Lambeth and Southwark but with a view to
scale the interventions that worked.
Companies trialed a total of 34 interventions using • Impactful trials could be relatively simple and
a range of approaches to improve the healthiness commercially sustainable
of consumer baskets. In-store trials were prioritised
• Trials that both increase the purchase of
and included changes to pricing and promotions,
healthier foods and decrease the purchase
availability, choice architecture, shelf and nutritional
of less healthy foods are required to support
labelling as well as social feedback techniques.
healthier diets
With support from Impact on Urban Health, the • Trials using pricing and promotional tactics,
University of Oxford evaluated some of these trials increasing the availability of healthier options
(see table below). Together, they found that: and some choice architecture trials have shown
a significant and positive impact.
• Companies were able to influence the
healthiness of consumer shopping baskets Results from successful trials have resulted in:
13% 72% 19% 22%
more fruit and more low sugar fewer standard fewer packets of
vegetables sold beans sold chips sold confectionary sold
Whilst there remains outstanding questions We’ve seen that good intentions aren’t enough
about these trials – including how long the when internal policies and priorities across
improvements can be sustained – we can clearly departments don’t align to support consumer
see the potential for companies to improve health. There is also great variation in efforts across
consumer health and shape consumer demand the sector and more progressive companies are
held back by an absence of regulation to level the
Not all trials were successful, and the analyses playing field and mitigate commercial risk.
suggests that shelf labelling and social feedback
tactics may not be as impactful unless paired with We’d like all companies to step-up a gear in their
other changes. This collaboration has efforts to prioritise health. Companies should be
shown that when companies take responsibility working toward the goal of decoupling overall sales
for public health, and are more ambitious in growth from the sale of unhealthy products. We
their attempts to improve it, they can have a believe companies should embrace transparency
positive impact. by disclosing and reporting their progress toward
8
Can supermarkets help turn the tide on obestiy?
this goal, setting time-bound targets that they can We’re calling on the government to support the
be held to account for achieving. To do this they’ll leaders within this sector with further targeted
need comprehensive health strategies that the whole regulation. Stronger regulation would create a
business can align around. These health strategies leveling-up across the sector and even the playing-
can include joining the CHL UK (for those not field, making healthy food environments – and the
already involved) and a focus on scaling those healthy shopping baskets they create – the default
trials that were successful to a national level. position for any commercial organisation.
Tactic Trial Impact* Learning
Pricing and Promoting fresh 13% net increase Price promotions that make healthier
promotion fruit and vegetables in sales food more affordable can increase sales
(Tesco) of these products.
Price and child- 72% rise in sales of The use of family-friendly characters to
focused promotions lower sugar beans incentivise and reward the purchase of
on healthier products and a 387% rise in healthier products, in combination with
(Sainsbury’s) sales of fruit price promotions, can have a significant
impact on sales.
Availability Healthier frozen 19% net decrease Food companies can shape demand.
chip alternative in sales of less Introducing healthier options in-store
introduced (McCain) healthy chip could possibly shift purchases toward
healthier options as well as decreasing
sales of the less healthy alternative.
Introducing healthier No significant Switching less healthy biscuits for
biscuit options in impact healthier ones could have a positive
place of less healthy impact, though Sainsbury’s data found
ones (Sainsbury’s) switching into different categories
occurred. Larger scale trials are needed.
Positioning Less healthy cereals No significant Positioning changes within aisles may
moved out of eye- impact need to be bolder and combine pricing
line (Sainsbury’s) and promotional tactics
to increase prominence and have
an impact.
Chocolate 22% net reduction Removing less healthy products from
confectionary in purchases prominent displays can have a positive
moved out of impact. Greater regulation to ensure
prominent displays parity across businesses could mitigate
(Tesco) commercial risks for some interventions.
Shelf and Shelf labels No significant Shelf labels in isolation may not be
nutritional highlighting impact enough to shift purchasing behaviour.
labelling healthier soft drinks The message within those labels can
(Co-op) also be an important determining factor
for whether they are impactful.
Social Shelf labels using No impact Providing social feedback in itself
feedback social feedback to (Independent may not be enough to shift purchasing.
nudge healthier analysis by charity Other methods of providing this feedback
options (Tesco) partners) that are more obvious than shelf labels
may have been more effective.
9
Impact on Urban Health
Introduction
At Impact on Urban Health we believe all children have the right to a
healthy, happy life. To have access to nutritious food, and opportunities
to run and play no matter where they grow up. Evidence shows that
many health conditions including childhood obesity are strongly linked
to income inequality.1 Income shapes our access to a nutritious diet.
This is unacceptable. Where a child grows up should not limit their
ability to be healthy.
In London, around 10 children in every year 6 This isn’t only a moral argument but a business
classroom are overweight or obese, this increases imperative. Investors are increasingly aware that
as area-level incomes decrease.2 This is higher than companies going further on their Environmental,
our peers in Paris, New York and Tokyo.3 Overweight Social and Corporate Governance (ESG) commitments
children are highly likely to become overweight adults tend to fare better financially, providing enhanced
and develop associated long-term health conditions.4 long-term returns.7 Since the COVID-19 pandemic,
the ‘S’ in ESG has gained greater attention.8 Investors
It’s little wonder when we’re constantly flooded by are increasingly looking at companies’ impact on
invitations to eat junk food. Whether that be on TV, society, and the health of their customers.9
on social media, through fast food companies and
their “school-kids deals” or when we walk into the The status quo is changing; companies that want to
supermarket and are bombarded with snacks on stay relevant and competitive must act now to ensure
promotion. We all make hundreds of food-related future growth is through the sale of increasingly
decisions every day, most of these are habitual healthy product portfolios. Change is possible. If all
and are strongly influenced by cues in our external companies move together, in partnership, they can
environment.5 Add to this a very constrained travel further in their journey to improve consumer
budget, alongside the stressors and trade-offs that health. We’re encouraged by what has been achieved
come with living on a low income, and it’s even through by the CHL UK group and pleased to have
harder to avoid the overwhelming incentives to eat strengthened the evidence in this area.
unhealthy food.
We all need to play our part to turn the tide on obesity “As a collective, members of the CGF and
and support good population health – from NGOs and their partners, are exploring, experimenting,
policy makers to retailers, manufacturers and caterers. innovating and evolving business models to support
For families on low incomes, 76% of food budgets are positive change, while sharing data and knowledge
spent in supermarkets and a relatively few companies at scale, cross industry. Health is not a competitive
dominate this market.6 These stores determine advantage; it’s a basic necessity. And, it’s clear no
the nutritional quality of people’s food purchases, company can solve this issue alone. Collaboration is
powerfully shaping their dietary habits and ultimately needed at scale and across sectors if the consumer
their health. How a manufacturer formulates or goods industry is to play the necessary role in the
packages its products, how a supermarket promotes health and wellbeing of people.”
and displays these items – these are central factors
Sharon Bligh, Healthier Lives Director,
influencing what people eat. We want to work with
The Consumer Goods Froum
businesses operating in our boroughs to positively
improve these environments for all.
10Can supermarkets help turn the tide on obestiy?
The partners and stakeholders:
CHL UK Participating Companies
CHL UK Collaborators, Advisors and Evaluators
11Impact on Urban Health
The Collaboration for
Healthier Lives Journey
Collaboration for Healthier Lives is a global movement led by
manufacturers, retailers, public health authorities and local
communities, delivering local movements in communities worldwide.
Led by The Consumers Goods Forum, there are currently nine CHL
initiatives running across fourteen countries.
The main objective of CHL is to have a positive impact products and services including oral care and tools
in three areas: supporting healthier behaviours, in-store to quit smoking (the non-food goal). The non-food
and in communities; building on digital innovations goals include the ‘Stay Well in the Winter’ campaign of
and data sharing, to inspire new business models; NHS. The group focused on trialing approaches from
and enabling healthy workforces, by implementing behavioral science, such as in-store nudges that make
Employee Health & Wellbeing programmes. the healthier option more affordable and accessible.
The key performance indicators (KPIs) of the Established in Spring 2018, CHL UK includes some
various CHL initiatives are to demonstrate progress of the UK’s leading food retailers and manufacturers.
towards healthier shopping baskets and improve Its focus is families living on lower incomes, bringing
wellbeing through access to healthier food and companies together to improve the healthiness of
preventative services. shopping baskets for those with less time and money
to spend. The group also includes wider public health
experts and stakeholders as seen on page 11.
The approach in the UK
Collaboration for Healthier Lives in the UK has two CHL UK partners aim to balance the need
specific goals: to make grocery shopping healthier for healthy, affordable interventions with the
(the food goal) and to increase access to health commercial necessities of a competitive sector.
Countries with CHL initiatives
PA R T I C I PAT I N G C O U N T R I E S
U.S.A.
UK
France
Turkey
Japan
Mexico China
Guatemala
El Salvador
South America Costa Rica
Colombia
Heunduras
Chile
12Can supermarkets help turn the tide on obestiy?
We know the role inequality plays in driving poor
health, so the group designs and tests initiatives that “As a co-chair, I am delighted with the
work particularly for those on the lowest incomes. progress CHL UK has made in the first year.
The NGO, policy and academic collaborators are an Starting with Lambeth and Southwark has been
important source of local insight, data and evidence, challenging but the CHL-UK team have worked
and key to holding the collaboration to account. with public health and local experts to help shape
the interventions that we’ve trialed. By sharing our
As a result of competition rules the group are unable data with academics and public health bodies we
to make and discuss detailed intervention plans with are showing our commitment to deepening the
each other. Instead, the collaboration set themselves understanding of what works so that we can make
a framework for activity which included food and quicker progress based on the evidence”
non-food related goals:
Judith Robinson, Head of Health for Product - Tesco
Food goals:
• Increase consumption of healthier categories10
• Enable switching into healthier alternatives
Health have partnered with the University of Oxford
• Reduce calories from treat foods
to analyse the results. This report will spotlight some
Non-food goals: of the trials, sharing learnings from this first phase of
• Improve oral care outcomes work. These insights form an important and growing
• Reduce smoking prevalence evidence base that will inform the development of
further interventions in South London and beyond. They
Drive the NHS’s ‘Stay Well This Winter’ campaign demonstrate the impact retailers and manufacturers
“Healthier categories” were defined as fruit and can have on health, when they make it a priority.
vegetables or products within other categories that
have lower calories / sugar / saturated fat or higher Following a busy first year, CHL UK’s activity paused in
fibre than the alternative product. Spring 2020 as companies grappled with the COVID-19
pandemic. Phase two of development began in
Efforts have so far focused on improving health in Autumn 2020, building on the first year’s learnings.
the London boroughs of Lambeth and Southwark, a
densely populated and diverse inner-city area with a Over the next year, the coalition will look to include a
population of c.600,000 people. This scope covered sustainability goal and grow the number of partners
around 200 stores, with a focus on those situated in involved. It will also aim to deepen the impact of the
the areas of lower than average household income. pilot, scaling initiatives that showed promise and
This was an area large enough for a pilot to gather increasing the data available on its impact. It’s clear
insights that had potential for scale. It was also small we need new thinking to put healthier food centre
enough to be able to experiment and implement stage, and businesses and investors are waking up to
activity that was relevant to a specific context. their responsibility when it comes to health.
This approach also reduced commercial risk for
companies by trialing things in a smaller area
“We’re pleased to be able to help CHL UK
before rolling out more widely. There have been
members to design impactful interventions
drawbacks to this geographic focus too, particularly
based on local insights and evidence. We’re interested
for the companies with fewer stores in the boroughs.
in this work both to support local families in Lambeth
The intention is for successful trials to be expanded,
and Southwark to live healthier lives but also to build
and the collaboration means that retailers are able to
a deeper understanding of what works in practice,
share what worked and what didn’t with one another.
with the aim of identifying which interventions are
impactful, sustainable and scalable enough to be
To date, members have told us they’ve tested 34
rolled out on a national or global scale.”
interventions. The University of Oxford received data for
a limited number of these and prioritised the analysis Kieron Boyle, CEO, Impact on Urban Health
of longer and more ambitious trials. Impact on Urban
13Impact on Urban Health
CHL UK in Numbers
84% 76%
of UK consumers believe that collaboration Families on low income in the UK spend up
between retailers and manufacturers would to 76% of their food budget on food from
make it easier to access as a healthier diet supermarkets
200+ 120millionft 2
There are more than 200 grocery stores is the combined retail footprint of the five
in Lambeth and Southwark retail members of CHL UK
91% 34
of parents think marketing tactics like the intentions have been rolled out
use of child-friendly characters on food
and drink leads to their children requesting
those products
13% more packs of fruit and
vegetables sold each week
during the intervention
12 72% more tins of lower sugar beans
5 Retailers sold each week
7 Manufacturers
Participating
companies
387% more packs of fruit sold
each week
19% fewer packs of standard variety
chips sold, with an equivalent rise
in healthier chip sales each week
during the intervention
22% fewer packs of Easter
confectionary sold each week
during the intervention
14Can supermarkets help turn the tide on obestiy?
15Impact on Urban Health
Intervention tactics
Of the 34 interventions trialled, many were designed based on
behavioural science with a variety of tactics used to shift consumer
purchasing. Below, the Behavioural Insights Team share six top tactics
for making the healthier option easier.
Our food environment has changed dramatically in behaviours; for example buying frozen yoghurt
recent years; tempting, calorie-dense food is now easy instead of ice cream. There is some evidence to
to access from an array of stores and food outlets. indicate the following tactics can positively impact
On top of this, external cues and the design of our purchasing behaviour by making the healthier
food environment act as prompts to eat, influencing option easier. Some of these tactics were used by
what food we buy. As a result, our environment companies as part of the CHL UK trials.
makes it incredibly easy to consume excess calories,
driving an increase in childhood obesity in the UK.
Reformation & portion size
Interventions often focus on information sharing As they do not rely on individual knowledge or
and education. However, the behavioural science motivation, reformulation and portion size reduction
literature points to eating behaviours being largely are considered some of the most impactful
automatic, that is we buy and eat food as an approaches to achieving universally easier healthy
instinctive response to what is in front of us, with choices. Evidence suggests that reformulation is
less conscious awareness than previously assumed. often unnoticeable and that on the whole people
What is in front of us is influenced heavily by what support portion size reductions. No CHL UK trials
is most accessible, available, and affordable in our have yet included reformulation or portion size
environment. In other words, when it comes to changes, however some companies will be working
eating we tend to go with the easiest option. on this individually. No companies who shared data
with us ran portion sizing or reformulation trials. 14
Our preference for the easy option is understandable;
our increasingly complex and busy lives mean we
Pricing and promotions
have little available time or attention for everyday
decision-making such as when and what to eat. For Financial incentives, through pricing and
families on lower incomes, this is further exacerbated promotions, can influence customer choice
by the context in which they live. High cognitive strain, by attracting attention and making products
time pressure, financial worries and other stressors more affordable.15 Therefore, price and volume
can lead to less healthy diets.11 In addition, families promotions should be applied only to healthy
on lower incomes often live in urban areas that are products to support customer health. Non-financial
flooded with unhealthy food options.12 promotions can also be effective. For example,
influential messengers16, such as kids characters, or
As the majority of food is consumed at home13, ‘gamified’ campaigns that involve collecting small
changes in retail settings could have a large impact incentives, such as cards or stickers17, could be
on our eating behaviour. Importantly, these changes used to encourage healthier choices. Tesco did a
can be designed to help people shop more trial promoting fruit and vegetable which is detailed
healthily while maintaining customer satisfaction on page 20. Sainsbury’s conducted a trial using
and profitability. The focus could be on ‘marginal Disney characters to promote healthier purchases
choices’ rather than expecting step changes in which can be found on page 22.
16Can supermarkets help turn the tide on obestiy?
“At Nestle we believe in unlocking the power of food to enhance lives. We strive to
contribute to a healthier future with our products and to empower everyone to make
healthier food and lifestyle choices. We know that there are huge health challenges
across the world, and want to be part of the solution to those. We know these societal
challenges will require collaboration to solve and that’s why we got involved with CHL
UK, together with a strong sense of responsibility and the desire to constantly push the
boundaries of what is possible.
I’m delighted to see that CHL UK’s work is already building new evidence around how
we can achieve that goal of healthier lives, and look forward to seeing more successes
in the coming years.”
Stefano Agostini, CEO Nestlé UK and Ireland
Availability
effective more generally if it is easy to understand
Shift the balance in favour of healthy options; and attracts attention. Front-of-pack heuristics,
increase the range of products to make the such as traffic-light labelling, can be effective by
healthier option more available and accessible simplifying information and using a colour-code.
than the less healthy equivalents. McCain’s did 24, 25
Prompts on shelves can be timed to disrupt
this by introducing a healthier frozen chip range habitual choices; for example, placing “stop” signs
into Tesco stores as detailed on page 24 and on shelves displaying less healthy food.26 The
Sainsbury’s edited their range of biscuits to provide Co-op trialled the use of shelf labels to switch
fewer calories across the range e.g. through behaviour which can be found on page 32.
smaller portions as deatiled on page 26.
Social Feedback
Positioning
People are strongly influenced by the behaviour of
The environmental design under which decisions others, conforming to the ‘norm’, that is the values,
are made affects our choices.18 The positioning of actions, and expectations of a particular group or
products, such as at the end of aisles19 and close wider society.27 Feedback on how your shopping
to checkouts20 attracts our attention to this more differs from others, could influence food choices;
convenient choice so these displays should be for example, pointing out the popularity of certain
focused on healthy products. Similarly, the amount healthy products. A similar approach was deployed
of shelf space a product is given influences sales, by Tesco and their Charity Health Partners which is
perhaps acting as a signal that the product is detailed on page 34.
popular.21,22 Sainsbury’s tried this tactic in their cereal
aisle on page 28 and Tesco trialled changes to The influences on eating behaviour are complex
the location of seasonal confectionary, more detail and multifaceted. Whilst any of the above
on this trial can be found on page 30. evidence-based interventions could potentially be
effective, in reality it is likely that a mix of the above
will be needed across different food categories to
Shelf labelling
be most effective. There is huge potential impact
Purely information provision tends to be more within retail settings; by designing environments
effective for those that can comprehend and pay with human behaviour in mind we can ensure the
attention to it.23 However, labelling can be healthy choice is the easy choice.
17Impact on Urban Health
The trials
The following case studies introduce some
of the interventions the group has trialled
over the last year. In each, we highlight
the approach taken, the results, and
broader learnings.
For the majority of these trials the University of Oxford have
independently evaluated their impact against matched control
stores and comparing the 2019 data to the same period in
the previous year. The exception to this is with Tesco’s social
feedback trial which is independently analysed by the Tesco
Charity Health Partnership.
Though we’ve grouped the trials according to the main tactic
they used, many of the trials used a mixture of tactics and it
isn’t always clear which tactic caused the impact, or whether
it was the combination that was necessary. It goes without
saying that we’ll continue to ask bigger questions of the
companies in relation to this data – did the effects last? Were
compensatory effects seen elsewhere in store? Were overall
improvements in shopping baskets seen? Here we present
some preliminary findings.
18Can supermarkets help turn the tide on obestiy?
Pricing and
promotional trials
Availability trial
Positioning trial
Shelf labelling trial
Social feedback
19Impact on Urban Health
Price promotion fruit & vegetable trial
In this trial, Tesco price promoted fresh fruit and vegetables
in a scheme called Fresh 3.
Why?
when possible. This trial is a great example of
The inspiration for this intervention was a series where promoting healthier options can be good
of pen portraits developed for Impact on Urban for business as well as for consumer health.
Health, based on ethnographic research carried This is the kind of intervention we would like to
out with local families (see example to the right). see Collaboration for Healthier Lives members
They highlighted the reality of living on a low scaling across their stores.
household income and how accessing healthier
food can be challenging when less healthy options
Data and results
are more affordable and convenient. We wanted
to try and rebalance this by reducing the cost of Over the intervention period (May to November
fruit and vegetables through price promotions. 2019) and when compared to the same period in
2018, intervention stores sold a weekly average
of 17% more sales of fruit / vegetables compared
What?
to control stores which increased sales by 4%
The promotion of fruit and vegetables included from 2018. This is a statistically significant result
a scheme called Fresh 3 where, every two weeks, representing a 13% net increase in sales from the
three different packs of fruit or vegetables could previous year and when compared to control stores.
be purchased on special offer. In addition, Tesco
introduced further Crop Flush promotions on in- This increase in packs of promoted fruit and
season fruit that also supported growers whose vegetables sold in intervention stores when
excess crops might otherwise have gone to compared to control stores equates to approximately
waste – helping to deliver against environmental 455 additional packs of fruits or vegetables sold
and sustainability objectives. per week across the 35 intervention stores.
% Change in sales of promoted fruit &
Learnings
vegetables during the intervention period
The Fresh 3 promotion on fruits and vegetables (May – Nov 2019)
was successful from both an impact and a
commercial perspective. It was therefore rolled
out to Express stores nationally in November
2019. Fresh 3 trials have since been paused along
with other promotions due to COVID-19 and the
resulting need to simplify store layouts. Tesco
+4% +17%
are keeping the situation under review and plan Control stores Intervention stores
to reintroduce offers on fruits and vegetables
Pricing and Promotional Trials
This was the most popular category of trial, including pricing and alternative promotional models.
These types of trials can be particularly persuassive in influencing or disrupting shopper habits.
20Can supermarkets help turn the tide on obestiy?
Pen Portraits
Lela
Lela is a 24-year-old single mum with two sons aged
two and five years old. They live in a one bedroom
flat on an estate in Kennington. The flat is small
and the kitchen is dark, contributing to a home
environment that often feels stressful to Lela. This is
exacerbated by her constant worrying about money
and bills. Lela is currently training to be a delivery
driver for a supermarket, but her main source of
income for the last few months has been benefits.
Her household income is currently under £15,000.
21Impact on Urban Health
Price and family focussed promotions
for healthier puchases
In this trial Sainsbury’s used reward cards in combination with price
incentives to encourage healthier purchases.
Why? Data and results
Sainsbury’s thought incentives, including those Over the intervention period (August to October
targeted at families, could be used to increase 2019) and when compared to the same period
healthier purchasing. There is evidence to indicate in 2018, intervention stores sold a weekly
this may be true, including research in the Sustain average of 72% more tins of lower sugar beans
(the food and farming charity) report Pester Power or and 387% more packs of fruit per store per
Parent Power which shows that 91% of parents agreed week. Though the University of Oxford did not
that the use of family-friendly characters results in have control stores to compare this data with,
children asking for the product being promoted. the increase is statistically significant when
compared to the previous year.
What?
When analysing the weeks following the
In partnership with Disney, Sainsbury’s was already intervention there is no significant sustained
giving away Disney Hero themed collectable cards increase in sales of lower sugar beans or fruit,
to families for every £10 spent across its 1,400 compared to 2018 sales data.
UK stores. The Healthy Living team at Sainsbury’s
subsequently created an intervention designed to
Learnings
nudge families to buy certain healthier products on
promotion, in exchange for additional free cards. It’s unclear from this trial to what extent the use of
the Disney characters drove the increase in sales
Sainsbury’s worked with the British Nutrition or whether this level of increase would have been
Foundation to analyse data for groups on lower seen as a result of the price promotions alone.
incomes to inform which products to promote in Future trials could look at the use of children’s
the trial – focusing on healthier categories like fruit characters to incentivise healthier purchasing on
and vegetables as well as healthier options within their own to see if they make a difference when not
other food categories. Products chosen included combined with a price promotion. Sustain, the food
breakfast cereals, oats, baked beans, fruit and some and farming charity, have previously highlighted
personal hygiene products. As well as partnering issues with the use of children’s characters on junk
with Disney on this trial, Sainsbury’s worked closely food in their Pester Power report. This trial shows
with suppliers to support the promotion. The how they could be used to improve children’s diets
intervention was rolled out in all stores nationwide, instead. Consideration could also be given to how
with Disney branding either on product packaging to sustain the healthier sales, repeat promotions on
or shopper displays, over a six-week period these products over a sustained period could help
between August and October 2019. to permanently shift behaviour.
22Can supermarkets help turn the tide on obestiy?
% Change in sales of promoted fruits
(Aug – Oct 2019)
450
Heroes Collectors album
400
Average % change per store/week
350
300
WARNING! Not suitable for children under 3 years due to small
parts – choking hazard. Toy should be used by young children under
250
adult supervision. Please retain this information for future reference.
SP1581 - Album
Produced by
BrandLoyalty Special Promotions BV, Koningsweg 101,
5211 BH ‘s-Hertogenbosch, The Netherlands.
Made in The Netherlands.
Produced by Joh. Enschedé Amsterdam, The Netherlands.
Importer: Sainsbury’s Supermarkets Ltd, 33 Holborn, EC1N 2HT
200 DISCOVER,
387%
©Disney ©Disney/Pixar © 2019 MARVEL © & ™ Lucasfilm Ltd.
CHALLENGE
AND UNLEASH
150 YOUR POWER
100
50
EAT WELL nce to solve complex problem
Banner use their intellige don’t, they might get tired
s. Our brains use a lot energy.
Scientists like Dr. Bruce need to eat well. If they FOOD WITH POWE
Therefore, scientists always get angry, do we?
y don’t want Bruce to
or angry. And we definitel
Eating foods filled with vitamins
17%
make you feel like a super hero
give you power? Pick your favo
0
Hulk
ARE YOU AS POWERFUL
AS THE HULK?
Unit Sales
Powerful bodies need lots of
energy. And with a body as
big and strong as the Hulk,
good food, like green vegetables,
is very important. Don’t worry,
you won’t turn green!
Intervention Post-intervention his strength
HULK
Did you know?
TO GROW BIG AND STRONG, YOU
NEED TO PUT THE RIGHT ENERGY
INTO YOUR BODY. YOU CAN DO
THIS WITH CARBOHYDRATES AND
PROTEINS, SUCH AS WHOLE WHEAT
PASTA,
BUT ALSO WITH FRUIT AND VEGETABLE FISH AND PULSES.
S, WHICH
SHOULD EAT A MINIMUM OF 5 PORTIONS IS WHY YOU
PER DAY.
13
% Change in sales of no-added sugar beans Black Widow
(Aug – Oct 2019) Captain America
Muscle power
Do you want strong legs like GROOT
the Hulk or Captain America?
If you do, then complete this exercise.
1. Run on the spot for ten seconds.
80 FIND THE POWER BALLS
2. Squat as if you were sitting on a chair
for another ten seconds.
3. Repeat.
SPIES LIKE BLACK WIDOW HAVE AN EYE
Your muscles will start to grow.
FOR DETAIL AND THEY CAN LOCATE
ANYTHING. CAN YOU FIND ALL THE HIDDEN
70 TEAM UP
GREEN POWER BALLS ON THESE PAGES?
Average % change per store/week
I count
are based on trust. Teaming
up with people you trust feels great!
The strongest friendships
Han Solo and Chewbacca
are with each other through
thick and thin.
REY REY AND
16
They always have each
other’s back.
CHEWBACCA
AND HAN SOLOVEGETABLES
EATING EVERY DAY
AND FINN BB-8
UNLOCK YOUR POWER BY:
C ew acca
8 ANSWER: There are 8 green power balls.
60 Han olo
HAN SOLO AND CHEWBACCA GET TO KNOW
EACH OTHER WHEN HAN IS IMPRISONED
AND THEY BECOME FRIENDS FOR LIFE. go
121 122 123
They travel around the galaxy and
on several missions together!
50 their strength
Together they control
the
Falcon Han Solo is
Millennium Falcon.
LUKE C-3PO ANAKIN AND
a great pilot and Chewbacca AND R2-D2 AND R2-D2 OBI-WAN
is his trusted co-pilot.
Millennium alcon
DID YOU KNOW? ON EARTH THERE’S
DID YOU KNOW THAT
40
CELEBRATE YOUR
AN OFFICIAL DAY TO
BEST FRIEND DAY
FRIENDS? IT’S CALLED TH teamwork!
AND IT’S ON 8 JUNE.
124 125 126
72%
Set a course on which you have to walk.
Friendship Hold a ball between your body and your
friend. then follow the course together
How strong is your friendship? without losing contact with the ball.
your friend have? Record your time! Create a creature together!
Which qualities does
apply to your friend!
Colour all planets which word power
Grab a piece of paper and fold it into
30 four sections as shown in the image.
Create the longest list of heroes with your
friend! Start by calling the name of one of Unfold the paper. Write the following 1. Hair or helmet
Brave
Loyal
Adventurous
your favourite heroes. Your friend should word on each section:
Kind then follow by saying the name of another
Funny
Creative
hero. But wait! There is one rule: The first 1. Hair or helmet 3. Nose 2. Eyes
Double muscle trust letter of the name has to match the last 2. Eyes 4. Mouth
letter of the previous hero’s name. How
Learn how to rely on each other! many heroes can you put on the list? Fold the paper in four and make sure you can 3. Nose
only see the first section. Draw the hair or
© & TM LucasFilm Ltd.
1. Stand FACE-TO-FACE with your friend.
2. Hold hands and stand toe to toe. Ackbar… Rey… helmet! Pass the paper to your friend and let
a… Admiral him or her draw the eyes. Continue until the 4. Mouth
Leia Organ
3. Together slowly bend your knees until you are
20
both in a sitting position. mouth is done. Unfold the paper and - tadaa!
4. Can you get back up while holding hands? Your own creature.
44
Combine your powers: BY TRUSTING YOUR FRIENDS 45
GET ACTIVE
10 if it’s trained.
17%
and endurance, especially
of incredible feats of strength and
The human body is capable players spend many hours every day exercising
football
Olympic athletes and strong and fast.
That’s how they get so
practising their skills. BLACK CAPTAIN
SPIDER-MAN PANTHER MARVEL
0 ARE YOU AS FIT AND STRONG
AS CAPTAIN MARVEL? Captain Marvel
25 26 27
Carol Danvers was always fit
but when she gains cosmic
Unit Sales
powers she moves on to a
whole new level.
her strength
Captain Marvel can
fly, shoot
her fingers THOR CAPTAIN FALCON
energy blasts from
and has superhuma
n levels of AMERICA
strength and stamina.
DID YOU KNOW?
YEARS AGO, WOMEN WERE NOT CONSIDERED FOR CERTAIN JOBS,
SUCH AS BEING AN ASTRONAUT OR PILOTING AN AIRPLANE. TODAY
MANY WOMEN ARE FLYING PLANES AND TRAINING TO GO INTO
SPACE AND HAVE PROVEN TO BE VERY GOOD AT IT!
Intervention Post-intervention
th 28 29 30
your streng
Wa p
Pick one!
WHICH powers would you like to have? What kind of athlete are you? Try this test!
Being mega flexible or Having ultra-fast reactions
Never giving up a battle or Being a quick runner What do you like to do after school?
A. Do sports by yourself
Being super-strong or Being as fast as lightning BECOMING STRONGER B. Play with friends
You can get stronger using just the weight
of your body. Lie face down, then support What is your favourite outing?
IMPROVING A. Watching a football match
your body on your elbows and toes. This
YOUR BALANCE is called planking. The longer you can do B. Practising a team sport Captain America
this, the stronger your body will get.
Hawkeye is an incredible shot What do you like about playing games?
because of his balance. How’s A. Winning
your balance? Stand on one leg B. Being active with other people
© 2019 MARVEL
for as long as you can.
out of yourself.
TRY AND DO IT FOR LONGER THAN Mainly As You like to get the best
others.
YOUR FRIENDS. Mainly Bs You like to be active with
12
Hawke e UNLOCK YOUR POWER BY: GETTING FIT 13
23Impact on Urban Health
Introducing a healthier version of a product
In this trial McCain added a new range of frozen baked chip with a
lower-fat content in 35 Tesco Express stores in Lambeth and Southwark.
Why?
was 19% less when compared to control stores, a
At the start of 2019, frozen food firm McCain statistically significant difference. The intervention
launched McCain Home Chips Lighter - an oven stores saw a similar equivalent uplift of the newly
chip containing less than 4% fat. This is 53% less fat introduced lighter chips. Given there is a similar rise
and 13% fewer calories per portion than their regular seen in the lighter chips this could indicate customer
recipe. McCain trialed switching Tesco customers switching from the standard to the healthier version.
from the regular to the lower fat alternative.
If switching behaviour has occurred this could
equate to those customers saving a combined
What?
total of approximately 700kcals, 455g of fat and
McCain added a healthier range of frozen chip 70g of saturated fat from customer shopping
alongside the standard variety as an additional baskets each week across the 35 stores. This trial
alternative. was deemed a success from both an impact and
commercial perspective.
Learnings
This intervention is a good case study to inspire
other manufacturers to get involved in the CHL % Change in sales of regular frozen chips
UK initiative. Simple, scalable changes to ranges in (Jan – Sep 2019)
store can add up to make a significant difference 0
to the healthiness of customer baskets, without
Average % change per store/week
affecting sales or margin. Though companies often -5 -9%
argue they supply what consumers demand, this -10
case study shows that retailers and manufacturers
-28%
have a key role in shaping that demand too. -15
-20
Data and Results -25
Over the intervention period (January to September -30
2019) and when compared to the same period in
2018, intervention stores sold an average 28% fewer
Control stores Intervention stores
packs of standard chips per store per week. This
Availability Trials
Changing the availability of products can influence purchasing decisions and surface unidentified
consumer demand.
24Can supermarkets help turn the tide on obestiy?
“Developing impactful interventions in small
store formats is challenging. This was one of the
simplest most impactful interventions that we
delivered in our Lambeth and Southwark Express
stores. Thanks to McCains for driving this forward
and to Dr Tim Chadbourn from PHE who advised
and supported throughout the CHL UK initiative
on the interventions that would deliver the most
impactful results.”
Judith Robinsonn
Head of Health - Product, Tesco
25
23
25Impact on Urban Health
Editing choice across a category
In this trial Sainsbury’s changed the range of biscuits available,
providing options with fewer calories per pack e.g biscuit things, mini
biscuits and smaller pack sizes in place of larger pack sizes and higher
calorie alternatives.
Why?
a smaller increase in calories sold across the
Following analysis of Nectar purchasing data, biscuit range in intervention stores compared
Sainsbury’s identified that one of the categories to the control stores. Overall, compared to the
selling the highest number of calories was same period in 2018, calories increased more in
biscuits, and this category was particularly popular the control stores containing the standard biscuit
amongst customers with low household incomes. range, compared with the intervention stores with
Sainsbury’s wanted to put choice editing theory to the trial range.
the test in the in-store environment, with the aim
of reducing calories sold from this category. Sainsbury’s report their data shows customers
switching into other categories as a result of
this trial and therefore there was no negative
What?
commercial impact. Future analysis is needed to
Sainsbury’s switched larger packs of biscuits look at whole basket data for all of these trials.
with biscuits delivering fewer calories to test if
increasing the availability of lower calorie packs
nudged customers toward healthier options. They
switched around 25% of the products in the range % Change in sales of biscuits and total kcal
across 8 stores, for 12 weeks. They didn’t highlight (May – Aug 2019)
any changes to the customer and didn’t receive 18
any complaints.
16
14
Learnings
Average % change per store/week
12
Choice editing a category to provide more lower
calorie and fewer high calorie options could have 10
a positive impact on health. Larger scale trials 8
17%
are needed to be certain of the health impact. As
well as being ran across a larger number of stores, 6
future analysis would benefit from looking at overall 4
impact on shopping baskets, to ensure switching 6% 6%
5%
into different high sugar categories isn’t taking place. 2
2%
0
Data and Results -2
-2%
Results from this trial were not statistically
Standard range Trial range Total kcal
significant. The graph shows that over the
intervention period (May-August 2019), and when
Control stores Intervention stores
compared to the same period in 2018, there was
26Can supermarkets help turn the tide on obestiy?
27Impact on Urban Health
In-aisle positional changes
Sainsbury’s trialed moving the location of cereals within a shopping aisle
so that the healthier ones were at eye-line and more of the less healthy
alternatives were at the top of the shelf.
Why?
More testing and analysis, including understanding
There have been increasing calls from the NGO what promotions were running during the trial
sector and others for high sugar products to be period are recommended.
removed from children’s eye-line. Changing the
choice architecture in this way was believed to help
Learnings
reduce pester power faced by parents’ shopping
with their children. Positional changes within aisle are always going to be
relatively modest, so it is not unsurprising the analysis
Nectar card basket analysis found that breakfast didn’t see significant results. We know that price
cereals were one of the most commonly purchased is a key factor in determining purchasing, and that
items among customers on lower incomes. This packaging showing kids characters which is often
made it a priority category for nudging customers used on less healthy cereals can also encourage
towards healthier options. purchasing. It’s likely that modest positional
changes aren’t enough to overcome these drivers.
What?
Sainsbury’s ran an initiative to change the shelf
% Changes in total fibre and sugars
position of high-fibre, low sugar cereals, moving
(May – Aug 2019)
them to eye-level, and placing higher sugar,
lower fibre cereals on the top shelf of 7 stores in 1500
Changes in grams/ store/ week
Lambeth and Southwark over a 12-week period.
1000
Data and results 500 1,111
587
These results are not statistically significant. The 0
analysis shows that over the intervention period -613
-803
-500
(May - August 2019) and when compared to the
same period in 2018, intervention stores appeared -1000
to sell more of the less healthy cereals and less
Total fibre Total sugars
of the healthier cereals. This resulted in sugars
increasing and fibre decreasing in intervention
Control stores Intervention stores
stores compared to the previous year.
Positioning Trial
Changing the amount and location of shelf space that a product is given can influence what
shoppers buy by making certain products more visible and easier to access.
28Can supermarkets help turn the tide on obestiy?
“This initiative is just one of many that
Sainsbury’s has introduced, but by uncovering
what works and what doesn’t, we are better
able to prioritise retail efforts to those measures
that have demonstrable impact in improving
consumer health.”
Nilani Sritharan
Group Healthy Living Manager, Sainsbury’s
29You can also read
