The Role of Supermarkets in Community Nutrition

Background: Chronic diseases related to nutrition are a serious threat to public health. Supermarkets offer an important and promising venue to improve diet quality and overall health. The purpose of this study is to evaluate the supermarkets’ community nutrition focus and interest in public health. Methods: This study emphasis’s a triangulated qualitative study design. It employs various methods and taps various sources for data. Twenty face-to-face, semi-structured key informant interviews were conducted with five full service supermarket chains in Montgomery County, Ohio; Wal-Mart, Kroger, Meijer, Cub Foods, and Dorothy Lane Market. Qualitative sources of information collected include store observation and supermarket flyers. Results: National, State, and Local involvement within the community was a theme for supermarkets throughout Montgomery County. Each individual supermarket chain has established their own unique strategies to provide nutritional information to consumers. Meijer is the only supermarket chain that provides a nutritional scoring system. Respondents from all five supermarket chains believe that their organizations advertisement services are meeting shoppers’ needs when it comes to assisting in purchasing healthy food. Conclusion: Supermarkets are taking different roles in community nutrition through the types of programs and services they offer to consumers. There are public health benefits to understanding the role supermarkets can play in influencing food choices. The collaboration of community health organizations and supermarkets would provide the opportunity to educate the public about the connection between diet and disease. 4 ROLE OF SUPERMARKETS IN COMMUNITY NUTRITION Introduction The choices we make in every aisle of the supermarket ultimately affect our health. Helping customers purchase and prepare nutritious foods, such as fresh fruits and vegetables, needs to be a key priority for many retailers, manufactures and health agencies. There is insufficient research about the role of supermarkets in community nutrition, and this is an area that has a great need for exploration. “Consumer demand for healthy products are growing and many manufacturers and retailers are starting to make the connection between healthy diets and healthy profits” (RWJF, 2011). This study seeks to evaluate the supermarkets community nutrition focus and interest in public health. Chronic diseases related to nutrition are a serious threat to public health (Katz et al., 2010). Supermarkets offer an important and promising venue to improve diet quality and overall health (Katz et al., 2010). This study address the hurdles that make it difficult for many to consume healthy meals, as well as the supermarkets’ interest in services they might provide to help customers overcome these obstacles to healthful eating. Education is fundamental to choosing healthy foods, and shoppers are increasingly seeking guidance on how to make the best choices. Seventy-two percent of shoppers acknowledge that their local supermarket stocks a wide variety of healthful foods and beverages; yet just half feel the same store helps educate or promote healthy eating (Catalina Marketing Corporation, 2010). The community as a whole would benefit from supermarkets recognizing the opportunity develop advocacy and increase usage of products that support healthy eating. Supermarkets have begun to experiment with a variety of tactics to provide consumers with helpful information (Catalina Marketing Corporation, 2010). Shelf signs, product labeling systems, brochures, extensive website content, recipes, nutrition counseling, and local health fairs are now provided 5 ROLE OF SUPERMARKETS IN COMMUNITY NUTRITION by many supermarket chains (Catalina Marketing Corporation, 2010). While products specifically formulated to help consumers manage or reduce the risk of developing nutritionrelated conditions are increasingly available in the supermarket, communities would benefit from programs and services that help consumers learn about, purchase and integrate these products into their daily habits. Purpose Statement The purpose of this study is to evaluate the supermarkets’ community nutrition focus and interest in public health. Community nutrition focus is promoting health and lowering disease risk by improving nutritional status within a population (Morland, Diez Roux, & Wing, 2006). The World Health Organization (WHO, 2003) indicates that a “probable” cause of obesity in adults and children is the intake of more energy than is expended. WHO warns that heavy marketing of energy dense foods encourages more energy intake among consumers. Since dietrelated chronic diseases such as heart disease, diabetes, stroke, and certain cancers are increasing. Throughout the world there is a need for programs and services to combat obesity. Supermarkets have the potential to design programs that make it easier for consumers to plan, shop for, and prepare healthy foods (Katz et al., 2010). This study examines the interest of supermarket operators and product marketers to help shoppers make positive choices in nutrition. Literature Review Introduction Supermarkets have been in existence since the late 1800’s. It was not until the 1920’s that supermarket chains such as Kroger, American Stores, and National Tea started to become a dominant force in American food retailing (Gwynn, 2011). In 2008, there were approximately 59,300 supermarkets in the United States selling a wide range of traditional grocery items 6 ROLE OF SUPERMARKETS IN COMMUNITY NUTRITION including fresh meats, produce, canned and frozen foods, and dry goods such as flour and sugar (Bureau of Labor Statistics & U.S. Department of Labor, 2010-2011). The supermarket is defined as a large corporate owned “chain” that sells food and other household goods, such as cleaning material and cooking utensils, and that is usually operated on a self-service basis (Morland et al., 2006). Supermarkets sell ninety-two percent of the volume of annual sales of all food and beverage stores in the United States (Morland et al., 2006). Supermarkets have a unique opportunity to help improve health and well-being when it comes to choices consumers make when purchasing food. Sam Kass, the White House Assistant Chef and Senior Policy Advisor for Healthy Food Initiatives stated, “If the supermarket can find healthy ways to harness the power of the store environment, it will go a long way toward showing consumers how to make healthy choices” (Catalina Marketing Corporation, 2010). Public Health Benefits “The ultimate goal of public health is to apply the art and science of preventing disease, prolonging life, and promoting health to the focused goal of saving and improving lives” (Nelson, Hesse, & Croyle, 2009). Understanding the role supermarkets can play in influencing food choices may provide substantial public health benefits. This understanding may provide a way to help fight the leading public health concern, obesity (Morland, Wing, & Diez Roux, 2002). Supermarkets are the dominant force in food sales. Public health professionals should make an effort to reach out to food retailers to improve health. For public health professionals, working with the supermarket industry is a way to get involved at an environmental level to educate people about the connection between diet and disease (Morland et al., 2006). By collaborating with supermarkets public health agencies can influence the local food environment and help facilitate healthier communities and reduce the burden of overweight and obesity. 7 ROLE OF SUPERMARKETS IN COMMUNITY NUTRITION Importance of Food Evidence suggests healthy eating plays an essential role in good health and prevention of chronic disease. Consuming the recommended five or more servings of fruits and vegetables a day is essential to healthy nutrition, chronic disease prevention, and weight control (Glanz & Yaroch, 2004). There is clear evidence from randomized control trials that decreasing body fat and consuming more fruits and vegetables were essential to healthy nutrition, weight control and chronic disease prevention (Maubach, Hoek, & McCreanor, 2009; Glanz & Mullis, 1988). Four of the top ten leading causes of death (heart disease, cancer, stroke, and diabetes mellitus) have a direct connection to nutrition (U.S. Department of Health and Human Services, 2000). Several leading organizations concerned with prevention of these diseases, the American Dietetic association, the American Cancer Society, the American Academy of Pediatrics, the National Institute of Health, and the American Heart Association, recommend a healthy eating program based on the department of agriculture’s food guide plate (United States Department of Agriculture, 2011b). In June 2011, as part of a comprehensive nutrition initiative, the United States Department of Agriculture replaced the food guide pyramid with an easy-to-understand food guide plate. “Choose My Plate” is based on balancing calories, increasing fruits vegetables and whole grains, comparing food numbers and choosing the healthier option (United States Department of Agriculture, 2011a). Supermarkets can play a role in the intervention effort directed at communities to modify dietary behavior in order to reduce diet-related chronic disease. The current trend toward over consumption of energy dense foods contributes to the fact that most Americans are not meeting recommended daily nutritional requirements. Over consumption is influenced by a range of factors including growing portion sizes and changes in 8 ROLE OF SUPERMARKETS IN COMMUNITY NUTRITION food production, marketing, and pricing (Katz et al., 2010). The calories provided by the United States food supply raised from 3,300 per capita in 1970 to 3,800 in the late 1990’s, an increase of 500 calories per day for the average person (Nestle, 2002). The Current Influence of Supermarkets on Food Choices Supermarket