How healthy and processed are food and drinks promoted in supermarket sales flyers? a cross-sectional study in the Netherlands
ABSTRACT Objective To investigate to what extent promotions in Dutch supermarket sales flyers contribute to a healthy diet and whether there are differences between supermarket types. Design A cross-sectional study investigating promotions on food 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 categorized by food group (e.g. dairy); contribution to a healthy diet (yes/no); degree of processing (e.g. ultra-processed), promotion type (advertised only, temporary reduction in price or volume-based promotions), and percentage discount of price promotions. Differences between supermarket chains in types of price promotions, the degree of healthiness and processing of products were investigated. Results 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% vs. 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 (respectively 69.6% and 56.6%). Conclusions The majority of promoted products via supermarkets 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.