The healthfulness of food and beverage purchases after the federal food package revisions: The case of two New England states

ObjectiveIn 2009, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) implemented new food packages to improve dietary intake among WIC participants. This paper examines how the healthfulness of food purchases among low-income households changed following this reform.MethodsPoint-of-sale data for 2137 WIC-participating and 1303 comparison households were obtained from a regional supermarket chain. The healthfulness of purchased foods and beverages was determined per their saturated fat, sugar, and sodium content. A pre-post assessment (2009–2010) of the product basket healthfulness was completed using generalized estimating equation models. Data were analyzed in 2015.ResultsAt baseline, healthy products accounted for most of the food volume purchased by WIC participants, but beverages were dominated by moderation (less healthy) items. With new subsidies for fruit, vegetables and whole grains, the WIC revisions increased the volume of healthy food purchases of WIC-participating households by 3.9% and reduced moderation foods by 1.8%. The biggest improvements were reductions in moderation beverages (down by 24.7% in volume), driven by milk fat restrictions in the WIC food package revisions. The healthfulness of the product basket increased post-WIC revisions; mainly due to a reduction in the volume of moderation food and beverages purchased (down by 15.5%) rather than growth in healthy products (up by 1.9%). No similar improvements were seen in a comparison group of low-income nonparticipants.ConclusionsAfter the WIC revisions, the healthfulness of participant purchases improved, particularly for beverages. Efforts to encourage healthy eating by people receiving federal food assistance are paying off.     

The Contribution of Major Food Categories and Companies to Household Purchases of Added Sugar in Australia

BackgroundThe Australian Government will soon be releasing a series of sugar reformulation targets for packaged foods.ObjectiveTo estimate the amount of added sugar purchased from packaged food and beverages and the relative contribution that food categories and food companies made to these purchases in 2018. The secondary objective was to examine differences in purchases of added sugar across income levels.DesignCross-sectional study.Participants/settingWe used 1 year of grocery purchase data from a nationally representative panel of Australian households (the NielsenIQ Homescan panel), combined with a packaged food and beverage database (FoodSwitch).Main outcome measuresAdded sugar purchases (grams per day per capita), purchase-weighted added sugar content (grams per 100 g) and total weight of products (with added sugar) purchased (grams per day per capita).Statistical analyses performedFood categories and food companies were ranked according to their contribution to added sugar purchases. Differences in added sugar purchases by income levels were assessed by 1-factor analysis of variance.ResultsAdded sugar information was available from 7188 households and across 26,291 unique foods and beverages. On average, the amount of added sugar acquired from packaged foods and beverages was (mean ± SE) 35.9 ± 0.01 g/d per capita. Low-income households purchased 11.0 g/d (95% CI: 10.9-11.0 g/d, P < .001) more added sugar from packaged products than high-income households per capita. The top 10 food categories accounted for 82.2% of added sugar purchased, largely due to purchases of chocolate and sweets, soft drinks, and ice cream and edible ices. Out of 994 food companies, the top 10 companies contributed to 62.1% of added sugar purchases.ConclusionsThe Australian Government can strengthen their proposed sugar reduction program by adding further category-specific targets, prioritizing engagement with key food companies and considering a broader range of policies to reduce added sugar intakes across the Australian population.     

Gender Comparison of the Diet Quality and Sources of Food Purchases Made by Urban Primary Household Food Purchasers

Objective

To compare food purchasing behaviors and diet quality of foods purchased between men and women who were the primary food purchaser for their households.

Customer Characteristics and Shopping Patterns Associated with Healthy and Unhealthy Purchases at Small and Non-traditional Food Stores

Small and non-traditional food stores (e.g., corner stores) are often the most accessible source of food for residents of lower income urban neighborhoods in the U.S. Although healthy options are often limited at these stores, little is known about customers who purchase healthy, versus less healthy, foods/beverages in these venues. We conducted 661 customer intercept interviews at 105 stores (corner stores, gas marts, pharmacies, dollar stores) in Minneapolis/St. Paul, Minnesota, assessing all food and beverage items purchased. We defined three categories of “healthy” and four categories of “unhealthy” purchases. Interviews assessed customer characteristics [e.g., demographics, body-mass index (BMI)]. We examined associations between healthy versus unhealthy purchases categories and customer characteristics. Overall, 11% of customers purchased ≥1 serving of healthy foods/beverages in one or more of the three categories: 8% purchased fruits/vegetables, 2% whole grains, and 1% non-/low-fat dairy. Seventy-one percent of customers purchased ≥1 serving of unhealthy foods/beverages in one or more of four categories: 46% purchased sugar-sweetened beverages, 17% savory snacks, 15% candy, and 13% sweet baked goods. Male (vs. female) customers, those with a lower education levels, and those who reported shopping at the store for convenience (vs. other reasons) were less likely to purchase fruits/vegetables. Unhealthy purchases were more common among customers with a BMI ≥30 kg/m² (vs. lower BMI). Results suggest intervention opportunities to increase healthy purchases at small and non-traditional food stores, particularly interventions aimed at male residents, those with lower education levels and residents living close to the store.     

Food Purchase Patterns at the Supermarket and their Relationship to Family Characteristics

The purpose of this study was to develop a system for characterizing food purchases by families using supermarket receipt data. One hundred and five shoppers contributed data that represented 363 people (138 children and 225 adults). Participants provided food purchase receipt data for at least 6 weeks, which included an average of at least 20 food items/week. Receipt information was entered by trained technicians for analysis using a database of over 2600 distinct foods containing nutritional information. Eighty-five percent of the items on the store receipts were identifiable by item and quantity from the information printed on the receipt; the data on the remaining items was determined by shopper annotation or by use of a default value. The average percent of energy purchased as fat by this convenience sample was 38.4%, total fiber purchased was 6.61 g/1000 kcal, and number of servings of fruits and vegetables was 1.44/1000 kcal. All foods were divided among 11 categories to evaluate the contributions of particular food groups to energy, fat, and fiber purchase.The three major contributors to fat purchase were, in order, “add-on and cooking fats;” “meats, poultry, and fish;” and “dairy.” Purchased fiber came primarily from “produce,” with “breads” and “cereals” next in proportion. The families at highest risk for poor nutrition quality of purchases were those with lower socioeconomic status, more children, and younger age of the primary shopper. This receipt collection system was successful in providing specific nutrition data on purchases of over 100 families. The assessment system is unique in that tracking of shopping patterns of individual families can be accomplished.     

Fruit and Vegetable Purchasing Patterns and Supplemental Nutrition Assistance Program Participation: Findings From a Nationally Representative Survey

BackgroundPrevious studies suggest that Supplemental Nutrition Assistance Program (SNAP) participants purchase less produce than nonparticipants. Whether this is due to buying smaller amounts or to being less likely to buy any produce is unclear. Purchase patterns may also differ over the monthly distribution cycle.ObjectiveTo examine differences in the likelihood and amounts of fruits and vegetables purchased between SNAP household compared with nonparticipant households and to determine differences in produce purchases among SNAP households at different time points in the monthly distribution cycle.DesignCross-sectional.Participants/settingData from 4708 households in the National Household Food Acquisition and Purchase Survey (April 2012 to January 2013). Participants recorded all foods acquired over 7 days.Main outcome measuresFruits and vegetables acquired over a 7-day period.Statistical analyses performedWeighted logistic and linear regression models adjusting for household and primary respondent characteristics were used to compare odds of purchasing fruits and vegetables and amounts purchased across 3 categories: SNAP participants, SNAP-eligible nonparticipants, and ineligible nonparticipants. SNAP participants were further subdivided according to weeks since last receiving benefits.ResultsIn adjusted analyses, SNAP participants and nonparticipants were similarly likely to purchase fruits and vegetables. However, SNAP households within a week of receiving benefits were more likely than SNAP households later in the benefit cycle to buy fruit overall, especially frozen or canned fruit, and vegetables overall, including fresh, frozen or canned, starchy, and nonstarchy vegetables (fruit odds ratio [OR] 1.68, 95% confidence interval [CI] 1.12, 2.53; vegetable OR 1.63, 95% CI 1.04, 2.55 vs households in middle of cycle). In contrast, those in the last week of the benefit cycle were less likely to purchase fruit, especially fresh fruit, and vegetables, especially fresh and nonstarchy vegetables (fruit OR 0.58, 95% CI 0.35, 0.94; vegetable OR 0.58, 95% CI 0.42, 0.79 vs. households in middle of cycle), and when they bought vegetables, they bought significantly less.ConclusionConsidering all SNAP households together at different points in their distribution cycle masks substantial declines in purchasing fruits and vegetables over the monthly cycle.     

Introducing taxes, subsidies or both: the effects of various food pricing strategies in a web-based supermarket randomized trial

Objective

Fiscal policies may form a solution in improving dietary intake. This study aimed to examine the effectiveness of varying taxing and subsiding schemes to stimulate healthier food purchases.

Methods

A randomized controlled trial with three levels of price reduction on healthy foods (no; 25%; 50%) × three levels of price increase on unhealthy foods (5%; 10%; 25%) factorial design was used. 150 participants were randomized into one of nine conditions and were asked to purchase groceries at a web-based supermarket. Data were collected in the Netherlands in January-February 2010 and analyzed using analysis of covariance.

Results

Subjects receiving 50% discount purchased significantly more healthy foods than subjects receiving no (mean difference = 6.62 items, p < 0.01) or 25% discount (mean difference = 4.87 items, p < 0.05). Moreover, these subjects purchased more vegetables (mean difference = 821 g; p < 0.05 compared to no discount). However, participants with the highest discount also purchased significantly more calories. No significant effects of the price increases on unhealthy foods were found.

Conclusion

Price decreases are effective in stimulating healthy food purchases, but the proportion of healthy foods remains unaffected. Price increases up to 25% on unhealthier products do not significantly affect food purchases. Future studies are important to validate these results in real supermarkets and across different countries.     

Secondary analysis of a marketing research database reveals patterns in dairy product purchases over time

OBJECTIVE: Development of a method using marketing research data to assess food purchase behavior and consequent nutrient availability for purposes of nutrition surveillance, evaluation of intervention effects, and epidemiologic studies of diet-health relationships. DESIGN: Data collected on household food purchases accrued over a 13-week period were selected by using Universal Product Code numbers and household characteristics from a marketing research database. Universal Product Code numbers for 39,408 dairy product purchases were linked to a standard reference for food composition to estimate the nutrient content of foods purchased over time. SUBJECTS/SETTING: Two thousand one hundred sixty-one households located in Victoria, Texas, and surrounding communities who were active members of a frequent shopper program. ANALYSES: Demographic characteristics of sample households and the nutrient content of their dairy product purchases were analyzed using frequency distribution, cross tabulation, analysis of variance, and t test procedures. RESULTS: A method for using marketing research data was successfully used to estimate household purchases of specific foods and their nutrient content from a marketing database containing hundreds of thousands of records. Distribution of dairy product purchases and their concomitant nutrients between Hispanic and non-Hispanic households were significant (P<.01, P<.001, respectively) and sustained over time. APPLICATION/CONCLUSIONS: Purchase records from large, nationally representative panels of shoppers, such as those maintained by major market research companies, might be used to accomplish detailed longitudinal epidemiologic studies or surveillance of national food- and nutrient-purchasing patterns within and between countries and segments of their respective populations.     

The Grocery Purchase Quality Index-2016 Performs Similarly to the Healthy Eating Index-2015 in a National Survey of Household Food Purchases

Background

Household food purchases are potential indicators of the quality of the home food environment, and grocery purchase behavior is a main focus of US Department of Agriculture (USDA) nutrition education programs; therefore, objective measures of grocery purchases are needed.

Food items consumed by students attending schools in different socioeconomic areas in Cape Town, South Africa

OBJECTIVE: We investigated the food consumption patterns of adolescent students at schools. Our findings are intended to reveal the overall nutritional quality of foods eaten by students at school, including foods brought to school and foods purchased at school. METHODS: A questionnaire was completed by 476 students, mostly from grades 7 and 10, from 14 schools in Cape Town, South Africa. The schools were representative of the various ethnic groups and socioeconomic strata of the population. The questionnaire requested information on eating habits at school, foods brought to school and food purchases, and breakfast consumption before school. We also tested whether students knew which foods are healthy and which are less healthy choices. RESULTS: The students were mostly 12 to 16 y of age (mean age 14.5 y). The large majority had breakfast before school (77.8%) and ate at school (79.7%). Food was brought to school by 41% to 56%, whereas 69.3% purchased food at school, mainly at the school store (tuck shop). Predefined "unhealthy" foods brought to school outnumbered "healthy" ones by 2 to 1. Among students who purchased food at school, 70.0% purchased no healthy items, whereas 73.2% purchased two or more unhealthy items. With six foods 84% of students correctly stated whether they were healthy or unhealthy; however, with cola drinks, samoosas (deep-fried pastry with spicy filling), and pies, only 47% to 61% knew that these were less healthy choices. Students' scores on this question were unrelated to whether they purchased healthy or unhealthy foods. Students who attended schools of high socioeconomic status were twice as likely to bring food to school (64.7% versus 31.0%, P<0.001), scored higher marks on the quiz of healthy versus unhealthy foods (P<0.01), but were no more likely to purchase healthy food. CONCLUSIONS: The large majority of food eaten by adolescent students in Cape Town is classified as being unhealthy choices. This applies to foods brought to school and food purchases. Consideration needs to be given to policy measures to improve this situation and to improve education of students and their parents.     

Choices made by low-income women provided with an economic supplement for fresh fruit and vegetable purchase

Vouchers for fresh fruit and vegetable purchase were provided to low-income women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Los Angeles, CA. As the program is currently constituted, the supplemental foods provided contain no fresh produce except for carrots for exclusively breastfeeding women. This study investigated whether providing supplemental financial support specifically for purchase of fresh fruits and vegetables would result in high uptake of the supplement, and what the individuals would choose to purchase. A total of 602 women enrolling for postpartum services at three selected WIC program sites in Los Angeles were recruited. Sites were assigned to intervention with vouchers redeemable at a local supermarket, a nearby year-round farmers' market, and a control site with a minimal nonfood incentive. Vouchers were issued bimonthly, at the level of US $10/wk, and carried out for 6 months. Of 454 participants who completed the study (75.4%), 86% were Hispanic, 7% non-Hispanic black, and 7% of other ethnic backgrounds. Assessment of uptake was by voucher redemption rates and was approximately 90% for both groups. Participants reported purchasing a wide variety of items at both sites. The 10 most frequently mentioned items were oranges, apples, bananas, peaches, grapes, tomatoes, carrots, lettuce, broccoli, and potatoes. In conclusion, low-income women used the supplement provided almost fully, and purchased a wide variety of fresh fruits and vegetables for their families. No particular barriers arose to redemption of the vouchers by either the participants or the retail vendors.     

A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: The Healthy Double Study

Objective

To carry out a pilot study to determine whether a supermarket double-dollar fruit and vegetable (F&V) incentive increases F&V purchases among low-income families.

Types and Amounts of Nonnutritive Sweeteners Purchased by US Households: A Comparison of 2002 and 2018 Nielsen Homescan Purchases

BackgroundPurchases of foods containing nonnutritive sweetener (NNS) alone or in combination with caloric sweeteners (CS) has increased in recent years in the United States. At the same time clinical evidence is emerging of different cardiometabolic effects of each NNS type.ObjectiveTo examine the prevalence and volume purchased of commonly consumed types of NNS in packaged food and beverage products comparing 2002 and 2018 using data from nationally representative samples of US households.Participants/settingNielsen Homescan Consumer Panels (The Nielsen Company); 2002 and 2018.Main outcome measuresPrevalence and volume of foods and beverages purchased containing CS, NNS, both CS and NNS, or neither CS nor NNS, as well as prevalence and volume of products containing specific NNS types.Statistical analyses performedDifferences examined using Student t test, P value of <.05 considered significant.ResultsVolume of products purchased containing CS decreased comparing 2002 and 2018 (436.6 ± 1.6 to 362.4 ± 1.3 g/d; P < .05), yet increased for products containing both CS and NNS (10.8-36.2 g/d; P < .05). Regarding specific types of NNS, changes were noted in the prevalence of households purchasing products containing saccharin (1.3%-1.1%; P < .05), aspartame (60.0%-49.4%; P < .05), rebaudioside A (0.1%-25.9%) and sucralose (38.7%-71.0%). Non-Hispanic whites purchased twice the volume of products containing NNS compared to Hispanics and non-Hispanic blacks in both years. Beverages were predominantly responsible for larger volume per capita purchases of products containing only NNS as well as both CS and NNS.ConclusionsA decline in purchases of products containing CS occurred in tandem with an increase in purchases of products containing both CS and NNS, along with a large shift in the specific types of NNS being purchased by US households. New NNS types enter the market regularly, and it is important to monitor changes in the amount of NNS and products containing NNS that consumers purchase.     

Impact of the Revised Special Supplemental Nutrition Program for Women,Infants, and Children (WIC) Food Package Policy on Fruit and Vegetable Prices

Obesity is generally inversely related to income among women in the United States. Less access to healthy foods is one way lower income can influence dietary behaviors and body weight. Federal food assistance programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), are an important source of healthy food for low-income populations. In 2009, as part of a nationwide policy revision, WIC added a fruit and vegetable (F/V) voucher to WIC food packages. This quasi-experimental study determined whether F/V prices at stores authorized to accept WIC (ie, WIC vendors) decreased after the policy revision in seven Illinois counties. It also examined cross-sectional F/V price variations by store type and neighborhood characteristics. Two pre-policy observations were conducted in 2008 and 2009; one post-policy observation was conducted in 2010. Small pre- to post-policy reductions in some F/V prices were found, particularly for canned fruit and frozen vegetables at small stores. Compared with chain supermarkets, mass merchandise stores had lower prices for fresh F/V and frozen F/V and small stores and non-chain supermarkets had higher canned and frozen F/V prices, but lower fresh F/V prices. Limited price differences were found across neighborhoods, although canned vegetables were more expensive in neighborhoods with higher concentrations of either Hispanics or blacks and fresh F/V prices were lower in neighborhoods with more Hispanics. Results suggest the WIC policy revision contributed to modest reductions in F/V prices. WIC participants’ purchasing power can differ depending on the type and neighborhood of the WIC vendor used.     

Caloric Beverage Intake Among Adult Supplemental Nutrition Assistance Program Participants

Objectives. We compared sugar-sweetened beverage (SSB), alcohol, and other caloric beverage (juice and milk) consumption of Supplemental Nutrition Assistance Program (SNAP) participants with that of low-income nonparticipants.Methods. We used 1 day of dietary intake data from the 2005–2008 National Health and Nutrition Examination Survey for 4594 adults aged 20 years and older with household income at or below 250% of the federal poverty line. We used bivariate and multivariate methods to compare the probability of consuming and the amount of calories consumed for each beverage type across 3 groups: current SNAP participants, former participants, and nonparticipants. We used instrumental variable methods to control for unobservable differences in participant groups.Results. After controlling for observable characteristics, SNAP participants were no more likely to consume SSBs than were nonparticipants. Instrumental variable estimates showed that current participants consumed fewer calories from SSBs than did similar nonparticipants. We found no differences in alcoholic beverage consumption, which cannot be purchased with SNAP benefits.Conclusions. SNAP participants are not unique in their consumption of SSBs or alcoholic beverages. Purchase restrictions may have little effect on SSB consumption.People in the Unites States consume about 20% of their calories from beverages, a share that has increased greatly over recent decades.1 Calories from beverages may be less satiating than calories from food and may therefore contribute to weight gain.2–5 Calories from sugar-sweetened beverages (SSBs) may be particularly problematic because they provide little if any essential nutrients. Policies suggested or enacted to reduce SSB consumption include taxing SSB purchases6–9 and restricting the size of SSBs sold by food service establishments. Most recently, the discussion has moved to whether participants in the Supplemental Nutrition Assistance Program (SNAP) should be prohibited from using benefits to purchase SSBs. SNAP provides nutrition assistance to low-income individuals and families through electronic benefit transfer cards that can be used to purchase food at authorized food retailers. SNAP benefits can be used to purchase almost all foods, with the exceptions of hot foods or food that will be eaten in the stores, alcoholic beverages and tobacco products.New York City requested a waiver from the Food and Nutrition Service of the US Department of Agriculture to restrict the use of SNAP benefits for purchases of some SSBs10 but was denied. Several high-profile commentators argued that the SNAP program may be subsidizing obesity and should be modified to encourage greater consumption of healthy foods and reduced consumption of empty calories such as SSBs.11,12 Others have argued that such restrictions could increase administrative costs but would have little impact on consumption patterns because most participants’ SNAP benefit only covers a portion of the household’s total food spending, and they could just use their cash food budgets to purchase SSBs.13 It has also been argued14 that imposing restrictions on only 1 part of the population is unfair when consumption of SSBs and obesity are fairly widespread among all Americans. Restrictions on SNAP purchases could have unintended consequences, such as reducing participation or substitution with other energy-dense foods.Despite the prominent appeals to restrict SNAP participants’ purchases, little evidence has shown that SNAP participants’ SSB consumption is different from that of the average consumer or other low-income consumers. Using longitudinal data for a cohort of US youths, no differences were found between SNAP participants and otherwise similar nonparticipants in the frequency of consumption (not total calories) of soft drinks, 100% fruit juice, and milk.15 Purchases of different beverages at 1 chain grocery store in New England for a sample of families that participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program over a 2-year period showed that among the participants, those who also received SNAP benefits purchased a higher percentage of SSBs than did non-SNAP participants.16 This study did not consider all SNAP households (or any other low-income households that did not participate in either SNAP or the Special Supplemental Nutrition Program for Women, Infants, and Children); examined beverage purchases at only 1 grocery store chain in New England; did not consider beverage purchases at bars, restaurants, or other food retailers; and did not consider beverage intake among household members. Both of these studies examined only a segment of all SNAP participants.Alcoholic beverages contribute a sizable share of total beverage calories for those who consume them. Alcoholic beverages cannot be purchased with SNAP benefits. If SSB purchases are restricted in SNAP, participants could use other resources to purchase SSBs, just as they may to purchase alcoholic beverages. Although there are important distinctions between SSBs and alcohol (e.g., tax rates, controlled points of purchase, limits on who can purchase, and some health benefits of moderate consumption), examining how alcohol consumption differs between participants and nonparticipants may provide insight into how a restriction on SSBs could affect purchases among SNAP participants.We used national-level data on individual beverage intake to investigate intake of SSBs, alcohol, and other caloric beverages (milk and juice) for SNAP participants and otherwise similar nonparticipants. After comparing average intake of these beverage types, we used regression to explore whether differences across participant groups are explained by differences in observable characteristics. We separately estimated the probability of consuming each beverage type and the total number of calories consumed among consumers of each beverage. We augmented our main estimates with instrumental variable estimates that account for self-selection of SNAP participants.     

Expenditure dispersion and dietary quality: evidence from Canada

This paper examines links between the way in which a household spreads their food expenditure over time and the dietary quality of the food they purchase. I find that households who make more frequent, smaller food purchases buy healthier foods than households who make fewer, larger purchases. These households are more likely to purchase foods with a lower share of total calories from fats, saturated fats and a larger share of calories from fruits and vegetables. The analysis is extended using quantile regression. The effect of expenditure dispersion is found to be largest among households with poor diets i.e. those households with diets high in saturated fats and low in fruits and vegetables.     

A Cross-Sectional Study of the Street Foods Purchased by Customers in Urban Areas of Central Asia

This study aimed to describe street food purchases in cities from Central Asia, considering customers’ characteristics and the nutritional composition of the foods and beverages. Cross-sectional studies were conducted in 2016/2017 in Dushanbe (Tajikistan), Bishkek (Kyrgyzstan), Ashgabat (Turkmenistan) and Almaty (Kazakhstan). Direct observation was used to collect data on the purchases made by street food customers, selected by random and systematic sampling. Nutritional composition was estimated using data from chemical analyses, food composition tables or food labels. A total of 714 customers (56.6% females, 55.5% aged ≥35 years, 23.3% overweight/obese) were observed, who bought 852 foods and beverages, the most frequent being savoury pastries/snacks (23.2%), main dishes (19.0%), sweet pastries/confectionery (17.9%), tea/coffee (11.3%) and soft drinks/juices (9.8%). Fruit was the least purchased food (1.1%). Nearly one-third of customers purchased industrial food items (31.9%). The median energy content of a street food purchase was 529 kcal/serving. Saturated and trans-fat median contents were 4.7 g/serving and 0.36 g/serving (21.4% and 16.5% of maximum daily intake recommendations, respectively). Median sodium and potassium contents were 745 mg/serving (37.3% of maximum recommendation) and 304 mg/serving (8.7% of minimum recommendation), respectively. In general, the purchases observed presented high contents of energy, saturated-fat, trans-fat and sodium, and low levels of potassium. Policies towards the improvement of these urban food environments should be encouraged.     

Exploring the main and moderating effects of individual-level characteristics on consumer responses to sugar taxes and front-of-pack nutrition labels in an experimental marketplace

InterventionThis study examined whether the impacts of sugar taxes and front-of-pack (FOP) nutrition labels differ across socio-demographic subgroups.Research questionWhat are the main and moderating effects of individual-level characteristics on the nutrient content of participants’ purchases in response to varying taxation levels and FOP labels?MethodsData from an experimental marketplace were analyzed. A sample of 3584 Canadians aged 13 years and older received $5 to purchase an item from a selection of 20 beverages and 20 snack foods. Participants were shown products with one of five FOP labels and completed eight within-subject purchasing tasks with different tax conditions. Linear mixed models were used to estimate the main and moderating effects of 11 individual-level variables on the sugars, sodium, saturated fats, and calorie content of participants’ purchases.ResultsParticipants who were younger, male, and more frequent consumers of sugary drinks purchased products containing more sugars, sodium, saturated fats, and calories. Sex and age moderated the relationship between tax condition and sugars or calories purchased: female participants were more responsive than males to a tax that included fruit juice, and younger participants were more responsive to all sugar tax conditions than older participants. Reported thirst and education level also moderated the relationship between tax condition and calories purchased. No individual-level characteristics moderated the effects of FOP labels.ConclusionA small proportion (7 of 176) of the moderating effects tested in this study were significant. Sugar taxes and FOP labelling policies may therefore produce similar effects across key socio-demographic groups.Supplementary InformationThe online version contains supplementary material available at 10.17269/s41997-021-00475-x.     

Comparison of grocery purchase patterns of diet soda buyers to those of regular soda buyers

The ultimate effect of regular and diet carbonated soft drinks on energy intakes depends on possible relations with other dietary components. With this motivation, this study compared grocery purchase patterns of regular and diet soft drink consumers using a large sample of US single-person households. We tested for differences in food-spending shares allocated to 43 food categories chosen mainly for their desirable/undesirable nutritional properties. We also investigated whether differences in purchased quantity of diet soft drinks are associated with differences in purchases of other food categories. We found a large number of significant differences, virtually all showing that more diet soda prone consumers make better nutrition choices, particularly regarding energy content. The study suggests that use of diet soft drinks does not lead to compensation by increased use of high-energy foods.