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Structural monitoring of the Dutch food environment is needed

4 November 2021
Few food products and food promotions in supermarkets and food service outlets align with the National Dietary Guidelines. Structural monitoring of the food environment is needed.

These are the two main conclusions of the study ‘Monitoring the healthiness of the food availability and food promotions in supermarkets and food service outlets’. This study, commissioned by the Ministry of Health, Welfare and Sport, is conducted by researchers from Wageningen University & Research, VU Amsterdam, and Utrecht University in the Netherlands. Monitoring is necessary for tracking the implementation of policies and self-regulation of supermarkets food service outlets that aim to create healthier food environments.   

Results of the study and how to proceed
The aims of this study were twofold. First, the researchers mapped out how convenient the healthy choice was by assessing the healthiness of the availability and promotions of foods in supermarkets and food service outlets (a so-called "photo of the market"). They also investigated the extent to which the food availability and food promotions align with the National Dietary Guidelines in the Netherlands.

Second, the researchers investigated how to implement a monitoring programme for the Netherlands to map out the food availability and food promotions in supermarkets and food service outlets. In order to do so, they conducted interviews with experts and stakeholders, including scientists, monitoring experts and professionals from supermarkets, food service outlets, and trade associations.

The results of this study will support the national government in evaluating its policies for improving food environments. To date, no such evaluation has been initiated by the government, although plans to make the healthy choice the easy choice have been proposed in the National Prevention Agreement. 

Supermarkets: 80% of the food products and food promotions do not align with the National Dietary Guidelines
The “photo of the market” that the researchers took of supermarkets and food service outlets shows that the food availability and food promotions for both sectors primarily consist of products that do not contribute to a healthy diet.

Roughly 80% of the assortment, price promotions, and in-store promotions of supermarkets did not align with the national dietary guidelines. The top five most available food products in supermarkets were non-alcoholic beverages, alcohol, sweets, biscuits, meat, and poultry, and together they made up 36% of the entire assortment.

The top five most available food product groups with the highest share of products that align with the National dietary guidelines were eggs, legumes, fish, fruit, and vegetables. However, together they only comprised 13% of the entire assortment.

Non-alcoholic drinks, sweets and confections, alcoholic beverages, dairy, and ready-to-eat meals were the most featured promotions in supermarket sales flyers. Sweets and confections, alcoholic beverages, non-alcoholic beverages, baked goods, and savoury snacks were most often available at end-of-aisle shelves and impulse displays. Of the nine products groups that were investigated, marketing towards children was predominantly observed for foods not contributing to a healthy diet.

Food service outlets: 91% of the available foods are not contributing to a healthy diet
91% of the available foods in food service outlets did not align with the national dietary guidelines. 81% of the instore promotions and 73% of the food service outlet promotions on Instagram did not align with the dietary guidelines either. Only a small part of the menus of food service outlets (6%) clearly indicated the nutritional information of the dishes or products. At 65% of the locations visited, it was possible to get free tap water, although this was rarely communicated clearly.

The researchers consider it an important step for the Ministry of Health, Welfare and Sport to investigate how healthy the food environment is in supermarkets and food service outlets and how the developments in that food environment can best be monitored. 

Monitoring is necessary
Almost all experts and stakeholders interviewed in this study agree that it would be necessary to set up this kind of monitor for the Netherlands and to evaluate how the healthiness of food availability and food promotions change over time. According to all experts and stakeholders, it is essential to first define the goals and consequences of a monitor. Simply monitoring the food environment does not cause change, but instead can be used to evaluate the progress or success of policies.

The current National Prevention Agreement runs until 2023, and there are many developments in this area. It is also of interest among the House of Representatives of the Dutch parliament. To illustrate, the recent adopted motion of members Dik-Faber and Sazias paved the way for the government to making agreements with supermarkets to dedicate 80% of their advertising to products in line with the national dietary guidelines.

There are already monitors in place to investigate how the food consumption of the population is changing over time. Research is also being conducted into whether product composition, such as salt content in specific product groups, is improving. There is however no monitoring system implemented in the Netherlands for mapping out the status of food environments including the food availability and food promotions in supermarkets and food service outlets. However, the latter is essential if the goal is to evaluate whether the healthy choice is becoming the easy choice.

This report provides several key recommendations on how to design and implement such a monitor in the Netherlands. Implementation of a monitor will enable the evaluation of healthy food environment policies and the creation of a healthy food environment.