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Road to supermarket offering more healthy choices bumpy

11 September 2023
Why is it so difficult to design the environment of supermarkets to encourage more healthy choices? Systems scientist Cédric Middel, who is pursuing his doctorate at VU Amsterdam, blames it on "rigid beliefs and perverse incentives."

That is why the current Dutch food system is at a standstill. Supermarkets acknowledge the importance of a healthier environment, but the commercial risks are seen as too great, causing supermarkets to wait for each other to take the first big step.

In his research, Middel looked at what components in the food system create unhealthy supermarket environments, and how you could change this. To do this, he analysed previous studies that have been conducted on creating healthy supermarket environments, but where attempts failed. He also took a closer look at the Dutch food system by consulting historical sources and conducting interviews with food system stakeholders.


The results show that several combined components of the food system impede the path to a healthier supermarket environment. First, supermarkets are commercial businesses that pursue profit and growth. "So, their way of thinking and working is optimised around promoting profitable products with a huge margin," says Middel.

Secondly, processed products, from major brands, are promoted much more than unprocessed products, from individual producers. As a result, these products tend to be more popular, which drives the supermarket to focus more on these products. This forms a self-reinforcing circle, where unhealthy products get more attention, and are produced and promoted more and more efficiently, making them more popular and cheaper.

Finally, the enormous competition among supermarkets means that there is little room to try other sales strategies. This, according to Middel, keeps the focus on the "well-known and proven successful" unhealthy products.

Promoting healthy choices

With this input, Middel then set up a partnership with a Dutch supermarket chain to develop strategies to promote healthier products. These strategies were put into practice in six stores of this chain for the duration of a year, after which they were extensively evaluated and adjusted. The results of this experiment were shared with stakeholders in the Dutch food system, who jointly drew up a roadmap for creating healthier supermarket environments on a larger scale.

In addition, Middel shares the following: "To break through the current situation, in which commerce prevails, national governance is also needed. This can be done, for example, by subsidising on the production side, or by lowering VAT, thus increasing the profit margin on the same consumer price. In addition, advertising for unhealthy products could be restricted (even more). Thirdly, the health costs of unhealthy products should be better represented in their price, for example with the well-known sugar tax, which has already been introduced in other countries. This kind of tax could fund subsidies on healthier products or contribute to the health costs that unhealthy products contribute to." The bottom line is that "producing and selling healthy products should be more rewarding than unhealthy products."

Chronically ill due to unhealthy eating habits.

So why is it so important for supermarkets to promote more healthier choices? That has to do with the link between unhealthy eating habits and chronic diseases. Unhealthy eating habits contribute to a variety of chronic diseases, such as diabetes, heart disease, and cancer. These diseases are a major burden on patients, and account for a significant portion of all healthcare costs. Consumers, in a supermarket environment with incentives such as "low price" or "ready-to-eat," seem to find it difficult to make healthier choices. The choice for processed (unhealthy) products is obvious then. Unless they’re given a helping hand with an environment that encourages healthier choices.

Read more about the dissertation: ‘Health (f)or Profit?’.