Principal Investigators: Janis Baird and Christina Vogel, Professor of Public Health and Epidemiology and Principal Research Fellow in Public Health Nutrition respectively, MRC Lifecourse Epidemiology Centre, University of Southampton

Team: Dr Sarah Crozier, Senior Statistician, MRC Lifecourse Epidemiology Centre, University of Southampton

Dr Hayward Godwin, Associate Professor of Psychology, University of Southampton

Professor Marcus Munafo and Dr Olivia Maynard, Bristol University

Ravita Taheem, Southampton City Council, Sure Start Children’s Centres

Started: 1st March 2022

Ends: 30th September 2024

Background

Poor diet is linked to an increased risk of obesity, diabetes and heart disease. Most adults in England consume too much salt, saturated fat and free sugar, and do not eat the recommended five daily portions of fruit and vegetables. People with lower education and income levels are more likely to have poor diet and to experience health problems as a result. Women of childbearing age are primarily responsible for domestic food tasks such as shopping and cooking, and their diets are closely linked to those of their children. Most families buy their food from supermarkets and their food choices can be influenced by placement of items in-store and by promotions.

Our research

We want to find out how the placement and packaging of healthy and unhealthy foods influence the foods that women choose to buy. We will do this by creating a ‘virtual’ supermarket layout that participants will interact with on a computer screen. We will recruit women attending Sure Start Children’s Centres in Hampshire and those whose children attend early years settings. Hampshire is a county within the Wessex region with some relatively deprived areas. We will choose centres and early years settings located in areas of higher deprivation. Local data suggests that 70% of families with young children are engaged with the centres.

Women using the virtual supermarket will be shown images of healthy and unhealthy foods and non-food items that are placed in noticeable locations in the supermarket like checkouts. We will measure the specific aspects of the images women look at using experimental techniques such as eye tracking, which records their gaze point and gaze duration. The eye tracker is positioned close to the computer screen allowing it to record where women look. We will then ask women to tell us the products that they saw for sale, the name of the products they considered purchasing, and aspects of the supermarket that took their interest, and why. Our findings will tell us how people respond to the placement and packaging of different types of food products and whether these reponses differ if families are poorer or more wealthy. These findings help us to design ways to layout supermarkets to help all families eat more healthy foods. 

Our research will begin in March 2022 and end in late 2022. We will share the findings from our study with local families attending Sure Start Children’s Centres and early years settings. We will inform local and national government employees about our findings which could help to refine current government policies to address childhood obesity. 

The Study

•68 mothers took part in an eye-tracking study at the University of Southampton.

•The women viewed scenes from a virtual supermarket which showed healthy, unhealthy and non-food products.

•Scenes focused on the areas in a store where most shoppers usually pass through including the store entrance, end-of-aisles and checkouts.

•Eye tracking software captured their eye movements to measure their attention. Participants were also asked to click on items on the screen that  they wanted to purchase.

•Twelve women also took part in interviews.mothers took part in an eye-tracking study at the University of Southampton.

What did we learn?

•We compared women’s attention to healthy, unhealthy and non-food items by showing them images of products side by side.

Women showed higher levels of attention to healthy products over unhealthy and non-food items.

Healthy products were viewed for 0.10 more seconds than unhealthy products and 0.15 more seconds than non-food items.

The eye-tracking study also showed that the women had higher intention to purchase healthy foods over unhealthy and non-food items. 

Interviews with the women showed they used strategies like shopping lists and avoiding aisle ends to avoid unhealthy purchases.

They wanted more healthy snacks or products they might have forgotten (such as paracetamol or batteries) at checkouts.

What difference can this new Knowledge make?

Supermarkets usually place unhealthy foods in noticeable places to make profits. Replacing these unhealthy foods with healthy or non-food items will just as likely, if not more successfully, lead to purchases. This can help families lead healthier lives.

Why is this important for patients, health and care providers and policy makers?

Placing unhealthy foods in noticeable locations can lead to impulse purchases of foods that can lead to obesity. Our study shows that women do not intend to buy these foods and would prefer healthier alternatives.

Since 2022, UK policy has banned the placement of some unhealthy foods at noticeable locations in supermarkets. This research provides evidence that customers are likely to support this policy as they would like to buy healthy and non-food items from these locations.

What Next?

We are creating an infographic to share our findings with families via Sure Start Children’s Centres, Facebook and local schools.

These results support our ongoing evaluation of the Food (Promotion and Placement) Regulations. Data will be shared in ongoing conversations with local authorities and via an academic publication.

We have received funding to expand our study from mothers to young people. Adolescence is a time when young people may start to make independent food purchases. We aim to further understand what environmental factors influence young people’s purchases on their journey to and from school.