Supermarkets: checking out health?

05 April 2018

As Tesco joins forces with three national charities to reduce the risk of disease by promoting healthy eating, journalist Juliette Astrup looks at the role of supermarkets in helping to improve public health.

Big Story

The UK is in the middle of an obesity crisis. More than half of the population – 65% of men and 58% of women – are overweight or obese and face an increased risk of diabetes, heart disease, stroke and some cancers (NHS Choices, 2015).

It is a crisis that is costing us dearly, both as individuals and as a society. The NHS in England spent an estimated £6.1bn on overweight- and obesity-related ill health in 2014-15 (PHE, 2017). The UK-wide NHS costs attributable to excess weight are projected to reach £9.7bn by 2050 (PHE, 2017).

A range of measures are in place to attempt to reverse this trend – from public health campaigns and obesity strategies, to a ‘sugar tax’ on soft drinks, restrictions on junk food advertising, improved labelling and the production of healthier products.

While the responsibility falls across many shoulders, undoubtedly supermarkets play a critical role in our food choices.


Criticism and change

In the past, supermarkets have faced criticism for not doing enough. In 2012, for example, the consumer magazine Which? published research assessing the response of leading manufacturers and retailers to the government’s 2011 Public Health Responsibility Deal, which encouraged them to sign up to voluntary pledges to act to improve health.

While some retailers, such as the Co-op and Marks & Spencer were praised for setting out specific commitments, for example around cutting the number of unhealthy products on offer, the report found a lack of consistent action and ambition among the retailers in addressing public health concerns (Which?, 2012).

The past six years, however, have seen supermarkets rising to the challenge, with Tesco – the UK’s biggest with a 28% share of the grocery market (Kantar, 2018) – catching up with early pioneers. In 2014, it was the first of several supermarkets to remove less healthy snacks from checkout areas (Lidl removed sweet checkouts around the same time) and to introduce free fruit in-store for children.

Other Tesco initiatives highlighted alternatives lower in saturated fat, salt and sugar, while the Food Love Stories campaign offers ideas on healthier cooking. This year, Tesco joined the Co-op in supporting the Public Health England (PHE) Change4Life campaign to promote healthier snacks for children.

Working in partnership with Diabetes UK and the British Heart Foundation (BHF) for the past three years and with Cancer Research UK’s Race for Life since 2002, Tesco has also helped raised tens of millions for health charities.


A new partnership

These relationships are to be taken to a new level following the announcement of the ‘Little helps for healthier living’ partnership between Tesco and the BHF, Cancer Research UK and Diabetes UK.

Over the next five years, the four organisations will work together to help tackle some of the UK’s biggest health challenges – cardiovascular disease, cancer and type 2 diabetes – supporting measurable changes in behaviours through a series of targeted activities and campaigns.

They will start with a health strategy for Tesco’s 300,000-strong workforce. Plans include aligning campaigns in-store and online with national health campaigns. The supermarket will also share anonymised sales information to help steer health policy and programmes and continue its fundraising for health research.

Dave Lewis, chief executive of Tesco, says: ‘We want to help people take small steps on their own terms to develop healthier habits. This is about unlocking the energy, knowledge and reach of our different organisations to help people take little steps to healthier living across the whole country.’

The four organisations have also pledged to share their findings with the UK health community to accelerate progress on public health goals. Simon Gillespie, chief executive of the BHF, says that measuring the impact of these initiatives could ‘pave the way’ for innovative strategies that ‘can be adopted across the country’.

The new partnership heralds a deeper level of collaboration by Tesco, which goes beyond fundraising and supporting public health campaigns.

Chris Askew, chief executive of Diabetes UK, speaking to Third Sector magazine, says: ‘It’s a different model and we don’t know what the extent and value of the opportunity that’s being offered to us will be. But we’ve worked with Tesco before and we know enough to be confident that it will make a really considerable contribution to our work.’



Responding to customers

Of course supermarkets are being proactive in this area not least because it’s what their customers want, explains Rachel Bradford, nutrition and scientific affairs manager at the Institute of Grocery Distribution (IGD).

‘Our research reveals that 85% of shoppers are making some attempt to improve their diets throughout the year,’ she says. ‘It makes good business sense for supermarkets to support the aspirations of their customers.’

And she adds: ‘All the major supermarkets have a programme of activity on health and are competing to build a reputation as the best in this area. Because they have different mixes of shoppers, with different health priorities, this leads them to focus on different areas, but it adds up to healthy competition; we expect that to step up further over time.’

The industry works collectively through the IGD on a range of programmes to support healthier eating: for example, with universities in their research, and with businesses to improve the nutritional content of their products. It has also produced guides to help companies address customer confusion around nutritional information on packaging.

Rachel says: ‘We would love to see health practitioners support the messages we have developed to help people understand and use nutrition labels. This involves helping people with some basic nutritional concepts such as calories, recommended intakes, portioning and the traffic-light colour-coding system.   ‘We’ve developed a guide specifically for educators and healthcare professionals to use when speaking to consumers.’ This guide to making more effective choices can be found at bit.ly/IGD_nutrition.


External pressure

As well as self-generated public health initiatives, supermarkets are also under external pressure to act.

PHE is working with the food industry through its Change4Life campaign to cut 20% of sugar from the products children consume most by 2020.

Alison Tedstone, chief nutritionist at PHE, has hinted at possible calorie caps for ready meals: ‘This is all about things like pizzas and ready-made sandwiches. We will need to set out guidelines and, I suspect, a series of calorie caps.’

More action to curb promotions on unhealthy products could also be coming. The health select committee in England reiterated its call for such action last year (House of Commons, 2017), and the Scottish Government’s proposed new diet and obesity strategy would restrict price promotions on food high in salt, sugar and fat (Scottish Government, 2017).

Many retailers have set out to address this issue themselves, but research by Which? looking at Asda, Morrisons, Ocado, Sainsbury’s, Tesco and Waitrose over two months in 2016, found that 53% of promotions were on foods high in fat, saturates, sugar or salt (Which?, 2016) showing no one has mastered it quite yet.


What next?

Undoubtedly, supermarkets are ideally placed to make health-promoting interventions. Not only do most of us pass through their doors at least once a week, but they are experts in influencing our shopping decisions, with an armoury of devices including design, product placement, packaging and offers. Loyalty card data also gives them the ability to target promotions.

But of course public health improvement is not solely down to supermarkets. And one could argue that supermarkets are having to step up their game because the government isn’t doing enough.

So, beyond making food more healthy and pricing it effectively, what can be done to harness the public health-promoting power of supermarkets and other retailers?

A four-year research programme launched in January aims to determine just that. Behavioural and cognitive scientists at the universities of Cambridge and Bristol investigate ways to ‘nudge’ people towards healthier behaviour, including improving diets, cutting back on alcohol and quitting smoking (University of Bristol, 2018).

This ambitious programme will investigate the design of supermarkets, the size and shape of products, their availability, placement and labelling.

Mary De Silva, head of population health at the global charitable foundation Wellcome, which is funding the research, says developing our understanding of such ‘nudge’ interventions ‘is a critical part of helping prevent non-communicable diseases such as heart attacks, obesity, stroke, cancer and diabetes’.

So while supermarkets are increasingly doing their bit to support their customers in healthier living, it seems their influence on public health could extend even further in future. And of course, the public need to want change too - which is where willpower will need to come in to the equation.


House of Commons. (2017) House of Commons Health Committee Childhood obesity: follow-up. Seventh Report of Session 2016–17. See: publications.parliament.uk/pa/cm201617/cmselect/cmhealth/928/928.pdf (Accessed 14 March 2018).

NHS Choices. (2015) Cut down on your calories. See: www.nhs.uk/Livewell/Goodfood/Pages/eat-less.aspx (Accessed 14 March 2018). Kantar. (2018) Health hits the aisles as UK supermarket sales continue to grow. See: uk.kantar.com/consumer/shoppers/2018/feb-2018-uk-grocery-market-share/ (Accessed 14 March 2018).

Public Health England. (2017) Health matters: obesity and the food environment. See: www.gov.uk/government/publications/health-matters-obesity-and-the-food-environment/health-matters-obesity-and-the-food-environment--2 (Accessed 14 March 2018).

Scottish Government. (2017) A Healthier future – action and ambitions on diet, activity and healthy weight consultation document. See: consult.gov.scot/health-and-social-care/a-healthier-future/user_uploads/00526543.pdf (Accessed 14 March 2018).

University of Bristol. (2018) Could re-designing supermarkets, bars and restaurants ‘nudge’ us towards healthy habits? See: www.bristol.ac.uk/news/2018/january/healthy-habits.html (Accessed 14 March 2018).

Which? (2012) A taste for change? Food companies assessed for action to enable healthier choices. See: www.which.co.uk/documents/pdf/a-taste-for-change---which-briefing---responsibility-deal-445309.pdf (Accessed 14 March 2018).

Which? (2016) More supermarket promotions on less healthy food. See: press.which.co.uk/whichpressreleases/more-supermarket-promotions-on-less-healthy-food/ (Accessed 14 March 2018).

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