Superlist Health 2020

How can we support people to make healthy eating choices?

A supermarket cannot make its customers healthier. However, supermarkets can make healthy food the easiest choice. In recent years, supermarkets have taken more and more measures to help achieve this. With Superlist Health, we show which supermarkets are leading the way and which are still lagging behind. The supermarkets that we've analyzed are Albert Heijn, Jumbo, Lidl, Aldi, Plus, Dirk, Coop en Ekoplaza.

For this study, we have collaborated with four civil society organisations representing health interests: the Heart Foundation, the Diabetes Research Foundation, the Kidney Foundation, and the Stomach, Liver and Bowel Foundation.

You can download the summary of the report here.

Supermarkets should do more to support healthy eating

Without exception, every supermarket is expressing the intention to make it easier to choose the healthier option. At Lidl, Dirk, Coop and Ekoplaza, this aim has been translated into policy and practice the best. But not a single supermarket has set adequate objectives for selling healthy products, and the weekly folders advertising specials are filled predominantly with unhealthy products. Nevertheless, almost every supermarket in this survey is a good example that can inspire other supermarkets.

How can supermarkets help us to make healthy choices?

This first Superlist Health examines how supermarkets help consumers to eat a healthy diet through the composition of their products on offer, their specials, shop design and objectives.

Despite the undisputed importance of healthy eating, the share of the population in the Netherlands that is overweight and suffering from the associated diseases and disorders has been growing for the past 30 years. It is thus crucial to support people better to eat a healthy diet.

It is important to understand in this context that education is not sufficient. Knowledge does not always lead to healthy behaviour, and a person’s food choice is not always rational. Our surroundings greatly influence what we eat. One significant component of our surroundings is the supermarket where most of our food comes from. This leads us to the obvious question: how can supermarkets help us to make healthy choices?

Recurring comparison

About 70 percent of our daily food comes from the supermarket. Supermarkets thus have an immense impact on our dietary pattern. In the past few years, supermarkets have jointly pledged to make healthy food the easier choice, a pledge that has been recorded in the National Prevention Agreement.

Superlist is a biennial recurring comparison of supermarkets, which reveals what supermarkets are doing to help their customers choose the healthy and sustainable option. In this first edition we focus on the theme of Health. The main question in this survey is: to what extent do supermarkets, as an environment for daily food choices, stimulate a healthy dietary pattern?

To elucidate this issue, Questionmark prepared a research method in collaboration with the Diabetes Fonds, Hartstichting, Maag Lever Darm Stichting and Nierstichting under the supervision of a Council of Scientists.

Prior to initiating the research, supermarkets were given the opportunity to comment on this method. In June 2020 the definitive version was published and the research period began, which continued until August 19. The research method focussed on the objectives that the supermarkets set for themselves for health, the share of healthy products on offer and in the advertising folder, and the extent to which they made the healthy choice easy to find on the shopfloor. The picture that emerged from the research could be summarized in four main findings.

1. Shop layout pays little attention to healthy choice

Almost every supermarket expressed the intention to stimulate healthy food on the shopfloor or at least discourage unhealthy choices. The description of the policy is often too noncommittal to be interpreted clearly. Real pain points, like marketing unhealthy products to children, are not being addressed strongly enough.

Dirk is the only supermarket that does not tempt customers with unhealthy impulse purchases at the checkout. Coop is the only supermarket consistently offering healthy recipes as inspiration for customers in the shop. Aldi is the only one consistently marketing healthy products to children.

We did note that several supermarkets have nutrient guides on their shelves: brightly coloured signs that indicate which products are relatively unhealthy in terms of their nutritional value. Dirk is however the only supermarket where this measure is implemented consistently. The figure below displays the differences in scores for shop layout.

2. Advertising folders promote too few healthy options

The folder with special offers can be a powerful means to help people eat a more healthy diet. In practice, unhealthy products predominate in all advertising folders. On average, 82% of the specials advertised in folders are unhealthy. In this survey just one folder contained more than 40% of products from the basic 5 food groups, and it was from Lidl. Sub-categories show greater differences. While advertising for sugar-filled drinks for children and alcohol is still the norm in many supermarkets, Ekoplaza occasionally issues 'alcohol-free' folders and Lidl does not have special offers of sugar-filled drinks in the small cartons that are typically given to children

3. Little transparency about objectives

Supermarkets do not provide much insight into the extent to which they are working to meet the pledges in the Prevention Agreement. Currently, none of the supermarkets has adequate objectives for selling healthy products. Existing objectives and reports are not easy to interpret because they are restricted to the range of own brands. From the supermarkets’ perspective, the distinction between own brand and A-brand is logical, but it is irrelevant for the health of their customers. The agreements in the Prevention Agreement about stimulating the basic 5 food groups do not distinguish  between A-brands and own brands. A number of supermarkets are taking steps to report about the entire range in the future, so society can gain some insight into how much effort is being made to fulfil the agreements in the Prevention Agreement.

4. Largely comparable assortment

The share of healthy products in the supermarkets’ range of goods on offer is similar in each case. Even if we ignore product groups of 'treats' like candy, chocolate and crisps, on average 59 percent of the range is not eligible for membership of the basic five food groups.

A striking aspect is the similarities between supermarkets: in some product groups, regardless of the supermarket, there are hardly any healthy varieties available. For example, dry bread products (biscuits, crackers) generally contain too little fibre to be included in the basic 5 food groups. More than 4 out of 5 meat and meat substitute products also fall outside the basic 5 food groups, generally because they contain too much salt. In terms of the quantity of sugar in soft drinks and salt in meat (substitutes) and sauces, some differences are evident, though. Aldi sells relatively high amounts of salt and sugar in those product groups, while the Ekoplaza assortment is distinguished by relatively low-sugar soft drinks and relatively low-salt meat and meat substitutes.

Ranking

Using these findings, a ranking of supermarkets was prepared based on a weighting set in advance. The ranking shows which supermarkets generally belong to the forerunners, laggards or the mediocre group. The boundaries between the groups are drawn where the differences between two supermarkets are the largest. But it was determined in advance that the forerunner and laggard groups would always contain more than one supermarket.

The actual distance between the three 'laggards' in this ranking is minimal. Although Albert Heijn, Aldi and Plus performed differently in various sub-categories, their place in the final ranking is practically the same.

This ranking must not be considered an absolute judgement. In contrast, it is striking that it is not always the same supermarket that is ahead in all areas. It’s those differences that show that all of the supermarkets stand to profit greatly if they learn from the good examples of their fellow supermarkets.

Full report

The full 62-page report is available on the Dutch version of this website.

Press release

Research Method

In this study we compared supermarkets on four topics:

Policy
Is the supermarket striving to sell more healthy products? And does the supermarket also try to sell fewer unhealthy products?

Assortment
How much of the assortment comprises products from the ‘Wheel of Five’? And for products outside the ‘Wheel of Five’, how unhealthy are they?

Promotions
Do the promotions in the weekly brochure help with healthy shopping?

Layout
Does the shop's layout help with healthy shopping? For example, is there candy on display at the checkout, or not? Or does the supermarket provide warnings about products which are high in sugar or low in fibre?

Based on the Superlist research method and these four topics, we developed the comparative criteria under the supervision of the Scientific Board.

The fFull comparative criteria for Health 2020 and the full Superlist Health report are not available in English. If you do want more information about the research, please do contact us at info@thequestionmark.org

Superlist Method