Rating Retailers for Health

Retailers have an important role to play in supporting government commitments to address obesity and poor diets as outlined in the White Paper on public health¹. The solutions lie in broad ranging action on diet and physical exercise. Everyone – the government, the food industry, health professionals, educators and consumers themselves – has a responsibility and a role to play.

Supermarkets are an important part of this picture. They have unprecedented influence in the marketplace, and their growth in recent decades has transformed the way we shop, cook and eat. As a nation, we now spend three-quarters of the national food bill of over £100 billion in just four food retailers – Tesco, Asda, Sainsbury’s and Morrisons (which now incorporates Safeway).

NCC recognises that supermarkets are already demonstrating their commitments to healthier eating². But how can we measure progress, and what more could retailers do to make healthier choices, easier for all consumers?

The NCC’s Health Responsibility Index carries out spot checks of supermarkets’ policies and practices for healthy eating, measuring and comparing company performance in four key areas:

Nutritional value of everyday, own-label foods – focussing on salt;

Nutrition information and interpretation on food labels;

The promotion in stores of “healthier” foods;

Availability in stores of customer information and advice on healthy eating.

Scores are awarded in each key area and these produce an overall ranking (and marks out of 10) for each retailer. Our survey in nine “flagship” stores around England during June 2004 shows that the more “up market” supermarkets rated more highly than those with a greater proportion of lower-income customers. The Co-Op is an exception – rating more highly than its customer demographic profile would suggest. It appears that retailers’ practices are contributing to, or exacerbating, the inequalities that exist between the diet and health of more and less affluent consumers.

Salt levels

At each retailer we recorded the levels of sodium declared in on-pack nutrition information panels of ten own-label “standard” foods and “healthier” equivalents, and compared these with Food Standard Agency (FSA) salt model “target average” levels. The products assessed were baked beans, canned tomato soup, cheese and tomato pizza, cornflakes, pork sausages, salt and vinegar crisps, sunflower/vegetable fat spread, tomato ketchup, tomato pasta sauce, and white sliced bread.

We found considerable variation between retailers in the salt profile of their own-label “standard” products. The Co-Op’s foods had the lowest levels of sodium and Morrison’s the highest, and from this we calculate that where people shop can mean up to 25 per cent more salt in their diet.

All retailers have more work to do to meet FSA salt targets – out of more than 90 products surveyed, only two met the targets and only just over a third (37 per cent) of 62 “healthier” products were within the limits.

We are urging the FSA to develop targets for fat, saturated fat and sugar in processed foods, a recommendation that now has government support, in the White Paper Choosing Health.

Labelling information

Food labels are an important source of nutrition information for consumers though it is often difficult for them to understand or use the information. We used several indicators to assess company practices towards nutrition labelling:

Whether companies provided the “Full 8” nutrients (energy, protein, fat, saturated fat, carbohydrate, sugars, fibre and sodium) on the survey products;

Whether they translated sodium figures into salt;

Whether they gave information on Guideline Daily Amounts (GDAs);

And whether they provided any kind of interpretative nutrition labelling.

Overall we found that all retailers surveyed declare the “Full 8” nutrients for virtually all products, but for our other indicators we found little consistency between the retailers’ practices – and even between products from the same retailer.

The Co-Op stands out in this category for the lead that it has taken on nutrition information. Since 1986 the Co-Op’s “banding scheme” has rated nutrition information on its products as “high”, “medium” or “low” on nutrition panels. It was the only retailer to provide interpretative information in our survey, though Tesco and Sainsbury’s have since said they are considering their own “front of pack” schemes.

We want the FSA to develop “good practice” guidance and to see this taken up across the food retail industry. Although our survey was limited in scope, we noted that brand manufacturers appeared to provide less information on products than the supermarkets. We support the development of nutrient profiling as a basis for “front of pack” interpretative labelling such as “traffic light” declarations³. We welcome the work of the FSA, which is currently considering options including “traffic light” schemes.

Promotions

The ways in which products are highlighted, promoted and positioned in stores has a great impact on consumer decisions. The majority of retailers put much greater emphasis on the promotion of “less healthy” foods and snacks, including foods high in sugar, than of healthier foods. We found many eye-catching special offers, including price discounts dominated by “less healthy” snacks foods, confectionery, soft drinks and sugared breakfast cereals. Many were linked – because of the timing of our survey – to football, or targeted children using film tie-ins.

We used two indicators to explore the emphasis retailers give to the promotion of “healthy” relative to “less healthy” foods:

Shelf space devoted to “healthy” foods (fruit) relative to “less healthy” products;

The presence of “less healthy” snacks at the checkout.

The top scorer in this category was Waitrose – with no sweets at the checkout. M&S and Safeway devoted more shelf space than Waitrose to fruit than to “less healthy” snacks, but neither M&S nor Safeway scored as well on removing “less healthy” snacks – including sweets at child height – from checkouts. Asda was the bottom scorer on the issue of “less healthy” snacks at checkouts.

Customer information and advice

The majority of retailers failed to get off the starting blocks in this category. They were unable, at their customer information desks, to provide information and advice on the sodium content of a tinned soup. Nor did we find information and advice leaflets in the stores we surveyed.

Waitrose was the only retailer whose staff could correctly provide information and interpretation on salt from food labels, while only Waitrose, M&S and Sainsbury’s had information leaflets on diet and health available in their stores.

Taking it forward

We have demonstrated the way in which our Health Responsibility Index allows companies, their customers, governments and others to measure, transparently, retailers’ performance and, if measured over time, the progress companies are making. The Index acknowledges and rewards good practice while highlighting poorer performance. In this way the highly competitive nature of the UK retailing sector can be harnessed to the public health good with retailers using their significant influence to do more to support the health of the nation.

We are now discussing our findings with retailers and government and urging adoption of our recommendations. These include calling for retailers to develop clear targets for improvements across the NCC healthy indicators and for the Food Standards Agency and Department of Health to audit progress of the supermarkets each year.

References

1. Choosing Health, Making Healthy Choices Easier, 2004.

2. British Retail Consortium, Eat Well, Drink Well: retail initiatives towards healthier eating, 2003.

3. Traffic Lights for Food? NCC, 2004.

Sue Dibb is senor policy officer with the NCC and author of Rating Retailers. sue.dibb@ncc.org.uk Rating Retailers for Health is available at http://www.ncc.org.uk/food/rating_retailers.pdf