healthful food/beverage stocking levels for small retail food stores

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Minimum Stocking Levels and Marketing Strategies of Healthful Foods for Small Retail Food Stores

Healthy Eating Research:Building Evidence to Prevent Childhood Obesity

We will be tweeting during the webinar, please tag @HEResearch in your tweets

PresentersMelissa LaskaAssociate Professor, Epidemiology & Community HealthUniversity of Minnesota School of Public Health

Jennifer PelletierPhD Candidate and Research AssistantUniversity of Minnesota School of Public Health

Tracy FoxPresident Food, Nutrition & Policy Consultants, LLC

Across the U.S., there are notable disparities in the healthfulness of foods and beverages found in retail settings.

Small food stores tend to lack a wide array of healthy, staple foods.

Introduction

Limited access to stores that carry healthful food may contribute – at least in part – to disparities in diet and health.

Addressing the Problem

Strategies for addressing limited access to stores that stock and sell healthy, staple foods and beverages include: • Attracting new grocery stores or supermarkets

to an underserved community. • Improving the healthfulness of products sold

by existing food retailers in a given community.

Small Food Stores

Small stores face challenges in stocking and selling healthy food.• “Healthy corner store” programming has

shown some success in addressing challenges.

• Policy action has been used to support healthy corner store work and to institute healthy stocking standards for retailers.

Key Challenge

Lack of consistency in standards across these programs and policies.

Aims of this report

Identify basic and preferred minimum stocking levels for healthful foods and beverages in small retail food stores. Identify marketing strategies small stores should use to enhance sales of healthy foods and beverages.

Expert Panel LeadershipPanel Conveners:Mary Story, PhD, RDDirector, Healthy Eating ResearchProfessor, Global Health and Community and Family MedicineAssociate Director of Education and TrainingDuke Global Health Institute Megan Lott, MPH, RDNSenior Associate of Policy and Research, Healthy Eating ResearchDuke Global Health Institute

Panel Chair:Melissa N. Laska, PhD, RDAssociate Professor, Epidemiology & Community HealthCo-Director, Obesity Prevention CenterSenior Program Advisor, Healthy Eating ResearchUniversity of Minnesota School of Public Health

Panel Support: Jennifer E. Pelletier, MPHPhD Candidate and Research AssistantUniversity of Minnesota School of Public Health

Lesley Schmidt Sindberg, MPHSenior Research Coordinator, Healthy Eating ResearchUniversity of Minnesota School of Public Health

Expert Panel MembersGuadalupe X. Ayala, PhD, MPHSan Diego State University

Brian Elbel, PhD, MPHNew York University School of Medicine andWagner Graduate School of Public Service

Christine Fry, MPPChangeLab Solutions

Joel Gittelsohn, PhDJohns Hopkins Bloomberg School of Public Health

Steve Gortmaker, PhDHarvard T.H. Chan School of Public Health

Allison Karpyn, PhDUniversity of Delaware

Fred A. Katz, MBA, MSDEJohns Hopkins University Carey Business School

Paul NojaimNojaim Brothers Supermarket

Collin R. Payne, PhDNew Mexico State University

Stephanie Jilcott Pitts, PhDEast Carolina University

Julie Ralston Aoki, JDPublic Health Law Center

Tracy Fox, MPH, RDFood, Nutrition & Policy Consultants, LLC

Bill McKinneyThe Food Trust

Scope

Small retail food stores• Have retail floor space dedicated to foods/ beverages• Have no more than 3 cash registers that may be

used for food/beverage transactions• Includes: dollar stores, retail pharmacies, stores

accepting WIC or SNAP• Excludes: home goods stores, electronics stores,

office supply stores

Methodology

Sources reviewed• 2015 Dietary Guidelines for Americans• Peer-reviewed research• National recommendations and guidelines• Existing retailer requirements in local, state, and

federal policies and programs• e.g. WIC retailer requirements, Healthy Corner

Store Certification Programs

Overview

1. Minimum Stocking Levels of Healthful Foods/Beverages (Table 1)• Fruits and Vegetables• Dairy and Fortified Soy Beverages• Whole Grain-Rich Staple Products• Meat/Protein• Beverages

Qualifying Standards (Table 2)

Overview

Two Levels of Minimum Stocking• Basic• Preferred

2. Marketing Strategies for Food Retailers• Apply to basic & preferred• May also apply to larger stores

Fruits and VegetablesBasic

Varieties • ≥4 FRUITS• ≥2 Fresh

• ≥6 VEGETABLES• ≥4 Fresh• ≥1 Dark green or

red/orange




red/orange

Single kind of product,

regardless of form, processing, or package size




red/orangePounds* ≥30

*No more than 50% from a single variety

Fruits and VegetablesBasic Preferred



red/orange

• ≥6 FRUITS• ≥3 Fresh


red/orangePounds* ≥30


Fruits and VegetablesBasic Preferred



red/orange

• ≥6 FRUITS• ≥3 Fresh


red/orangePounds* ≥30 ≥45


Standards: (SEE TABLE 2 OF REPORT FOR MORE DETAIL)Fresh, frozen, or cannedNon-expired, non-spoiledCanned/frozen fruit packed in water, 100% juice, extra light or light syrupCanned/frozen vegetables with no added ingredients and no more than 240 mg sodiumExcludes fruit or vegetable juice, garlic, herbs, condiments, ginger root, lemons, and limes

Dairy and Fortified Soy BeveragesBasic

Milk/Fortified Soy Beverage

• ≥5 gallons• ≥1 variety

Standards: (SEE TABLE 2 OF REPORT FOR MORE DETAIL)Milk: skim (0% fat), low-fat (1%), in half gallon package or largerFortified soy beverage: original or plain, fortified with calcium and vitamins A and D, in half gallon package or largerYogurt with no more than 23 g total sugar/6 oz serving. No frozen yogurt or yogurt with mix-in ingredients.Cheese that is low-fat, part-skim, or fat free. Excludes processed cheese products and cheese packaged with other foods




Yogurt • ≥32 ounces• ≥ 1 variety






Cheese* • ≥2 pounds• ≥1 variety

*Only if cheese is stockedStandards: (SEE TABLE 2 OF REPORT FOR MORE DETAIL)Milk: skim (0% fat), low-fat (1%), in half gallon package or largerFortified soy beverage: original or plain, fortified with calcium and vitamins A and D, in half gallon package or largerYogurt with no more than 23 g total sugar/6 oz serving. No frozen yogurt or yogurt with mix-in ingredients.Cheese that is low-fat, part-skim, or fat free. Excludes processed cheese products and cheese packaged with other foods

Dairy and Fortified Soy BeveragesBasic Preferred



• ≥10 gallons• ≥ 2 varieties


• ≥64 ounces• ≥ 2 varieties

Cheese* • ≥2 pounds• ≥1 variety

• ≥4 pounds• ≥2 varieties


*Only if cheese is stocked

Whole Grain-Rich Staple ProductsBasic

Whole Grain-Rich Staple Products*


*Excluding cereal

Standards: (SEE TABLE 2 OF REPORT FOR MORE DETAIL)Varieties of staple products include but are not limited to whole grain bread, brown rice, whole wheat or whole corn tortillas, quinoa, and barley.Whole grain is the first ingredientExcludes whole grain-rich snacks and sweetsWhole grain-rich cereal must have no more than 21.2 g total sugar per 100 g, or no more than 6 g per 1 dry ounce and be in packages of at least 11 ounces

Whole Grain-Rich Staple ProductsBasic



Whole Grain-Rich Cereal

• ≥4 containers• ≥3 varieties

*Excluding cereal


Whole Grain-Rich Staple ProductsBasic Preferred



• ≥10 pounds• ≥ 2 varieties

Whole Grain-Rich Cereal

• ≥4 containers• ≥3 varieties

• ≥12 containers• ≥ 4 varieties

*Excluding cereal


Meat/ProteinBasic

VarietiesMeat productsPoultryFishEggsDried or canned beans Dried split peasBlack-eyed peasLentilsSoybean products (including tofu)NutsNut butter

• ≥4 total varieties

Standards (SEE TABLE 2 OF REPORT FOR MORE DETAIL):Cuts of meat or deli meat that are labeled by USDA as lean or extra lean. Qualifying products must be plain and packages with no oils, sauces, or other food products. All products in this category must be low sodium (no more than 360 mg per serving). Nuts must have no added sugar and nut butter must be packaged with no other food products.

Meat/ProteinBasic


• ≥4 total varieties• ≥1 lean or

extra lean red meat*

*Only if red meat is stocked


Meat/ProteinBasic Preferred


• ≥4 total varieties• ≥1 lean or

extra lean red meat*

• ≥8 total varieties• ≥1 lean or extra

lean red meat*

*Only if red meat is stocked


BeveragesBasic

Plain water • ≥384 ounces (24 bottles of size 16 oz)

Standards (SEE TABLE 2 OF REPORT FOR MORE DETAIL):Low-calorie beverages have no more than 40 calories per 8 ounce servingVegetable juice with no more than 140 mg sodium per servingsFamily size containers are 59 ounces or larger, or 11.5-12 ounces frozen or non-frozen concentrate

BeveragesBasic


Fountain beverages*

*Only if fountain beverages are sold

• Plain water available• ≥1 low-calorie beverage• ≥1 container size 12

ounces or smaller


BeveragesBasic


Fountain beverages*



ounces or smaller

100% Fruit or Vegetable Juice*

*Only if juice or juice-flavored beverages are stocked

• ≥6 family-sized containers OR

• ≥24 individual-sized bottles (8 ounces)


BeveragesBasic Preferred


• ≥384 ounces (24 bottles of size 16 oz)

Fountain beverages*



ounces or smaller

• Plain water available• ≥2 low-calorie beverages• ≥2 container sizes 12

ounces or smaller• No container sizes larger

than 16 ounces100% Fruit or Vegetable Juice*







BeveragesBasic Preferred


• ≥384 ounces (24 bottles of size 16 oz)

Fountain beverages*



ounces or smaller

• Plain water available• ≥2 low-calorie beverages• ≥2 container sizes 12

ounces or smaller• No container sizes larger

than 16 ounces100% Fruit or Vegetable Juice*






Access to dispensed, potable water

• Must be provided free of charge


Marketing Strategies

Marketing StrategiesCategory Description

Placement Physical location of products in store



Price Relative and absolute prices of products



Price Relative and absolute prices of products

Promotion Deals, advertisements, signage

Marketing Strategies: PlacementCategory StrategiesPlacement Place healthier foods/beverages in multiple prominent

locations throughout the store• Eye level• End caps• Grab & go displays near entrance/checkout



Stock only healthier foods/beverages/non-food items in some or all checkout areas-OR-Increase the proportion of healthier foods/beverages/non-food items in all checkout areas



Stock only healthier foods/beverages/non-food items in some or all checkout areas-OR-Increase the proportion of healthier foods/beverages/non-food items in all checkout areasCross-merchandize healthier foods/beverages by placing complementary products near each other

Marketing Strategies: PriceCategory StrategiesPrice Offer at least 10% price discount in promotions for

fruits and vegetables through coupons, vouchers, rebates, or other methods



Offer at least 10% price discount in promotions for healthier versions of products within a product category (e.g., whole grain-rich bread vs. white bread)



Offer at least 10% price discount in promotions for healthier versions of products within a product category (e.g., whole grain-rich bread vs. white bread)

Use proportional pricing, as opposed to value pricing, for full-calorie fountain beverages

Marketing Strategies: PromotionCategory Strategies

Promotion Cross-promote healthier foods/beverages by offering price promotions for complementary products purchased together (e.g., through circulars, digital media, in-store signage)

Marketing Strategies: PromotionCategory Strategies

Promotion Cross-promote healthier foods/beverages by offering price promotions for complementary products purchased together (e.g., through circulars, digital media, in-store signage)

Use shelf tags, labels, tear off cards, and/or other point-of-purchase signage to promote healthier foods/beverages

SummaryBasic Level Preferred LevelMinimum Stocking Requirements• Fruits and Vegetables• Dairy and Fortified Soy Beverages• Whole Grain-Rich Staple Products• Meat/Protein• Beverages

Minimum Stocking Requirements• Fruits and Vegetables• Dairy and Fortified Soy Beverages• Whole Grain-Rich Staple Products• Meat/Protein• Beverages

SummaryBasic Level Preferred LevelMinimum Stocking Requirements• Fruits and Vegetables• Dairy and Fortified Soy Beverages• Whole Grain-Rich Staple Products• Meat/Protein• Beverages

Minimum Stocking Requirements• Fruits and Vegetables• Dairy and Fortified Soy Beverages• Whole Grain-Rich Staple Products• Meat/Protein• Beverages

Marketing Strategies• Placement• Price• Promotion


Tracy Fox, MPH, RDPresident, Food, Nutrition & Policy Consultants, LLC

Culver, IN

www.foodnutritionpolicy.com

@TracyFoxRD

Policy Implications Feb. 10, 2016

http://www.foodnutritionpolicy.com/

Policy Opportunities• SNAP: Enhancing Food

Retail Eligibility (proposed rule anticipated)

• National Commission on Hunger Report

• SNAP EBT Pilot and Expansion

• Healthy Food Financing Initiatives

SNAP: Enhancing Retail Food Store Eligibility

Aug. 2013: FNS issued a Request for Information on ways to “enhance retailer definitions and requirements in a manner that improves access to healthy food choices for SNAP participants”FNS “considers access to a variety of healthy foods at SNAP retailers to be fundamental to the effectiveness of… the program”Proposed rule expected – soon?

Freedom from Hunger: An Achievable Goal for the US National Commission on Hunger Report

Rec. 5. Use evidence-based product placement strategies that encourage purchase of healthy products with SNAP

benefits, and tie it to SNAP eligibility for stores.Action ItemThe USDA should create new standards for SNAP vendor eligibility to ensure that participating store… comply with improved health and nutrition standards; ie.: USDA should require SNAP retail stores (or those applying to become one) to provide enhanced and immediately visible shelf space for healthy foods and beverages.

https://hungercommission.rti.org

SNAP Summer EBT Pilot and Expansion

Households receiving free or reduced price school meals got either a $60 increase in SNAP or a $30 increase in SNAP per month over summerBoth resulted in reduced food insecurity (more food security)Sites that had a WIC delivery (specified certain foods) resulted in same improvement in food security at regular SNAP delivery (no limits on purchases)

One concern was redemption: lower redemption with WIC

Healthy Food Financing Initiatives

Stocking recommendations could be used in setting standards for financing of new retail food stores in underserved communities

Subscribe to RWJF Weekly Policy Update• Go to:

http://www.rwjf.org/en/manage-your-subscriptions.html

• Select: “Childhood Obesity Weekly Policy Update Newsletter”


Tracy Fox, MPH, RDPresident, Food, Nutrition & Policy Consultants, LLC

Culver, IN

www.foodnutritionpolicy.com

@TracyFoxRD

Thank You

http://www.foodnutritionpolicy.com/

QUESTIONS?


http://healthyeatingresearch.org

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healthful food/beverage stocking levels for small retail food stores

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