The Scottish diet has become a short-hand for unhealthy living.  All the evidence points to its stubborn lack of change despite information, exhortation and even small measures of legislation.  Whilst retailers and manufacturers have taken some actions on reformulation of products and promotional activities, this has proved insufficient to address the issue. Many Scots remain addicted to a diet high in sugar, salt and saturated fats, to the detriment of individuals, communities and the economy.

Food Standards Scotland (FSS) is tasked by the Scottish Government to address this issue. The organisation agreed five new recommendations in March 2017 to help improve the Scottish diet.  These include calls for greater regulation of the food environment, regulation around the promotion of unhealthy food and drinks and the recognition of the need to support and assist small- to medium-sized food businesses in making these changes

FSS commissioned a report from the Institute for Retail Studies at the University of Stirling to look into “identifying and understanding the factors that can transform the retail environment to enable healthier purchasing by consumers”.  This report is published today.

This is a controversial issue.  The reactions by retailers and manufacturers to restrictions on tobacco and alcohol sales, the concepts of the “Sugar Tax” and Minimum Unit Pricing for alcohol as well limiting junk food advertising to children, point to a fierce protection of the rights of people and businesses to sell and buy whatever they want, whenever, at whatever price.  This is often enshrined as the rights of individual freedom; people should be free to choose, even when the choices are damaging.

For any consumer, walking into a supermarket or a small food store means being confronted by a plethora of choice.  Finding a way through that choice is not easy.  Retailers and manufacturers try to assist in this by their presentation, placement, pricing and promotion of varying product lines and products.  The consumer is bombarded with information of various types, some overt and some more subtle.

The in-store food retail environment is not a neutral one where consumers can exercise full information and true freedom of choice, but a powerful selling environment with conflicting and confusing messages.  Overwhelmingly, the placement and promotion of products, as well as pricing, tends to favour what are regarded as unhealthy as opposed to healthy products.  Consumers are attracted to, and purchase, these products above others, often on promotion, and often in bulk sizes far beyond immediate consumption needs.  The environment is obesogenic in that it encourages over-indulgence and a focus on unhealthy purchasing.

The slide deck shows aspects of the in-store situation, promotions and products that are used.

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So what can or should be done?  The report considers the academic literature to date on the topic, focusing on nudging, behavioural and choice architecture adjustments and regulation.  Most practical experiments have been limited or short-term, often occurring in the USA, and evidence for impact is patchy, though with some positive indicators.

The report thus considers the current practices of food retailing from the ground up, before setting out what might be done under each of these areas (e.g. product, place, price, promotion).  The report considers what might be possible (e.g. balancing promotions, limiting package sizes, product reformulation, information provision) and likely reactions and effects.  This is presented via a large matrix which can be downloaded here, supported by discussion.  This matrix outlines the retail landscape that confronts consumers and which, it is argued needs rebalancing to support the concept of ‘free choice’.

This issue (and that of the Scottish diet) is not just a retail problem though.  Any restrictions or interventions addressed to retailing will also need to consider individual vs societal considerations (i.e. the ‘nanny state’), retailing vs non-retail food consumption sites (e.g. restaurants, food and beverage outlets), sector vs company vs store levels (can interventions be applied to all sizes of store?) and the issue of physical vs online retailing (avoiding privileging internet retailers).  In store purchasing is not the only method of obtaining food, nor is it carried out in a single way, with one aim or in a unified setting.  Resolutions to interventions across such different settings and approaches/activities are not simple.  If the Scottish diet is to be tackled however, then the steps outlined in this report need to be considered widely.

The report’s recommendations are that:

1. Salt, fat and sugar ‘levies’ be introduced along the lines of the ‘sugar tax’ to encourage reformulation and resizing;
2. Product and display information be enhanced, standardised and regulated;
3. Trials at store level should be funded and undertaken to investigate combinations of interventions providing the most impact in the Scottish context;
4. A Food Retail Standard (along the lines of the Scottish Healthcare Retail Standard) be developed to rebalance promotion of healthy and unhealthy products;
5. The retail sector not be considered in isolation and measures be adopted in all food consumption/purchasing settings.

This is not an easy area on which to reach, and contradictory views are prevalent.  However the environment confronting consumers is not a neutral one allowing ‘free choice’.  The Scottish diet has been difficult to alter.  Retailing is part of the problem, but also could be a major part of the solution.  Voluntary initiatives and ‘simple’ healthy promotion have failed; the time to consider a range of actions to alter the architecture of in-store choice may now be upon us.

The full 80 page report is available for download here.

A summary of the report/findings is available for download here.

The press release issued to launch the report is available for download here.