Guiding Stars: the effect of a nutrition navigation program on consumer purchases at the supermarket12345

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Background: To improve diet quality and overall population health, the need to develop nutritional rating systems that are comprehensive in scope and easy for the consumer to understand and use at the point-of-purchase has emerged.

Objective: Our aim was to examine the effect of a comprehensive storewide supermarket point-of-purchase nutrition navigation intervention by using a shelf-label 3-tiered star icon on consumer food and beverage choices and their associated nutritional quality.

Design: By using a natural experiment design, purchasing data from 2006 to 2008 were obtained from a Northeast supermarket chain with 168 stores located in northern New England and New York and examined at preimplementation and at 1- and 2-y follow-up periods.

Results: The nutrition navigation system studied showed significant changes in food purchasing immediately after implementation, and these changes continued to be significant 1 and 2 y later. When the same 8-mo period (January–August) each year was compared, in 2006, 24.50% of items purchased earned a star rating; this proportion increased to 24.98% (P < 0.001) and 25.89% (P < 0.0001) at the 1- and 2-y follow-up periods, respectively. For a 4-wk period, 1 y after program implementation, consumers purchased significantly more ready-to-eat cereals with stars (eg, less added sugars and more dietary fiber) and fewer no-star, high-sugar, low-fiber cereals.

Conclusion: Increasing rates of obesity and declining diet quality for Americans strongly support the need for effective supermarket point-of-purchase programs, such as the Guiding Stars nutrition navigation program, that provide clear, concise, and simplified nutrition information to guide consumer food and beverage choices.

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1

From the Community Health Research Program Hood Center for ChildrenFamiliesthe Department of PediatricsAdolescent Medicine Dartmouth Medical School Lebanon NH 03756 (LAS); the Muskie School of Public Service the University of Southern Maine Augusta ME 04330 (LAK);the Department of Nutrition School of Public Health University of North Carolina Chapel Hill NC 27514 (LF).

2

Presented at the symposium “Where is the Science? Do Current Nutrition Profiling/Food Scoring Systems Promote Consumer Intake of Nutrient Dense Foods,” held at Experimental Biology 2009, New Orleans, LA, 20 April 2009.

3

The funding agency had no role in the study design, analysis, or interpretation of data; in the decision regarding publication; or in the preparation of this article.

4

Supported by Hannaford Brothers who provided financial support for the development, implementation, and data collection and data management. Guiding Stars Licensing Company provided unrestricted funding for the study design, data analyses, and interpretation of results.

5

Address correspondence to LA Sutherland, Department of Pediatrics, HB 7465, Community Health Research Program, Hood Center for Children and Families, Dartmouth Medical School, One Medical Center Drive, Lebanon, NH 03756. E-mail: [email protected].