Healthy checkout ordinance linked to lower soda and candy sales

A new study found that a healthy checkout ordinance implemented in Berkeley, Calif. supermarkets, drug stores, and mass-market retailers in 2021 was linked to notable decreases in soda sales overall and small-package candy in supermarkets, but greater enforcement of such policies is essential for sustained and meaningful public health benefit.

In March 2021, Berkeley, Calif. became the first city in the world to ban the display of sugary beverages and snacks in store checkout lanes, where candy, chocolate, and soda are commonly placed to encourage impulse buying while shoppers are in line.

Published in The Lancet Public Health, the study assessed candy and soda sales in supermarkets, drug stores, and mass-market retailers in Berkeley, as well as three comparison cities in California, after the HCO was implemented in 2021 and then became enforceable in 2022. Changes in sales varied by product and store type: soda sales decreased substantially after the HCO was implemented and enforced, while sales of small-packaged candy decreased significantly in supermarkets after the HCO was enforced. Overall candy sales increased moderately after the policy was implemented (but not after enforcement), but so did sales in healthy, lower-sugar items such as snack-sized nuts and seeds. Supermarkets, which complied the most with the HCO, saw the greatest declines in sales of these sugary items, while drug stores, which complied the least, did not have reduced candy or soda sales.

Overconsumption of candy and sugar-sweetened beverages can lead to a range of health issues, including type 2 diabetes, heart disease, and tooth decay. The 2025-2030 federal Dietary Guidelines for Americans recommend that children under 11 refrain from consuming any added sugar, yet nationwide, 6 in 10 youth drank a sugar-sweetened beverage on a given day, according to the Centers for Disease Control and Prevention.

As other cities in the US and other countries consider and begin to implement similar HCO policies, this new insight can inform checkout standards in other settings.

"The healthy checkout ordinance does not prohibit stores from simply relocating sugary drinks and snacks to other areas of the store, or including them in seasonal displays," says Dr. White, emphasizing that stores should consider implementing more comprehensive restrictions on sugary products to decrease total candy sales and achieve maximum public health benefit.

"No single policy alone can address the problems with our food system," says Dr. Falbe. "However, expanding healthy checkout policies to cover other prime locations and pairing this policy with evidence-based strategies like mandatory front-of-package labeling, sweetened-beverage excise taxes, and subsidies for healthy foods, could improve diet quality."

The US Food and Drug Administration is already considering a mandatory front-of-package labeling rule, but the final label design has yet to be determined. "If the FDA moves forward with a well-designed front-of-package label, they could make it easier to implement healthy-product-placement policies," Dr. Falbe says. "Stores and city inspectors could use 'high in added sugar' or 'high in sodium' labels, to spot products that should not be placed in prime locations like checkout lanes."

Source:

Boston University School of Public Health

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