{
  "abstract": "Background Poor diet is a leading risk factor for non-communicable diseases and costs the NHS £5.8 billion annually. Product placement strategies used extensively in retail outlets can influence customers’ food preferences. The UK Government introduced legislation in October 2022 restricting chain retailers from using product placement strategies on unhealthy food and drinks in an effort to curb population obesity levels. High-quality scientific evidence is needed to inform whether healthier product placement approaches could be incorporated into these regulations. This study assessed whether positioning an expanded fresh fruit and vegetable section near store entrances in discount supermarkets which do not routinely market produce this way improved store sales, household purchasing and the diets of more than one household member.Methods This prospective matched controlled cluster trial (NIHR 17/44/46) involved 36 stores (18 intervention and 18 control) of a discount supermarket chain in England. The intervention was implemented for six months. Control stores were matched on store sales, customer profiles and neighbourhood deprivation. Women customers aged 18 to 60 years, with loyalty cards, were assigned to the intervention (n=280) or control group (n=300).Results Interrupted time series analyses showed increases in store-level sales of fruit and vegetables were greater in intervention stores than predicted at intervention implementation (0.32SDs (95%CI 0.11, 0.53), p=0.002) and 3-months (0.23SDs (95%CI -0.05, 0.52), p=0.10) and 6-months follow-up (0.18SDs (-0.16, 0.52), p=0.29), equivalent to ~2525 (95% CI 775, 4115), 1940 (95% CI 380, 3950) and 1450 (95% CI -945, 3950) extra portions per store, per week respectively. Effect sizes were somewhat stronger in stores where the produce section moved forward further. Proportion of households purchasing fruit and vegetables were somewhat protected among intervention compared to control participants. Changes in dietary quality were small but generally in the direction for health benefit. Change in frequency of household vegetable waste was negligible at 3-month follow-up but increased at 6-months.Discussion Positioning produce sections near supermarket entrances can improve the nutrition profile of store sales, and may improve household purchasing and dietary quality. Placing fruit and vegetables near store entrances should be considered alongside policies to limit prominent placement of unhealthy foods. The UK Food (Promotions and Placement) regulation could be refined to require a produce section near supermarket entrances to increase its health impact. Future research should continue to build the evidence for which healthy eating interventions are effective in retail outlets.",
  "authors": [
    {
      "affiliations": [
        "Centre for Food Policy, City St George’s, University of London, London, UK",
        "MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK"
      ],
      "name": "Christina Vogel"
    },
    {
      "affiliations": [
        "MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK"
      ],
      "name": "Sarah Crozier"
    },
    {
      "affiliations": [
        "MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK"
      ],
      "name": "Preeti Dhuria"
    },
    {
      "affiliations": [
        "NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK"
      ],
      "name": "Joanne Lord"
    },
    {
      "affiliations": [
        "Geography and Environmental Science, University of Southampton, Southampton, UK"
      ],
      "name": "Graham Moon"
    },
    {
      "affiliations": [
        "MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK"
      ],
      "name": "Wendy Lawrence"
    },
    {
      "affiliations": [
        "8. School of Food Science and Nutrition, University of Leeds, Leeds, UK"
      ],
      "name": "Janet Cade"
    },
    {
      "affiliations": [
        "Institute of Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia"
      ],
      "name": "Kylie Ball"
    },
    {
      "affiliations": [
        "MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK"
      ],
      "name": "Cyrus Cooper"
    },
    {
      "affiliations": [
        "MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK"
      ],
      "name": "Janis Baird"
    }
  ],
  "title": "OP52 Supermarket fruit and vegetable placement trial: outcomes on store sales, customer purchasing, diet and household waste in a prospective matched-controlled cluster study",
  "uid": "92d2bec9-2c3d-5431-b915-3901ffc5da9b"
}