How healthy and processed are foods and drinks promoted in supermarket sales flyers? A cross-sectional study in the Netherlands

Audrey Hendriksen, Romy Jansen, Sanne Coosje DIjkstra, Marlijn Huitink, Jacob C. Seidell, Maartje P. Poelman*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Abstract Objective: To investigate to what extent promotions in Dutch supermarket sales flyers contribute to a healthy diet and whether there are differences between supermarket types. Design: A cross-sectional study investigating promotions on foods and beverages (n 7825) in supermarket sales flyers from thirteen Dutch supermarket chains (8-week period), including ten traditional, two discount and one organic supermarket chain(s). Promoted products were categorised by food group (e.g. bread), contribution to a healthy diet (yes/no), degree of processing (e.g. ultra-processed), promotion type (temporary reduction in price, volume-based promotions or advertised only) and percentage discount of price promotions. Differences between supermarket chains in the degree of healthiness and processing of products and the types of price promotions were investigated. Results: In total, 70·7 % of all promoted products in supermarket sales flyers did not contribute to a healthy diet and 56·6 % was ultra-processed. The average discount on less healthy products (28·7 %) was similar to that of healthy products (28·9 %). Less healthy products were more frequently promoted via volume-based promotions than healthy products (37·6 % v. 25·4 %, P < 0·001). Discount supermarket chains promoted less healthy (80·3 %) and ultra-processed (65·1 %) products more often than traditional supermarket chains (69·6 % and 56·6 %, respectively). Conclusions: The majority of promoted products via supermarket sales flyers do not contribute to a healthy diet. As promotions are an important determinant of food purchasing decisions, supermarkets do not support healthy choices. Future studies should identify barriers that withhold supermarket chains from promoting more healthy foods in supermarket sales flyers.

Original languageEnglish
Pages (from-to)3000-3008
Number of pages9
JournalPublic Health Nutrition
Issue number10
Publication statusPublished - Jul 2021

Bibliographical note

Funding Information:
Acknowledgements: N/A. Financial support: The contribution of the final author (MPP) was funded by the Innovational Research Incentives Scheme Veni (grant number 451-16-029), financed by the Netherlands Organisation for Scientific Research (NWO). Conflict of interest: None. Authorship: AH and RJ formulated the research questions and collected the data, analysed the data, drafted a first version of the manuscript. MPP and CD designed the study, contributed to the formulation of the research question and analysing the data, and critically reviewed and revised the final version of the manuscript. MH and JS critically reviewed the manuscript. All authors approved the final version of the manuscript for submission. Ethics of human subject participation: Approval of the study by the Medical Ethics Committee was not required.

Publisher Copyright:

Copyright 2021 Elsevier B.V., All rights reserved.


  • Food environment
  • Price promotions
  • Sales flyers
  • Supermarkets
  • Ultra-processed food


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