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International Journal of
Environmental Research
and Public Health
Article
Marketing to Children in Supermarkets: An
Opportunity for Public Policy to Improve
Children’s Diets
Jennifer L. Harris 1, *, Victoria Webb 2, Shane J. Sacco 3and Jennifer L. Pomeranz 4
1Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, CT 06103, USA
2Springfield Psychological, Philadelphia, PA 19102, USA; vwebb@springpsych.com
3Department of Allied Health Sciences, University of Connecticut, Mansfield, Storrs, CT 06269, USA;
shane.sacco@uconn.edu
4College of Global Public Health, New York University, New York, NY 10003, USA; jlp284@nyu.edu
*Correspondence: jennifer.harris@uconn.edu; Tel.: +860-380-1016
Received: 5 January 2020; Accepted: 13 February 2020; Published: 17 February 2020
Abstract:
Public health experts worldwide are calling for a reduction of the marketing of nutrient-poor
food and beverages to children. However, industry self-regulation and most government policies
do not address in-store marketing, including shelf placement and retail promotions. This paper
reports two U.S.-based studies examining the prevalence and potential impact of in-store marketing
for nutrient-poor child-targeted products. Study 1 compares the in-store marketing of children’s
breakfast cereals with the marketing of other (family/adult) cereals, including shelf space allocation
and placement, special displays and promotions, using a national audit of U.S. supermarkets.
Child-targeted cereals received more shelf space, middle- and lower-shelf placements, special displays,
and promotions compared with other cereals. Study 2 compares the proportion of product sales
associated with in-store displays and promotions for child-targeted versus other fruit drinks/juices,
using syndicated sales data. A higher proportion of child-targeted drink sales were associated with
displays and promotions than sales of other drinks. In both categories, the results were due primarily
to major company products. Although in-store marketing of child-targeted products likely appeals to
both children and parents, these practices encourage children’s consumption of nutrient-poor food
and drinks. If companies will not voluntarily address in-store marketing to children, government
policy options are available to limit the marketing of unhealthy foods in the supermarket.
Keywords:
food and beverage marketing; in-store marketing; childhood obesity; pester power;
sugary drinks; children’s foods; food policy
1. Introduction
Food marketing is a significant contributor to poor diet and obesity among children, and experts
are calling for significant reductions in unhealthy food marketing to children to address this worldwide
public health crisis [
1
–
3
]. In the United States, food and beverage companies spent almost $1 billion on
marketing targeted directly at children under 12 in 2009; this was almost entirely on nutrient-poor
products, including fast-food restaurants, high-sugar cereals, sugary drinks, snack foods, candy,
and desserts [
4
]. Worldwide, food marketing to children overwhelmingly promotes nutrient-poor
foods [3,5].
In most countries, governments have relied upon industry self-regulatory programs to implement
improvements in child-targeted food marketing [
6
,
7
], and the food industry has responded with
promises to market healthier dietary choices to children [
8
]. Through voluntary industry self-regulatory
initiatives, such as the Children’s Food and Beverage Advertising Initiative (CFBAI), in the United
Int. J. Environ. Res. Public Health 2020,17, 1284; doi:10.3390/ijerph17041284 www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2020,17, 1284 2 of 20
States, companies pledge to only advertise healthier dietary choices in “child-directed” media [
9
].
However, independent evaluations of industry self-regulation demonstrate limited improvements in
the amount of food marketing to children, and the majority of advertised products remain high in
sugar, fat, sodium, and/or calories [10].
Furthermore, the CFBAI and other industry self-regulatory initiatives have been criticized for
loopholes that enable companies to continue to market unhealthy foods and beverages to children
in ways not covered by CFBAI pledges [
11
,
12
]. One significant loophole of the CFBAI and other
self-regulatory initiatives is that they do not cover any form of marketing that occurs in retail
establishments, including product packaging and in-store marketing. Yet parents identify in-store
marketing, such as licensed characters on packaging and unhealthy products placed at children’s eye
level, as some of the most common and highly effective types of marketing to children [
13
,
14
]. In 2009,
U.S. food companies reported spending $72 million on product packaging and marketing at retailers
specifically aimed at children, primarily makers of snack foods, cereals, beverages, candy, and frozen
desserts [
4
]. As a result, public health experts have called on food and beverage companies to reduce
child-targeted marketing of nutrient-poor products in the supermarket, including through product
packaging and in-store marketing practices [11].
However, the majority of research on food marketing to children has focused on traditional forms
of media advertising, especially TV advertising [
2
,
3
]. In this paper, we begin to address this research gap
by summarizing the existing literature on child-targeted marketing in the supermarket. We then present
results of two studies comparing U.S. in-store marketing for child-targeted versus other products in
the cereal and fruit drinks and juice categories, two types of products commonly marketed to children
under 12 in stores [
4
]. Our primary aims for these studies were to: (1) document the prevalence of
in-store marketing for children’s cereals and fruit drinks; (2) examine differences in in-store marketing
between children’s products and other similar products; and (3) quantify associations between in-store
marketing and product sales. We conclude with a discussion of possible policy interventions to limit
unhealthy food marketing in the retail environment.
1.1. Child-Targeted Marketing in the Supermarket
Food companies utilize a variety of tactics to market to children in supermarkets, including
child-targeted marketing messages on product packages, special displays to attract children’s attention,
and even mini events and contests at retailers [
4
]. Several studies have documented the prevalence of
child-targeted packaging in supermarkets [
15
–
20
]. Common techniques include premiums (e.g., toys,
games, contests), brand spokes-characters, licensed characters, and other cross-promotions. Product
packages also attract children with bright colors, fun fonts, colorful graphics, and unusual shapes,
and through portable, easy-to-use, and durable package designs. These studies also conclude that
products high in fat, sugar, and/or sodium most commonly utilize child-targeted techniques on
product packaging.
In addition to product packaging, child-targeted marketing in supermarkets includes strategic
shelf placement, special displays (e.g., endcap displays at the end of aisles, free-standing displays
or bins in aisles or the front of store), pricing incentives, and samples or tastings [
4
,
21
]. Researchers
have observed that child-targeted foods are commonly placed on shelves at children’s eye level [
15
,
22
].
Dixon and colleagues found that products with promotions or colorful packaging were generally
positioned at the lowest point within reach of a child [
22
]. Supermarkets also dedicate ample shelf
space to products that appeal to children. For example, Winson demonstrated that 55%-80% of shelf
space in the cereal aisle was dedicated to pre-sweetened cereals [23].
Special displays are also primarily used to market low-nutrient foods. Candy, salty snacks,
sugary drinks, and sweetened cereals are often placed in special bins, endcap displays, and checkout
lanes [
22
–
25
]. One Australian study found that more than one-third of endcap displays in stores
featured snack foods, and stores averaged four free-standing bins that contained chocolate items [
25
].
A U.S. study showed that supermarkets had significantly more special displays and price reductions
Int. J. Environ. Res. Public Health 2020,17, 1284 3 of 20
for sugary drinks and foods high in saturated fats, added sugar, and sodium compared with nutritious
foods [
24
]. Although supermarket displays for nutrient-poor foods likely attract children’s attention,
these studies did not specifically examine children’s products or child-targeted techniques on displays.
“Slotting allowances” represent another form of marketing in supermarkets. Companies report
that they often pay a slotting allowance to retailers in order to secure shelf placement for new products or
space in checkout lanes [
26
–
28
]. Concerns about slotting fees focus primarily on their disproportionate
use by large manufacturers, which places smaller manufacturers who cannot afford to pay at a
competitive disadvantage. The U.S. Federal Trade Commission (FTC) did not include this practice in
its analysis of expenditures on marketing to youth [4], but these fees can be substantial [26–28].
1.2. In-Store Marketing Effectiveness
Numerous studies indicate that children influence their parents’ shopping decisions (often referred
to as “pester power”) [
29
–
32
], and mothers report that their children influence food purchases more
than any other product [
33
]. Multiple observational studies and surveys indicate that children’s in-store
persuasion attempts are often successful [31,32,34,35], and that children commonly request sweets or
snacks [31].
Research also has identified in-store marketing tactics that enhance both the likelihood and
effectiveness of a child’s “pester power” and its interaction with television advertising to encourage
children to request products they have seen advertised [
36
,
37
]. For example, families with children
exhibited greater variety seeking for children’s cereals and sodas [
38
], and households with children
purchased child-targeted cereals with TV advertising 13 times more frequently than non-advertised
cereals [
39
]. These studies suggest that advertising may persuade children and parents to purchase
advertised brands.
Although few academic studies have examined the effects of in-store marketing overall [
40
]
and no studies have examined direct effects on children, research has shown that special displays,
shelf placement, and pricing affect adults’ food purchases. Special displays attract consumers’ attention
and are especially effective at increasing unplanned or impulse purchases [
41
,
42
]. Displays are
more effective than increasing amount of shelf space alone [
43
]. Cohen and colleagues also found
that individuals’ exposure to in-store displays for nutrient-poor foods, including sugary drinks and
unhealthy foods, was associated with higher BMI [
24
]. Another study found that endcap displays
increased sales of carbonated drinks by approximately 50% [44].
The amount of shelf space in supermarkets (i.e., “facings” or number of product packages on
the shelf “facing” a shopper) also increases purchases of impulse products, but not staples [
45
].
One eye-tracking study also showed that the number of shelf facings for a brand strongly influenced
consumers’ attention toward and evaluation of the brand [
46
]. However, the number of facings appears
to be less important than the shelf placement, with eye-level shelf placement most effective, including
for breakfast cereals [
47
] and snack foods [
42
]. Therefore, products placed at eye level (i.e., middle shelf
for adults) are likely to capture the attention of consumers and thus have the opportunity to influence
purchase decisions, especially for unplanned or impulse purchases. On the other hand, studies show
that many child-targeted foods are placed on the bottom shelf, at children’s eye level and within their
reach [
15
,
22
], and children are more likely to request products at their eye level [
35
]. Although studies
with children have not measured the direct effects of shelf placement on product sales, it is likely that
additional child requests result in increased sales.
Surveys of parents often cite product price as another influential component of their purchasing
decision [
35
,
48
,
49
]. Intervention studies have lowered the prices of healthier foods in supermarkets,
vending machines, and cafeterias to show that discounts increase product sales [
50
–
52
]. Cohen
and colleagues also demonstrated that exposure to in-store price reductions for sugary drinks was
associated with higher BMI [24].
Overall, research indicates that in-store marketing, including marketing targeted directly to
children, is common and likely impacts family purchases and children’s diets. Numerous studies
Int. J. Environ. Res. Public Health 2020,17, 1284 4 of 20
have documented the extent and content of food packaging that attracts children’s attention in the
supermarket. In addition, research with adults demonstrates that eye-level shelf placement, special
displays, and pricing incentives motivate purchase, especially for unplanned or impulse purchases.
However, few studies have examined these forms of in-store marketing for child-targeted products.
Given that in-store marketing commonly promotes nutrient-poor foods, likely affects children and
their parents, and negatively impacts children’s diets and long-term health, it is important to better
understand the extent and impact of marketing for child-targeted products in the supermarket.
1.3. The Present Research
We report results of two research studies that examined in-store marketing for two categories
that are commonly marketed to children: breakfast cereals and fruit drinks [
4
]. Using data from
two previous studies, we examined number of facings, shelf placement, special displays, and price
promotions for cereals in a national sample of supermarkets, and national sales data for fruit drinks
and juices. These studies test the following hypotheses: (1) child-targeted products are more likely
to be placed at children’s eye level (i.e., on the bottom shelf or shelves) compared with products
marketed to adults only (Study 1); (2) supermarkets disproportionately feature child-targeted products
in special displays and price promotions (Studies 1 and 2); and (3) displays and price promotions are
associated with higher sales of child-targeted products (Study 2). We also examine whether differences
in marketing of child-targeted versus adult products in stores are greater for major food manufacturers
compared with smaller manufacturers (Studies 1 and 2).
2. Study 1: Breakfast Cereals
U.S. cereal companies spent $173 million in marketing to children under 12, more than any other
type of packaged food [
4
]. Expenditures included $5.2 million on marketing in stores; only snack food
companies spent more to target children in stores ($6.3 million). In addition, previous studies have
documented a clear distinction between children’s cereals (i.e., those marketed directly to children),
“family” cereals marketed to parents to serve their children, and adult cereals marketed to adults
for their own consumption [
53
,
54
]. Furthermore, child-targeted cereals are less nutritious than adult
cereals, with 57% more sugar, 50% more sodium, and 52% less fiber [
53
]. In 2017, the majority of
children’s cereals had 9–10 g of sugar per 27–30 g serving [10].
In this study, we compare in-store marketing of children’s breakfast cereals with marketing of family
and adult cereals, including shelf space allocation and placement, special displays, and promotions.
We also compare results for the two largest cereal manufacturers versus other manufacturers.
2.1. Materials and Methods
Researchers commissioned an audit of cereal marketing in supermarkets using a market research
firm specializing in retail research with a nationwide network of experienced field personnel [
55
].
Descriptive results by cereal and detailed methods have been reported previously [
56
]. Field
representatives visited 400 large supermarkets and Walmart branches in 16 major U.S. cities during
May-June 2009. In week 1, they recorded the number of facings (i.e., number of package fronts on
the shelf facing the customer) for each breakfast cereal product (N =208) and the shelf or shelves on
which each cereal was located (top, middle, bottom). If the store had five or six shelves, representatives
categorized the top two and bottom two shelves as top and bottom, respectively.
Representatives then conducted follow-up audits in 87 stores each week for four subsequent
weeks. These 87 stores were randomly selected from the original 400 stores to include one store from
each supermarket chain in each of the 16 cities. The follow-up audits examined special displays
and promotions for cereals. They documented all special displays for cereals and other promotional
materials present anywhere within the store. Special displays were classified as: (1) endcaps, displays
located at the end of an aisle; (2) in-aisle displays, free-standing manufacturer or case displays located
within an aisle; and (3) all other displays located elsewhere in the store, such as the entrance or exit.
Int. J. Environ. Res. Public Health 2020,17, 1284 5 of 20
Promotions were categorized according to the three types used most often by cereal manufacturers
in supermarkets [
57
]: (1) price promotions, special price signage in the aisle that communicated sale
prices or special bargains, these could be either store or manufacturer generated; (2) shelf coupon
machines, dispensers of manufacturer coupons placed within the aisle; and (3) shelf danglers, signs
that hang from a shelf calling attention to a particular item. In addition, all other in-store promotions
not fitting into these categories, such as floor graphics or shopping-cart advertisements, were recorded.
Using the week 1 data, researchers calculated the following dependent variables for analysis:
percent of stores stocking each cereal; the average number of facings per store stocking it; and
the percent of stores stocking the cereal on the bottom, middle, and top shelves. Using the
four-week data, researchers calculated additional dependent variables for the average number of stores
featuring each type of display and promotion per cereal over the four-week period (total number of
displays/promotions during the four weeks for each cereal divided by the number of stores stocking
the cereal).
All cereal products were categorized according to target audience (child, family or adult) and
company type (major or other). Target audience was identified using data collected for a comprehensive
study of cereal marketing to children [
56
]. Cereals designated as child-targeted had some type of
marketing aimed directly at children, such as child-targeted TV advertising or websites, or featured a
children’s licensed character. Family products included all other brands with any marketing suggesting
that it was appropriate to serve to children, but that did not utilize other forms of marketing appealing
directly to children. All other products were designated as adult products. None of the marketing
materials for adult cereals indicated that children should or would want to consume the product.
Products from the two largest cereal manufacturers (General Mills and Kellogg) were classified
as major company products. These manufacturers stocked their products in 100% of supermarkets
and represented more than one-half of total cereal shelf facings [
56
]. In addition, the two companies
spent over $300 million to advertise their products in 2008, which represented 93% of all advertising
spending for the cereal category. All other companies were classified as other company. Although
Kellogg and General Mills own Kashi and Cascadian Farms, they were classified as separate companies
as their association with the parent company did not appear in any of their marketing and was not
readily apparent to the consumer.
We conducted a series of two (company type) by three (target audience) multivariate analyses of
variance (MANOVAs) to evaluate differences in: (1) number of facings per cereal; percent of stores
stocking the cereal; and percent stocking it on bottom, middle and top shelves; (2) total number of
special displays including endcap, in-aisle, and all other; and (3) total number of promotions, including
price promotions, coupons, danglers, and all other. To examine significant interactions, we conducted
one-way MANOVAs for target audience, looking at major and other companies separately. Significant
differences between individual target audiences were assessed using the Bonferroni procedure. Means
and 95% confidence intervals (CIs) are reported.
2.2. Results
Of the 208 cereals examined, 23% qualified as child-targeted, 35% targeted families, and 42%
targeted adults only. Overall, the two major companies produced 54% of cereals in the analysis, but this
proportion varied by target audience,
χ2
(2, N=208) =12.2, p=0.002. Major companies offered 65% of
child-targeted cereals and 64% of family cereals, but just 40% of adult-targeted cereals.
2.2.1. Percent Stocking and Shelf Facings
Stores were significantly more likely to stock cereals from major companies (M
m
=54% (48, 61) of
stores stocking) than cereals from other companies (M
o
=40% (32, 48)), F(1202) =7.9, p=0.006. A higher
percentage of stores stocked adult cereals (M
a
=54% (47, 62)) than family cereals
Mf=43% (35, 51))
and child-targeted cereals (M
c
=44%, (34, 54)), but the difference was not significant,
F(2202) =2.6,
Int. J. Environ. Res. Public Health 2020,17, 1284 6 of 20
p=0.08.
In addition, the interaction between company type and target audience for percent stocking
was not significant (p=0.30).
Stores also devoted more facings to major-company cereals (M
m
=2.6 (2.4, 2.9) facings per cereal)
than to other-company cereals (M
o
=2.1 (1.8, 2.4)), F(1, 202) =7.1, p=0.008. The number of facings
per cereal also differed by target audience, F(2, 202) =3.8, p=0.03. Stores averaged more facings for
child-targeted cereals (M
c
=2.7, (2.3, 3.1)) than family cereals (M
f
=2.0 (1.7, 2.3), p=0.02), but not
adult cereals (Ma=2.4 (2.1, 2.6), p=0.47).
The interaction between company type and target audience was marginally significant for number
of facings, F(2, 202) =2.9, p=0.06. For cereals from major companies, number of facings differed by
target audience, F(2, 109) =4.5, p=0.01, with stores devoting more facings to child-targeted cereals
(M
c
=3.2 [2.7, 3.8]) compared with family (M
f
=2.3 (1.9, 2.7), p=0.02) and adult cereals (M
a
=2.3
(1.9, 2.8), p=0.04) from major companies. The number of facings also differed by target audience
for cereals from other companies, F(2, 93) =3.3, p=0.04, but stores devoted more facings to adult
cereals (M
a
=2.4 (2.1, 2.7)) than to family cereals (M
f
=1.8 (1.4, 2.2), p=0.04). However, facings for
other-company child-targeted cereals (M
c
=2.2 (1.7, 2.7)) did not differ from their adult or family
cereals (all p>0.61).
2.2.2. Shelf Placement
Stores were significantly more likely to place cereals from major companies (M
m
=53% (49, 57))
on the prime middle shelf, compared with other companies’ cereals (M
o
=43% (39, 48)),
F(1202) =10.7,
p=0.001. They also placed fewer major-company cereals on the bottom shelf (M
m
=22% (18, 25))
versus other-company cereals (M
o
=32% (27, 36)), F(1, 202) =12.0, p=0.001. Top-shelf stocking did
not differ by company type (p=0.78).
The percent of stores stocking cereals on the bottom, middle, and top shelves also differed by
target audience, F(2, 202) =21.7, 22.5, and 75.9, respectively, all p<0.001. Stores were significantly
more likely to place child-targeted and family cereals on the prime middle shelves (M
c
=52% (46, 57);
Mf=57% (52, 61))
compared with adult cereals (M
a
=36% (32, 40), p<0.001); but middle-shelf stocking
did not differ between child and family cereals (p=0.52). Stores were also significantly more likely
to stock child-targeted cereals on bottom shelves (M
c
=38%, (32, 44)) compared to family and adult
cereals (M
f
=27% (22, 31), p=0.008; M
a
=15% (11, 19), p<0.001); family cereals were also more
likely to be stocked on bottom shelves than adult cereals (p=0.001). In contrast, significantly more
stores stocked adult cereals (53% (48, 52)) on top shelves, compared with child and family cereals
(
Mc=14%
[
8
,
20
]; M
f
=19% (14, 23); p<0.001); but the percent stocking child and family cereals on top
shelves did not differ (p=0.68).
Figure 1illustrates the interaction between type of company and target audience for percent of
supermarkets stocking cereals on top, middle and bottom shelves. Means and 95% CIs are reported.
Major companies include General Mills and Kellogg. Percent of supermarkets that stocked a cereal can
exceed 100% because some stores stocked cereals on more than one shelf in a store.
Interactions between company type and target audience were also significant for the middle
and top shelves (F(2, 202) =29.5 and 19.5, respectively; p<0.001), but not for the bottom shelf
(p=0.86).
For major-company cereals only, supermarkets stocked the majority of child and family
cereals on the middle shelves, whereas middle-shelf stocking did not differ by target audience for
cereals from other companies (see Figure 1). For both types of companies, stores were more likely to
stock child-targeted cereals on bottom shelves and adult cereals on top shelves, compared to cereals
targeting other audiences.
Int. J. Environ. Res. Public Health 2020,17, 1284 7 of 20
Int. J. Environ. Res. Public Health 2020, 17, x 7 of 21
Figure 1. Percent of supermarkets stocking cereals by shelf location.
2.2.3. Special Displays and Promotions
On average, 75% of major-company cereals and 59% of other-company cereals were featured in
any type of special display during the four weeks analyzed. Endcaps represented approximately
three-quarters of displays for cereals from both types of companies. Major company cereals had more
total displays (Mm = 0.27, (0.20, 0.34) vs. Mo = 0.13, (0.05, 0.22)), F(1, 202) = 5.7, p = 0.02; endcaps (Mm =
0.22, (0.15, 0.29) vs. Mo = 10, (0.02, 0.18)), F(1, 202) = 5.1, p = 0.03; and other displays (Mm = 0.03, (0.03,
0.04) vs. Mo = 0.02, (0.01, 0.03)), F(1, 202) = 7.7, p = 0.006, compared to other companies, but in-aisle
displays did not differ by company type (p = 0.41).
Figure 2 presents the average number of displays per cereal over four weeks, including endcaps,
in-aisle and other displays, by company type and cereal target audience. Means and 95% CIs are
reported for number of total displays and endcaps. Major companies include General Mills and
Kellogg.
32% (25-40 )
22% (16-28)
11% (4-18)
44% (36-52)
31% (25-38)
19% (15-24)
67% (61-74)
65% (60-70)
26% (20-35)
36% (26-46)
49% (41- 57)
46% (40-52)
6% (0-12)
15% (10-20)
66% (59-72)
22% (11-33) 22% (13-31)
40% (34-46)
Child (n=31) Family (n=46) Adult (n=35) Child (n=17) Family (n=26) Adult (n=53)
Stores stocking by shelf location (%)
Major companies Other companies
Top
Midd le
Bottom
Figure 1. Percent of supermarkets stocking cereals by shelf location.
2.2.3. Special Displays and Promotions
On average, 75% of major-company cereals and 59% of other-company cereals were featured
in any type of special display during the four weeks analyzed. Endcaps represented approximately
three-quarters of displays for cereals from both types of companies. Major company cereals had
more total displays (M
m
=0.27, (0.20, 0.34) vs. M
o
=0.13, (0.05, 0.22)), F(1, 202) =5.7, p=0.02;
endcaps (Mm=0.22,
(0.15, 0.29) vs. M
o
=10, (0.02, 0.18)), F(1, 202) =5.1, p=0.03; and other displays
(M
m
=0.03, (0.03, 0.04) vs. M
o
=0.02, (0.01, 0.03)), F(1, 202) =7.7, p=0.006, compared to other
companies, but in-aisle displays did not differ by company type (p=0.41).
Figure 2presents the average number of displays per cereal over four weeks, including endcaps,
in-aisle and other displays, by company type and cereal target audience. Means and 95% CIs are
reported for number of total displays and endcaps. Major companies include General Mills and Kellogg.
The number of total displays, endcaps and in-aisle displays differed by target audience,
F(2, 202) =5.3,
4.2 and 6.9, p=0.006, 0.02 and 0.001, respectively, with child cereals featured in
the most displays of all types. The number of endcaps for child cereals (M
c
=0.28 (0.17, 0.38)) was
almost three times higher than for family (M
f
=0.10 (0.01, 0.19), p=0.03) and adult cereals (M
a
=0.10
(0.03, 0.18), p=0.03); and in-aisle displays for child cereals (
Mc=0.03,
(0.02, 0.04)) were significantly
higher than for family (M
f
=0.01, (0.00, 0.02), p=0.006) and adult cereals (M
a
=0.01, (0.00, 0.01),
p<0.001
). However, the number of endcaps, in-aisle displays, and other displays did not differ
for family and adult cereals (all p=0.99). The number of other displays did not differ by target
audience (p=0.23). Interactions between target audience and company type for all display types were
non-significant (all p>0.16) (see Figure 2).
Cereals from major companies averaged marginally more total promotions per cereal over the four
weeks (M
m
=1.5 [(1.3, 1.7)) than other-company cereals (M
o
=1.2 (0.9, 1.4)), F(1, 202) =3.7,
p=0.06.
For all companies, price promotions made up approximately 90% of total promotions. Due to low
incidence of coupon machines, shelf danglers and other promotions, we combined these types as other
promotions in the analysis.
Int. J. Environ. Res. Public Health 2020,17, 1284 8 of 20
Int. J. Environ. Res. Public Health 2020, 17, x 8 of 21
Figure 2. In-store displays per cereal over four weeks.
The number of total displays, endcaps and in-aisle displays differed by target audience, F(2, 202)
= 5.3, 4.2 and 6.9, p = 0.006, 0.02 and 0.001, respectively, with child cereals featured in the most displays
of all types. The number of endcaps for child cereals (Mc = 0.28 (0.17, 0.38)) was almost three times
higher than for family (Mf = 0.10 (0.01, 0.19), p = 0.03) and adult cereals (Ma = 0.10 (0.03, 0.18), p = 0.03);
and in-aisle displays for child cereals (Mc = 0.03, (0.02, 0.04)) were significantly higher than for family
(Mf = 0.01, (0.00, 0.02), p = 0.006) and adult cereals (Ma = 0.01, (0.00, 0.01), p < 0.001). However, the
number of endcaps, in-aisle displays, and other displays did not differ for family and adult cereals
(all p = 0.99). The number of other displays did not differ by target audience (p = 0.23). Interactions
between target audience and company type for all display types were non-significant (all p > 0.16)
(see Figure 2).
Cereals from major companies averaged marginally more total promotions per cereal over the
four weeks (Mm = 1.5 [(1.3, 1.7)) than other-company cereals (Mo = 1.2 (0.9, 1.4)), F(1, 202) = 3.7, p =
0.06. For all companies, price promotions made up approximately 90% of total promotions. Due to
low incidence of coupon machines, shelf danglers and other promotions, we combined these types
as other promotions in the analysis.
Figure 3 presents the average number of price promotions and all other promotions per cereal
over four weeks by company type and cereal target audience. Means and 95% CIs are reported. Major
companies include General Mills and Kellogg.
0.39
(0.23-0.56)
0.12
(0.00-0.26)
0.14
(0.00-0.30)
0.16
(0.11-0.22)
0.08
(0.03-0.12) 0.06
(0.03-0.10)
Total : 0.4 6
95% CI (0.29-0.64)
Tota l: 0 .17
95% CI (0.03-0.32) Tota l: 0.1 7
95% CI (0.00-0.33)
Tota l: 0 .22
95% CI (0.15-0.29)
Tota l: 0 .10
95% CI (0.04-0.15) Tota l: 0.0 9
95% CI (0.05-0.13)
0.00
0.05
0.10
0.15
0.20
0.25
0.30
0.35
0.40
0.45
0.50
Child (n=31) Family (n=46) Adult (n=35) Child (n=17) Family (n=26) Adult (n=53)
Major companies Other companies
Number of displays per cereal (4 weeks)
Other displays
In-ais le displays
Endcaps
Figure 2. In-store displays per cereal over four weeks.
Figure 3presents the average number of price promotions and all other promotions per cereal
over four weeks by company type and cereal target audience. Means and 95% CIs are reported. Major
companies include General Mills and Kellogg.
Int. J. Environ. Res. Public Health 2020, 17, x 9 of 21
Figure 3. In-store promotions per cereal over four weeks.
Children’s cereals averaged 1.6 (1.3, 2.0) total promotions over the four weeks, while family
cereals averaged 1.2 (0.9, 1.5), and adult cereals also averaged 1.2 (1.0, 1.5). However, the number of
promotions per cereal, including total promotions, price promotions and all other promotions, did
not differ significantly by target audience (all p > 0.10). Similarly, interactions between target audience
and company type for all promotion types were not significant (p > 0.19) (see Figure 3).
2.3. Discussion.
Stores were more likely to stock cereals from major companies than from other companies, and
they allocated more facings to major-company cereals and stocked a higher proportion on prime
middle shelves. Child-targeted cereals also received prime shelf placement. Although stores were not
more likely to stock child-targeted cereals, they devoted significantly more shelf space (i.e., number
of facings) to child cereals than to family and adult cereals. As hypothesized, stores were more likely
to stock child cereals on the middle shelf, compared to adult cereals (but not family cereals). Stores
were also more likely to stock children’s cereals on the bottom shelves, at children’s eye level,
whereas adult cereals were more likely to be placed on top shelves, the position that receives the least
attention. However, some of these results differed by company type. Although child-targeted cereals
from major companies received better shelf placement than major-company adult cereals, adult
cereals from other companies received more facings and were more likely to be placed on the prime
middle shelf compared to child cereals from other companies.
Endcaps and price promotions represented the majority of special displays and promotions
featuring cereals in supermarkets. As hypothesized, child-targeted cereals also received significantly
more marketing support in stores through special displays, compared with adult and family cereals.
On average, child-targeted cereals were featured in some type of display in almost one-half of stores
during the four weeks examined, more than double the total displays for family and adult cereals,
and almost three times the number of endcaps. Child-targeted cereals also averaged 1.6 price
promotions over the four weeks, but this number was not significantly higher than price promotions
for family and adult cereals.
As expected, major companies’ cereals also received significantly more in-store marketing
support, including displays and price promotions, than other companies’ cereals. For both types of
1.66
(1.30-2.00)
1.30
(1.01-1.60) 1.04
(0.70-1.38)
1.22
(0.82-1.62 0.92
(0.60-1.25)
1.13
(0.91-1.36)
0.27
(0.11-0.44)
0.09 (0.00-0.23)
0.15 (0.00-0.30)
0.07 (0.02-0.13)
0.04 (0.00-0.09)
0.12 (0.09-0.15)
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40
1.60
1.80
2.00
Child (n=31) Family (n=46) Adult (n=35) Child (n=17) Family (n=26) Adult (n=53)
Major companies Other companies
Number of promotions per cereal (4 weeks)
Other promotions
Price promotions
Figure 3. In-store promotions per cereal over four weeks.
Children’s cereals averaged 1.6 (1.3, 2.0) total promotions over the four weeks, while family
cereals averaged 1.2 (0.9, 1.5), and adult cereals also averaged 1.2 (1.0, 1.5). However, the number of
Int. J. Environ. Res. Public Health 2020,17, 1284 9 of 20
promotions per cereal, including total promotions, price promotions and all other promotions, did not
differ significantly by target audience (all p>0.10). Similarly, interactions between target audience and
company type for all promotion types were not significant (p>0.19) (see Figure 3).
2.3. Discussion
Stores were more likely to stock cereals from major companies than from other companies, and
they allocated more facings to major-company cereals and stocked a higher proportion on prime
middle shelves. Child-targeted cereals also received prime shelf placement. Although stores were not
more likely to stock child-targeted cereals, they devoted significantly more shelf space (i.e., number of
facings) to child cereals than to family and adult cereals. As hypothesized, stores were more likely
to stock child cereals on the middle shelf, compared to adult cereals (but not family cereals). Stores
were also more likely to stock children’s cereals on the bottom shelves, at children’s eye level, whereas
adult cereals were more likely to be placed on top shelves, the position that receives the least attention.
However, some of these results differed by company type. Although child-targeted cereals from
major companies received better shelf placement than major-company adult cereals, adult cereals from
other companies received more facings and were more likely to be placed on the prime middle shelf
compared to child cereals from other companies.
Endcaps and price promotions represented the majority of special displays and promotions
featuring cereals in supermarkets. As hypothesized, child-targeted cereals also received significantly
more marketing support in stores through special displays, compared with adult and family cereals.
On average, child-targeted cereals were featured in some type of display in almost one-half of
stores during the four weeks examined, more than double the total displays for family and adult
cereals, and almost three times the number of endcaps. Child-targeted cereals also averaged 1.6 price
promotions over the four weeks, but this number was not significantly higher than price promotions
for family and adult cereals.
As expected, major companies’ cereals also received significantly more in-store marketing support,
including displays and price promotions, than other companies’ cereals. For both types of companies,
child-targeted cereals were featured in more displays, but not more price promotions, compared to the
same companies’ adult and family cereals.
3. Study 2: Fruit Drinks and Juices
Study 2 examines incremental product sales attributed to in-store marketing for fruit drinks
(fruit-flavored or juice drinks that contain added sugar) and juices (100% juice and juice/water blends
without added sweeteners), including child-targeted and other products. In 2009, beverage companies
reported spending over $43 million on marketing of juices and other noncarbonated beverages to
children under 12, including approximately $3 million (5% of expenditures) on in-store marketing [
4
].
As with cereals, sugar-sweetened fruit drinks are commonly advertised to both children and adults,
while children’s 100% fruit juices and juice/water blends (without added sweeteners) are more often
advertised to adults only [
58
]. Although the American Academy of Pediatrics (AAP) and other
key nutrition and health organizations recommend that children never consume drinks with added
sugar [
59
], sugary drinks contribute almost half of all added sugar consumed by children [
60
].
Furthermore, fruit drinks are the most common type, consumed by approximately one-quarter of two-
to 11-year-olds on a given day [
60
]. In 2018, sugar-sweetened fruit drinks represented 62% of children’s
drinks sold in the United States [
58
]. The AAP also recommends limiting children’s consumption of
juice, but concludes that one serving per day can be provided as part of a healthy diet [11].
In this study, we use syndicated sales data to compare the proportion of product sales associated
with in-store displays and promotions for child-targeted versus other (i.e., products not marketed
directly to children) fruit drinks and juices. We also predict a greater difference in sales due to in-store
marketing for child-targeted versus other products from major companies relative to smaller ones.
Int. J. Environ. Res. Public Health 2020,17, 1284 10 of 20
Lastly, we predict that these differences will be greater for products with added sugar (i.e., fruit/juice
drinks) compared to those without added sweeteners (i.e., 100% juices, juice/water blends).
3.1. Materials and Methods
To track beverage sales, we acquired data from IRi Worldwide, a company that provides marketing
and shopper data primarily to retailers and product manufacturers [
61
]. Specifically, we utilized the
company’s scanner-based tracking service, which provides weekly sales data for a sample of food
stores (including grocery stores with over $2 million in total sales) for all products scanned in those
stores in a given week. IRi also identifies sales that occurred under promotional conditions, including:
(1) displays (endcap, lobby, and shipper free-standing [i.e., in-aisle] displays); and (2) temporary price
reductions. To identify sales due to displays, IRi representatives conduct weekly store audits to identify
products featured in different types of in-store displays that week. In its dataset, IRi reports sales of
products that occurred in stores with each type of display in a given week. To identify sales due to
price promotions, IRi examines weekly pricing data for each product and store and identifies products
with a temporary price reduction, defined as a reduction of 5% or more from the item’s base price for
that store. It also reports sales of products that occurred in stores with a temporary price reduction in
that week. We used these variables to identify incremental sales that can be attributed to displays and
price reductions. These measures were developed and primarily used by manufacturers and retailers
to monitor their competitors’ in-store marketing activities.
We licensed sales data for bottled juices (including fruit drinks) and aseptic juices and drinks
(i.e., products in box or pouch containers) for supermarkets in eight U.S. cities of various sizes and
geographic regions. We received data for all universal product codes (UPCs) with more than $500,000
in sales nationwide for the calendar year 2010. For each UPC, we received total sales in dollars and
units (i.e., packages), as well as sales due to displays and price reductions. To determine the percentage
of sales due to displays, we divided sales that occurred in stores with displays and incremental sales
due to price promotions by the product’s total sales.
Children’s fruit drinks and juices typically come in 4- to 8-ounce single-serving containers such
as aseptic juice boxes and pouches, whereas other products (not specifically for children) often
come in larger sized multi-serving bottles, as well as single-serve containers [
58
]. Therefore, we
examined sales for single-serving products only. Products sold in a 20-ounce container or smaller and
packages of multiple single-serving containers were categorized as single-serving items. We excluded
private-label brands.
Products also were categorized according to target audience. Items were coded as child-targeted
if they belonged to a brand marketed exclusively to children (i.e., Capri Sun, Kool Aid, Hawaiian
Punch, Hi C, and Sunny D) as identified in a prior study of child-targeted beverages [
62
]. All other
products (including products aimed at parents, but not marketed directly to children) were coded as
other. Additionally, products were categorized according to the type of manufacturer. Companies that
advertised any of their brands on national television in 2010 [
62
] were categorized as major companies,
whereas those that did not engage in national television advertising were labeled as other companies.
Finally, we categorized items according to whether they contained added sugar or no added sweeteners
(including added sugars and non-nutritive sweeteners).
We conducted two (target audience: child vs. other) by two (company type: major vs. other)
by two (added sugar: added sugar vs. no added sweeteners) three-way MANOVAs to evaluate
differences in incremental sales for displays and price promotions. Non-parametric bootstrapping
was performed [63]. We used unit sales as the outcome variables to capture the relationship between
promotions and the number of packages sold, as price promotions could mask associations with dollar
sales. We report means with 95% CIs.
Int. J. Environ. Res. Public Health 2020,17, 1284 11 of 20
3.2. Results
Of the 2321 single-serving fruit drink and juice UPCs in the dataset, one-third (32%) qualified as
child-targeted, and major companies manufactured two-thirds (64%) of products examined (see Table 1).
More than half of the products (54%) contained added sugar and 38% contained no added sweeteners
(including 100% juice, juice blends, and juice diluted with water). Another 8% were diet drinks that
contained non-nutritive sweeteners with no added sugar. As none of these products
(n=185)
were
targeted to children, they were removed from the analyses. Significantly more child-targeted products
contained added sugar (69%) compared to other products (52%), χ2=57.57 (1, N=2136), p<0.001.
Table 1. Child-targeted and other fruit drinks and juices.
Type of Company and Sweetener Target Audience
Child-Targeted N=733 (31.6%) Other N=1588 (68.4%)
Company type
Major 428 (58.4%) 1048 (66.0%)
Other 305 (41.6%) 540 (34.0%)
Sweetener type
Added sugar 509 (69.4%) 735 (46.3%)
No added sweeteners 224 (30.6%) 668 (42.1%)
Non-nutritive sweeteners only 0 (0.0%) 185 (11.6%)
Products with non-nutritive sweeteners were removed from the analyses (final N=2136).
We found the predicted main effect of target audience, such that a higher percentage of unit sales
for child-targeted products was due to displays (6.5% (5.7, 7.2)) than for other products (5.6% (5.1, 6.2)),
F(1, 2128) =3.2, p=0.006. Proportion of sales due to price reductions also was higher for child-targeted
products (13.9%, (12.8, 15.1)) than for other products (12.1% (11.3, 12.9)), F(1, 2128) =6.5, p=0.007.
In addition, there was a significant main effect of company type on sales due to displays, with a
higher percentage of other-company sales due to displays (7.3% [6.6, 8.0]) than for major companies
(4.8% (4.3, 5.4)),
F(1, 2128) =26.9, p=0.007. However, proportion of sales from price reductions did not
differ by company type, p=0.78. Additionally, we observed a significant main effect of added sugar
on sales due to displays and price reductions. Products with added sugar had a higher percentage of
sales due to displays (9.6% (9.1, 10.2)) compared to products without added sweeteners (2.5% (1.8,
3.3)), F(1, 2128) =227.0, p<0.001, as well as price reductions (17.1% (16.3, 17.9) vs. 8.9% (7.8, 10.0)),
F(1, 2128) =133.2, p<0.001.
In addition to these main effects, we observed significant two-way interactions between target
audience and company type for percentage of sales due to displays, F(1, 2128) =20.5, p=0.01, and
price reductions, F(1, 2128) =19.9, p=0.006; between target audience and added sugar for displays,
F(1, 2128) =7.3, p=0.01, but not price reductions (p=0.51); and between company type and added
sugar for displays, F(1, 2128) =4.2, p=0.03, but not price reductions (p=0.18). Furthermore, these
effects were qualified by a significant three-way interaction between target audience, company type
and added sugar for both displays, F(1, 2128) =36.9, p=0.003, and price reductions, F(1, 2128) =39.1,
p=0.003. In order to understand these interactions, we conducted two-way MANOVAs for target
audience and added sugar, with separate models for major and other companies (see Figure 4).
Figure 4illustrates the three-way interaction between fruit drink and 100% juice products by
company type (major vs. other), target audience (child-targeted vs. other) and sweeteners (added
sugar vs. no add sweeteners). Major companies include companies that advertised their brands on
national television.
For major companies, child-targeted products had a significantly higher percentage of sales due to
displays (6.3% (5.5, 7.2)) versus other products (3.4% (2.9, 3.9)), F(1, 1360) =36.7, p<0.001, and a higher
percentage due to price reductions (15.5% (14.1, 17.0) vs. 10.6% (9.7, 11.4)), F(1, 1360) =34.1,
p<0.001.
Similarly, products with added sugar had a significantly higher percentage of sales due to displays
Int. J. Environ. Res. Public Health 2020,17, 1284 12 of 20
(7.9% (7.3, 8.5)) than products without added sweeteners (1.8% (1.0, 2.6)), F(1, 1360) =156.2,
p<0.001,
and a higher percentage due to price reductions (17.1% (16.1, 18.0) vs. 9.0% (7.7, 10.4),
F(1, 1360) =88.4,
p<0.001.
Int. J. Environ. Res. Public Health 2020, 17, x 12 of 21
sweeteners (2.5% (1.8, 3.3)), F(1, 2128) = 227.0, p < 0.001, as well as price reductions (17.1% (16.3, 17.9)
vs. 8.9% (7.8, 10.0)), F(1, 2128) = 133.2, p < 0.001.
In addition to these main effects, we observed significant two-way interactions between target
audience and company type for percentage of sales due to displays, F(1, 2128) = 20.5, p = 0.01, and
price reductions, F(1, 2128) = 19.9, p = 0.006; between target audience and added sugar for displays,
F(1, 2128) = 7.3, p = 0.01, but not price reductions (p = 0.51); and between company type and added
sugar for displays, F(1, 2128) = 4.2, p = 0.03, but not price reductions (p = 0.18). Furthermore, these
effects were qualified by a significant three-way interaction between target audience, company type
and added sugar for both displays, F(1, 2128) = 36.9, p = 0.003, and price reductions, F(1, 2128) = 39.1,
p = 0.003. In order to understand these interactions, we conducted two-way MANOVAs for target
audience and added sugar, with separate models for major and other companies (see Figure 4).
Figure 4 illustrates the three-way interaction between fruit drink and 100% juice products by
company type (major vs. other), target audience (child-targeted vs. other) and sweeteners (added
sugar vs. no add sweeteners). Major companies include companies that advertised their brands on
national television.
For major companies, child-targeted products had a significantly higher percentage of sales due
to displays (6.3% (5.5, 7.2)) versus other products (3.4% (2.9, 3.9)), F(1, 1360) = 36.7, p < 0.001, and a
higher percentage due to price reductions (15.5% (14.1, 17.0) vs. 10.6% (9.7, 11.4)), F(1, 1360) = 34.1, p
< 0.001. Similarly, products with added sugar had a significantly higher percentage of sales due to
displays (7.9% (7.3, 8.5)) than products without added sweeteners (1.8% (1.0, 2.6)), F(1, 1360) = 156.2,
p < 0.001, and a higher percentage due to price reductions (17.1% (16.1, 18.0) vs. 9.0% (7.7, 10.4), F(1,
1360) = 88.4, p < 0.001.
Figure 4. Percentage of sales due to displays and price promotions.
Additionally, we observed a significant interaction between target audience and added sugar
for percentage of sales due to displays, F(1, 1360) = 70.9, p = 0.001, and price reductions, F(1, 1360) =
25.1, p = 0.01. The higher proportion of sales of added sugar products due to in-store marketing was
due primarily to differences for child-targeted products. Child-targeted products with added sugar
had more than double the proportion of sales due to displays and price reductions compared to other
added-sugar products. Differences between targeted audiences for products without added
sweeteners were significantly lower.
For the other companies, the main effects of target audience on sales due to displays and price
reductions were not significant (p > 0.59). However, we again observed main effects for added sugar,
such that percentage of sales due to displays was almost four times higher for added-sugar products
(11.3% (10.2, 12.4)) than for products without added sweeteners (3.3% (1.8, 4.7)), F(1, 768) = 77.8, p <
Figure 4. Percentage of sales due to displays and price promotions.
Additionally, we observed a significant interaction between target audience and added sugar for
percentage of sales due to displays, F(1, 1360) =70.9, p=0.001, and price reductions,
F(1, 1360) =25.1,
p=0.01. The higher proportion of sales of added sugar products due to in-store marketing was due
primarily to differences for child-targeted products. Child-targeted products with added sugar had
more than double the proportion of sales due to displays and price reductions compared to other
added-sugar products. Differences between targeted audiences for products without added sweeteners
were significantly lower.
For the other companies, the main effects of target audience on sales due to displays and price
reductions were not significant (p>0.59). However, we again observed main effects for added sugar,
such that percentage of sales due to displays was almost four times higher for added-sugar products
(11.3% (10.2, 12.4)) than for products without added sweeteners (3.3% (1.8, 4.7)), F(1, 768) =77.8,
p<0.001,
and sales due to price reductions was more than twice as high (17.2%(15.7, 18.6) vs. 8.8%
(6.9, 10.7)), F(1, 768) =49.5, p<0.001.
We also observed a significant interaction between target audience and added sugar for percentage
of sales due to price reductions for other companies, F(1, 768) =15.0, p=0.002, but not for displays
(p=0.10). Also, in contrast to the major companies, child-targeted products with added sugar from
other companies had a lower percentage of sales due to price reductions compared to other (not
child-targeted) products. As found for major companies, the difference between target audiences in
sales due to prices reductions for products without added sweeteners was lower.
3.3. Discussion
Child-targeted single-serving fruit drinks and juices had a higher percentage of unit sales due
to displays and price reductions overall than did similar drinks not targeted to children. A higher
percentage of sales of products with added sugar were also due to displays and price reductions
compared to products without added sweeteners. These findings indicate that in-store marketing may
have a greater impact on sales of drink brands with marketing targeted to children compared to drinks
marketed to adults only, as well as on sales of sugary drinks (i.e., fruit drinks in this analysis) versus
healthier 100% juices and other juice drinks without added sweeteners.
Int. J. Environ. Res. Public Health 2020,17, 1284 13 of 20
In contrast to predictions, sales due to displays was lower for major companies (i.e., companies
that did not advertise nationally), while sales due to price reductions did not vary by company
type. Although not expected, this finding indicates that additional visibility in the supermarket
(i.e., through displays) may be more important for products that consumers have not been introduced
to through advertising. However, examining the interactions between factors identified some additional
differences by company type. For example, sales of child-targeted products from major companies
were more likely to be due to displays and price reductions than sales of their other products, whereas
differences between child-targeted and other products from other companies were not significant.
These relationships also differed by product type. Although a higher proportion of sales of
products with added sugar were due to displays and price reductions for both major and other
companies, the interaction with target audience differed by company type. For major companies,
sales of sugar-sweetened child-targeted products were most likely to be due to displays and price
reductions, compared to other drinks from these companies. In contrast, sales of other sugar-sweetened
products (i.e., not child-targeted) from other companies were most likely to be due to displays and
price reductions. Thus, in-store displays and price promotions appeared to have the greatest impact on
the sales of sugar-sweetened products, including child-targeted fruit drinks, from major companies
(e.g., Capri Sun Original [juice drink], Kool-Aid, and Sunny D).
Further research is needed to determine whether major companies promoted sugar-sweetened
child-targeted fruit drinks more often in stores (i.e., through displays and price reductions) than
they promoted other products or whether these products required additional retail support to drive
sales. Regardless, displays and price reductions of sugar-sweetened child-targeted drinks from major
companies were associated with 22% and 12% of sales for these products, respectively, compared
with just 9% and 1% of sales for major companies’ child-targeted drinks without added sweeteners
(primarily 100% juice products), and 12% and 4% of their sugar-sweetened drinks that were not
marketed directly to children.
4. General Discussion
Together, these studies demonstrate extensive marketing of nutrient-poor child-targeted products
in the supermarket and provide evidence that a substantial proportion of sales can be attributed
to in-store marketing through displays and price promotions. In Study 1, the two major cereal
manufacturers utilized disproportionately more in-store displays and promotions for children’s cereals
than for cereals marketed only for adult consumption. Furthermore, major-company children’s
cereals received prime middle-shelf placement on supermarket shelves, while children’s cereals from
all companies were more likely to be placed on bottom shelves at children’s eye level. Study 2
demonstrated that a higher proportion of sales of sugar-sweetened child-targeted fruit drinks from
major companies were due to in-store marketing (special displays and price reductions) compared to
sales of other sugar-sweetened drinks not marketed directly to children, as well as child-targeted juices
without added sweeteners. In both studies, in-store marketing of nutrient-poor children’s products
was greater for major companies than for other companies. These major cereal companies (General
Mills and Kellogg) and fruit drink/juice companies that support their products with advertising also
likely have more resources to influence promotions and placements in supermarkets.
This evidence of extensive in-store marketing for child-targeted products is problematic due
to the poor nutritional quality of these products. Both child-targeted cereals and fruit drinks have
worse overall nutritional profiles than products aimed at adults [
53
,
58
]. This finding is not unique
to the cereal and fruit drinks categories. A large body of literature documents the consistently poor
and disproportionately worse nutritional quality of food and beverages marketed to children [
3
].
Furthermore, despite implementation of food industry self-regulatory initiatives worldwide and
repeated promises by industry to market healthier foods to children, independent evaluations of
industry self-regulation demonstrate minimal improvements [
3
]. This lack of industry-led progress
provided the basis for the WHO to endorse a set of recommendations for countries to take actions to
Int. J. Environ. Res. Public Health 2020,17, 1284 14 of 20
reduce the negative impact food marketing to children [
1
]. The FTC report also highlighted the poor
nutritional quality of products in other food and beverage categories marketed directly to children
in stores in the United States, including snack foods, candy and frozen desserts, and carbonated
beverages [4].
One limitation of this research is that data were collected in 2009 and 2010 for previous studies
that reported top-line findings [
56
,
62
]. Due to the considerable expense of conducting in-store audits
and purchasing syndicated sales data, we were not able to purchase more recent data for these studies.
However, these findings remain relevant as recent comprehensive analyses of the nutrition quality
and child-directed marketing of cereals [
10
,
53
] and children’s drinks [
58
] demonstrate few changes
in the nutrition quality of child-targeted products or in the ways they are marketed to children and
their parents.
5. Policy Implications
Public health experts have emphasized the positive role that supermarkets can play in helping
to reverse the childhood obesity epidemic due to the variety of healthier foods that they offer [
64
].
However, these findings also support the need for public health policy to address unhealthy marketing
directed to children in supermarkets and other types of retailers. Potential policy options include both
industry self-regulation and government regulation.
5.1. Industry Self-Regulation
Food and beverage manufacturers and trade associations have promised to advertise healthier
products to children [
9
,
65
]. The Grocery Manufacturers Association and some individual retailers have
also implemented programs to encourage healthier choices in the supermarket, such as introducing
the Facts Up Front nutrition label to help consumers make informed choices and funding nutrition
and health-related community programs [
66
]. Individual retailers, including Walmart and Hannaford,
have introduced nutrition rating systems to help all consumers easily identify healthier choices [
67
,
68
].
Public health advocates have also partnered with retailers and manufacturers to promote healthy
foods to children in supermarkets and other food retailers. For example, the Produce Marketing
Association partnered with Sesame Workshop to make its characters available for the promotion of fresh
fruits and vegetables [
69
]. The Partnership for a Healthier American has also partnered with industry
and public health organizations to support “FNV,” a campaign that incorporates youth-targeted
celebrity endorsements to encourage fruit and vegetable consumption at retailers [
70
]. The Food Trust,
in coordination with local communities, has developed a number of initiatives to encourage availability
and marketing of healthier choices in corner stores in neighborhoods without supermarket access [
71
].
Public health campaigns also call for removing unhealthy food and drinks from checkout aisles at
supermarkets and other retailers [72,73].
However, noticeably absent from industry self-regulatory initiatives and public health partnerships
are actions to reduce in-store marketing techniques commonly used to promote child-targeted products,
including product packaging, special displays, price reductions, and other types of promotions,
or to limit in-store access and availability of nutrient-poor foods that appeal to children beyond the
checkout aisle.
Food industry representatives argue that self-regulatory initiatives to improve children’s diets
and reduce childhood obesity should not address in-store marketing because parents make the final
decision about their supermarket purchases [
11
]. Indeed, our analyses do not examine parents’
decision-making process when choosing to purchase child-targeted products. However, it is likely
that in-store marketing of children’s products also influences parents—for example, by attracting
their attention and reminding them that their child has asked for the product, or by giving them
permission to buy the product when it is on sale. Furthermore, nutrition-related claims on product
packaging and other parent-directed marketing techniques often lead parents to believe that high-sugar
products, including children’s cereals [74] and fruit drinks [75], are healthy options for their children.
Int. J. Environ. Res. Public Health 2020,17, 1284 15 of 20
Regardless of the mechanism, food manufacturers would not invest in this level of in-store marketing
for nutrient-poor children’s products unless it increases sales.
5.2. Government Regulation
Given that reducing in-store marketing would likely affect a significant revenue source for
both food manufacturers and retailers, government action may be required to effectively reduce the
amount of in-store marketing of nutrient-poor child-targeted products. However, in the United States,
the government faces substantial limitations to how it can regulate marketing communications, due
to protection of marketing under the First Amendment as commercial speech. In order for a retail
regulation to not violate the First Amendment, it must be “unrelated to expression” [
76
], meaning that
the advertising content itself (e.g., child-targeted features on a special display) cannot be restricted.
However, the government could enact regulations aimed at other characteristics of food products, such
as nutrient profiles.
In addition, U.S. states have the authority to enact laws to protect and promote health, safety,
and the general welfare of their population that could be used to regulate other practices in the retail
environment [
77
,
78
]. Under this “police power,” state (and local governments if authorized) can
regulate the retail environment and sale of products through direct controls and licensing requirements.
States can also influence purchase decisions through their powers to tax and spend and to convey
factual information. Therefore, U.S. states have a number of legally viable policy options to regulate
in-store marketing (see Table 2). These policy strategies could also be applied in other countries with
similar retail environments.
Table 2.
Legally viable policy options at the U.S. state level to regulate unhealthy food marketing in
retail locations *.
Type of Policy Examples
Information provision Public service announcements
Product location in stores
Require that nutrient-poor products be stocked in less accessible locations, such
as separate store aisles or specifically identified check-out aisles, and thus
removed from prominent locations such as endcaps, freestanding and other
special displays, store entrances, and general check-out aisles
Purchase restrictions Institute age limits on purchases of harmful products (e.g., energy drinks)
Conditional licensing
Require retailers to meet conditions (e.g., product location, age limits) to maintain
their license
Utilize license fees to cover inspections to ensure compliance
Pricing
Excise tax on sales of certain products (e.g., sugary drinks)
Set minimum price mandates and/or prohibitions on coupons and discounting
(independently or in conjunction with a tax)
Earmark tax revenues for health promotion, such as subsidizing fruits and
vegetables
* These policies would apply to foods and beverages that do not meet minimum nutrition standards and/or products
that are harmful to children’s health (e.g., sugary drinks, energy drinks).
First, states may enact non-speech related restrictions that aim to protect youth, such as age limits
on children’s ability to purchase harmful products. For example, one county in New York banned
the sale of energy drinks to youth under eighteen years old in county parks [
79
]. This could also be
accomplished as a state-wide age restriction.
The government may address the location of unhealthy food products in stores to positively shape
the retail environment for all shoppers, as long as the rationale behind the prohibition is unrelated to
communication on the packaging or display (i.e., commercial speech). Therefore, states could regulate
placement in the supermarket, such as requiring certain products to be located behind the counter or in
a separate aisle. One method to do this is to target food products according to their nutritional profile
(e.g., high-sugar products) and apply the nutrition criteria regulation to entire product categories.
If the government properly tailored the regulation to address the nutrition quality of products, this
Int. J. Environ. Res. Public Health 2020,17, 1284 16 of 20
would not be considered regulation of speech. These same considerations could apply to restrictions
on the placement of products in endcaps, at store entrances, freestanding displays in aisles, and in
checkout lanes.
State governments could accomplish the same objectives through conditional licensing, whereby
a retailer must obtain a license to operate a supermarket on the condition that it abides by directives
specified in the licensing requirements [
80
]. For example, tobacco retailers often must agree to certain
conditions such as posting signs regarding the legal age of purchase, not selling single cigarettes,
and not selling tobacco in vending machines or certain locations [
81
]. One benefit to this strategy is
that the license fee can cover the cost of inspection, which is a built-in method of enforcement [
80
].
Moreover, the threat of losing one’s license is often a stronger deterrent than the threat of a fine alone,
so conditional licensing can encourage compliance.
Lastly, government regulation could address incentives and promotions that reduce the price of
unhealthy products, such as enacting excise taxes. An excise tax is levied upon businesses engaged in
the manufacture, distribution, or sale of commodities. The goal of the tax would be to deter purchase
and consumption and additionally raise revenue for the government. The revenue from an excise tax
can be earmarked, or dedicated to a certain program such as subsidizing healthy foods. As of February
2017, two U.S. states, one U.S. tribal government, and seven U.S. municipalities taxed junk food or
sugary beverage using various taxing mechanisms [82].
The government could also enact minimum price mandates and prohibitions on coupons and
discounting. Federal courts have upheld municipal laws that prohibited retailers from redeeming
coupons and multipack discounts or prohibited the sale of tobacco products below the listed price [
83
,
84
].
This strategy is viable for unhealthy food products and could be enacted independently or in conjunction
with a tax to ensure the cost of the tax is passed on to consumers through price increases [80]. Such a
mandate or prohibition would counteract food manufacturer pricing strategies that reduce the price of
unhealthy products and function to nullify the impact of any tax.
Outside the United States, sugary drink taxes are also increasingly common, and early evaluations
show that they effectively reduce the consumption of taxed products [
85
]. However, despite WHO
calls for regulation of unhealthy food marketing targeted to children [
1
], few countries regulate
child-targeted marketing in any form, and current regulations primarily address TV advertising and
marketing in schools [
7
]. One country, Chile, implemented a law that prohibits child-targeted messages
(including licensed characters and brand spokes-characters) on product packaging for foods high in
fat, sugar, salt, or calories in 2016. To our knowledge, no other country regulates in-store marketing of
child-targeted food and drinks in any form.
Public health experts call on food manufacturers and retailers to utilize the power of the
supermarket environment to encourage more purchases of fruits and vegetables [
86
], as well as
healthier packaged food options [
64
]. However, no country currently regulates the common in-store
marketing techniques for child-targeted products examined in this paper, including shelf placement,
special displays, and price promotions [7].
6. Conclusions
Together, these two studies demonstrate that cereal and fruit drink/juice manufacturers engage in
extensive in-store marketing-including strategic shelf placement, special displays, and price promotions
to promote child-targeted products in supermarkets. Furthermore, major manufacturers utilize these
practices significantly more often for child-targeted compared with other products. The analysis
of fruit drink/juice products also demonstrates that in-store marketing is associated with higher
incremental sales for sugar-sweetened child-targeted products from major companies compared with
their other products, including products without added sweeteners and those not targeted to children.
Unfortunately, child-targeted products in both categories are high in added sugar and contribute to
children’s unhealthy levels of sugar consumption [
60
]. These findings support public health concerns
that marketing in supermarkets contributes to the epidemic of childhood obesity and that government
Int. J. Environ. Res. Public Health 2020,17, 1284 17 of 20
regulation should be enacted to improve the supermarket environment to promote healthy diets
for children.
Author Contributions:
Conceptualization, J.L.H. and J.L.P.; methodology, J.L.H., V.W., S.J.S. and J.L.P.; formal
analysis, V.W. and S.J.S.; writing—original draft preparation, J.L.H., V.W. and J.L.P.; writing—review and editing,
J.L.H., V.W., S.J.S. and J.L.P.; funding acquisition, J.L.H. All authors have read and agreed to the published version
of the manuscript.
Funding: This research was funded by a grant to J.L.H. from the Robert Wood Johnson Foundation.
Acknowledgments:
J.L.P. wishes to thank Ian McLaughlin of ChangeLab Solutions for his thoughtful exchange of
ideas on topics related to this paper.
Conflicts of Interest:
The authors declare no conflicts of interest. The funder had no role in the design of the
study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript; or in the decision
to publish the results.
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