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Explore Articles from The 8 Pillars of a Nutritious Life Drink Up Water is a magic elixir and one of the most beneficial things we can put in our bodies. Eat Empowered Fuel your body and mind with nutrient-dense foods to look and feel amazing. Live Consciously Creating time and space to notice the world around you leads to more mindful choices and actions.

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More Z s, please! PLoS Med. Aust N Z J Public Health. Giesen JC, Payne CR, Havermans RC, Jansen A: Exploring how calorie information and taxes on high-calorie foods influence lunch decisions. Anderson ET, Simester DI: Mind your pricing cues. Harv Bus Rev. Darke PR, Chung CMY: Effects of pricing and promotion on consumer perceptions: it depends on how you frame it.

J Retailing. Download references. We would like to thank Kim Dolstra, Lennart Roest and Marcel Mekkes for their excellent help with the data collection. This work was supported by a grant from the Netherlands Organization for Health Research and Development ZonMw — project number: This funding body was involved in study design but had no other role in this manuscript.

Second, we received funding from a special Software Development Fund of VU University Amsterdam which is dedicated to SARA Computing and Networking Services Amsterdam for use in the development of new scientific software tools VU — SARA collaboration.

This funding was used to develop the Virtual Supermarket the funding body had no further role in this study. Present address: National Institute for Health Innovation, School of Population Health, The University of Auckland — Tamaki Campus, Auckland Mail Centre, Private Bag , Auckland, , New Zealand.

Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan , Amsterdam, , HV, The Netherlands. Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, P.

Box , Groningen, The Netherlands. National Institute for Public Health and the Environment, P. Box 1, Bilthoven, , BA, The Netherlands. You can also search for this author in PubMed Google Scholar. Correspondence to Wilma E Waterlander.

WEW was responsible for designing the study, data collection, analysis and interpretation of data. This author was involved in drafting the manuscript and has given final approval of the version to be published. IHMS was responsible for the conception and design of this study.

This author also revised the manuscript critically for important intellectual content and has given final approval of the version to be published. MRB was responsible for analysis and interpretation of data.

AJS was responsible for the conception and design of this study. JCS was responsible for the conception and design of this study. All authors read and approved the final manuscript.

Additional file 1: Effects of varying price discount levels on the percentage of healthy food products purchased within eight different product categories, the Netherlands DOCX 17 KB. Additional file 2: Effects of varying different promotion labels on the percentage of healthy food products purchased within eight different product categories, the Netherlands This article is published under license to BioMed Central Ltd.

Reprints and permissions. Waterlander, W. et al. Effects of different discount levels on healthy products coupled with a healthy choice label, special offer label or both: results from a web-based supermarket experiment.

Int J Behav Nutr Phys Act 10 , 59 Download citation. Received : 06 August Accepted : 14 May Published : 16 May Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Download ePub. Conclusion This study brings some relevant insights into the effects of price discounts on healthier foods coupled with different labels and shows that price effects over shadowed food labels.

Methods The study was conducted using a three-dimensional 3-D web-based supermarket Figure 1. Figure 1. Impression of the web - based supermarket and the used food labels.

Full size image. Table 1 Number of healthy food products within the 38 food categories in the web-based supermarket a Full size table. Figure 2. CONSORT flow diagram. Table 2 Participant characteristics Full size table. Table 3 Effects of varying price discount levels on food purchases in the web-based supermarket — results two-way ANCOVA analyses a Full size table.

Table 4 Effects of varying price promotion labels on food purchases in the web-based supermarket — results two-way ANCOVA analyses a Full size table. Discussion This study in an experimental web-based supermarket examined the effects on food purchases of price discounts on healthy foods in combination with three different labels.

Conclusion This study brings some relevant insights into the effects of different price discounts on healthier foods coupled with different labels on overall food purchases and forms a valuable basis for future research.

Abbreviations FOP labels: Front-of-pack labels RCT: Randomized controlled trial. Article CAS Google Scholar Faulkner G, Grootendorst P, Nguyen VH, Andreyeva T, Arbour-Nicitopoulos K, Christopher M, Cash SB, Cawley J, Donelly P, Drewnowski A: Economic instruments for obesity prevention: results of a scoping review and modified delphi survey.

Google Scholar Hersey JC, Wohlgenant KC, Arsenault JE, Kosa KM, Muth MK: Effects of front-of-package and shelf nutrition labeling systems on consumers. Article Google Scholar Epstein LH, Jankowiak N, Nederkoorn C, Raynor HA, French SA, Finkelstein E: Experimental research on the relation between food price changes and food-purchasing patterns: a targeted review.

At the end of the study, however, we revealed to all participants that individuals who won the lottery were instead provided a gift card with the equivalent amount of money loaded onto it that they spent in the study.

This approach was used to mitigate potential issues related to delivery and to minimize the collection of personally identifiable information.

Fruits and vegetables that qualified for the discount were labeled as eligible in the store, and the discount was applied to items at the point of selection.

Based on healthy eating guidelines, 39 eligible items included fresh, frozen, and canned fruits and vegetables with no more than mg of sodium per serving and prepared produce intended for off-premises consumption.

Ineligible items included herbs and spices, dried fruits and vegetables, fruit and vegetable juices, and fruits and vegetables with added sugars or fat. Participants randomized to the default condition had their cart prefilled with 1 fruit product and 1 vegetable product, which they could remove at any point while shopping.

Default items were based on expenditure data from FoodAPS, which we used to identify the 5 most frequently purchased fruits apples, bananas, grapes, oranges, and strawberries and vegetables carrots, green beans, lettuce, onions, and tomatoes in SNAP-participating households.

We then identified 10 corresponding products from our online store database. In the survey, participants were asked to select which of the 5 fruits and 5 vegetables they purchased the most frequently, and we used their selections to tailor their default options, for a total of 25 possible combinations of default products eAppendix 3 in Supplement 2.

Participants randomized to the control condition received no discount or default products. To account for differences in item prices across conditions and shopping budget by household size, our primary outcome was the percentage of nondiscounted dollars spent on eligible fruit and vegetables per basket ie, dollars spent before subtracting a discount.

Secondary outcomes included nondiscounted and out-of-pocket dollars spent on fruits and vegetables; nondiscounted dollars spent on fruits only, vegetables only, fresh fruits and vegetables, frozen fruits and vegetables, and canned fruits and vegetables; and total calories, fat in grams , saturated fat in grams , carbohydrates in grams , fiber in grams , protein in grams , and salt in milligrams from fruits and vegetables.

We calculated spending or nutrient value in each category by multiplying the price or nutrient value per item by the quantity purchased of that item, then summed across all items purchased in that category. We used linear regression to regress the outcome variable on indicator variables for each of the experimental conditions, with the control condition as referent.

Prespecified analyses indicated that a sample size of adults also allowed for examination of interaction effects by age, sex, and race and ethnicity. Race and ethnicity were self-reported by participants using National Health and Nutrition Examination Survey categories American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or other Pacific Islander, White, multiple races or ethnicities, and other race or ethnicity , given demographic differences in fruit and vegetable consumption.

In post hoc analyses, we also examined interaction effects by income, educational level, and food security status. To assess robustness of our results to differences in online grocery shopping history, we conducted a sensitivity analysis excluding participants who reported they had never shopped online for groceries.

We also used logistic regression to assess differences in the likelihood of purchasing a default shopping cart item from the shopping cart or store aisles by condition. We calculated the percentage of participants who endorsed positive statements about their experience in the store.

To assess attrition bias, we compared the characteristics of those who completed the survey task but not the shopping task with the characteristics of those who completed both tasks. All analyses were conducted using Stata, version The final sample included adults who had ever received SNAP benefits.

The mean SD age of participants was A total of 39 participants 1. Mean SD household size was 2. A little over half of participants [ Those who completed the survey and shopping task vs survey only were more likely to be women of [ Compared with the control condition, those in the discount condition spent 4.

Default cart items were purchased by participants Spending on fruits only, vegetables only, and fresh fruits and vegetables was higher among participants randomized to receive discounts alone or in combination vs no intervention. Total calories, carbohydrates, and fiber from fruits and vegetables were higher in the discount and combination conditions compared with no intervention.

We did not observe meaningful differences in expenditures on frozen or canned fruits and vegetables across conditions, or in other nutrient groups. We observed no interaction effects by age, sex, race and ethnicity, income, educational level, or food security status and no differences when excluding those who reported never shopping online for groceries eTable 3 in Supplement 2.

Most participants reported that the store felt like a real online grocery store [ There was a high degree of support for default options as a retailer strategy, with [ Previous research has found that nutrition labels, 42 - 45 product placement, 44 , 46 - 48 and offering healthy alternatives 44 , 46 promote healthier food choices in online supermarkets.

We found that financial incentives are also effective in promoting online fruit and vegetable purchases in a large, diverse sample of individuals with low income.

The effect from our discount alone 4. Participants also expressed a high degree of support for default options as a retailer strategy. Taken together, these results suggest that default options are effective in motivating individuals to purchase fruits and vegetables.

We also found evidence that combining discounts and default options had a synergistic effect, which provides support for the implementation of multiple healthy eating strategies in an online setting.

Given how changes in expenditures translated into positive changes in fruit and vegetable intake in the Healthy Incentives Pilot, 50 we expect that effects observed in this study would meaningfully improve population health. Participants were recruited online, so they may have been more likely to shop online than the broader SNAP population.

However, results did not differ when we excluded those who reported never shopping online for groceries. The sample may not have been representative of the target population, given how non-English speakers were excluded and those who started the shopping task were slightly more likely to be women and have higher education.

It is possible that hypothetical shopping choices do not reflect actual purchases, but we informed participants they were entered into a lottery to receive the items in their cart, so we expect participants selected items they actually wanted to receive. Furthermore, most reported their purchases were similar to their regular purchases.

The results of this randomized clinical trial support the use of financial incentives to meaningfully increase fruit and vegetable purchases for those shopping with SNAP benefits online.

We also found evidence that prefilling shopping carts with fruits and vegetables motivated individuals to purchase default products, with a synergistic effect with discounts. Future research should explore the effectiveness of strategies designed to mitigate lack of trust and other noneconomic barriers on purchases of fresh products online.

Evaluating other interventions in online settings, such as restrictions on targeted marketing, is also a valuable next step. Published: March 10, Open Access: This is an open access article distributed under the terms of the CC-BY License.

JAMA Network Open. Corresponding Author: Pasquale E. Rummo, PhD, MPH, Section on Health Choice, Policy and Evaluation, Department of Population Health, New York University Grossman School of Medicine, Madison Ave, 3rd Floor, New York, NY pasquale.

rummo nyulangone. Author Contributions: Dr Rummo had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Acquisition, analysis, or interpretation of data: Rummo, Roberto, Thorpe, Troxel. Critical revision of the manuscript for important intellectual content: All authors. Conflict of Interest Disclosures: Dr Troxel reported receiving grant funding from the National Institutes of Health NIH during the conduct of the study.

No other disclosures were reported. Data Sharing Statement: See Supplement 3. Additional Contributions: Jamie Halula, MPH, University of North Carolina UNC at Chapel Hill, Sophia Hurr, BS, Advisory Board, Rhea Naik, MS, Carmen Prestemon, BSPH, UNC at Chapel Hill, and Carla Seet, MPH, New York University Grossman School of Medicine, helped in cleaning the dataset and reviewing the online grocery store.

Emily Busey, MPH, RD, UNC at Chapel Hill, designed our online grocery store logo, Bridgett Hollingsworth, MPH, RD, UNC at Chapel Hill, provided guidance on how to tag red meat and processed red meat, Yiqing Zhang, BS, Barnard College of Columbia University, provided insight into the data scraping process, and Wilma Waterlander, PhD, Amsterdam UMC, contributed general feedback on store development and the process evaluation.

We thank the researchers involved in developing the Woods supermarket platform for their support, including Susan Jebb, PhD, and Brian Cook, PhD, at the Nuffield Department of Primary Care Health Sciences at the University of Oxford.

full text icon Full Text. Download PDF Comment. Top of Article Key Points Abstract Introduction Methods Results Discussion Conclusions Article Information References.

Visual Abstract. RCT: Effect of Financial Incentives and Default Options on Food Choices in Online Retail Settings. View Large Download. Table 1. Sociodemographic Characteristics and Diet Behaviors of Adult Study Participants, Overall and by Condition, a.

Table 2. Shopping Task Purchase Descriptive Statistics, Overall and by Condition. Table 3. Experimental Results, Primary and Secondary Outcomes. Supplement 1. Trial Protocol. Supplement 2. Sociodemographic Characteristics and Diet Behaviors of Adult Study Participants eTable 2.

Grocery Shopping Behaviors and Attitudes Overall and by Condition eTable 3. Sensitivity and Interaction Analyses eTable 4. Postshopping Task Question Responses eAppendix 1. Preshopping and Postshopping Task Surveys eAppendix 2.

Experimental Online Grocery Store Appearance and Instructions eAppendix 3. Supplement 3. Data Sharing Statement. Hu EA, Steffen LM, Coresh J, Appel LJ, Rebholz CM. Adherence to the Healthy Eating Index and other dietary patterns may reduce risk of cardiovascular disease, cardiovascular mortality, and all-cause mortality.

doi: Zhan J, Liu YJ, Cai LB, Xu FR, Xie T, He QQ. Fruit and vegetable consumption and risk of cardiovascular disease: a meta-analysis of prospective cohort studies.

This study in an experimental web-based supermarket examined the effects on food purchases of price discounts on healthy foods in combination This cheap and healthy grocery list includes tips and recommendations on ways to make smart purchases on nutritious foods without breaking SNAP healthy incentive programs encourage people participating in SNAP to purchase healthy foods by providing a coupon, discount, gift card, bonus food item

Video

Discounted Food Choices - 12 healthy and affordable foods for your grocery list · Brown rice. · Cans or packets of chicken or tuna. · Dried beans and lentils. · Eggs. · Frozen This study in an experimental web-based supermarket examined the effects on food purchases of price discounts on healthy foods in combination This cheap and healthy grocery list includes tips and recommendations on ways to make smart purchases on nutritious foods without breaking SNAP healthy incentive programs encourage people participating in SNAP to purchase healthy foods by providing a coupon, discount, gift card, bonus food item

Lentils are popular in many plant-based diets. They are very affordable and provide a great source of protein, fiber, iron and manganese. They also contain antioxidants that may help to fight inflammation and reduce the onset of chronic diseases. Lentils can be used in a variety of ways and are very easy to prepare.

Simply rinse dry lentils to remove any debris, place them in a large pot and fill it halfway with water. Let the lentils simmer until they're tender, then enjoy!

Lentils can be used to make veggie burgers, soups and stews. Popcorn is often associated with binge-watching your favorite TV show or movie, but it can be enjoyed as a healthy snack at any time.

Popcorn provides fiber, magnesium and several disease-fighting antioxidants. Plain popcorn is also relatively low in calories, making it a helpful snack for those wanting to lose weight.

The great thing about popcorn is that it's very versatile. You can add toppings such as sea salt and cheese for a savory treat, or cinnamon and sugar for a delicious sweet treat. It can be expensive to buy pre-popped popcorn in bags or microwaveable pouches, so purchasing kernels helps make this nutritious snack more affordable.

You can pop the kernels yourself in the microwave with just a brown bag. Frozen berries are easy to keep on hand and can be very cost-effective when compared to fresh fruit. A couple of great choices to keep on hand are frozen blueberries and frozen strawberries.

Check the bags and buy berries without added sugar. Blueberries may be small in size, but they are rich in nutrients and are a good source of vitamin C and dietary fiber. Blueberries have been linked to improved cardiovascular health and can contribute to an overall healthy lifestyle.

Strawberries are also high in vitamin C and fiber, as well as folate. They are also rich in antioxidants. A review in Nutrients of studies done with strawberries and blueberries found they helped reduce inflammation, improved insulin sensitivity and helped keep blood pressure in check, among other benefits.

Add frozen berries to your favorite smoothie recipe or make a yogurt parfait with them. Frozen berries can be used to make jams, pies and other desserts. Tuna is a smart choice for those wanting to increase their fish intake while still keeping their groceries affordable.

Tuna is a great source of protein, and it also contains some omega-3 fatty acids , which are important for brain health and reducing inflammation. Tuna also provides a fair amount of the minerals selenium, phosphorus and potassium.

Choose canned tuna for salads, sandwiches and pasta dishes. Eggs are a staple item in most homes. They're extremely nutritious and typically cost less than 20 cents per egg. A whole large egg contains 6 grams of protein and delivers some vitamin D as well.

Eggs also contain the antioxidants lutein and zeaxanthin, which support eye health and decrease the risk of age-related macular degeneration. We often think of eggs for breakfast, but they can be enjoyed in a variety of ways.

Look to eggs to make a savory dinner quiche, vegetable-packed fried rice or egg salad sandwiches. Now that we've got a list of healthy, budget-friendly foods to keep on hand, let's explore a few more ways to help you save even more money on your grocery bill. Most people don't realize this, but the ingredients in store-brand products are usually similar to brand-name products.

So, instead of paying extra money for well-known brands, look for generic or store-brand products instead. Before you head to the grocery store, take inventory of everything that you have on hand.

You may be surprised to find a few extra cans of chickpeas, or some leftover broccoli that may be on the verge of going bad. To help avoid food waste and save a little money, try to make recipes with these items first. Get creative with what you have. Nonperishable items, such as grains, rice, nuts and beans, are typically cheaper when purchased in bulk or larger containers.

Even though a larger container of rice will be more expensive, look for the unit price when you shop.

When oil is warm, add patties and cook on each side for about 3 minutes. Eat the patties over a bed of greens or assemble on a whole grain bun with your favorite toppings.

Homemade chicken nuggets Preheat oven to F. Place 1 cup nonfat plain yogurt in a bowl. Cut 1 pound of boneless skinless chicken breast or thighs into 2-inch pieces. Dip each chicken piece into the yogurt and then dredge in cornflakes.

Place onto baking sheet and repeat with all chicken pieces. Bake for about 25 minutes or until chicken is cooked through. Three-bean chili Heat 1 tablespoon olive oil on medium-high heat in a large pot.

Add 1 large diced onion, 1 ½ teaspoons garlic powder, and 3 tablespoons chili powder and cook until onions soften.

Add one ounce can each of drained rinsed black beans, kidney beans, and pinto beans; one ounce can diced tomatoes with the juice; and 2 cups water or low-sodium broth.

Bring to a boil and then reduce heat to low. Cover pot and simmer for 20 minutes, stirring occasionally. Serve plain or over cooked brown rice. References Rao M, Afshin A, Singh G, Mozaffarian D. Do healthier foods and diet patterns cost more than less healthy options? A systematic review and meta-analysis.

BMJ open. Daniel C. Is healthy eating too expensive? Funny fact about the retailer known for selling the largest bundles of paper towels you can find: the chain has been prioritizing organic foods for a while.

It actually sells more certified organic food than Whole Foods, and at much lower prices. RELATED: The Official Nutritious Life Guide to Choosing Healthy Groceries. If you live in New York City, Westchester, New Jersey, or Connecticut, FreshDirect is an amazing resource.

Pro tip: If you stock your cupboards once every few weeks with non-perishables and then wait, they tend to send free delivery coupons to lure you back. Target started selling food in addition to, well, everything else a while back.

Its Simply Balanced line of packaged foods is made without artificial ingredients or additives and also includes lots of certified organic options.

Prices are low, and you can shop online for many of the items. RELATED: The Healthy Sunscreens Beauty Experts Actually Use. Launched a few years ago to make healthy pantry items more accessible, Thrive stocks a curated selection of natural and organic packaged foods like snacks, nut butters , and protein bars.

It also sells bath and body products, cleaning supplies, supplements, and pet food. Prices are lower than at conventional grocery stores but you have to buy a membership to shop. About Nutritious Life Editors. The Nutritious Life Editors are a team of healthy lifestyle enthusiasts who not only subscribe to — and live!

From the hottest trends in wellness to the latest medical science, we stay on top of it all in order to deliver the info YOU need to live your most nutritious life. Get FREE access to some of the core training materials that make up our signature program — Become a Nutrition Coach.

Interested in joining our wellness community and becoming a Nutritious Life Master Certified Nutrition and Wellness Coach? Enter your info, get free access now to a sample class!