Guiding stars: the effect of a nutrition navigation program on consumer purchases at the supermarket.
BACKGROUND
To improve diet quality and overall population health, the need to develop nutritional rating systems that are comprehensive in scope and easy for the consumer to understand and use at the point-of-purchase has emerged.


OBJECTIVE
Our aim was to examine the effect of a comprehensive storewide supermarket point-of-purchase nutrition navigation intervention by using a shelf-label 3-tiered star icon on consumer food and beverage choices and their associated nutritional quality.


METHODS
By using a natural experiment design, purchasing data from 2006 to 2008 were obtained from a Northeast supermarket chain with 168 stores located in northern New England and New York and examined at preimplementation and at 1- and 2-y follow-up periods.


RESULTS
The nutrition navigation system studied showed significant changes in food purchasing immediately after implementation, and these changes continued to be significant 1 and 2 y later. When the same 8-mo period (January-August) each year was compared, in 2006, 24.50% of items purchased earned a star rating; this proportion increased to 24.98% (P < 0.001) and 25.89% (P < 0.0001) at the 1- and 2-y follow-up periods, respectively. For a 4-wk period, 1 y after program implementation, consumers purchased significantly more ready-to-eat cereals with stars (eg, less added sugars and more dietary fiber) and fewer no-star, high-sugar, low-fiber cereals.


CONCLUSIONS
Increasing rates of obesity and declining diet quality for Americans strongly support the need for effective supermarket point-of-purchase programs, such as the Guiding Stars nutrition navigation program, that provide clear, concise, and simplified nutrition information to guide consumer food and beverage choices.
Community Health Research Program, Hood Center for Children Families, and the Department of Pediatrics and Adolescent Medicine, Dartmouth Medical School, Lebanon, NH 03756, USA. lisa.a.sutherland@dartmouth.edu
Lisa A
LA
Sutherland
Lori A
LA
Kaley
Leslie
L
Fischer
D054626:Consumer Health Information; D004032:Diet / Q000191:economics / Q000592:standards; D005515:Food Labeling; D005518:Food Preferences; D005523:Food Supply; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D009753:Nutritive Value; D014481:United States