title: 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.
abstract: BACKGROUND
  Two strategies commonly recommended to improve population diets include food labels and food taxes/subsidies. The aim of this study was to examine the effects of both strategies separately and in combination.
  
  
  RESULTS
  An experiment with a 3x3 factorial design was conducted, including: three levels of price reduction (10%; 25%; and 50%) x three labels ('special offer', 'healthy choice' and 'special offer & healthy choice') on healthy foods defined following the Choices front-of-pack nutrition label. N=109 participants completed the experiment by conducting a typical weekly shop for their household at a three-dimensional web-based supermarket. Data were analysed using analysis of covariance. Participants receiving a 50% price discount purchased significantly more healthy foods for their household in a typical weekly shop than the 10% discount (+8.7 items; 95%CI=3.8-13.6) and the 25% discount group (+7.7 items; 95%CI=2.74 - 12.6). However, the proportion of healthy foods was not significantly higher and the discounts lead to an increased amount of energy purchased. No significant effects of the labels were found.
  
  
  CONCLUSIONS
  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. However, price discounts seem to have ambiguous effects; they do encourage the purchase of healthy products, but also lead to increased energy purchases. More research is needed to examine how pricing strategies can work in directing consumers towards interchanging unhealthier options for healthier alternatives.
authors.affiliation: Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands. w.waterlander@nihi.auckland.ac.nz
authors.forename: Wilma E
authors.initials: WE
authors.lastname: Waterlander
authors.forename: Ingrid H M
authors.initials: IH
authors.lastname: Steenhuis
authors.forename: Michiel R
authors.initials: MR
authors.lastname: de Boer
authors.forename: Albertine J
authors.initials: AJ
authors.lastname: Schuit
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Seidell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003132:Commerce; D003258:Consumer Behavior / Q000191:economics*; D004032:Diet / Q000191:economics* / Q000592:standards; D002149:Energy Intake; D005260:Female; D005515:Food Labeling / Q000191:economics*; D005518:Food Preferences; D005523:Food Supply / Q000191:economics*; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008297:Male; D040541:Marketing / Q000191:economics*; D008875:Middle Aged; D013660:Taxes; D055815:Young Adult