COVER STORY: Weighing obesity

Obesity has quickly become one of the most talked-about health epidemics in the United States, and the issue could have some weighty implications for the food industry. Already manufacturers, prompted by experts who point to diet as part of the problem, have begun looking for short- and long-term solutions. Many are offering health-related information on their Web sites, some have altered their advertising and marketing strategies, and product innovations are coming down the pipeline faster than you can say skinny.

Obviously retailers aren't being blamed for consumers' eating choices, but observers say they have an opportunity, even a responsibility, to take on a significant role in America's quest for better health and smaller waistlines. Retailers can offer value-added services like nutrition education, which may ultimately win shoppers' loyalty. They can also create diet- or health-related sections that are easier to find, and they can highlight healthy foods that more mainstream shoppers are now looking for.

The magnitude of the issue came to light at the end of 2001, when the U.S. Surgeon General began calling for a national plan of action against obesity. The government reported that six in 10 Americans are either overweight or obese. Even more alarming was the news that the proportion of overweight children had doubled in the past 20 years to 13 percent. The factors contributing to this complex problem, now largely seen as a social issue, are thought to be many. Among them are lack of exercise (the Centers for Disease Control and Prevention report that one in four Americans gets virtually no exercise), an on-the-go lifestyle that leaves little time for healthy eating, and, in some cases, heredity. But no one can deny that food plays a significant role.

Most experts agree that the average portion eaten by Americans—at restaurants and at home—is too large. However, when it comes to individual foods and the role they play, the issue gets tricky, especially when you're in business to sell food.

More than one observer has begun likening the food business to the tobacco industry, which became the target of lawsuits and high taxes as smoking came to be viewed as a social issue. Kelly Brownell, director of the Yale University Center for Eating and Weight Disorders, was quoted in a USA Today article observing, "Thirty years ago no one could have imagined that smoking would be banned in most public places, that there would be very high taxes on cigarettes, and that states would have successfully sued tobacco companies." Brownell and others, who view certain high-calorie foods as culprits, have suggested adding a small tax on soft drinks, candy, and some snack foods.

Other preventive measures being touted include banning junk-food ads during children's TV programs and offering healthier snacks and drinks in school vending machines. One San Francisco lawyer made headlines in May when he filed a lawsuit against Kraft Foods to ban the sale of Oreo cookies to children living in California. He quickly withdrew the suit, admitting that it was a stunt to draw attention to his crusade against trans fat, also known as partially hydrogenated vegetable oil.

Some critics warn that this negative attention is just the beginning. Marion Nestle, chair of the department of nutrition and food studies at New York University and author of Food Politics: How the Food Industry Influences Nutrition and Health, is particularly outspoken on the topic. "From an industry standpoint, the issue is very simple," she says. "People are obese because they're eating too much for the amount of energy they're expending. If they want to do something about it, they have to eat less. Eating less is going to have a huge effect on the food industry."

Food manufacturers need to make changes now or they'll run the risk of a consumer backlash, Nestle warns. They should be contemplating their products, package sizes, and advertising and marketing strategies, particularly the ads that target children. Even investment analysts are beginning to get involved by doing analyses of the vulnerability of food companies to those who are doing something about the obesity epidemic, says Nestle.

'A vicious circle'

Chicago-based public relations firm Golin/Harris last summer created a Global Obesity Task Force designed to counsel businesses that come under fire. "Most of what we're doing is tracking the issue daily and then looking for the right kinds of partnerships for our clients, whether it be government, not-for-profit, or other," says Kathy Weber, Golin/Harris s.v.p. and director of food and nutrition marketing. "Certain industries are obviously under more scrutiny than others," she adds, putting food manufacturers near the top of the list, but behind the foodservice industry because its products aren't labeled. "It's hard for food companies, because they're trying to meet a lot of needs, certainly convenience being a big one. It's a vicious circle," she says.

Many leading consumer packaged goods firms have begun making changes in their business practices to show their concern about the obesity epidemic. Perhaps most notable was PepsiCo's commitment that 50 percent of its new products will be composed of healthier ingredients or offer improved health benefits. The company began by eliminating all trans fats from its Frito-Lay division's corn chips, and announced in April the launch of a new Natural line of snacks under the Frito-Lay brand. Other companies that have taken proactive measures include Gerber Products, General Mills, and ConAgra. (See sidebar at left.)

Many in the food industry point to the importance of exercise in maintaining a healthy weight. A coalition of food and beverage companies, not-for-profit organizations, and trade associations formed a nonprofit group called the American Council for Fitness and Nutrition, which maintains that individual foods aren't bad when eaten in moderation, and that the importance of good physical condition can't be overemphasized. "We have wonderful food choices in America—we just have to select them wisely. That's not to say you don't have a soda, candy, or cookies," says council chair Susan Finn.

Nutrition education is a primary function of the council, says Finn, a former president of the American Dietetic Association. Americans get most of their nutrition information from the media, and schools are "sorely lacking" good programs, she notes. To counter that, the council is referring adults to the U.S. Department of Agriculture and other sources of information, as well as promoting more fitness and nutrition education in schools.

Education is one area where supermarkets can help consumers, say Finn and others in the industry. Seventy-five percent of meals are eaten at home, which means consumers are making a substantial share of their food choices in supermarkets. That's a built-in captive audience in need of education and guidance, and the retailers who seize the opportunity can establish a niche in customers' minds.

Supermarkets as educators

Landover, Md.-based Giant Food has been at the forefront of nutrition education, advising customers on diabetes and other health issues, including obesity, for nearly 30 years. The retailer has two dietitians on staff—unusual for a supermarket company—and offers store tours and free nutrition advice to customers on its Web site, in newsletters, and via a telephone hotline.

Janet Tenney, manager of nutrition programs, says the services are value-added, but they are a point of differentiation for Giant. "Supermarkets aren't the absolute education source, but they can provide information for those customers who want the information," she says. "We've put more than 10,000 people through diabetes-focused store tours, and I'd say 99 percent of those people would say they learned a lot and would recommend it to anyone else who has diabetes."

Giant's Healthy Ideas newsletter focuses on weight issues at least once a year, adds Tenney. The chain also partners with the Produce for Better Health Foundation, which runs the 5 A Day program, and other groups to promote nutritious eating. (Suggestions from PBH president Elizabeth Pivonka on boosting produce sales during the September observance of 5 A Day Month appear on page 72.)

In Virginia, Richmond-based Ukrop's Super Markets, Inc. has established a niche in nutrition and wellness, with a new emphasis being placed on obesity. The company's pharmacy departments now offer obesity screening, or measurement of body mass index, among other health screening services.

"We care about it because we want to have an impact on the health of our customers, but it's also a big opportunity," says John Beckner, director of pharmacy and health services. "I think supermarkets have a responsibility. You can't preach to people, but you can offer healthy choices and healthy options, then let them make their own decision based on the information you give them."

Ukrop's staff includes a manager of nutrition and wellness, as well as three full-time and two part-time dietitians, who are all able and willing to answer consumers' questions. The company's nutrition hotline has received a steady increase in obesity-related questions from consumers in the past year, notes Beckner.

Like Giant and Ukrop's, Asheville, N.C.-based Ingles Markets has a corporate dietitian and offers a hotline, health screenings, and nutrition information on its Web site. But the company's dietitian, Leah McGrath, says she sees supermarkets' primary role as responding to consumer demand rather than being primary educator. "In focus groups, I'm hearing more concern about lower-sodium products and products that fit into Weight Watchers or other diets. Customers are looking for specific products that will help them lower their cholesterol, blood pressure, fat intake, and sugar intake," says McGrath.

An influx of these health-related products has presented new merchandising challenges for supermarkets. Some manufacturers, including Atkins Nutritionals, promoter of the popular Atkins diet, are offering ready-made displays with their products. "Many of our supermarket clients are putting up four-foot Controlled Carbohydrate centers. We've found that they increase velocity by four times," says Matthew Wiant, Atkins' chief marketing officer. The centers are often placed next to Slim-Fast or other diet products, or in some cases natural food sections, so customers don't have to run around the store looking for products. Albertsons and other supermarket operators have dedicated more space to diet/weight-loss sections, he adds.

Beckner says Ukrop's is allotting space in its new stores for special natural/organic and health-related sections, which are placed near the pharmacy.

Whole health merchandising

Obesity, like other health-related issues that have impacted food retailing in recent years, relates back to an emphasis on whole health merchandising, a concept touted by the General Merchandise Distributors Council. Whole health merchandising brings together product groupings that enhance health but are not necessarily controlled by the same department within a supermarket's buying organization. The elements include healthy foods such as produce, organics, and bulk foods; vitamins, supplements, natural products, and herbals; health care devices; over-the-counter drugs; and pharmaceuticals. "The national concern about obesity can only help the development of whole health, because at its heart is healthy eating," says Roy White, v.p. of education at the New York-based GMDC Educational Foundation.

To make whole health merchandising work, however, there must be an advocate at store level, says White. "If you're going to roll the obesity issue into your whole health concept, there will have to be an advocate. It takes staffing, but it also takes recognition back at headquarters that there should be some marketing against it."

Some retailers have found it helpful to partner with health-related organizations to provide services. New Stanton, Pa.-based Shop 'n Save recently offered a program called Three Rivers Lifestyle, which was developed and administered by the nutrition and fitness staff at HealthPLACE, a division of Highmark Blue Cross Blue Shield. The program combined a four-week nutritious meal plan with health and fitness tips, and included a series of cooking and health-related programs at designated stores. Shoppers were given different menus and recipes that incorporated specific food items specially marked in each store. More than 75,000 pamphlets were distributed—a 25 percent increase compared to last year's program, according to Shop 'n Save senior advertising manager Rich Haeflein.

"The program offered help and guidance about an important health issue—obesity," says Haeflein. "The four weeks of menus and recipes incorporated a variety of food choices. The food preparation was designed to be easy and time-saving, while providing all the essential nutrients needed to maintain good adult health."

Call to action

Realistically speaking, how far should a supermarket go in advising customers on diet? The issue remains complicated, especially when factors like slotting fees and how they influence product placement are taken into consideration. Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, a consumer group, says she wishes supermarkets would place their products in a way that supports families' efforts to eat better. As the mother of a young daughter, she sees the impact of placing kids' products featuring cartoon characters at children's eye level. "Parents are tired of our kids pestering us for products that have all these characters. The food industry talks about parental responsibility, saying it's up to parents to make sure their kids eat well. But they make it harder for us as parents to be responsible," she says.

While this is just one view, it may be indicative of problems that will surface as society examines the food industry's practices. That's why it's important that everyone's on the same page, says Finn of the American Council for Fitness and Nutrition. "If we really believe that the long-term solution is variety, moderation, balance, and activity, then we all need to be singing from the same hymnbook.

"This is a major epidemic—it's not going to go away," Finn continues. "When you have 10 percent of America's health care costs and 30 chronic diseases attributed to obesity, and you're seeing type 2 diabetes in kids, it's not a fad." Another statistic sure to prompt action: Obesity accounted for 300,000 deaths last year, putting it in the same league as tobacco.

Supermarkets, viewed in many areas as community centers, have always had a responsibility to be good corporate citizens. Wootan of the Center for Science in the Public Interest says she sees their obligation now as higher. "The grocers aren't responsible for obesity, but some of their practices are contributing. They should step up to the plate and do what they can."
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