Health experts from the Netherlands have suggested that government food policy would be more effective at improving diet if the focus were on maintaining low prices for healthy foods, rather than on 'consumer awareness.'

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Current food policy, which places the onus for nutrition on the consumer has fallen down, according to experts, for assuming that consumers have a working knowledge of nutrition and will act logically, an assumption which repeated tests have revealed is deeply flawed.

Researchers split Dutch shoppers into groups and provided some with money off coupons for fresh produce, some with access to free nutrition information and another group with both. The shoppers given access to money off coupons and those given discounts and healthy eating information were found not just to have bought more fruit and vegetables over the course of the study, but to have consumed more as well, whereas participants provided with cookbooks and free nutrition information did not increase consumption of vegetables.

Participants given money off coupons upped their fruit and veg consumption considerably, as well as merely buying more healthy produce, with 60 percent reported to have consumed the recommended amount of fruit and vegetables each day compared to 42 percent at the outset. Shoppers provided with money off coupons and information bought around 5kg more fresh produce than their counterparts with access to nutritional advice, while those with only discounts bought 4kg more fruit and veg.

The study was conducted by Wilma Waterlander from the University of Auckland and VU University Amsterdam. Elaborating on her results, she told Farming Online that nutritional information had played even less of a role in driving healthy eating than her team had expected at the outset. Dr Waterlander said, "We did hypothesize that the nutrition education could further increase the effects of the pricing strategy, however, this was not the case. The price discounts did significantly and substantially increase fruit and vegetable purchases, but there were no effects of the nutrition education on fruit and vegetable purchases."

Nevertheless, the six month study did reveal a number of positive trends associated with discounting; notably that consumers didn't spend money saved on highly processed food items in other areas of the store. She claimed that her findings run counter to actual supermarket business practices and government health strategies; in supermarket price wars being fought across Europe, retailers tend to price certain items, including beer, milk and bread at a loss, whilst keeping the price of fresh produce high to compensate, she said.

This is a problem in the Netherlands, where bitter price wars are ongoing, though Dr Waterlander acknowledged that the situation is not always so simple, and "In Belgium… this is less the case because a law prevents supermarkets from selling products under buying price." She said supermarkets "can definitely play a role in stimulating healthier food choices, for example by reducing the price promotions on unhealthier food and lowering fruit and vegetable prices." She explained that large retailers are merely one player in a highly commercialized food system.

Adding that government policies also uphold the current food system, Dr Waterlander said that in some cases current policy directly contradicts her findings on promoting healthy diets. She said, "Agricultural subsidies (such as CAP) also play a role in this. Some commodities (dairy, sugar, corn) are highly subsidized leading to relatively low prices for many (unhealthy) processed foods."

Food policy expert: "Make healthy food the easy choice"

In earlier research in New Zealand, Waterlander found that a 25 percent discount on fruits and vegetables was effective in stimulating purchases of those products without leading to higher expenditures on unhealthy foods. However, she said that further study is needed before her findings can be implemented in health policy, including finding an optimal amount for discounts to be effective and examining variations between countries and socio-economic groups.

Evidence from the EU provides conflicting images of changing consumption patterns in the current recession; although in Cyprus, purchases of fresh produce appear to have fallen, in Spain, which has been severely hit, fruit and vegetable purchases have remained steady, whilst almost all varieties of meat have suffered.

Expanding on the relevance of the study to recession-stricken European consumers, Dr Waterlander said, "Healthy food has previously been found to be relatively more expensive then unhealthy food and studies have shown that price is indeed a barrier for healthy food choices, especially for people with a lower income. This was also one of the reasons that we were interested in the effects of price discounts on fruits and vegetables. The current economic recession means that a growing number of people are struggling with their finances. Making sure that healthy food is affordable is therefore very relevant."

On the policy implications of her study, Dr Waterlander was critical of the neoliberal approach to nutritional health, as adopted in the UK; the policy, which focuses on 'education', tends to pit the government against food retailers (through advising on healthy diets while marketing 'value added', unhealthy products). Dr Waterlander said, "My research does not support the education model which posits that if we educate people about healthy eating, they will make healthier food choices. If we want that people choose healthier diets, we should make the healthy choice the easy choice."

She reiterated that "intensive" nutrition education (which included telephone counselling by a qualified dietician) had no effects on fruit and vegetable purchases. Dr Waterlander said that, although price discounts did have substantial effects on fruit and vegetable purchases, the positive effects disappeared when the price intervention stopped. She continued, "My idea about nutrition education is that we should not aim to educate people to resist a highly commercialised food system that builds on consumption based growth (e.g. sell as much food as possible), instead, we should try to change the system and make the healthy choice the easy choice."

For the next stage of her research, Dr Waterlander hopes to expand her analysis of the food system  to cover production, wholesale and distribution a s well as retail, "to identify drivers that determine the availability, affordability and accessibility of healthy and unhealthy food [in order] to develop interventions that can make healthy food more affordable and accessible." Expressing the desire to include an element of environmental sustainability into her ongoing research, She stated, "Changing the food system might be more sustainable then developing interventions that have to work against it".

However, based on her current findings, Dr Waterlander concluded that in countries where fresh produce is expensive, "Discounting Fruit and Vegetables is a promising intervention strategy," because it has been shown to translate into "substantially higher purchases, and no adverse effects." De Waterlander is now continuing her research at the University of Auckland, New Zealand.