The Food (Promotion and Placement) regulations are beginning to shift the onus for healthier choices from individuals to businesses: in-depth perspectives from health experts

Abstract

Background: retail food environments in the UK use intense marketing strategies to promote the purchase and consumption of less-healthy foods that are associated with ill-health. To help address this issue, the Food (Promotion and Placement) regulations were introduced in England from October 2022, banning the placement of foods high in fat, salt, or sugar (HFSS) at checkouts, aisle-ends, and entrances in qualifying retail settings. Ahead of their introduction, this study examined health experts' (i) perspectives on the likely effectiveness of these regulations and (ii) recommendations to enhance their impact.

Methods: this cross-sectional qualitative study aimed to recruit health experts to partake in focus groups/semi-structured interviews via MS Teams. Data were collected, coded, and analysed by three researchers with input from senior colleagues, using Braun and Clarke's reflexive thematic analysis method.

Results: data were collected between October 2021 and March 2022 from 28 health experts, including public health and food policy academics (n = 9) and experts from civil society organisations (n = 19). Health experts perceived regulations as a major policy innovation which recognised businesses' role in driving poor dietary choices that contribute to obesity. They also raised concerns about the outdated nutrient profiling model, limited regulatory scope, and weak enforcement. They were apprehensive about the potential for disproportionate impacts on smaller businesses and certain consumer groups. To enhance the impact of the regulations, they recommended funding independent and diverse evaluations, mandating the reporting of business sales data, and strengthening enforcement efforts. To improve the regulations' effectiveness, they also suggested establishing mechanisms to refine regulatory guidance and introducing complementary policies within the food system.

Conclusions: health experts believed that the regulations represent a significant step to curb the promotion of unhealthy foods in retail environments but will be insufficient on their own to improve population diet. To maximise their impact, a systems approach is essential, addressing shortcomings of the regulations, supporting smaller retailers in adopting health initiatives, and implementing thorough monitoring and evaluation. The regulations must form part of a comprehensive set of policies across various sectors, including manufacturing and retail, to accelerate food system transformation and address the dietary drivers of ill-health.

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