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Changing global food retail environments linked to rise in obesity

Changes in retail food environments – particularly the growing prominence of large chains – are positively correlated with rising obesity prevalence, a study suggests.

Researchers investigated how retail food environments impact consumers’ purchasing decisions and dietary patterns, examining differences across geographical regions and the link with diet-related non-communicable diseases (NCDs).

Writing in the journal Nature Food, they found that “global food retail environments are increasingly dominated by large chains

and linked to the rising prevalence of obesity”.

Researchers from the Global Centre for Preventive Health and Nutrition (GLOBE) at Deakin University in Australia and the UNICEF East Asia and Pacific Regional Office in Thailand conducted a global analysis of the food retail environments from 2009 to 2023, across 97 countries.

The rise of large retail chains

The study found increases in the density of retail chain outlets, chain retailers’ grocery sales, unhealthy sales per capital, digital grocery sales, and non-retail chain outlet numbers over this period. The ratio of non-chain to chain retail outlets decreased over the 14 years measured, indicating a relative rise in retail chains worldwide.

Global urbanisation, industrialisation, and increasingly digitalised food systems have been behind the move away from independently owned retailers and traditional food systems and towards the growth of large retail chains.

South Asia was the geographical region that saw the biggest and most noticeable change. From a demographic perspective, low- and middle-income countries witnessed the most significant transformation. In some low- and middle-income countries, as well as underserved areas in higher-income countries, independent outlets can be the only source of a community’s food.

The researchers found a positive relationship between changes in retail environments and the prevalence of obesity. As the shopping landscape becomes increasingly digital and led by larger chains, they anticipate significant impacts on diet and health, particularly in lower-income countries.

Links between retail environments and obesity

How retail environments are owned and managed can have an important influence on public health.

Larger and more uniform retail environments offer advantages such as food safety standards, convenience, and more affordable prices due to economies of scale. However, they also intensify the imbalance in access to food and public health concerns and contribute to the replacement of traditional diets of grains, fruits, and vegetables with more highly processed packaged food.

Large retail chains have multifaceted supply chains and considerable positioning and power within the food and beverage market. As such, researchers found that their status can influence food access, dietary patterns and health at local, national, and global levels.

Moreover, the close collaboration between retail outlets and multinational food producers can create a consistent marketing message and elevate the promotion of highly processed foods.

Highly processed foods that lack nutritional value are concerning, as they contribute to the current diet-related NCD pandemic of obesity, type 2 diabetes, and cardiovascular diseases.

The World Health Organisation (WHO) reports that NCDs killed at least 43 million people in 2021. The researchers also noted that the overconsumption of such foods has a negative impact on planetary health.

How to shape retail to tackle obesity

The researchers recommended that stakeholders urgently consider the impact of the changing global retail environment on human and planetary health, particularly in low- and middle-income countries where change is most noticeable.

Countries in the early stages of a food retail transition need to ensure that consumer health is taken into account from the outset when large chains are established, as this is difficult to address once the chains have reached a dominant status.

Policymakers, public health advocates, and retailers in countries that have well-developed large retail chain environments have trouble retro-fitting them to focus on public and planetary health, the researchers added.