Trial reportBMC medicine2024
Real-world nudging, pricing, and mobile physical activity coaching was insufficient to improve lifestyle behaviours and cardiometabolic health: the Supreme Nudge parallel cluster-randomised controlled supermarket trial.
Trial report in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Just-in-Time Adaptive Interventions for Behavior Change in Physiological Health Outcomes and the Use Case for Knee Osteoarthritis: Systematic Review.Journal of medical Internet research · 2024Pooled it
- Impact of supermarket fruit and vegetable placement on store sales, customer purchasing, diet and household waste: A prospective matched-controlled cluster trial.PLoS medicine · 2026Trial
- Are Dutch adults equally susceptible to nudging and pricing strategies? Secondary analyses of the Supreme Nudge parallel cluster-randomised controlled supermarket trial.BMC medicine · 2024Trial
- Trial
- Leveraging Neighborhood-Level Interventions to Improve Cardiovascular Health: A Scoping Review.Circulation. Population health and outcomes · 2026Article
- Toward an Emerging Public Health Paradigm: Agriculture and Food Production for Health.Foods (Basel, Switzerland) · 2026Article
- Supermarket Loyalty Card Data for Delivering and Evaluating Dietary Interventions: A Narrative Review.International journal of population data science · 2026Review
- Enacting healthy checkout policies: lessons from Berkeley and Perris, California.Public health nutrition · 2025Article
- Causal loop diagramming the dynamics that shape food environments in Dutch supermarkets.BMC medicine · 2025Article
- Shopping Data for Population Health Surveillance: Opportunities, Challenges, and Future Directions.Journal of medical Internet research · 2025Article
- Can (dynamic) social norms encourage plant-based food purchases? a quasi-experimental study in real-world Dutch supermarkets.BMC medicine · 2025Article
- Can nudge interventions targeting healthy food purchases in real-world grocery stores reduce diet-related health disparities? A pooled analysis of four controlled trials.The international journal of behavioral nutrition and physical activity · 2024Article
- How might Hospital at Home enable a greener and healthier future?NPJ digital medicine · 2024Article
- Supermarket interventions to improve dietary and lifestyle behaviours: what is the key to success?BMC medicine · 2024Article
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Authors and funding
15 authors.
Funding
Abstract
backgroundContext-specific interventions may contribute to sustained behaviour change and improved health outcomes. We evaluated the real-world effects of supermarket nudging and pricing strategies and mobile physical activity coaching on diet quality, food-purchasing behaviour, walking behaviour, and cardiometabolic risk markers.
methodsThis parallel cluster-randomised controlled trial included supermarkets in socially disadvantaged neighbourhoods across the Netherlands with regular shoppers aged 30-80 years. Supermarkets were randomised to receive co-created nudging and pricing strategies promoting healthier purchasing (N = 6) or not (N = 6). Nudges targeted 9% of supermarket products and pricing strategies 3%. Subsequently, participants were individually randomised to a control (step counter app) or intervention arm (step counter and mobile coaching app) to promote walking. The primary outcome was the average change in diet quality (low (0) to high (150)) over all follow-up time points measured with a validated 40-item food frequency questionnaire at baseline and 3, 6, and 12 months. Secondary outcomes included healthier food purchasing (loyalty card-derived), daily step count (step counter app), cardiometabolic risk markers (lipid profile and HbA1c via finger prick, and waist circumference via measuring tape), and supermarket customer satisfaction (questionnaire-based: very unsatisfied (1) to very satisfied (7)), evaluated using linear mixed-models. Healthy supermarket sales (an exploratory outcome) were analysed via controlled interrupted time series analyses.
resultsOf 361 participants (162 intervention, 199 control), 73% were female, the average age was 58 (SD 11) years, and 42% were highly educated. Compared to the control arm, the intervention arm showed no statistically significant average changes over time in diet quality (β - 1.1 (95% CI - 3.8 to 1.7)), percentage healthy purchasing (β 0.7 ( - 2.7 to 4.0)), step count (β - 124.0 (- 723.1 to 475.1), or any of the cardiometabolic risk markers. Participants in the intervention arm scored 0.3 points (0.1 to 0.5) higher on customer satisfaction on average over time. Supermarket-level sales were unaffected (β - 0.0 (- 0.0 to 0.0)).
conclusionsCo-created nudging and pricing strategies that predominantly targeted healthy products via nudges were unable to increase healthier food purchases and intake nor improve cardiometabolic health. The mobile coaching intervention did not affect step count. Governmental policy measures are needed to ensure more impactful supermarket modifications that promote healthier purchases.
trial registrationDutch Trial Register ID NL7064, 30 May 2018, https://www.onderzoekmetmensen.nl/en/trial/20990.
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