Food at checkouts in non-food stores: a cross-sectional study of a large indoor shopping mall.

OBJECTIVE To investigate the display of food at non-food store checkouts; and to classify foods by type and nutrient content, presence of price promotions and whether food was at child height. DESIGN Cross-sectional survey of checkout displays at non-food stores. Foods were classified as 'less healthy' or healthier using the UK Food Standards Agency's Nutrient Profile Model. Written price promotions were recorded. Child height was defined as the sight line of an 11-year-old approximated from UK growth charts. SETTING A large indoor shopping mall, Gateshead, UK, February-March 2014. SUBJECTS Two hundred and five out of 219 non-food stores in the shopping mall directory which were open for trading. RESULTS Thirty-two (15·6%) of 205 non-food stores displayed food at the checkout. All displayed less healthy foods, and fourteen (43·8%) had healthier foods. Overall, 5911 checkout foods were identified. Of these, 4763 (80·6%) were 'less healthy'. No fruits, vegetables, nuts or seeds were found. Of 4763 less healthy foods displayed, 195 (4·1%) were subject to price promotions, compared with twelve of 1148 (1·0%) healthier foods (χ 2(df=1)=25·4, P<0·0001). There was no difference in the proportion of less healthy (95·1%) and healthier (96·2%) foods displayed at child height. CONCLUSIONS Almost one-sixth of non-food stores displayed checkout food, the majority of which was 'less healthy' and displayed at child height. Less healthy food was more likely to be subject to a written price promotion than healthier food. Further research into the drivers and consequences of checkout food in non-food stores is needed. Public health regulation may be warranted.