Heart to Heart

JULIE GALLAGHER

Heart disease remains the No. 1 killer of both men and women in the U.S., with 80 million Americans afflicted with one or more types of cardiovascular disease.

The statistics are sobering, but Americans at risk are by no means helpless when it comes to improving their chances for survival.

That's because the keys to better health are no farther than the local grocery store.

Experts agree that food and diet play a major roll in managing or reducing risk for heart disease, heart attack, stroke, and lowering blood pressure and cholesterol.

The American Heart Association is so confident in the ability of food to minimize heart-related death, it's partnered with supermarkets to help steer shoppers toward heart-healthy food choices.

As part of a pilot coinciding with Cholesterol Awareness Month in September, the Washington-based AHA joined forces with more than 2,000 stores to gauge awareness and test the impact on sales of items bearing the AHA's heart-check mark symbol. About 900 products have been certified as heart-healthy by the AHA.

“We know that there are other nutrition systems in grocery stores and we've been looking at how the heart-check mark dovetails with them,” said Kim Stitzel, director of nutrition and obesity for the AHA.

To qualify for the on-package heart-check mark, a single serving must have: less than 3 grams of total fat; 1 gram or less of saturated fat; 20 grams or less of cholesterol; 480 milligrams or less of sodium; 10% or more of the daily value of at least vitamin A, vitamin C, iron, calcium, protein or dietary fiber; and less than 0.5 gram of trans fat.

To familiarize shoppers with these items, the AHA arranged to hang shelf tags under products bearing the heart-check mark in A&P, Albertsons, Food City, Food Town, Shaw's, Harris Teeter, Jewel-Osco, Pathmark and ShopRite stores. To avoid confusion, hanging tags included the related product's name and pricing information, the heart-check mark and the message: “Products with this mark meet criteria for Saturated Fat & Cholesterol.”

“We partnered with Vestcom, a third party who guarantees 96% accuracy,” noted Stitzel. “They went into the stores and hung the shelf tags so as not to add additional burden to the stores.” The effort was funded with fees collected from marketers of heart-check mark products.

Messages about how the heart-check mark can help shoppers maintain a heart-healthy diet were conveyed with front-of-store signs and brochures at the checkout. Reminders to look for the heart-check mark were reinforced on receipts through a partnership with Catalina Marketing.

In addition to bearing the heart-check mark symbol, receipts featured messages like: “A healthy heart is as close as your cart. Look for the American Heart Association's heart-check mark on food packaging and shelf tags throughout your store.”

Shoppers who purchased two or more items were invited, via receipt message, to take an online survey, the objective of which is to evaluate consumer awareness of in-store media on the heart-check program and to learn if and how shoppers use the heart-check mark to make purchasing decisions.

“We were trying to get a sense for who is buying these products,” Stitzel said.

Though it's too soon to gauge results, past research has shown that when consumers are presented with comparable products that meet their needs for price and taste, 50% choose the product that carries the heart-check mark.

Symbol familiarity has also proven to be high.

When consumers were presented with icons commonly used on food packaging, the heart-check mark was recognized by 83% of shoppers — that's more than those who recognized the Susan G. Komen pink breast cancer awareness ribbon, the Whole Grain Stamp and other symbols. Close to two-thirds (63%) expressed they trusted the mark.

Until the AHA finishes collecting comparison data between control stores and pilot participants, the shelf tag program's effectiveness remains to be seen.

Though results won't be compiled until December, plans for an expanded shelf tag program are already under way.

In honor of Heart Health Month in February, 5,000 stores will feature the hanging shelf tags, brochures, signs and receipt messaging in February and March.

New banners including Bashas', Food Lion, Hannaford Bros., H.E. Butt Grocery Co., Winn-Dixie, Kroger, Marsh, Price Chopper, Ralphs, Roundy's, Stater Bros. and Safeway are among the participants. H-E-B and Kroger will even feature store brands bearing the heart-check mark.

The shelf tag program will supplement other Heart Health Month efforts designed to raise awareness and influence shoppers' eating habits.

Last February, as part of Safeway's “Love Your Heart” program, it offered blood pressure, BMI (body mass index) and cholesterol level screenings (a $40 value) free of charge at store pharmacies. Campbell's Soup Co., Kellogg's, Healthy Choice, Diet Coke, Fresh Express, StarKist, Barilla Plus and Health Magazine helped sponsor the effort.

“We find this sort of outreach important to our customers because heart disease is a serious and pervasive problem,” Safeway spokeswoman Teena Massingill told SN. “It's important for everyone to be aware of the risk factors and what they can do to promote heart health.”

In addition to empowering shoppers with information about their health, the move successfully drove traffic to Safeway.“Thousands of customers were screened, and more than half said they came to the store specifically for the screening,” Massingill said.

Once there, shoppers were met with five high-traffic endcap displays featuring heart-healthy products from Coke, Campbell's, ConAgra, StarKist, Barilla, Kellogg and others, along with recipes incorporating the items, according to Mike Salzberg, president of Campbell Sales Co.

Although efforts like these focus on raising heart-health awareness, heart disease is already top of mind with almost half of all consumers.

Forty-eight percent of those polled by the International Food Information Council for its 2009 Functional Foods/Foods for Health survey said that cardiovascular disease, including heart disease, heart attack, high blood pressure, cholesterol and stroke, is their top health concern, followed by weight (31%) and cancer (24%).

The vast majority (85%) of Americans are aware that foods and beverages can help improve their heart health.

“They're seeing food as an option available to them that they can control,” said Liz Rahavi, associate director of wellness, IFIC, Washington.

Knowledge about the functional benefits tied to specific foods is also on the rise.

Awareness that whole grains can reduce heart disease risk has grown from 72% in 2007, to 83% in 2009, while the knowledge that B vitamins can reduce heart disease risk has climbed from 61% in 2007 to 78% today.

Awareness about folic acid for reduced risk of heart disease has likewise risen, from 55% two years ago to 70% today, and plant sterols from 30% to 45%.

Supermarket initiatives are likely influencing these numbers. When the AHA surveyed consumers about sources of nutrition advice, food retailers ranked fourth behind the most frequent source: the nutrition facts label, followed by physicians and the Internet, according to Stitzel.

Indeed, as more shoppers become interested in managing health care costs through diet, consumers are empowering themselves with knowledge. Supermarkets, in turn, are ramping up their educational efforts.

One of the goals at Big Y Foods, now that it's brought a second dietitian on board, is to build educational initiatives in-store, Big Y's registered dietitian, Carrie Taylor, told SN.

She hopes to launch a series of disease-specific programs that will educate small groups about specific health issues and the role that food can play in preventing and managing them. Store tours zeroing in on functional foods will help students put their knowledge to use.

Since many questions reaching the “Ask Carrie” inbox have to do with either diabetes or cholesterol, she hopes to dedicate an entire series to heart health, guiding shoppers towards foods that are low in sodium and rich in monounsaturated and polyunsaturated fats, plant sterols, antioxidants, whole grains, potassium and omega-3s.

“Heart disease is a long and chronic disease, and you can really impact your risk of developing it by taking inventory of what your risks are and start changing your behaviors,” said Taylor.