Supermarkets and convenience stores have been costly to people’s health

In many countries, buying food at supermarkets, convenience stores and online has become the norm. But what’s the convenience of modern food shopping doing to our health?

Our study, published on March 3 with colleagues from Unicef, looked at how people in 97 countries shopped for groceries over 15 years.

Globally, we found a huge increase in the number of supermarkets and convenience stores (which we’ll shorten to chain grocery stores in this article). We also found people are spending more money in these stores and on their online platforms.

But this has come at a cost to our health. People in countries with the most chain grocery stores per person buy more unhealthy food and are more likely to be obese.

Here’s why we’re so concerned about this public health disaster.

Rise of chain grocery stores

Our study analysed food industry data from a business database to understand how the food retail sector has changed worldwide over time. We looked at the kinds of stores, how much people spend there, and how much unhealthy processed food is sold. We linked these trends with changes in obesity rates using data from a large global initiative.

We found the density of chain grocery stores (number of stores per 10,000 people) has increased globally by 23.6 per cent over 15 years (from 2009 to 2023).

We found far more of these stores per person in high-income countries, as you may expect. However, it’s in low- and middle-income countries where numbers are increasing the fastest.

Rapid urbanisation, rising incomes and customer demand mean large retail companies see these countries as new potential markets.

For example, the density of chain grocery stores increased by about 21 per cent a year in Myanmar, about 18 per cent a year in Vietnam and about 12 per cent a year in Cambodia.

Online shopping

The data in our study also covers the rise of online food shopping. For instance, the worldwide spend on online grocery shopping was 325 per cent more in 2023 compared with 2014.

Out of the 27 countries we looked at for online food shopping, people in the United Arab Emirates (UAE) and the United States were the top spenders. In 2023, the average person in the UAE spent US$617 (S$830), 570 per cent more than in 2014. In the US, the average person spent US$387 in 2023. That’s about 125 per cent more than in 2014.

It seems many of us took to online shopping during the early days of the Covid-19 pandemic, a habit that appears to have stuck.

More chain stores, more junk food, more obesity

The rise of chain grocery stores, including their online platforms, is also changing what we eat.

Over the 15 years of our study, there has been a 10.9 per cent increase in the sales of unhealthy processed food from those chain grocery stores.

In South Asia, the rise has been particularly rapid. People in Pakistan have been buying 5 per cent more unhealthy processed foods from chain grocery stores each year for the past 15 years. In India, it’s 4 per cent more and in Bangladesh it’s 3 per cent more.

Over 15 years, our study also showed the percentage of people with obesity across all countries rose from 18.2 per cent to 23.7 per cent. It was the countries with the biggest increases in chain grocery stores where we saw the sharpest increases in obesity.

Laos is a good example. The number of chain grocery stores per person in the country has been increasing by 15 per cent each year since 2009, while the percentage of people with obesity has doubled from 2009 to 2023.

In almost all countries, obesity is on the rise. In Australia, obesity and being overweight have recently officially overtaken tobacco as the biggest burden on the country’s health.

Why are supermarkets to blame?

Supermarkets and hypermarkets sell healthy foods, such as fruit and vegetables. Yet, there are good reasons to think our retail environment might be to blame for the rise in obesity.

What can we do about it?

There are many social, political, cultural and economic factors that contribute to the rise in obesity globally. Many of these relate to the price, availability and promotion of food in retail settings and the way the retail industry is structured.

We think it’s time for governments and retailers to step up and start making changes to where and how we shop for food.

Some countries are already beginning to act. In Britain, for example, government legislation now prevents the placement of unhealthy foods in prominent places such as the checkout counter and at the ends of aisles close to checkouts. From October 2025, further restrictions on the price promotion of unhealthy foods (such as “buy one, get one free”) will also come into force in the country.

There is also plenty that retailers can do. In Norway, for example, one major grocery chain launched a comprehensive healthy eating campaign several years ago, including by increasing the size and prominence of healthy food displays and offering discounts on fruit and vegetables. This led to a 42 per cent increase in vegetable sales and a 25 per cent rise in fruit sales from 2012 until 2020.

But most grocery chains are still not doing enough to prioritise their customers’ health and nutrition. In the US, we see this in particular for supermarkets catering to people on low incomes. And in Britain, although there has been some promising progress by some supermarket retailers, all those assessed have considerable scope for improvement.

Now more than ever, it is time to create healthier retail food environments that support nutritious diets and help reverse the rising rates of obesity.