Nordic Innovation Report 2011:04 // March Nordic Young Health. Possibilities and barriers for new, healthy concepts in the fast food sector

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1 Nordic Innovation Report 2011:04 // March 2011 Nordic Young Health Possibilities and barriers for new, healthy concepts in the fast food sector

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3 Nordic Young Health Possibilities and barriers for new, healthy concepts in the fast food sector Authors: Johanna Mäkelä, Kjersti Lillebø and Minna Lammi (eds.) March 2011 Nordic Innovation Publication 2011:04

4 Nordic Young Health Possibilities and barriers for new, healthy concepts in the fast food sector Nordic Innovation Publication 2011:04 Nordic Innovation, Oslo 2011 ISBN (Print) ISBN (URL: This publication can be downloaded free of charge as a pdf-file from Other Nordic Innovation publications are also freely available at the same web address. Publisher Nordic Innovation, Stensberggata 25, NO-0170 Oslo, Norway Phone: (+47) Fax: (+47) info@nordicinnovation.org Cover photo: istockphoto.com Copyright Nordic Innovation All rights reserved. This publication includes material protected under copyright law, the copyright for which is held by Nordic Innovation or a third party. Material contained here may not be used for commercial purposes. The contents are the opinion of the writers concerned and do not represent the official Nordic Innovation position. Nordic Innovation bears no responsibility Copyright for any possible Nordic damage Innovation arising from All the rights use of reserved. this material. The original source must be mentioned when quoting from This this publication. includes material protected under copyright law, the copyright for which is held by Nordic Innovation or a third party. Material contained here may not be used for commercial purposes. The contents are the opinion of the writers concerned and do not represent the official Nordic Innovation position. Nordic Innovation bears no responsibility for any possible damage arising from the use of this material. The original source must be mentioned when quoting from this publication.

5 Project participants Research group Norway National Institute for Consumer Research (SIFO) Kjersti Lillebø (project leader) Randi Lavik Nofima Mat AS Øydis Ueland Denmark DTU National Food Institute, Department of Nutrition Margit V. Groth Mette Rosenlund Sørensen Reference group Norway Norwegian Hospitality Association/ NHO Reiseliv SAS Service Partner Snadderkiosken Umoe Catering NorgesGruppen ASA Shell Mix-kjeden Tine Stabburet Bama Ministry of Children and Equality, BLD Finland S Group Raisio Group National Nutrition Council Finland National Consumer Research Centre (NCRC) Johanna Mäkelä Minna Lammi Iceland University of Iceland & Landspitali-University Hospital Unit for Nutrition Research Alfons Ramel Fjóla Dröfn Guðmundsdóttir Sweden Center for Consumer Science (CFK) Helene Brembeck Jakob Wenzer Denmark Unilever Foodsolutions DK Unilever Nordic Lantmännen Unibake Kost-og ernæringsforbundet DI/Fødevareindustrien Sweden Findus ICA Sodexho Skolmåltidsakademin Institutionen för mat, hälsa och miljö Göteborg universitet Nordic Service Partners Eurest Services AB

6 6 Nordic Young Health: Possibilities and barriers for new, healthy concepts in the fast food sector Executive summary The aim of the Nordic Young Health project was to produce new knowledge on the personal, socio-economic and structural determinants influencing Nordic young people s food practices and preferences in the fast food sector. The goal was also to create innovative concepts that can lead to better fast food products and menus, and also to stimulate effective policies that can make healthier choices more easily available for young people. Objectives of the project To establish a platform for cooperation between consumer research institutions, authorities and fast food industries. To secure Nordic young people (age 15-29) a voice in the development of viable and healthier fast food products. To produce new knowledge on the personal, socio-economic and structural determinants influencing Nordic young people s food practices and preferences in the fast food sector. To translate the knowledge into innovative concepts that can stimulate the development of healthier fast food products and menus and effective policies that can make healthier choices more easily available for young people. The study has achieved this aim by Six work packages. WP 1 was the kick-off meeting in Oslo in spring 2009 where goals and framework of the project was discussed and agreed upon with the reference group that included food companies active in Nordic markets and authorities.

7 Executive summary 7 WP 2 included surveys on Nordic young people s views on food on the go. WP 3 consisted of fieldwork mapping young people and the Nordic fast food markets in Oslo and Gothenburg. WP 4 focused on testing new healthier products in Oslo and Reykjavik. WP 5 disseminated results. WP 6 was about coordination of the project. A platform for cooperation between consumer research institutions, authorities and fast food industry was created as a collaborative network that kept in contact through an inspiring kick-off meeting and seminar in Norway, YoungHealth list and newsletters, and participation at a successful concluding seminar in Copenhagen. A well-planned multi-sectored workshop in Stockholm was cancelled due to the industry s sudden change in economic situation, as the financial crisis emerged at that specific time. This network has, non-the-less, opened up for easier cooperation between the stakeholders and researchers in the future, and has participated in dialog groups with health and consumer authorities. There is every reason to believe that the connections and networks made through this Nordic Young Health project will continue in a more informal manner after the project s finalization. Nordic young people (age 15-29) voices have been heard and secured through the executed and analyzed quantitative surveys, school visits, interviews and conversations during the fieldworks, as well as representation at the final, concluding seminar which allowed for direct discussions with, and input to, industry representatives and authorities. The process of testing a new, healthier product on Iceland was done in close cooperation with young people. Distribution of these findings will secure these voices to be heard also in the future. All project presentations are publicly accessible on the internet. Methods The project consisted of several sub-studies that used a number of different methods including questionnaires, qualitative fieldwork, focus group discussions and an experimental dietary crossover study.

8 8 Nordic Young Health: Possibilities and barriers for new, healthy concepts in the fast food sector Main results Similar barriers for healthy eating were revealed by the different studies: food (no healthy options), price (healthy options are too expensive), premises (not enough places), location (centre-outskirts, a fair amount of choice in city centres, hardly any in the outskirts). Possibilities Fast food with less fat, or that is less processed, with more fruit and vegetables and wholegrain were the changes most commonly called for by the participants. The specific products suggested by the young people were soups, whole grain bread, fish and low fat meat One third of the participants in the survey did not eat fast food because they found it too unhealthy. Health-conscious people are a market opportunity The respondents who were served a healthy fast food meal liked it to a similar extent as the unhealthy meal they were served Taste was mentioned often as a reason to eat fast food. Healthy fast food should taste good and be cheap. Value-for-money offers on healthy food More flexibility and variation for individual choice could favour healthier fast food. The healthy option should be made the standard and not something special you have to ask for Emotions and nostalgia were other important reasons to choose a meal, and this should be accommodated by healthy fast food meals as well Possibilities for social engagement during the meal is important Healthy ingredients (e.g. chicken) contributed to the high status of a fast food product Barriers The present market does not offer the consumer free choice unhealthy fast food is the standard Information about the products might be misleading Keeping products fresh

9 Executive summary 9 The need for corporate responsibility from the fast food industry for producing healthy fast food Difficult to have low prices on healthy options Impact on fast food market and policy during project period Innovation: Difficult to estimate this project s specific role in market changes during project period as innovation of new products takes time. Concrete recommendations from our findings have been discussed with industry. Policy: Dialog groups between authorities, researchers and industry on the topic of healthier fast food has been formed in Norway and Denmark. Increased focus on the need for more knowledge on the fast food market in order to change it, i.e. additional surveys by the Norwegian Consumer Council (Forbrukerrådet). Public Discourse: Young Health results have achieved much attention in all Nordic countries, there is great interest in the topic of healthier fast food in the Nordic media today. Recommendations for continued studies Studies on triggers and cues for the choice of healthier fast food combined with observation studies in fast food outlets about the marketing and presentation of healthy and unhealthy food Studies of logistics and possibilities to use more local products Projects on product development and optimization for healthy options, storage and handling

10 Table of contents Project participants...5 Executive summary...6 Preface Introduction Nordic Young Health Studies Aims and structure of Nordic Young Health Increasing knowledge, inspiring change Survey: Young people in the fast food market in Nordic Countries Qualitative field studies Access and availability in the Norwegian fast food market a qualitative mapping Food-related practices in Gothenburg, Sweden Towards healthier food on the go in Norway and Sweden Testing of new healthy fast food concepts Acceptability of improved fast food in Iceland Young consumers fast food behaviour in Norway Dissemination activities Newsletters Concluding seminar Factors ensuring a successful Concluding Seminar Lessons learned Barriers and possibilities Collaboration and innovation Creativity in spite of financial constraints Appendices Common Observation Guide Nordic Web survey (English Version) Young Health Project Poster Young Health Concluding Seminar Program...55 Table of abstract...60

11 PREFACE 11 Preface A paradox of our time is that despite the increasing consumption rates of high fat, high sugar fast food, young people report trying to avoid eating unhealthy. This indicates a fast food market with untapped potential when it comes to offering healthier options. The Nordic Young Health: Possibilities and barriers for new, healthy concepts in the fast food sector project s point of departure is that people today, and youth in particular, would eat healthier if they had easier access to affordable healthy food options in the public sphere. Therefore, by establishing cooperation between consumer research institutions, authorities and businesses, the Nordic Young Health project s main aim has been to yield new information on Nordic young people s fast food practices and preferences by means of both quantitative and qualitative studies. Specifically, we have been interested in disclosing structural barriers and possibilities that influence the Nordic fast food landscape. The project is part of Nordic Innovations Center (NICe) s Healthier choices made easier for all focus area, and has been partly funded by NICe. The National Institute for Consumer Research (SIFO) in Norway has initiated and coordinated the project and Kjersti Lillebø (SIFO) has been the project leader. The rest of the research group consists of Randi Lavik (SIFO, Norway), Johanna Mäkelä (National Consumer Research Centre NCRC, Finland), Margit V. Groth, Mette Rosenlund Sørensen (DTU National Food Institute, Department of Nutrition, Denmark) Alfons Ramel, Fjóla Dröfn Guðmundsdóttir (University of Iceland & Landspitali-University Hospital, Unit for Nutrition Research, Iceland), Øydis Ueland (Nofima Mat AS, Norway), Helene Brembeck, Jakob Wenzer, Center for Consumer Science CFK, Sweden). We wish to thank everyone in the research group for their important contributions in this project. Particularly we would like to thank Johanna Mäkelä for her with this report during the six months Kjersti Lillebø was away on parental leave. We would also like to thank Susan Heiskanen for the language editing of the report. March, 2011 The National Institute for Consumer Research, Norway Randi Lavik

12 12 Nordic Young Health: Possibilities and barriers for new, healthy concepts in the fast food sector 1 Introduction A major public health threat in today s Nordic societies are the increasing rates of overweight and obesity, especially among children and young people. The fast food sector, which constitutes a main venue where young people eat outside the home, is thus an important arena to study in order to open up for changes in this trend. Despite the increasing consumption rates of unhealthy fast food, many young people report trying to avoid eating unhealthy. This indicates a fast food market with untapped potential when it comes to offering healthier options. The point of departure of the project Nordic Young Health: Possibilities and barriers for new, healthy concepts in the fast food sector has been that people today, and young people in particular, would eat healthier if they had easier access to affordable healthy food options in the public sphere. Therefore the central aim is to produce new knowledge on the personal, socio-economic and structural determinants influencing Nordic young people s food practices and preferences in the fast food sector. In the project fast food was defined as follows: By fast food we refer to ready-prepared hot foods like hot dogs, hamburgers, French fries and pizza slices, as well as cold foods, like baguettes/sandwiches, snacks, fruit, sweet buns, yogurt etc. The short definition is: Quick to prepare, to serve and to eat. The most typical fast foods are pizza slices, hamburgers, French fries, hot dogs and buns. Fast food is often also food on the go, i.e. food that can be eaten while walking or driving. Nordic Young Health is a collaborative project among Nordic researchers in consumer research and nutrition. The National Institute for Consumer Research (SIFO) in Norway has coordinated the project. The other research partners are the Centre for Consumer Science (CFK) in Sweden, National Consumer Research Centre (NCRC) in Finland, DTU National Food Institute in Denmark, Nofima Mat AS in Norway and Landspitali-University Hospital University of Iceland, Unit for Nutrition Research in Iceland. The project was financed by the Nordic Innovation Centre (NICe) and the participating institutions. The project also had a reference group that was established in order to enhance cooperation between consumer research institutions, authorities and businesses.

13 Nordic Young Health Studies 13 2 Nordic Young Health Studies 2.1 Aims and structure of Nordic Young Health The aim of the Nordic Young Health project was to provide new knowledge on the personal, socio-economic and structural determinants connected to young people s food practices and preferences in the eating-out sector. New knowledge was gathered through surveys in four and qualitative fieldwork in two Nordic countries. Another goal was to investigate young people s attitudes towards products on the current fast food market and to translate this knowledge into innovative concepts by testing an improved fast food menu. Furthermore, an important goal was to facilitate exchange of best practices and to translate the new knowledge produced into the development of innovative concepts for new and better food products and menus in the public out-of-home eating sector. Therefore, special attention was paid to the dissemination of results in the form of newsletters and seminars as an integral part of the project already in its implementation phase. The project consisted of six work packages. The first work package was the kick-off meeting in Oslo in spring 2009, where the general aims and framework of the project were discussed and approved among the project group and the reference group. The second work package included planning, executing and analyzing the surveys conducted in four Nordic countries. The third work package was fieldwork mapping young people in the Nordic fast food markets in Oslo and Gothenburg. The fourth work package focused on identifying and testing new healthier fast food products in Oslo and Reykjavik. The fifth package concentrated on dissemination of results. This was done with newsletters, a seminar and the report at hand. The last work package was administration and coordination of the project, carried out by SIFO. This report consists of 4 chapters. NCRC has compiled and edited the report and the partners responsible for the WPs have produced the texts about the main results of each WP. The structure of the project as well as each WP are illustrated in Figure 1.

14 14 Nordic Young Health: Possibilities and barriers for new, healthy concepts in the fast food sector Figure 1. The structure and work packages of the Nordic Young Health project

15 Nordic Young Health Studies Increasing knowledge, inspiring change Establishing a platform for cooperation One aim of this project was to establish a platform, or a meeting point, for cooperation between consumer research institutions, authorities and fast food industry in order to enhance the understanding of barriers and opportunities for affordable, healthy food, and inspire processes of change in the existing Nordic fast food landscape. This particular cooperation was an explicit aim in order to better adjust the methodological approach to the empirical field through different actors looking at the same phenomenon from different perspectives and inspiring change. This was done through establishing a reference group that was included as an integral part of the project process throughout the project period. Our main venues of contact were the kick-off meeting, the planned multi-sectored workshop and the concluding seminar, as well as a common list. The Young Health project kick-off meeting was held as a whole day seminar at Gardermoen hotel in Norway, and included representatives from our Nordic reference group (commercial actors, authorities, researchers), and NICe representatives. The kickoff meeting was a great success and a crucial part of our attempt to create a platform for cooperation i.e. a network among researchers and stakeholders that share a common interest in the betterment of the Nordic fast food landscape. This meeting ensured the reference group participants to meet and greet in order to enhance cooperation between the stakeholders and lower the barriers to contact each other. The meeting also functioned as an important fundament where the industry and authorities were able to participate and comment on the project layout and overall plan in the initial stages of the project. The researchers presented their work packages and all participants agreed upon concrete common guidelines, grid and questionnaire regarding the fieldwork. Also discussed was how to best go about with the testing of a new healthier product within the project budget constrains and possible industry cooperation. These valuable discussions lead to an important cooperation footing and certain practical changes in the project proposal (methodological additions, alterations, comments) and ensured even stronger integration between the work packages. The multi-sectored workshop in Stockholm was organized together with the wellrenounced Kairos Future, an international research and consulting firm specializing in helping companies understand and shape their futures. The project partners met in Stockholm prior to the workshop, and planned a full day s workshop and a consecutive day of internal meetings for the project partners only. Students for the discussion panel had been booked. Regrettably, this well planned workshop had to be cancelled due to poor participation from commercial actors. The reasons given for the lack of commitment from the industry was the economic situation, as this coincided with the immanent threat of international financial crisis in 2010). This workshop was thus instead turned into a strategic meeting with all our research partners represented. This

16 16 Nordic Young Health: Possibilities and barriers for new, healthy concepts in the fast food sector was a minor setback for the planned, hands-on collaboration between research and industry, and somewhat shaped the platform s strength. In order to still secure young people a voice, we added some school visits and interviews with young students to our data collection process. Finally, the reference group was invited to join and participate actively in the dissemination of results in the concluding seminar (see chapter 3). This seminar was open for all, and became a great success which distributed results and generated further discussions broadly; both to our project participants, but also beyond. Present in the audience were also young people and students. Even though we did not succeed entirely in promoting interaction and collaboration between companies and researchers in the form of the stable platform initially planned for, the outcome of this collaboration has never-the-less been fruitful for the project scope, data collection process and final results. We have though the collaborative efforts in this project noticed, and also inspired to, a lot of concrete activity and genuine willingness in the industry to create new, innovative and healthier fastfood products. 2.2 Survey: Young people in the fast food market in Nordic Countries Randi Lavik and Kjersti Lillebø, SIFO In WP2 the aim was to gather quantitative and comparative data uncovering Nordic young people s views and food practices. The web survey focused on the most common venues where young people eat during their leisure, work and school time: fast food restaurants, convenience stores, snack bars, kiosks, petrol stations, and outlets at sports halls. These venues have been studied with respect to structural features such as healthy/unhealthy food selection, menus, price, shelf placement and marketing. SIFO in Norway was responsible for this work package that consisted of a common web survey conducted in four Nordic countries: Denmark, Finland, Sweden and Norway. The survey was developed in collaboration with all the project partners, and executed locally in each country. The respondents belonged to a panel, and they gave their consent in advance to participate in the surveys. The surveys were carried out by NORSTAT and consisted of young people aged from Denmark (807 respondents), Finland (801), Sweden (816) and Norway (792). The answers of the web survey are weighted in each country according to the population distribution of gender and age among 15 to 29 -year-olds.

17 Nordic Young Health Studies 17 We asked questions about eating habits and preferences when on the go. This was contextualized to being on the way to and from school or work, shopping, walking, travelling, etc. We chose to describe the food eaten in such situations as fast food (i.e. ready-made hot meals such as hot dogs, hamburgers and French fries, as well as baguettes/sandwiches, snacks, fruit, sweet buns, yoghurt etc.). There were some specific differences between the Nordic countries in the young people s eating patterns at fast food outlets. When buying fast food; kiosks, petrol stations and grocery stores were visited more often in Norway compared to the other Nordic countries. Hamburger restaurants were more often visited by Finnish and Swedish young people. Pizza and takeaway outlets were more often frequented by young people in Denmark and Sweden compared to the other two countries. Some of these differences could be explained by the specific national market structure and the availability of certain types of places. Figure 2. How often do you eat food on the go: once a month or more often? Proportion. N= % 55 % 52 % 52 % 52 % 50 % 46 % 48 % 47 % 43 % 40 % 40 % 41 % 40 % 39 % 37 % 30 % 30 % 29 % 34 % 30 % 31 % 32 % 30 % 29 % 30 % 34 % 29 % 27 % 30 % 20 % 21 % 24 % 19 % 23 % 13 % 13 % 10 % 10 % 10 % 8 % 9 % 8 % 8 % 4 % 5 % 0 % Kiosk Fast food outlet Pizza outlet Other typical Petrol station Roadside Cafe etc. Take Away Grocery store (Hamburger fast food outlets restaurant (take out or outlets) delivery) DK FI SE NO Automat Young men ate fast food more often at kiosks, pizza outlets and petrol stations than young women. Young men in Denmark, Sweden and Norway ate hamburgers more often than young women, but not in Finland. In Finland there was no difference between the sexes, and hamburgers seemed in general to be especially popular in Finland. Young women ate more often at cafes, confectionaries, bakeries and sandwich/coffee bars than young men; this tendency was found in all the four countries.

18 18 Nordic Young Health: Possibilities and barriers for new, healthy concepts in the fast food sector The most common reasons given to selecting the fast food place they had last visited were short distance, I was passing by and the food was easy to bring along and eat. These rankings were the same in all the four countries. These reasons are typically convenience-oriented. Hamburgers were the most common fast food product purchased by the respondents the last time they had eaten on the go. This was particularly true in the case of Finland. This corresponds well with another question where the respondents were asked to choose which menu they would prefer if price were not an issue. In most of the answers the respondents again chose the hamburger, which again was especially dominating in Finland. About two third of the respondents frequented fast food outlets more or less regularly (once a month or more often). The most important reasons given for eating fast food was the good taste of food like hot dogs, hamburgers etc. This was the case Especially in Finland. The next reason was I m generally on the go a lot and often need something quick and easy to eat. This is also a typical convenience reason and fits well with the main idea behind the convenience market. The one third of the respondents who never or rarely ate at fast food outlets were asked why they didn t. The two most frequent answers were It is too unhealthy and It is too expensive. The health argument and the price argument were given most importance among the Danish and Norwegian respondents. Lower fat was the most frequent answer given when asked what changes in particular they wished for in fast food. Next on the list was easier access to food made on the spot, in other words; less processed food. More fruit and vegetables was also an important request among the young people s wishes. Denmark and Norway stood out also in this regard, as the respondents there more markedly wished for foods lower in fat when asked what changes they wanted in the fast food market.

19 Nordic Young Health Studies 19 Figure 3. What changes would you particularly wish for in fast food? (Max. three answers). Proportion. N=3216 Foods lower in fats 48 Food made on the spot (less processed-food) 28 More fruit and vegetables 25 More whole grains 23 Tastier food Use of organic food More local food (from local suppliers) Foods lower in salt Wider selection Availability of nutritional info More traditional food 9 More lean meats 8 8 More ethnic/exotic food The wishes for changes in fast food can be categorized within a four dimension index: Ethical dimension: More use of organic food, more fair trade products Traditional dimension: More food made on the spot (less processed food), more traditional food, more local food (from local suppliers) Health dimension: More foods lower in fats, more foods lower in salt Healthy eating dimension: More fruit and vegetables, more whole grains These latent variables (dimensions) were transformed into four indexes, each coded as dummies (0 and 1). This means that the Ethical variable with code 1 is more use of organic food or/and more fair trade products. The same logic is used for the other three indexes.

20 20 Nordic Young Health: Possibilities and barriers for new, healthy concepts in the fast food sector Figure 4. Changes in the fast food market, by countries. Proportion. N= Denmark Finland Sweden Norway Ethic Traditional Health Healthier eating The ethical dimension proved the most common in Denmark and Sweden, and the traditional dimension the most common in Finland and Sweden, whereas the health dimension was the most common in Denmark and Norway, as was also the pattern for the soundness dimension. In all the four countries the young women were more health and healthy eating oriented than the young men. Summing up, there are indications that Danish and Norwegian young people are slightly more health-oriented than young people in Finland and Sweden. Therefore, in the next step the results from quantitative survey were deepened by conducting qualitative field works in two cities. 2.3 Qualitative field studies The main objective of WP3 was to explore which structural barriers are preventing young people from access to healthy and nutritious food during their daytime activities, especially at lunch-time on school days. It should be noted that the most obvious difference between the Nordic countries is the free-of-charge lunch option in Sweden and Finland. In Norway and Denmark schools do not provide free hot lunches. In Norway many young people eat home-made packed lunches. Qualitative ethnographic fieldwork investigating the existing foodscape, and the possibilities and barriers young people are faced with both in urban environments and in