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    COVER STORY: Health and Wellness: Get fit

    Some supermarket operators are gaining the expertise needed to make their stores more health-minded destinations -- but there's no miracle diet plan.

    Look around while you walk down the street, or shop the mall, or hit your favorite eating spot. For many of us, it's as simple as looking in the mirror. What you'll see is that America is fat. And if you listen to the government’s studies, the generations coming up are getting even fatter. Fortunately the supermarket industry is looking in the mirror, too, at its own role in the situation, and some smart merchants are seeing hefty opportunities.

    Grocers across the nation are aggressively promoting good health as it relates to diet, in myriad ways. Indeed, some pioneers have been running the issue of healthy eating up the flagpole, to some degree or another, for years. The crucial difference now and going forward is that health and nutrition are becoming core corporate initiatives for more operators. The timing could scarcely be better, and the practice is only likely to grow.

    The latest tactics being employed by savvy supermarket operators include:

    --Increasing their selections of organics and "natural" products, either in-line or in standalone sections.

    --Bringing their own private label initiatives to fighting trim, lately by removing trans fats where they can.

    --Installing in-store signage and shelf tags that tout the specific health benefits of products in easy-to-understand language.

    --Using external communications tools, including Web sites, brochures, and in-house magazines, to offer advice to consumers on healthy cooking and other ways to improve their lifestyles.

    The retailers taking such strategic steps understand that health-centric retailing means good politics, good customer relations, and good business. Today's top-spending consumers -- from concerned parents to empty-nested baby boomers -- seem hungrier than ever for the latest advice and tools for living longer, healthier lives, and trends indicate that this hunger for guidance is likely to spread beyond big spenders to the general population.

    But while it's all good, it's not easy to be a health-minded grocer. The scientific community seems to produce a constant flood of often conflicting health information based on new research, and then the media's own filter frequently adds even more confusion. The din makes it difficult for any retailer to sound like an authority on healthy living.

    "There are a very high percentage of consumers who want to improve their health," confirms Odonna Matthews, who for many years was the in-house consumer advisor for the Washington, D.C. area's Giant Food, and now is a consultant to

    both Giant Food and Stop & Shop. "Can we as an industry help them? Yes, we can. And the retailer can do it best, because he is not beholden to any particular product."

    Matthews, who received the 2005 Esther Peterson Award from the Food Marketing Institute for a lifetime of dedicated service to consumers, launched programs at Giant to educate consumers about fat, calories, fiber, and cholesterol long before the nation became focused on obesity and health.

    "Being a reliable purveyor of scientific information is key," she says. "That's why we've aligned ourselves with various government agencies over the years."

    Matthews says parent company Ahold has developed "a global healthy-living strategy," and is working in several countries, including the Netherlands and the Czech Republic, to provide sound information that can help shoppers make healthy choices.

    In the United States the company has published booklets promoting the new dietary guidelines reflected in the government's MyPyramid program. Now Matthews' successor, Andrea Astrachan, says the stores can't keep them in stock.

    "That demonstrates a thirst for knowledge," maintains Astrachan, "so we just published a new booklet, Healthy New You, which helps consumers keep their resolutions to be healthier through small, steady steps instead of radical change."

    The company also develops and promotes recipes to help consumers balance the need for good health with their busy schedules. Some are "Five and 30 recipes -- five ingredients in 30 minutes or less." Some take old recipes and adjust them to be healthier but still tasty, and all are promoted on Stop & Shop's and Giant Food's Web sites.

    "We are trying to provide the tools so our customers can lead a healthier lifestyle," says Astrachan, who is also Ahold's health-and-wellness manager, as well as a dietitian and nutritionist. She, like other nutrition professionals in the retail business, is applying her health-related skills to develop programs that could boost her company's credibility among health-oriented shoppers.

    The total package

    Supermarkets have the built-in advantage of being able to sell the healthy foods they preach about. And if they can combine health advocacy and convenience, they have a powerful tool for influencing behavior, according to Lisa Katic, a registered dietitian and food industry consultant whose clients include the Snack Food Association.

    "There's a huge market out there of people who are not used to stopping at a fast-food chain, but they are very busy, and they need something quick," contends Katic. "They want it to be healthy, too." She credits chains such as Whole Foods, Wegmans, and Harris Teeter for meeting this need with high-quality ready-made meals that are healthy. "Mom can get a prepared meal, add a salad, and feel like she's done something healthy for her family."

    The real win, she adds, is when grocers take advantage of their role as purveyors of a wide variety of foods to help shoppers develop a macro approach to diet and nutrition. "Retailers can help consumers figure out how to fit the foods they purchase into the total picture," says Katic. "Consumers would be happy to know, if they can have a 2,000-calorie-per-day diet, that a 100-calorie snack is pretty good. That's an opportunity retailers can build on."

    Safeway, Inc. is increasing its offerings of lower-fat, lower-calorie dishes in its deli and prepared food sections, as well as offering a line of Safeway-brand frozen dinners, says the Pleasanton, Calif.-based company's spokeswoman, Teena Massengill.

    Safeway sees it as a service issue. "Our corporate view is to meet our customers where he or she is at," explains Massengill. "If they are interested in healthier food, in organic products, we want to provide it. We have a broad health focus."

    Bob Millsap, former national director of grocery at Wild Oats and now a Glendale, Ariz.-based industry consultant on natural and organic foods, believes the most effective way to market such products in conventional supermarkets is to integrate them with traditional products throughout the stores, "rather than sticking them in a corner off by themselves."

    In this scenario, says Millsap, signage becomes especially important. "By retailers doing a good job with point-of-purchase signage and with proper placement, more and more shoppers will say, 'The health benefit for my family of this item far outweighs the price difference,' and they are much more apt to move to the natural or organic alternative. But the choices need to be simply and strategically laid out in front of the shopper."

    Consultant Katic also encourages retailers to develop programs to help youngsters choose these healthier options. "If you can get kids [to] acquire a taste [for healthier foods], that's how you develop good eating habits early on," she notes.

    Starting early

    Training healthy consumers when they're young is a fresh emphasis for Asheville, N.C.-based organic/natural supermarket operator Earth Fare. The chain is rolling out a new kid-focused healthy-eating program in all 13 of its stores in North Carolina, South Carolina, Tennessee, and Georgia. The initiative includes cooking classes for children, shelf tags that designate "healthy Red-approved" items, and a membership club that rewards kids with good-for-you treats like fresh fruit.

    Called "Red's Eat Right Club," the program centers on a cartoon mascot known as "Red, the tomato-headed boy." It was first tested in several stores, according to Troy DeGroff, Earth Fare's director of sales and marketing.

    Cartoon mascots aside, Earth Fare took some serious steps to make sure the program is backed by sound science, says DeGroff. "We began by identifying organic and natural alternatives for kids to eat, and took that to the school system in Charlotte, N.C. But they wanted to know what dietary standards our recommendations were based on. So we went back and cut down the items, based on the guidelines in California State Bill 19, which basically limits the amounts of fat and sugar that are fed to kids in school."

    For its in-store initiatives, Wild Oats, another retailer that specializes in health-and-wellness trends, has turned to the expertise of best-selling author Dr. Steven Pratt, who espouses a diet plan focused on nutrient-dense "superfoods" such as nuts, green leafy vegetables, kiwifruit, and pomegranates.

    The chain features a storewide superfoods education program, and also recently introduced the "Superfoods -- Super You! Healthy Eating Plan" to help consumers understand the benefits of vitamins, minerals, and supplements, and to consider the balance between eating well and exercising regularly.

    "These foods are good for you, and they're tasty, too," notes chain spokeswoman Krista Coleman. "They aren't diet foods. We're showing people how you can make these foods a part of your everyday diet."

    Wild Oats sells a $1 48-page guide in stores, which includes information on the health benefits of various superfoods, recipes, a flexible meal plan developed by Wild Oats dietitians and nutritionists, handy shopping lists, information on vitamins and supplements, recommendations for living a healthy lifestyle, and tips on hydration, fitness, and mindful eating.

    Smart tags

    For many retailers, their efforts to inform consumers about healthy products are coming down to the important intersection of shoppers and the shelf. Shelf tag programs are hard to beat as a way to explain the specific roles certain products can play in disease management.

    For example, United Supermarkets, based in Lubbock, Texas, is unveiling a revised and expanded tagging program this month, which includes the following symbols designating specific food attributes: GF for Gluten Free, O for Organic, and HH/DM for Heart Healthy and Diabetes Management.

    With 47 stores operated under the banners United Supermarkets, Market Street, and United Supermercado, the regional chain decided to kick its effort up a notch by bringing in Tyra Carter, a registered and licensed dietitian, to help optimize its healthy initiatives.

    "United had started a tag program last year and had begun incorporating it in the stores, but as they got into it, they realized it was a huge undertaking," explains Carter, who carries the title of corporate dietitian at United. "They decided they needed someone who could be a part of the team, to help develop and oversee the program."

    With Carter's help, the retailer recently launched a Living Well monthly newsletter, which is placed in its larger Market Street Stores. "We have a special focus each month," she explains. In February, for example, Living Well focused on heart health, and the food items represented in its advertisements were items that promote heart health. In March the newsletter is focusing on National Nutrition Month, with input from the American Dietetic Association.

    To build momentum from the publication, on one Saturday each month United features "Living Well" expos in six of its stores. The expos are all-day events, with recipes and sampling. "There are all kinds of food booths for customers, based on the theme for the month," says Carter. "Many times other educational events are going on in the store, related to the theme. We usually have activities for children."

    United's efforts are paying off, according to Carter. "Communities are beginning to recognize our expos. Sometimes it's difficult for customers to find a place to park on Saturdays," she notes. That's clear evidence United is tapping into a strong current of consumer demand.

    "We have a higher interest in nutrition and labeling than we've ever had before," adds Carter.

    Ukrop's Super Markets, a 28-store chain based in Richmond, Va., is another operator that has made health and wellness a top priority, equipping itself with one full-time staff dietitian, plus 21 consulting dietitians.

    Ukrop's provides its shoppers with plenty of resources. "We do a lot of education on health and wellness," notes Julie Bishop, manager, wellness products and services. "We use any marketing vehicle available to cover issues ranging from trans fat to diabetes. We use the Internet, print, and periodic e-mails to customers."

    In its stores Ukrop's also uses a shelf tag program similar to the one at United Supermarkets. "We use 'wellness keys' to highlight specific products throughout the store," explains Bishop. The tags in Ukrop's program are GF for Gluten Free, LF for Low Fat, LS for Low Sodium, V for Vegan, and D, denoting a good choice as a meal component for people with diabetes.

    Bishop says that shoppers have commented on the helpfulness of the wellness keys, and some have requested that Ukrop's expand the program to more products throughout the store, which Bishop says is easier said than done.

    "It's kind of hard to put keys on printed scale labels," she notes, "but we do have gluten-free items marked on laminated signs in the soup and salad bar, and in the Chef's Case, which is our refrigerated section of prepared foods. We're able to use the wellness keys on our traditional prepared items, since the ingredients don't change. On some of our newer items, however, where chefs might deviate from the recipe if they need to use alternative ingredients, we don't provide this information. We try to provide as much as we can without creating a risk for our customers."

    Rx for health info

    Some operators are taking the challenge of providing a more holistic answer to the health needs of their shoppers even further, by linking their diet-related efforts with the in-store pharmacy, to provide information about medications in tandem with guidance on nutrition and healthy living. For those with pharmacy operations, the expertise is already on hand -- the pharmacists -- but some operators are also adding other staffers to help answer shoppers' questions.

    "The supermarket environment offers the best opportunity to capitalize on whole health, with food and pharmacy under one roof," notes Laurie Gethin, senior manager for education at FMI, "and professionals such as pharmacists and nutritionists, who can help consumers with their needs."

    While leveraging the pharmacy operation in an overall whole-health program makes perfect sense on paper or in the executive suite, however, making it happen in the stores can be another matter. Gethin says operators must be willing and able to overcome departmental silos.

    "Making whole health work for the benefit of the consumer takes real dedication of time and resources, and requires cross-departmental cooperation," she says. "It's easier said than done -- which is probably why many companies haven't truly done it."

    John Beckner, director of pharmacy and health services at Ukrop's, says in FMI's 2005 Supermarket Pharmacy Trends report that the "nutrition component" is an important differentiator for the supermarket pharmacy, but it means "being able to tie nutrition and healthy eating into both wellness and disease management."

    John Fegan, s.v.p. of pharmacy at Quincy, Mass.-based Ahold USA, predicts that supermarket pharmacies have a clear opportunity to help patients in ways far beyond dispensing medications. "Over the next five years the information and services provided by pharmacists to consumers will be as important as the medications being dispensed through their pharmacies," he writes in the same report. The concept, Medication Therapy Management, is covered under the new Medicare Part D prescription drug program for seniors. "As the drug therapy experts on the health care team, pharmacists need to be ready to meet the growing demands of older patients," notes Beckner.

    Taking that health care vision a step further, a few supermarkets are using their stores as sites for actual health clinics.

    One Ukrop's store, for instance, has both a YMCA fitness center and an OB/GYN medical office on the premises. Clearly that's an unusual case, but increasing numbers of supermarkets are providing walk-in clinics in conjunction with third-party providers.

    For example, at a Meijer store in Taylor, Mich., an Early Solutions Clinic greets parents and their youngsters with convenient, affordable walk-in services. Early Solutions Clinics offer limited health care services from nurse practitioners, for fixed prices.

    In the South, Jacksonville, Fla.-based Publix Super Markets has just signed an exclusive agreement with the Little Clinic, LLC in Louisville, Ky. to open medical clinics within an unspecified number of Publix stores this year. The first will be located in the Miami, Orlando, and Tampa, Fla. markets.

    The Little Clinic health care centers, measuring around 150 square feet on average, are staffed by nurse practitioners who can write prescriptions, provide diagnoses and treatment of common ailments and minor injuries, and offer wellness care, such as physicals, screenings, and vaccinations. The clinics are typically open seven days a week, and most of their services cost less than $50.

    The Little Clinic also currently operates seven health clinics inside Kroger supermarkets, with an eighth set to open soon, says Bruce Peacock, the Little Clinic's c.e.o., adding that the company is "actively seeking discussions with potential retail hosts" in other parts of the country, including the Northeast and New England.

    Some critics of such partnerships argue that in-store health clinics take away from the central importance of a patient-physician relationship, but Peacock maintains that the clinics are designed for fill-in health care trips only.

    "We're not trying to replace the family doctor," he says. "A lot of what we offer is convenience. The nice thing about us being located in the supermarket is that someone can come in and see the nurse and get their prescription filled at the retail host center. A mother with a sick child can visit the clinic, and then pick up Children's Tylenol, sorbet for a sore throat, and a prepared meal for dinner all in the same location."

    And at the end of the day, if that same supermarket has additional added-value, health-related shopping perks -- such as practical in-store signage; healthful, prepared meals and easy-to-find healthy snacks; and a free newsletter with healthy recipes -- chances are that that Mom will know she's found a trustworthy source of information and services in support of her family's well-being. And that's the kind of relationship that's hard to put a price on.

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