Did High in Fat, Sugar, and Salt (HFSS) product placement legislation in England lead to reduced HFSS purchases? An interrupted time series analysis

In October 2022, legislation in England restricted retailer placement of High in Fat, Sugar, and Salt (HFSS) products in prominent locations in-store and online. This study evaluates the impacts of the legislation, and whether impacts were equitable. Interrupted time series analyses, using daily store-level sales data from up-to-18-months pre- and 12-months post-legislation across 480 stores from three retailers in England were conducted. Results revealed 0.63 percentage-point (95% CI: -1.24, -0.51) reduction in in-store sales of in-scope HFSS products by weight and a 1.19 percentage-point (95% CI: -1.61, -0.77) reduction by unit volume, following the introduction of the legislation. Subgroup analysis indicated impact was equitable for stores across Priority Places for Food Index deciles. Findings demonstrate that legislation restricting promotion of less healthy foods drives meaningful reductions in sales of in-scope HFSS products. Further legislation is needed to achieve the magnitude of change necessary to reverse obesity trends and improve population health.