By Jodi Helmer
Source: Civil Eats

The COVID-19 pandemic hasn’t just changed our lives; it has also changed our diets. Research conducted during the pandemic showed that 85 percent of adults have changed their eating habits since the start of the pandemic, with increased snacking and higher quantities of food as the most frequently reported changes. One study found that these shifts have led to even greater feelings of anxiety.

“The pandemic has come with a great deal of unknowns, stress, isolation, anxiety, and challenges,” said Alicia Romano, a registered dietitian (RD) for Tufts Medical Center. “It’s not surprising that the way individuals are eating is different.”

Supermarkets are stepping in to help. Over the course of the last year, regional grocers including ShopRite, Stop & Shop, Hy-Vee, and Giant Food have launched virtual nutrition services—some targeted to low-income shoppers—that include cooking demonstrations, online classes, virtual store tours, and one-on-one chats with registered dietitians who can answer questions and provide advice about menu planning, shopping on a budget, and making healthier food choices.

In May 2020, Kroger launched a free “telenutrition” service to help shoppers plan healthy meals during the pandemic after their data showed increases in baking, eating comfort foods, purchasing packaged foods, and snacking during quarantine. During these two-way video chats, trained dietitians share food, grocery, and nutrition information with customers and help them develop a plan for meeting their personal nutrition goals.

Studies have shown that supermarket tours increase interest in eating fruits and vegetables, and in-store interventions, including advice for food swaps—switching from sugar-laden sodas to fruit-infused waters, for example, or trading traditional pasta for chickpea pasta—had changed their purchasing habits and could be part of successful public health interventions to improve health. Consulting with a dietitian is also associated with improvements in diet quality, weight loss outcomes, and diabetes control.

“These services are a great way to educate consumers in a productive way,” Romano says.

While supermarkets offered similar services before the pandemic, quarantine triggered a transition to virtual services—and the online offerings are even more popular than the in-store offerings. The GIANT Company, a supermarket chain that operates stores in Pennsylvania, Maryland, Virginia, and West Virginia, declined to provide participation data, but regional nutritionist Holly Doan said class attendance has been increasing each month.

For Black, Latinx, and Native American consumers, hurdles to accessing healthcare and affordable, nutritious foods are key factors to the disproportionate rates of obesity, diabetes, and other diet-related chronic disease—all comorbidities to COVID-19. New research published in the New England Journal of Medicine found that disparities in nutrition access and obesity might have played a role in higher rates of COVID-19 infections, more hospitalizations, and poorer health outcomes from the virus.

Elisa Sloss, the vice president of health markets for the Midwest supermarket chain Hy-Vee, sees supermarkets as ideal providers of nutrition information. “Grocery stores are really the best place to meet with a dietitian because it’s the frontline of where our food decisions are made and where people have the most questions,” she said.

In recent years, grocery retailers have been gathering data from shoppers and using it to retain them and increase their spending. Now, those goals are becoming increasingly urgent—especially for supermarkets that may have lost customers to online shopping.

“The pandemic has catalyzed in a big way a trend that was happening anyway—the death of traditional retail,” said Jean-Pierre Dubé, the Sigmund E. Edelstone Professor of Marketing at the University of Chicago Booth School of Business. “People are finding for a lot of stuff—especially things they buy on a regular basis, like groceries—they’re not as wed to the physical store.”

COVID-19 Changed Shopping Habits

A number of factors have shifted shopping habits since COVID-19 took hold.

Doan believes pandemic fatigue has caused shoppers to lose interest in healthy cooking and eating. “As the pandemic has lingered, meal preparation has become a daunting task,” she said. “What once was exciting—to get in the kitchen and experiment with new recipes—has lost its luster, which can lead to increased takeout, skipping meals, and lack of meal balance.”

The pandemic has also made some shoppers dread their weekly trips to the supermarket. One survey found that half of consumers felt stressed about shopping in the store, causing them to purchase groceries less often; the survey also associated less frequent shopping trips with fewer fresh food purchases.

Economic stress has also played a role in altering shopping habits. The national unemployment rate is 6.0 percent, though the rates are much higher in Black, Indigenous, and people of color (BIPOC) communities—9.6 percent for the Black community and 7.9 percent for Latinx shoppers. With less income, many people struggle to fill their carts with enough nutritious foods to feed their families.

The pandemic has led to a 14 percent increase in the number of households receiving SNAP benefits, with increases as high as 41 percent in Florida and more than 36 percent in Georgia. Even though Congress voted to increase monthly SNAP benefits by 15 percent through June, and the wave of vaccinations is bringing back some jobs, many shoppers still face financial strain that makes buying healthy food a challenge.

To help serve SNAP recipients specifically, Hy-Vee is developing a virtual store tour that takes shoppers down the aisle, pointing out foods that can be included in a balanced diet and fit into a shopping budget to help dispel the myth that healthy eating is expensive. “A registered dietitian can go over individualized ways to get the most bang for your buck, from incorporating frozen and canned fruits and veggies to [buying] bulk bin products like grains and beans, and can certainly help to create budget shopping lists based on your budget or [SNAP] benefits,” Romano said.

The programs may help grocery stores compete with fast food restaurants and other companies offering prepared foods.

“A grocery store needs to teach a shopper that when they pay a price premium to get a broader array of nutritious groceries,” said Dubé. “They’re getting something for that premium: nutrition, health, the pro-social benefits of lower pesticides or more humane meats, and with nutrition education they may agree that healthy food tastes better than [heavily processed] foods with a lot of fat and additives.”

Increasing Accessibility and Stretching the Dollar

During one-on-one consults, Doan notes that registered dietitians aim to provide “realistic solutions to family mealtime challenges,” including stretching food dollars. The virtual format allows shoppers to connect on their schedules, send messages through online chats, and log into free nutrition webinars while riding public transportation, taking a lunch break, or making dinner.

There is one caveat, says Romano. The services must be accessible to low-income shoppers.

Some supermarkets charge a fee for their virtual dietitian services. Hy-Vee charges $99 for menu planning and up to $250 for nutrition counseling services, putting them out of reach for many Americans; their virtual store tours and events are free.

Stop & Shop and ShopRite, on the other hand, offer the same service with free phone or video chats with registered dietitians. And to reward shoppers for engaging in educational events, The GIANT Company hosts free nutrition classes via Zoom and gives attendees reward points that can be redeemed to save money on groceries.

Doan adds that dietitians can also teach customers techniques for stretching their budgets, helping them make the most of store brands and recipes that take advantage of “quick sale” produce. And those tips can also help keep shoppers coming back.

“What stores can do as a service is provide helpful and unintimidating ways to bring in an unskilled shopper and teach them how to eat,” said Dubé. “And it gives people a reason to keep coming back to that store. As you shop, you help [stores develop] personalized recommendations; as the personalization gets better, you want to shop there more, and pretty soon you have a lock-in; [a customer thinks,] ‘If I abandon this store, another store won’t offer that personalization.’”

And while getting customers to spend more isn’t an explicit goal of most of these programs, it’s often one of the results.

A recent virtual class, Family Meal Planning to Fit Your Budget, offered through the Washington, D.C.-based Giant Food, Inc., included advice to purchase cooked rotisserie chicken and precut vegetables—options that are much more expensive than raw chicken and whole vegetables. Emily Massi, the registered dietitian leading the class even noted, “Convenience is expensive.”

But accessibility is about more than price. Most of the classes are only offered in English. Giant Food Inc offers one class, Sugar in Check/Azucar Bajo Control, in Spanish, and Hy-Vee just hired a bilingual dietitian and plans to offer classes for Spanish-speaking shoppers in the future, but the options are limited.

The virtual format also requires a computer and internet connection. Given that low-income families and communities of color often lack broadband access, supermarkets might not be providing the services to those who need it most.

During classes and consultations, dietitians can also answer questions about eating for specific health conditions. At the Kroger store in Forest Park, Ohio, shoppers with diabetes, heart disease, or cancer can bring in “food prescriptions” from their doctor, and a store dietitian will provide free counseling and food suggestions through a Food as Medicine pilot program, which is part of its telenutrition services. Kroger made all virtual appointments with dietitians free during the pandemic.

“A healthcare provider might give you a big list of restricted items or things to avoid [if you have a health condition],” Sloss said. “In the supermarket, we come from a positive place and show them options that will fit into their diets, taking into account individual preferences and taste and budget.”

The fact that virtual appointments with dietitians are offered in mainstream supermarkets—and not just boutique grocers—is noteworthy, according to Romano.

“Nutrition should not be viewed as a luxury and should not only be available at upscale markets—this type of service should be accessible to everyone,” she says.