Supreme nudge

Nudging and pricing in supermarket setting.

Aim project

The aim of this project was to investigate the effects of nudging and pricing in a supermarket setting, combined with a mobile physical activity app, on energy balance-related behaviours and cardiometabolic risk factors in adults with low socioeconomic status.

Targeting the environment in which health behaviour choices are made can reduce cardiometabolic risk. Supermarkets form one of the most important point-of-choice settings with the potential to directly influence purchasing behaviors. ‘Nudges’ (small environmental encouragements) target the quick, automatic choices and do not require conscious decision making, and pricing strategies can seduce consumers to buy healthier alternatives. Such environmental cues can make it easier to initiate and maintain a healthy lifestyle, and as such, to improve cardiometabolic health. In addition, the use of theory-based mobile applications is an effective way to provide tailored and context-specific feedback on physical activity behaviors through the stimulation of ‘goal setting’ and ‘self-management’.

We investigated the effects of this approach on dietary behaviours, physical activity and established cardiometabolic risk factors in adults with a lower SES. Using principles from Participatory Action Research and systems thinking, we consulted with the relevant stakeholders to explore options for upscaling and further implementation in society. Outcomes provide policy- and practice relevant evidence with clear, stepwise and realistic leverage points for helping individuals to maintain healthy behaviors and improve their cardiometabolic health by making the healthy choice the easy choice.



Role of research group in this project

Joline Beulens (PI of this project), Jeroen Lakerveld and Joreintje Mackenbach form the coordinating team of Supreme Nudge. Further, Joline Beulens, Jeroen Lakerveld, Joreintje Mackenbach and Femke Rutters are involved in the supervision of the PhD students in Supreme Nudge.


Media attention

The Supreme Nudge study received considerable attention in the media. 

  • Article in the Volkskrant newspaper (November 2022)
  • Article in the AD newspaper (November 2022)
  • Article in the ND (November 2022)
  • Radio fragment at BNR radio (November 2022)
  • German TV program Galileo (June 2021; see video)
  • Article in the AD (April 2021)



Stuber JM, Mackenbach JD, de Bruin GJ, et al. (2024) Real-world nudging, pricing and mobile physical activity coaching was insufficient to improve lifestyle behaviours and cardiometabolic health: the Supreme Nudge parallel cluster-randomised controlled supermarket trial. BMC Medicine [IN PRESS]


Gillebaart M, Blom SSAH, de Boer F et al. (2023) Prompting vegetable purchases in the supermarket by an affordance nudge: Examining effectiveness and appreciation in a set of field experiments. Appetite 184, 1-9.


Stuber JM, Hoek BACE, Vos AL et al. (2023) Participant recruitment, baseline characteristics and at-home-measurements of cardiometabolic risk markers: insights from the Supreme Nudge parallel cluster-randomised controlled supermarket trial. Trials, 1-15.


Stuber JM, Lakerveld J, Beulens JJW et al. (2023) Better understanding determinants of dietary guideline adherence among Dutch adults with varying socio-economic backgrounds through a mixed-methods exploration. Public Health Nutr, 1-13.



Stuber JM, Mackenbach JD, de Boer FE et al. (2022) Correction: Reducing cardiometabolic risk in adults with a low socioeconomic position: protocol of the Supreme Nudge parallel cluster-randomised controlled supermarket trial. Nutr J 21, 44:1-8.


Mackenbach JD, Lakerveld J, Stuber JM, Beulens JWJ (2022). Het Supreme Nudge project: Preventie van hart- en vaatziekten door aanpassingen in de leefomgeving (deel 1). Geron, 9(2):1-5. 


Stuber JM, Lakerveld J, Kievitsbosch LW et al. (2022) Nudging customers towards healthier food and beverage purchases in a real-life online supermarket: a multi-arm randomized controlled trial. BMC Med 20, 10.



Middel CHN, Schuitmaker-Warnaar TJ, Mackenbach JD et al. (2021) Designing a Healthy Food-Store intervention; a co-creative process between interventionists and supermarket actors. IJHPM , x(x), 1–14.


van der Molen AEH, Hoenink JC, Mackenbach JD et al. (2021) Are nudging and pricing strategies on food purchasing behaviors equally effective for all? Secondary analyses from the Supreme Nudge virtual supermarket study. Appetite, 105655.


Harbers MC, Middel CNH, Stuber JM et al. (2021) Determinants of Food Choice and Perceptions of Supermarket-Based Nudging Interventions among Adults with Low Socioeconomic Position: The SUPREME NUDGE Project. Int J Env Res Pub He 18.


Stuber JM, Hoenink JC, Beulens JWJ et al. (2021) Shifting toward a healthier dietary pattern through nudging and pricing strategies: A secondary analysis of a randomized virtual supermarket experiment. Am J Clin Nutr.


Hoenink JC, Stuber JM, Lakerveld J et al. (2021) The effect of on-shelf sugar labeling on beverage sales in the supermarket: a comparative interrupted time series analysis of a natural experiment. Int J Behav Nutr Phys Act 18, 49.


Hoenink JC, Mackenbach JD, van der Laan N et al. (2021) Recruitment of Participants for a 3D Virtual Supermarket: Cross-sectional Observational StudyJMIR Formative Res 5(2):e19234.  


Blom S, Gillebaart M, De Boer F et al. (2021) Under pressure: Nudging increases healthy food choice in a virtual reality supermarket, irrespective of system 1 reasoningAppetite, 105116.  



Harbers MC, Beulens JWJ, Rutters F et al. (2020) The effects of nudges on purchases, food choice, and energy intake or content of purchases in real-life food purchasing environments: a systematic review and evidence synthesisNutr J 19, 103.  


Hoenink JC, Beulens JWJ, Harbers MC et al. (2020) To what extent do dietary costs explain socio-economic differences in dietary behavior? Nutr J 19, 88. 


Hoenink JC, Mackenbach JD, Waterlander W et al. (2020) The effects of nudging and pricing on healthy food purchasing behavior in a virtual supermarket setting: a randomized experiment. Int J Behav Nutr Phys Act 17, 98. 


Stuber JM, Mackenbach JD, de Boer FE et al. (2020) Reducing cardiometabolic risk in adults with a low socioeconomic position: protocol of the Supreme Nudge parallel cluster-randomised controlled supermarket trial. Nutr J 19, 46. 


Stuber JM, Middel CNH, Mackenbach JD et al. (2020) Successfully Recruiting Adults with a Low Socioeconomic Position into Community-Based Lifestyle Programs: A Qualitative Study on Expert Opinions. Int J Environ Res Public Health 17  



Middel CNH, Schuitmaker-Warnaar TJ, Mackenbach JD et al. (2019) Systematic review: a systems innovation perspective on barriers and facilitators for the implementation of healthy food-store interventions. Int J Behav Nutr Phys Act 16, 108. 


Bruijn G-J, Dallinga JM, Deutekom M (2019) Predictors of walking app usage: comparing current users, previous users, and informed non-users in a sample of Dutch adults. JMIR mHealth and uHealth. (IN PRESS) 


Mackenbach JD, Lakerveld J, Beulens JWJ (2019) Preventie van hart- en vaatziekten door aanpassingen in de leefomgeving. Voeding Nu 2  



Lakerveld J, Mackenbach JD, de Boer F et al. (2018) Improving cardiometabolic health through nudging dietary behaviours and physical activity in low SES adults: design of the Supreme Nudge projectBmc Public Health 18