The hidden hand in retail: a qualitative analysis of how ultra-processed food companies shape consumer purchasing

Abstract

Background

Ultra-processed foods (UPFs) are increasingly recognized for their health harms, yet consumer selection of UPFs is strongly shaped by retail marketing strategies. Despite widespread acknowledgment of these tactics, detailed understanding of their implementation has been limited by restricted access to industry insider information. This study aimed to obtain direct, industry-based insights into the implementation of retail marketing strategies designed to influence consumer purchasing of UPFs.

Methods

We conducted 49 interviews with 27 sales representatives and distributors of major UPF companies and 22 managers of chain and independent stores. Participants provided marketing agreements, planograms, and other business files (n = 46). Using reflexive thematic analysis, we coded and analyzed the 95 documents and identified key themes.

Results

Findings reveal UPF manufacturers and retailers deliberately orchestrate the 4Ps—product, placement, price, and promotion—to condition predictable UPF customer selection responses. Strategies included leveraging precise sales data, embedding scripted marketing tactics in contracts, monitoring retailer compliance, refreshing store layouts to create an illusion of choice and innovation, and integrating all 4Ps simultaneously while prioritizing placement. These strategies were organized into six sub-themes across two overarching themes: Guiding Principles of 4Ps Implementation (Simultaneous use of the 4Ps, Placement as a top priority, and Keeping things fresh) and Governance and Surveillance Mechanisms to Best Execute the 4Ps (Monitoring every move, Contracts dictate the 4Ps, and Maintaining store compliance).

Conclusions

Overall, UPF companies exert extensive and deliberate control over retail spaces, challenging the narrative that food and beverage purchases reflect consumer choice. Enhanced regulation of the 4Ps and counter-marketing campaigns that reveal overlooked marketing practices may mitigate UPF companies’ influence on customer purchases and thus reduce their related health harms.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12916-026-04968-9.

Background

The health harms of ultra-processed foods (UPFs) are increasingly recognized by US government, scientific, and other health authorities [1–5]. Characterized by their hyper-palatability, high energy density, and potentially addictive properties, UPFs have made up the majority of calories (> 50%) among Americans for two decades [3, 6, 7]. A large and growing body of evidence continues to link UPF consumption to poor health outcomes [4, 8, 9].

The prevalence of UPFs in American diets is a product of industry tactics that shape scientific discourse, policies, as well as the customer selection of foods [5, 10, 11]. Retail food environments, like grocery stores, supermarkets, and convenience stores, are the primary venues where most foods and beverages, including UPFs, are purchased [12] and where the majority of US food assistance benefits are redeemed [13]. In fact, despite recent growth in online shopping, in-store grocery shopping continues to comprise > 85% of food and beverage purchase selections [14].

Customer purchases in retail settings are influenced by the UPF industry through marketing strategies known as the “4Ps”—product, placement, price, and promotion (see Box 1) [15, 16]. Prior literature reviews indicate that strategies such as price discounts and promotional placements are associated with increased selection of unhealthy products [15, 17]. Evidence from quasi-experimental policy evaluations further bolsters these findings, as taxes and promotional placement restrictions on unhealthy products have been linked to reductions in sales [18, 19] alongside health benefits including improved weight- and dental-related outcomes among children and low-income populations [20, 21]. Experimental studies have similarly demonstrated that the 4Ps can be strategically applied to increase sales of healthier products [22–24]. Yet, despite this growing body of evidence, measurement of these various marketing strategies in public health nutrition research remains largely unrefined. Researchers often rely on crude indicators, such as the simple presence or absence of a marketing strategy (e.g., any promotional placement of soda) and rarely examine how multiple strategies are intentionally implemented together for synergistic effects.

Box 1.

Brief Descriptions of the 4Ps of Marketing

Marketing Strategy	Description
Product	Strategies related to decisions on how to package and formulate the product that companies provide. It also involves decisions around adapting current products or inventing new versions.
Placement	Strategies used to get products seen by customers. This includes decisions about which distribution channels to offer a product, such as a grocery store versus convenience store. In retail settings, this primarily focuses on where products are placed within a store.
Price	Strategies related to decisions on the amount customers pay for a product, including whether and how often to offer discounts.
Promotion	Strategies used to communicate product features to consumers and attract customers. In retail settings, this can involve trade-oriented promotions to incentive retailers to push the product to consumers, such as cooperative advertising and signage.

Note. Descriptions informed by prior literature [15, 52]

One reason the field has been unable to advance more nuanced measurement and characterization of the 4Ps is that much remains unknown around how industry insiders view and implement these strategies [5]. For instance, while marketing agreements between retailers and manufacturers are widespread and known to dictate in-store marketing [25, 26], few researchers have been able to access these documents [27]. As an example, currently only one 2012 agreement exists in the University of California San Francisco’s Industry Documents Library. [28]. Relatedly, interviews with informants from major UPF manufacturers and large retailers remain limited [5, 29]. The few prior investigations that have succeeded in obtaining insider perspectives have offered valuable insights, including the overall prevalence of marketing agreements [26, 27], variation in contract terms, services, and treatment offered by food and beverage companies based on retailers’ market size [26, 27, 30], and real or anticipated marketing responses to public health policies [31, 32]. However, this work has largely relied on accounts from more accessible informants (e.g., independent managers) [26, 30], been limited to a small number ( < = 12) of food industry perspectives [31, 32], or not applied such insider information to systematically assess the strategic implementation of the 4Ps [27]. Such insider insights would provide a deeper understanding of tactics to promote UPFs, helping inform regulatory and other approaches to counter the influence of the UPF industry at the point of sale.

The purpose of this study was to examine tactics used by the UPF industry to influence the consumer selection of food and drinks in retail settings. We analyzed UPF industry-insider interviews and business documents, including marketing agreements (also referred to as ‘marketing contracts’ in this paper), to better understand how industry uses and goes beyond the 4Ps of marketing to increase their profits. We focused on uncovering novel or underappreciated in-store marketing insights to advance the evidence base for future research and policy.

Methods

We purposively sampled industry informants with different experiences selling UPFs to customers in retail settings. This included 22 managers responsible for deciding which food and beverage products were ordered and offered to customers in chain and independent stores and 27 sales representatives and/or distributors of major food, beverage, and wholesale companies (i.e., personnel who directly interact with, sell, and/or distribute products to retailers). Sales representatives and distributors represented a wide range of national and global UPF companies, with the majority selling or distributing shelf-stable UPF packaged beverages and snacks. Industry interviews were conducted within a larger study that aimed to understand relationships between retailers and food/beverage companies, including retailers’ ability to negotiate the terms within marketing agreements [27, 29]. In the study, we also inquired about consumer-focused marketing strategies, priorities, and contract stipulations addressing the 4Ps of UPF products, which was the focus of this analysis.

Semi-structured interviews were conducted from October 2021-November 2022 in-person or online via video platform, lasted approximately 1–2 h, and were recorded. The interview guide asked about daily business practices and decision-making about UPFs, while avoiding explicit inquiries about, or reference to, a product’s nutrient quality or healthfulness (see Additional File 1: Figure S1 for sales representative guide[29]). Interviewers completed post-interview field notes, and interviews were transcribed and checked against recordings for accuracy. To enhance rigor and information redundancy, we triangulated interviews with other data sources. During interviews, we asked participants for business files (n = 23), including marketing contracts and planograms, and we took photographs (n = 23) of features in participants’ associated retail settings (e.g., “in-field” planogram implementation by distributors, product in-store displays).

Full details on the sampling and recruitment strategy, response rate, interviewers, and protocol for each industry group are published elsewhere [29]. Briefly, we took several steps to minimize potential recruitment bias. These included recruiting participants from multiple UPF companies, ensuring anonymity, addressing any concerns about participation, and avoiding the recruitment of senior company leaders whose responses might reflect organizational reputational management rather than everyday decisions about implementing marketing strategies [29]. In addition, the number of participants we recruited aligns with guidance on sample sizes suitable for achieving information redundancy in qualitative research [33]. We also critically evaluated our dataset size using the concept of information power assessing the relevance and richness of the data to determine whether the interviews and documents collectively provided sufficient information to address the aims of the study [34, 35].

To analyze all 95 interviews, business files, and photographs, we used an adapted reflexive thematic analysis approach [35]. Each file was systematically and thoroughly coded with the same framework twice by CA and SS, guided by MW, across 2024–2025 using Atlas.ti (version 23). The analytic team (CA, SS, and MW) met frequently to resolve coding differences, interrogate assumptions, and refine shared interpretations. MW then developed and revised initial themes by comprehensively reviewing them alongside all coded extracts. All authors reviewed key data segments and themes and helped refine final theme descriptions. Throughout the analytic process, we maintained memos to document analytic decisions, interpretive developments, and reflexive observations.

We adopted a realist-contextualist analytic approach to coding and analysis [35], meaning we examined both semantic and latent meanings of the data though often prioritized inductive and explicit interpretations. As researchers trained in individual and population health, food systems, and nutrition policy, our analysis was also oriented toward understanding how industry practices influence health inequities, dietary patterns, and retail food environments. At the same time, we maintained a reflexive analytic stance by continually revisiting our assumptions, discussing positionality as a team, and ensuring all interpretations remained firmly grounded in the data. Finally, we followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines to report our methods and results [36].

Results

Table 1 details participants’ demographic characteristics. Most participants identified as men (86%). Educational attainment, race/ethnicity, and years of industry experience were diverse, though most reported a Bachelor’s education or higher (47%) and ≥ 10 years of experience (45%).

Table 1.

Characteristics of industry participants (n = 49)

Characteristic			Overall (N = 49), No. (%)	Sales representative and/or distributor (n = 27)a, No. (%)	Retail Manager (n = 22)b, No. (%)
Age, y
< 30			7 (14)	4 (15)	3 (14)
30–44			17 (35)	10 (37)	7 (32)
45–59			13 (27)	5 (19)	8 (36)
>=60			10 (20)	8 (30)	2 (9)
missing			2 (4)	0 (0)	2 (9)
Gender (man)			42 (86)	25 (93)	17 (67)
Race/ ethnicity
	Hispanic		3 (6)	3 (11)	0 (0)
	Non-Hispanic Asian		7 (14)	0 (0)	7 (32)
	Non-Hispanic Black		13 (27)	12 (44)	1 (5)
	Non-Hispanic Multiple		2 (4)	1 (4)	1 (5)
	Non-Hispanic White		24 (49)	11 (41)	13 (59)
Educational attainment
		High school graduate, GED, or less	18 (37)	10 (37)	8 (36)
		Some college or associate degree	8 (16)	5 (19)	3 (14)
		≥Bachelor’s degree	23 (47)	12 (44)	11 (50)
Years of industry experience
< 3			10 (20)	6 (22)	4 (18)
3–5			11 (22)	8 (30)	3 (14)
6–9			6 (12)	2 (7)	4 (18)
10 or more			22 (45)	11 (41)	11 (50)

^a Consisted of sales representatives and/or distributors (some participants held both roles) of major food & beverage companies (n = 15) or wholesale companies (n = 12)

^b Managers consisted of independent store owners and managers (n = 10) and category managers of chain retail stores (i.e., personnel who manage specific food and beverage product categories for the entire chain) (n = 12) across the southern US

Our thematic analysis revealed that industry players carefully implemented the 4Ps and other strategies to shape customer selections and build their company’s UPF sales. We organized these insights across 2 overarching themes and 6 sub-themes, as shown in Table 2 and described below. Exemplar quotes are included to demonstrate evidence of themes. Additional File 1: Table S1 provides a dictionary of industry terms used by participants throughout the results, and Fig. 1 portrays how the marketing behaviors (sub-themes) used by the UPF industry interact to shape consumer experiences and behaviors.

Table 2.

Overview of Themes with Exemplar quotes

Overarching Theme 1: Guiding Principles of 4Ps Implementation
Sub-Theme	Exemplar Quotes
(1) Simultaneous use of the 4Ps	“We do [promotional] pairings… If I run a sandwich and a [energy drink], then we drop those [drinks] right next to the sandwiches just to make it easy for them to get that [discount price] bundle.” (Chain Manager 3)
(2) For UPF companies, placement is top priority	“We’ll put [the UPF] at the highest eyesight. … And anything you put [there] will sell, literally… You can literally come out with your own brand name, and I’ll literally put it right there [at eye level], and I promise you it will sell.” (Independent Manager 9) “That ‘action alley’ stuff is usually where we would roll out the new products, because that is where… every customer has to pass, even if you’re not coming to the store for [our product] …you still have to walk down action alley to get there, and [so] that’s where the new product is.” (Sales Representative 9)
(3) Keeping things “fresh”	“[UPF company is] creating new products all the time. That’s just an endless cycle.” (Sales Representative 2) “Data [show] that… the more variety of types that you have of a product, flavors, sizes, the more that people will purchase and impulse purchase, and it’s very true.” (Sales representative 5)

Overarching Theme 2: Governance and Surveillance Mechanisms to Best Execute the 4Ps
Sub-Theme	Exemplar Quotes
(4) Monitoring every move	“Some of those [UPF companies] …they’ve done a lot of research and spent a lot of money knowing what to put in there [the planogram/store] too. So, it’s sort of hard for us [as retailers] to, without any data to back yourself, just say, well, you know, my gut feeling is this, and most of the time the feeling’s not real good.” (Chain Manager 11) “[Sales representatives have] a tracking software that they use on the iPads…whereby they will have inventory from prior months, prior years, what we have done, what we have not done, what we are selling, what we are not selling….” (Independent Manager 7)
(5) Contracts dictate the 4Ps	“Rack placements must be in locations approved by a [Company] representative; must be filled and tagged with 100% [Company] items, set to [Company] approved planograms” (Documents 67). “You do have stores who they’re on a contract …[and] there’s an everyday low price that must be [guaranteed]… get two for 4.22… two for 5.33. That’s in the contract.” (Sales representative 13)
(6) Maintaining store compliance	“As far as the [UPF Companies], they will send people into our stores periodically to check our planograms and to make sure that we’re meeting contract requirements and we’re carrying the right number of SKUs.” (Chain manager 1) “[The purpose of the sales supervisor] position is to make sure that…if you sell [retailers] a drink for the cheap price, [that] they’re…selling it [to customers] at the price they’re supposed to sell it at instead of raising their own price.” (Sales representative 1)

Fig. 1.

Conceptual Model Illustrating the Relationships among the UPF Industry Marketing Behaviors (Sub-Themes) and their Influence on Consumers

Guiding principles of 4Ps implementation (Overarching Theme 1)

Across the various data sources, three guiding principles were identified that discussed how the UPF industry applied the 4Ps to increase customer exposure, stimulation, visibility, and cuing of products to ultimately influence consumer sales. These principles (sub-themes) included: Simultaneous use of the 4Ps, Placement as a top priority, and Keeping things fresh.

Simultaneous use of the 4Ps (Sub-Theme 1)

Public health nutrition research and policy often focus on only one of the 4Ps at a time. For example, healthy checkout policies typically involve regulations focused solely on product placement, while taxes target only price. Yet, industry business files and informants repeatedly illustrated how the 4Ps are not implemented separately but rather are simultaneously considered all the time.

Industry planograms and in-field photos were one of the most apparent places this simultaneous consideration was demonstrated, where, for example, a classic potato chip brand had a new flavor (product) that was placed in the endcap at eye-level (placement), with a price discount (e.g., “2 for $5”) and advertising promotion (e.g., “ignite bold flavor,” professional athlete on packaging). Even business negotiations between retailers and UPF companies considered the 4Ps concurrently. As one retailer described, when a retailer-decided consumer price was higher than the UPF company wanted, “then, we have to come to some kind of deal, [such as] location…promotion” (Chain manager 8). This concurrent consideration was also used when assessing how to tailor all 4Ps for customer engagement and UPF sale success, “if [UPFs] don’t sell, then you go back and re-evaluate…was it the item [product]… was it the retail [price] …was it placement?… [and/or was it] lack of promotional activity around particular items that it didn’t do well.” (Chain manager 2).

For UPF companies, placement is top priority (Sub-Theme 2)

While industry-insiders considered the 4Ps together, placement was a top priority and was meticulously planned and negotiated by UPF companies. As one participant summarized, “So the biggest strategy that we have for promotion isn’t necessarily price promotion, but it’s access and availability. So, what I mean by that is on the shelf…facings and planograms” (Sales representative 10). As another participant described, certain products “have to be up front, in people’s faces” (Sales representative 18), which often required being in multiple locations throughout a store and/or in high-traffic areas, like entrances or checkouts. The importance of product visibility and accessibility was corroborated by other participants that talked about how they “have to fight for” (Sales representative 3) or “jockeying for space” (Sales representative 16). Retail managers also talked about space being “at a premium” (Chain manager 1) and “you don’t want to have an empty spot” (Independent manager 9). Language in marketing contracts emphasized this too, as one company specified that shipper displays must be “promptly placed… with open access and unfettered visibility” (Document 68).

Emphasis on placement was also conveyed in the careful design and precision of planograms, which were used across stores for most UPFs. Participants talked about a best (i.e., “first”) position at eye-level or a “strike zone. It’s shoulders to waist…If it’s right there where they [customers] put their hand, that’s the bestselling spot. So, you put your highest movers right there” (Chain Manager 4). Participants also described meticulous designs of planograms based on: product revenue (“you try to put your higher margin items…in an eye level position”, Chain Manager 11); amount of product sales or “volume” (“the most popular flavors will be up top,” Distributor 3); or customer demographics (“all of your kids’ stuff… is always towards the bottom,” Chain Manager 9).

Keeping things “fresh” (Sub-Theme 3)

One predominant marketing strategy identified that has received little attention in the literature is the continual creation of new customer experiences and “choices” around UPFs, which were implemented across the 4Ps. A common way participants talked about this strategy was through the growing portfolio of product flavors for classic brands, like creating spicy or fruit-inspired varieties, that supported an illusion of enhanced customer choice despite relatively stable offerings. One sales representative recalled, “when I started selling [the UPF], it was back before they had 75 different flavors. It was like normal or sugar-free, and that was it…those two” (Sales Representative 9). Some retailers greatly valued this “innovation” and the industry-induced sense of urgency (“limited time offer” products), as they wanted “to find something new, exciting to bring in” (Chain Manager 10) for their customers.

Placement was another domain for keeping customer experiences fresh. Retailers and UPF companies annually or bi-annually performed a planogram “refresh,” where retailers often encouraged UPF companies to drop low-selling items, and companies aimed to get new products and more options (customer “choices”) into stores. Relatedly, store layout “resets” were also commonly used to support UPF sales despite being resource intensive. As one participant explained, “You basically do a layout of the store, and you go off [product] sales, and you say well, this will sell better here, and that—move there… I remember one store we took from a triangle shaped gondola to a 60-inch-tall gondola. It was a huge difference [in improving customer sales]” (Chain manager 9). Similarly, price and placement promotions for company UPFs were typically refreshed on a monthly rotation, where one core brand was promoted for one month followed by another the next month. While most refreshing strategies were implemented to keep classic brands relevant and circumvent customer boredom, participants also described how the introduction of new UPF product items likewise became part of the refresh strategy.

Governance and surveillance mechanisms to best execute the 4Ps (Overarching Theme 2)

In addition to the guiding principles used to design and apply the 4Ps to enhance customer UPF purchases, we also identified three mechanisms the industry employed to ensure that implementation and design were consistently executed to best serve their interests. As detailed below, these mechanisms included: Monitoring every move, Contracts dictate the 4Ps, and Maintaining store compliance.

Monitoring every move (Sub-Theme 4)

One of the primary ways marketing strategies were executed to maximize UPF customer purchases was through retailers’ and companies’ precise and comprehensive monitoring of sales and competitor company behavior. As one sales representative mentioned, it was paramount that everyone was “using good data. That data is everything” (Sales representative 5). “Good data” was so important that both retailers and companies monitored sales independently, which were then discussed quarterly to yearly to re-evaluate sale successes and failures of every product and variety. A manager explained: “Every year we have…a ‘lab session’ where we will have [Company] analysts in the room, and… we’ll look at data. We’ll look at… what we’ve sold … what do we need to take out, and what needs to stay in. Where can we add a new item.” (Chain Manager 1). These data were not only used to inform annual planogram “resets,” but also utilized by UPF company representatives weekly to know how much of each product to order for each store. In fact, representatives had handheld devices to access historical weekly sales data for every product and variety in every store.

The importance of accessing precise data was also demonstrated through UPF marketing agreements where retailers had to comply with data releases to companies to receive a company’s rebate on the UPFs they sold. In one agreement, retailers authorized release of “item and store level purchase and velocity data for all [UPF Company] purchases by Retailer to [UPF Company] …Only data supplied … on a weekly basis and in the proper format will be accepted.” (Document 67). A key motivation for capturing these data was not only to track customer purchasing, but for UPF companies, these data offered a stronger negotiation position during annual “resets.” Having the “best data” in negotiations could help UPF companies get more shelf space and ensured space did not get “skewed by just a manufacturer’s rep that comes in there and just gets as much [of] his stuff on the shelf as you can” (Sales representative 2). Beyond sales data, retailers and companies also carefully tracked competitors’ customer prices. As one sales representative explained, “everybody keeps tabs on everybody. When price just goes up, we want to see their prices. When ours goes up, they want to see our prices” (Sales representative 3).

Contracts dictate the 4Ps (Sub-Theme 5)

While “good data” were critical for UPF companies to monitor customer selections and marketing strategies, marketing agreements (i.e., contracts) were the primary strategy used to ensure the 4Ps were implemented in ways that benefited UPF companies. Specifically, every retailer agreed to specific contracted terms to receive UPF company services (e.g., direct-store-delivery [DSD]) or incentives (e.g., rebates, shelving allowances), and terms were specified across the 4Ps. For instance, for product terms, contracts specified a minimum number of SKUs to offer (“Must carry all agreed upon [company] SKUs,” Document 61) or minimum shelf space for specific products (“minimum 8 energy shelves,” Document 42). There were also terms about new products (“there would be, like, clauses… like… you have to agree to take all new innovative products,” Sales representative 11).

Contracts also specified: placement locations, like front lobby or checkout areas; which shelves UPFs must be placed on (i.e., at eye-level); and, in some cases, exclusive rights to certain locations (i.e., prohibiting competitor products in high-customer traffic areas). Promotional strategies were also specified throughout contracts. For instance, some companies required retailer participation in seasonal promotions to receive rebates. Other terms required retailers to implement industry-designed point-of-sale signage, like “Execute statics, shelf tags, shelf talkers, neck hangers, coroplast signs, window signs” (Document 63).

While all contracts specified price terms, these requirements were diverse. Some agreements only specified what retailers paid; however, companies “reserve[d] the right to adjust [retailer] pricing with a 30-day notice” (Document 42). Sometimes this meant customer prices for UPFs automatically increased, as retailers needed to “hit” profit margins. However, some UPF companies wanted the customer price to remain in a certain range. In those instances, either another marketing solution (e.g., co-funding a customer price promotion), retailer rebate, or discount was negotiated and included within the contract. Yet, some UPF companies wanted even more explicit control over customer price and either printed prices on the packaging or dictated price in the contract.

Maintaining Store Compliance (Sub-Theme 6)

The final approach we identified that UPF companies used to ensure the implementation of the 4Ps was through the constant inspections of stores. Participants talked about how planograms, shelf space, placement, prices, and SKUs were frequently inspected by company personnel. For UPF products delivered by wholesalers, this typically involved personnel from the UPF company corporate office periodically visiting stores (e.g., quarterly, biannually). In comparison, for UPF companies offering DSD, “those [terms] are inspected a minimum of three to four times a week whenever the salesperson is getting an order, or a merchandiser is helping merchandise the account itself … If there is any violation or what they call “foreign” products in [our space], then that’s [either] a conversation for it to be adjusted,… move to a different contract agreement, or the contract will just [become] null and void” (Sales Representative 10). These inspections were specified in the contract (e.g., “racks are subject to audit for validation”, Document 67) along with termination conditions (e.g., “Failure to comply with merchandising… at any time will terminate agreement” Document 61).

Discussion

The UPF industry, including retailers and product manufacturers, carefully implement the 4Ps (price, placement, product, promotion) to orchestrate predictable and conditioned UPF customer selection responses. As shown in this study, they leverage precise data on sales and marketing strategy effects, require scripted implementation of marketing tactics in contracts, closely monitor contract compliance, emphasize “refreshed” customer retail experiences to create the illusion of enhanced customer choice and product innovation, and carefully choreograph strategies that integrate all 4Ps simultaneously, while giving preference to location whenever possible. The result is retail settings that are carefully staged by UPF companies with the explicit intention of increasing customer purchases of UPFs.

By better understanding the UPF industry’s manipulation of retail settings, these findings challenge the long-standing industry narrative that food and beverage selections primarily reflect consumer choice [37, 38]. A substantial body of research demonstrates that many retail marketing strategies are effective precisely because they operate through automatic, non‑deliberative cognitive and affective processes rather than conscious, reflective decision‑making [39–45]. For instance, environmental food cues, including packaging, branding, and promotional messaging, have been shown to influence behavior through emotional responses, at times more strongly than through evaluative judgments such as product liking [44–49]. Further, UPF companies have consistently leveraged these emotive mechanisms to associate their products with positive feelings, sometimes in ways that undermine consumers’ intentions [39, 41, 50]. Price cues, such as discounts and limited time offers, are a further example as these can activate heuristic judgments about value and scarcity, nudging consumers towards purchases without deep reflection [51]. Collectively, these tactics shape purchasing behavior by exploiting cognitive shortcuts and affective responses, allowing UPF retail marketing to influence behavior well before customers consciously deliberate or exercise “choice.”

In this study, we found companies and retailers simultaneous considered all 4Ps for every UPF and recognized the need to tailor all for sales success. Clarifying the industry does not think about the 4Ps separately but rather as a strategically refined marketing mix [52] suggests public health policies and research should do the same. Indeed, industry’s adaptive marketing mix behavior has been previously described—where they reorient their extensive slate of marketing strategies to maintain compliance with a narrow public health policy, such as a tax, while recouping as much of the anticipated lost sales as possible and potentially undermining the policy’s intended effect [31]. Similarly, due to various data collection challenges, research has not fully examined this simultaneous implementation, as studies on customer food and beverage purchasing examine strategies separately or limit interactions to two strategies instead of the overall cumulative effect companies create [15, 53–55]. While greater consideration of the full marketing mix is important, the prioritization of placement by UPF companies also suggests this strategy warrants closer attention by policy regulations. Useful approaches might include short-term policy tools such as requiring that UPF products remain in their designated aisle [56] instead of in multiple high-traffic promotional locations. Yet, regulations could also target other marketing practices, such as restricting price discounts or the number of promotions offered annually for UPFs.

Our findings also help extend understanding of how UPF marketing agreements are implemented to ensure the carefully designed 4Ps result in optimal consumer behavior (i.e., sales) towards a company’s UPF products. Not only do these contracts stipulate the 4Ps, but our data also provided insights into companies’ careful monitoring of store compliance with the contracted terms. Additionally, the extensive and precise collection of each product’s sales per store highlights how the industry optimizes product offerings and marketing strategies to each store’s customer base that best serves the UPF company’s overall profits. These strategies point to the need for more structural policy reforms. Examples could include Sunshine laws that have been proposed to make contract-based retail strategies for other harmful products publicly transparent [57] and greater scrutiny of anti-trust violations, an area that has gained renewed US attention following the Federal Trade Commission’s case filed against PepsiCo in December 2025 [58].

Notably, many of the retail marketing strategies used by the UPF industry reflect those of other harmful industries including tobacco. Evidence increasingly demonstrates the overlap in tactics both industries have used in product formulation [59] and influences on science, regulation, and public opinion [10, 11, 37]. Even recent legislative cases brought against UPF companies highlight their deep ties and parallels to tobacco companies through product development [60]. Our study adds to this growing literature to highlight this industry alignment extends into the use of retail marketing strategies and contracts, as these have been a mainstay for tobacco products for decades using similar terms [61]. The overlap in strategies and practices underscores the need to further expand the commercial determinants of health literature to shed additional light on how diverse commercial entities with diverse products continue to operate in similar ways [38].

Limitations and Strengths

Participants were recruited from the southeastern US, and interviews mainly focused on shelf-stable packaged snack and beverage UPFs versus other products (e.g., packaged bread, frozen desserts). We also relied on industry-insiders who agreed to be interviewed. Consequently, findings may not provide a comprehensive view of all UPF market strategies and may raise concerns about the accuracy and representativeness of information obtained from industry-insiders. However, the following study design strengths suggest the UPF marketing strategies identified are likely predominant and widespread: (a) many participants represented national and global UPF companies, (b) participants in different industry roles provided corroborating insights, and (c) other data sources, including contracts, were used to triangulate interview data.

In addition, this study makes substantial contributions to analytic generalizability by generating conceptual insights into how the UPF industry implements the 4Ps in ways that extend beyond the specific participants, companies, and products examined here. These insights both provide greater specificity to previously recognized strategies (e.g., contracts, the 4Ps) and illuminate newer practices that have received limited attention in the literature to date (e.g., compliance checks, data monitoring). Nevertheless, future research is needed to assess whether implementation of these strategies varies across UPF companies or product categories, across country contexts with different regulatory regimes or stages of economic development, and in relation to their effects on customer purchasing and health outcomes.

Conclusions

The current US administration has taken initial steps to highlight the overreliance of UPFs in the American diet. They have issued calls to develop an official government UPF definition and to implement policies prohibiting the use of petroleum-based food dyes common in UPFs [62]. Government agencies also announced a new joint research initiative on nutrition regulatory science to understand biological mechanisms for how UPFs and food additives harm health [63]. In addition, at the time of this writing, the US Secretary of Agriculture has approved 23 states waiver requests to prohibit some UPFs, like candy and beverages that contain natural or artificial sweeteners, from being purchased with government food assistance benefits [64]. While such approaches intend to curb UPF customer purchasing and consumption, they also largely emphasize the problem as one of personal responsibility [65] ignoring the role the UPF industry plays in manipulating customer selections at the point of sale.

The precise implementation of marketing strategies for UPF products as described by industry-insiders and documents in this study highlights that policy designs to regulate tactics within retail food environments are urgently needed. To date, most policies targeting UPFs in the United States and globally have focused on the product and pricing retail marketing strategies [66–68], with some current U.S. efforts ignoring retail settings and narrowly targeting school meals [66, 69, 70]. While these strategies can lead to industry reformulation [68], policies that address multiple 4Ps or that more comprehensively limit the number of UPF placement exposures throughout retail settings may offer additional population health benefits. However, it will be critical that these measures are regulated, adequately enforced, and consistently monitored for intended effects rather than implemented through voluntary industry self-regulation, which has repeatedly proven ineffective in improving public health [38]—and is likely to be circumvented by the very marketing strategies we identified. Moreover, counter-marketing campaigns deployed by public health agencies and non-governmental organizations could be another tool to help reveal these underrecognized strategies and have been effectively used for other public health domains, such as alcohol and tobacco [71, 72]. By bringing these industry tactics to light in accessible and compelling ways, such campaigns can help shift public perceptions, foster skepticism toward harmful promotional practices, and ultimately support broader policy efforts aimed at reducing the influence of UPF marketing on consumer experiences.

Supplementary Information

Below is the link to the electronic supplementary material.

Abbreviations

4Ps

product, placement, price, and promotion.

DSD

direct-store delivery and servicing.

SKU

stock keeping unit.

UPFs

ultra-processed foods.

Author contributions

MRW – Responsible for formulating research questions, leading the overall study from which these data originated including conception/design, funding acquisition, and implementation; led and conducted the analysis, results interpretation, and manuscript writing. SS – Responsible for assisting with data analysis, interpreting results, and contributing to manuscript writing/ revisions. CCA– Responsible for collecting data, assisting with data analysis, and reviewing and editing the manuscript. MNL – Responsible for contributing to the formulation of the research question, interpretation of results, reviewing and editing the manuscript. All authors read and approved the final manuscript.

Funding

This work was funded by the National Heart, Lung, and Blood Institute under Award Number R00HL144824 (PI: M. Winkler) and S. Sundermeir effort was supported by a National Heart, Lung, and Blood Institute training grant (T32HL130025). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding agencies had no role in the design, analysis or writing of this article.

Data availability

The qualitative datasets were generated and analyzed by the research team. Anonymized data can be made available upon reasonable request to the corresponding author pending approval.

Declarations

Ethics approval and consent to participate

Ethical approval for this study was granted by the Emory University Institutional Review Board (Protocol STUDY00005972). All participants provided their consent to participate and be recorded prior to study activities via email or video call. Any identifying details such as names of participating individuals and their affiliations are removed to ensure anonymity. The study adhered to the Declaration of Helsinki, Research Governance Framework for Health and Social Care, Data Protection Act 2018 and the Consolidated Criteria for Qualitative Research (COREQ) recommendations [36].

Consent for publication

We obtained consent from all the participants prior to interviews for anonymized quotes to be published in study outputs.

Competing interests

The authors declare no competing interests.

Declarations of interest

None.