Marketing fat and sugar to children on New Zealand television

30+ years of media analysis of relevance to chronic disease: a scoping review

BACKGROUND

Chronic, non-communicable diseases are a significant public health priority, requiring action at individual, community and population levels, and public and political will for such action. Exposure to media, including news, entertainment, and advertising media, is likely to influence both individual behaviours, and attitudes towards preventive actions at the population level. In recent years there has been a proliferation of research exploring how chronic diseases and their risk factors are portrayed across various forms of media. This scoping review aims to map the literature in this area to identify key themes, gaps, and opportunities for future research in this area.

METHODS

We searched three databases (Medline, PsycINFO and Global Health) in July 2016 and identified 499 original research articles meeting inclusion criteria: original research article, published in English, focusing on media representations of chronic disease (including how issues are framed in media, impact or effect of media representations, and factors that influence media representations). We extracted key data from included articles and examined the health topics, media channels and methods of included studies, and synthesised key themes across studies.

RESULTS

Our findings show that research on media portrayals of chronic disease increased substantially between 1985 and 2016. Smoking and nutrition were the most frequent health topics, and television and print were the most common forms of media examined, although, as expected, research on online and social media channels has increased in recent years. The majority of studies focused on the amount and type of media coverage, including how issues are framed, typically using content analysis approaches. In comparison, there was much less research on the influences on and consequences of media coverage related to chronic disease, suggesting an important direction for future work.

CONCLUSIONS

The results highlight key themes across media research of relevance to chronic disease. More in-depth syntheses of studies within the identified themes will allow us to draw out the key patterns and learnings across the literature.

Identifying food marketing to teenagers: a scoping review

Background

Teenagers are aggressively targeted by food marketing messages (primarily for unhealthy foods) and susceptible to this messaging due to developmental vulnerabilities and peer-group influence. Yet limited research exists on the exposure and power of food marketing specifically to teenage populations. Research studies often collapse “teenagers” under the umbrella of children or do not recognize the uniqueness of teen-targeted appeals. Child- and teen-targeted marketing strategies are not the same, and this study aims to advance understanding of teen-targeted food marketing by identifying the teen-specific promotion platforms, techniques and indicators detailed in existing literature.

Methods

A systematic scoping review collected all available literature on food marketing/advertising with the term “teenager” or “adolescent” from nine databases, as well as Google Scholar for grey literature, and a hand search of relevant institutional websites. Included were all peer-reviewed journal articles, book chapters, and grey literature in which food marketing to youth was the central topic of the article, of any study type (i.e., original research, reviews, commentaries and reports), and including any part of the 12–17 age range.

Results

The 122 articles reviewed define the scope of existing literature on food marketing to young people age 17 and under, identifying leading trends in countries studied (United States, 52%), populations identified (children and teens studied concurrently, 36%), outcomes measured (advertising exposure, 54%), study type (cross-sectional, 58%) and methods used (content analysis, 46%). The promotion platforms and techniques used by food marketers to appeal to young people (as reported in the literature) are also identified and classified. Few studies (7%) use indicators to identify teen-targeted food marketing.

Conclusions

Unique treatments of teen populations are limited in food marketing literature, as is the application of clear indicators to identify and differentiate teen-targeted food marketing from child- or adult-targeted content. Given the need to better measure the presence and power of teen food marketing, this is a significant oversight in existing literature. The indicators identified will help researchers to develop more accurate strategies for researching and monitoring teen-targeted food promotion.

Children's everyday exposure to food marketing: an objective analysis using wearable cameras

Background

Over the past three decades the global prevalence of childhood overweight and obesity has increased by 47%. Marketing of energy-dense nutrient-poor foods and beverages contributes to this worldwide increase. Previous research on food marketing to children largely uses self-report, reporting by parents, or third-party observation of children’s environments, with the focus mostly on single settings and/or media. This paper reports on innovative research, Kids’Cam, in which children wore cameras to examine the frequency and nature of everyday exposure to food marketing across multiple media and settings.

Methods

Kids’Cam was a cross-sectional study of 168 children (mean age 12.6 years, SD = 0.5) in Wellington, New Zealand. Each child wore a wearable camera on four consecutive days, capturing images automatically every seven seconds. Images were manually coded as either recommended (core) or not recommended (non-core) to be marketed to children by setting, marketing medium, and product category. Images in convenience stores and supermarkets were excluded as marketing examples were considered too numerous to count.

Results

On average, children were exposed to non-core food marketing 27.3 times a day (95% CI 24.8, 30.1) across all settings. This was more than twice their average exposure to core food marketing (12.3 per day, 95% CI 8.7, 17.4). Most non-core exposures occurred at home (33%), in public spaces (30%) and at school (19%). Food packaging was the predominant marketing medium (74% and 64% for core and non-core foods) followed by signs (21% and 28% for core and non-core). Sugary drinks, fast food, confectionary and snack foods were the most commonly encountered non-core foods marketed. Rates were calculated using Poisson regression.

Conclusions

Children in this study were frequently exposed, across multiple settings, to marketing of non-core foods not recommended to be marketed to children. The study provides further evidence of the need for urgent action to reduce children’s exposure to marketing of unhealthy foods, and suggests the settings and media in which to act. Such action is necessary if the Commission on Ending Childhood Obesity’s vision is to be achieved.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-017-0570-3) contains supplementary material, which is available to authorized users.

Unhealthy food advertising directed to children on New Zealand television: extent, nature, impact and policy implications

Objective

To comprehensively assess the extent, nature and impact of unhealthy food advertising targeted to children on New Zealand television.

Design

Four weekdays and four weekend days were randomly selected over the period June–August 2015. Programming was recorded from 06.00 to 00.00 hours (midnight), for a total of 432 h. Audience ratings were used to identify children’s peak viewing times.

Setting

New Zealand.

Subjects

The three major free-to-air channels.

Results

The majority of foods advertised (n 1807) were unhealthy; 68·5 % of food advertisements included at least one food not permitted to be marketed to children according to the WHO nutrient profiling model. The mean hourly rate of unhealthy food advertising was 9·1 (sd 5·2). One-third of unhealthy food advertisements included a promotional character and one-third a premium offer. About 88 % of unhealthy food advertisements were shown during children’s peak viewing times. If unhealthy food advertisements were to be restricted during times when at least 25 % of children are watching television, this would reduce the average unhealthy food advertising impact by 24 % during weekdays and 50 % during weekend days, and if the WHO instead of the current nutrient profiling model were used to restrict unhealthy food advertising to children, the average impact would be reduced by 24 % during weekdays and 29 % during weekend days.

Conclusions

Current self-regulation is ineffective in protecting children from exposure to unhealthy food advertising on television. The WHO nutrient profiling model needs to be used to restrict unhealthy food advertising, especially during children’s peak viewing times.

Preventing type 2 diabetes: Changing the food industry

Improving our global diet by working with the food industry is a fairly complex task. Previously the global food manufacturing companies and governments were the major players. However, matters have shifted rapidly so that food retailers, food manufacturers, the restaurant-food service sector, and agribusinesses are now the major players. The current modern system of packaged processed food has now penetrated the globe-rich and poor, rural and urban are all in reach of this food system. Consequently, working with this complex sector when possible and an array of governmental regulatory large-scale options to improve our diet have increased in importance. Taxation of unhealthy foods and beverages, marketing controls, and front of the package labeling are the primary current options. Evaluations of the impacts of both public and industry initiatives are needed.

Inverting the pyramid! Extent and quality of food advertised on Austrian television

BACKGROUND

Research showed that food marketing for children frequently contradicts national dietary guidelines. Children, unlike adults, are not able to understand the persuasiveness of the advertisements with its short- and long-term effects on health, thus the common international tenor is to restrict food marketing. In the European Union, marketing restriction based on self-regulation have been initiated (EU Pledge Nutrition Criteria). The study aims contribute to depict the status quo of television advertisement targeted at children before the pledged initiative came into full effect.

METHODS

In this study we analyze the quality and displaying frequency of a set of advertisements targeted at children broadcasted on Austrian television. Promoted food products targeted at children or adults were identified. Category-based analysis of the displayed food was performed based on the Austrian Nutrition guidelines (number of displayed food per food category). The children's food content was analyzed according to the newly established nutritional quality criteria for advertised food in the EU to assess the nutritional quality of the depicted food.

RESULTS

In total, 360 h of video material was recorded in February and March 2014. A set of 1919 food advertisements, with 15.1 % targeted at children were broadcasted. Of all food advertisements targeted at children, 92.4 % was for fatty, sweet and salty snacks, while no advertisements for vegetables, legumes or fruits were shown. From all food advertisements for children, 65.9 % originated from participating companies of the EU Pledge Nutrition Criteria. Further analysis revealed that 95.9 % of the advertised food for children showed at least one aspect of nonconformity with the EU Pledge Nutrition Criteria; on the contrary 64.7 % of the displayed food advertisement also featured at least one desirable food component (e.g. high fibre content, high protein content).

CONCLUSIONS

The present research suggests that the majority of advertised food for children do not conform with the pledged criteria as defined in the EU Pledge Nutrition Criteria and almost all advertisements would be prohibited. We discuss our findings in the context of public health nutrition and present a perspective for future directions in this important field of research.

Demographic and psychographic associations of consumer intentions to purchase healthier food products

OBJECTIVE

This study investigated the associations of nutrition concerns, demographics, universalism (community oriented) values, perceived control over personal health and food buying, and perceived influence over the food system with intentions to purchase low fat, sugar and salt (LFSS) food products.

METHODS

A national online survey of 2204 Australian consumers administered in November 2011. Structural equation modeling was used to examine associations of LFSS purchasing intentions with demographic, values, perceived control, and influence factors.

RESULTS

Nutrition concern, perceived influence over the food system, and universalism values were key predictors of LFSS purchasing intentions. Almost two thirds (64.6%) of the variance associated with LFSS purchasing was explained by the structural equation model.

CONCLUSION

Communication programs which focus on universalism values, nutrition concern and perceived influence over the food system are likely to increase LFSS purchasing and perhaps reduce the demand for energy dense, nutrient poor foods.

A nutritional comparison of foods and beverages marketed to children in two advertising policy environments

Childhood obesity is associated with children's exposure to food/beverage marketing. Policy options in this area are being sought in order to reduce childhood obesity rates on a population-level. We examined the nutritional quality of foods advertised to children during their preferred television viewing in Ontario (Canada), where advertising is self-regulated by industry, and in Quebec (Canada), where a child-directed advertising ban exists. A total of 428 children aged 10-12 years completed television viewing diaries for 7 days. Thirty-two television stations were recorded simultaneously between 6 AM and midnight. A content analysis of 90 h of English Ontario, French Quebec, and English Quebec children's preferred viewing was then undertaken. A total of 429 food and beverage advertisements were analyzed and their nutritional quality was assessed. Food advertisements in the Quebec French sample were statistically significantly higher in total fat, saturated fat and protein, and lower in carbohydrates and sugar per 100 g, and as a percentage of energy than food ads in the two English samples. A statistically significantly lower percentage of the Quebec French food advertisements were classified as either high fat, sugar or sodium and a smaller proportion of food ads were classified as "less healthy" compared to the Ontario and Quebec English samples. These results suggest that the Quebec advertising ban is influencing the macronutrient profile of advertised foods viewed by French Quebec children during their preferred viewing and that their promotions are marginally healthier than that viewed by the English samples.

Branded food references in children's magazines: 'advertisements' are the tip of the iceberg

OBJECTIVE

While children's magazines 'blur the lines' between editorial content and advertising, this medium has escaped the calls for government restrictions that are currently associated with food advertisements aired during children's television programming. The aim of this study was to address significant gaps in the evidence base in relation to commercial food messages in children's magazines by systematically investigating the nature and extent of food advertising and promotions over a 12-month period.

METHOD

All issues of Australian children's magazines published in the calendar year 2009 were examined for references to foods or beverages.

RESULTS

Approximately 16% of the 1678 food references identified were portrayals of branded food products (or food brands). However, only 83 of these 269 were clearly identified as advertisements. Of these 269 branded food references, 86% were for non-core (broadly, less healthy) foods, including all but seven of the advertisements.

CONCLUSIONS

It appears that recent reductions in televised promotions for non-core foods, and industry initiatives to reduce the targeting of children, have not carried through to magazine advertising. This study adds to the evidence base that the marketing of unhealthy food to children is widespread, and often covert, and supports public health calls for the strengthening of advertising regulation.

Adolescent weight status and receptivity to food TV advertisements

OBJECTIVE

This study examined the relationship between adolescent weight status and food advertisement receptivity.

DESIGN

Survey-based evaluation with data collected at baseline (initial and at 2 months), and at follow-up (11 months).

SETTING

New Hampshire and Vermont.

PARTICIPANTS

Students (n = 2,281) aged 10-13 in 2002-2005.

MAIN OUTCOME MEASURE

Overweight.

ANALYSIS

Generalized estimating equations to model the relationship between identifying a food advertisement as their favorite and being overweight.

RESULTS

Overall, 35.9% of the adolescents were overweight. Less than one fifth named a food advertisement as their favorite (16.1%). Most of the food advertisements were for less-healthful food (89.6%). After controlling for school, age, sex, sociodemographics, physical activity, number of TV sessions watched, and having a TV in the bedroom, overweight adolescents were significantly less likely to be receptive to food advertisements (relative risk = 0.83, 95% confidence interval 0.70, 0.98) compared to non-overweight adolescents.

CONCLUSIONS AND IMPLICATIONS

This study provides preliminary evidence that normal-weight adolescents are receptive to unhealthful food advertisements. Longitudinal studies are needed to evaluate whether consistent exposure to advertisements for unhealthful food, particularly if they are promoted with healthful behaviors such as being physically active, influence adolescents' food choices, and ultimately their body mass index, over the long term.

Impact of commercials on food preferences of low-income, minority preschoolers

OBJECTIVE

To determine whether fruit and vegetable (FV) commercials have an impact on preschool children's preferences for specific FV.

DESIGN

A year of extensive formative assessment was conducted to develop 2 30-second commercials: "Judy Fruity" promoted apples and bananas and "Reggie Veggie" promoted broccoli and carrots. The commercials were embedded into a 15-minute TV program. Fruit and vegetable preferences were assessed before and after 4 exposures to each of the commercials.

SETTING

Four Head Start centers in Houston, Texas.

PARTICIPANTS

One hundred eighty-three preschool children (39% African American; 61% Hispanic American).

MAIN OUTCOME MEASURES

Assessment of whether FV preferences were significantly higher in the treatment group than the control group, controlling for baseline FV preferences, age, race, and intervention dose in the model.

ANALYSIS

A general linear model was used.

RESULTS

There was a significantly higher preference for broccoli and carrots (P = .02) in the intervention group compared to the control group after multiple exposures to the vegetable commercial.

CONCLUSIONS AND IMPLICATIONS

Data suggest that commercials promoting vegetables may be an effective strategy to influence young children's preferences for vegetables. This may not be the case with fruit preferences, which are already high in this age group.

An experimental study on the effects of exposure to magazine advertising on children's food choices

Objective

The present study sought to determine the feasibility of an experimental research design to investigate the effects of exposure to magazine advertising on children's food choices.

Design

Children were randomized to read either a magazine with food advertisements or a magazine with no food advertisements. They then chose two food items from the intervention ‘store’ to eat after the session. Data were also collected on attitudes to advertising and snack food preferences. Finally, participants’ parents were provided with a self-completion survey on food choices and other variables (n24).

Setting

Three vacation care centres in regional New South Wales, Australia.

Subjects

Children aged 5–12 years (n47).

Results

Children in the experimental condition were more likely to choose advertised foods than those in the control group. Interestingly, the majority reported taste and healthiness as the most important factors in snack food choices; however, when faced with the actual food choice, they predominantly chose unhealthy foods (eighty-two unhealthy and only twelve healthy items were chosen).

Conclusions

This was the first study to assess the effects on children of exposure to food advertising within the context of reading a child-targeted magazine. Importantly, even with the small sample size and venue limitations, we found that exposure to magazine advertising influenced food choices. Children's magazines are an under-researched and poorly regulated medium, with considerable potential to influence children's food choices. The present study shows that the methodology is feasible, and future studies could replicate this with larger samples.

Identifying 'unhealthy' food advertising on television: a case study applying the UK Nutrient Profile model

OBJECTIVES

To evaluate the feasibility of the UK Nutrient Profile (NP) model for identifying 'unhealthy' food advertisements using a case study of New Zealand television advertisements.

DESIGN

Four weeks of weekday television from 15.30 hours to 18.30 hours was videotaped from a state-owned (free-to-air) television channel popular with children. Food advertisements were identified and their nutritional information collected in accordance with the requirements of the NP model. Nutrient information was obtained from a variety of sources including food labels, company websites and a national nutritional database.

RESULTS

From the 60 h sample of weekday afternoon television, there were 1893 advertisements, of which 483 were for food products or retailers. After applying the NP model, 66 % of these were classified as advertising high-fat, high-salt and high-sugar (HFSS) foods; 28 % were classified as advertising non-HFSS foods; and the remaining 2 % were unclassifiable. More than half (53 %) of the HFSS food advertisements were for 'mixed meal' items promoted by major fast-food franchises. The advertising of non-HFSS food was sparse, covering a narrow range of food groups, with no advertisements for fresh fruit or vegetables.

CONCLUSIONS

Despite the NP model having some design limitations in classifying real-world televised food advertisements, it was easily applied to this sample and could clearly identify HFSS products. Policy makers who do not wish to completely restrict food advertising to children outright should consider using this NP model for regulating food advertising.

Comida en venta: after-school advertising on Spanish-language television in the United States

OBJECTIVE

To analyze the content of food and drink commercials aired during after-school hours on Spanish-language television.

STUDY DESIGN

We performed a content analysis of food and drink advertisements, evaluating product type, food category, and message content. All advertisements aired during after-school hours (3 to 9 p.m.) on 2 U.S. Spanish-language television stations were sampled over a 1-week period in the spring of 2006.

RESULTS

We reviewed 60 hours of programming. Of the non-program content, 47% was for product advertisements, 15% (n = 153) of which was for food/drink. A mean of 2.5 food/drink commercials aired per hour (range 0-8), and the median duration was 30 seconds; 31% of food/drink commercials advertised fast food, and 27% advertised drinks, most (54%) of which were sugared. About one third (31%) of the food/drink commercials targeted children, 12% featured Latino celebrities, and 19% made reference to Latino culture. Only 16% of the food/drink commercials had health-related content.

CONCLUSIONS

Children viewing Spanish-language television in the United States after school are exposed to food and drink commercials, most of which advertise unhealthy foods, including fast food and sugared drinks. Food and beverage advertising on Spanish-language television may play an important role in the high risk of overweight among Latino children.

Television food advertising to children: the extent and nature of exposure

Objective

To describe the pattern and prevalence of food and drink advertisements to children on commercial television in Sydney, Australia, and compare these with advertising regulations set out in the Children's Television Standards and results from a similar study in 2002.

Design

Data were collected by recording television from 06.00 hours until 23.00 hours on all three commercial channels from Sunday 14 May 2006 to Saturday 20 May 2006 (357 h). The study analysed advertisements in two children's viewing periods, one as defined in the 2002 study and the other according to current standards. Food advertisements were coded using 18 food categories and were analysed by time period and popular children's programmes.

Results

Food advertisements occurred in similar proportions during children's viewing hours and adult's viewing hours (25.5 vs. 26.9% of all advertisements, respectively), although there was a higher rate of high-fat/high-sugar food advertisements during children's viewing hours (49 vs. 39% of all food advertisements,P < 0.001). There were even more advertisements for high-fat/high-sugar foods during popular children's programmes, contributing to 65.9% of all food advertisements. Estimates of exposure indicate that children aged 5–12 years were exposed to 96 food advertisements, including 63 high-fat/high-sugar advertisements per week. Since 2002, there has been a reduction in overall food and high-fat/high-sugar food advertisements.

Conclusion

Despite reductions in overall levels of food advertising, children continue to experience high levels of exposure to food advertisements, which remain skewed towards unhealthy foods. Further food advertising regulation should be required to curtail the current levels of advertising of high-fat/high-sugar foods to children, to make them commensurate with recommended levels of consumption.

Regulating and litigating in the public interest: regulating food marketing to young people worldwide: trends and policy drivers

The pressure to regulate the marketing of high-energy, nutrient-poor foods to young people has been mounting in light of concern about rising worldwide levels of overweight and obesity. In 2004, the World Health Organization called on governments, industry, and civil society to act to reduce unhealthy marketing messages. Since then, important changes have taken place in the global regulatory environment regarding the marketing of food to young people. Industry has developed self-regulatory approaches, civil society has campaigned for statutory restrictions, and governments have dealt with a range of regulatory proposals. Still, there have been few new regulations that restrict food marketing to young people. Despite calls for evidence-based policy, new regulatory developments appear to have been driven less by evidence than by ethics.

The effects of television advertisements for junk food versus nutritious food on children's food attitudes and preferences

Television (TV) food advertising has attracted criticism for its potential role in promoting unhealthy dietary practices among children. Content analyses indicate junk food advertising is prevalent on Australian children's TV; healthy eating is rarely promoted. This paper presents (a) a cross-sectional survey examining associations between children's regular TV viewing habits and their food-related attitudes and behaviour; and (b) an experiment assessing the impact of varying combinations of TV advertisements (ads) for unhealthy and healthy foods on children's dietary knowledge, attitudes and intentions. The experimental conditions simulated possible models for regulating food ads on children's TV. Participants were 919 grade five and six students from schools in Melbourne, Australia. The survey showed that heavier TV use and more frequent commercial TV viewing were independently associated with more positive attitudes toward junk food; heavier TV use was also independently associated with higher reported junk food consumption. The experiment found that ads for nutritious foods promote selected positive attitudes and beliefs concerning these foods. Findings are discussed in light of methodological issues in media effects research and their implications for policy and practice. It is concluded that changing the food advertising environment on children's TV to one where nutritious foods are promoted and junk foods are relatively unrepresented would help to normalize and reinforce healthy eating.

The effects of different regulation systems on television food advertising to children

OBJECTIVE

The aim of this study was to model children's potential exposure to television food advertisements under different regulatory scenarios to demonstrate the policy implications of regulatory change in Australia.

METHODS

Television advertising data was collected from Sydney commercial television channels from 14-20 May 2006. Extrapolating from these data, the patterns of food advertising under four regulatory scenarios were examined, including arrangements restricting the content, volume and timing of advertisements.

RESULTS

Each scenario resulted in a reduction of total and non-core food advertisements. The scenario to restrict non-core food advertisements during the major viewing period (7:00-20:30) led to the largest reduction in total and non-core food advertisements (79.2% reduction), with no change in the frequency of core food advertisements.

CONCLUSIONS

The results illustrate the potential for reducing children's exposure to food advertising through simple regulatory restrictions.

IMPLICATIONS

This research contributes to future debates on the regulation of television food advertising. It is particularly relevant as Australian regulations will be under review in 2007.

Patterns of sports sponsorship by gambling, alcohol and food companies: an Internet survey

Background

Sports sponsorship is a significant marketing tool. As such, it can promote products that pose risks to health (eg, high fat and high sugar foods) or it can promote health-supporting products (eg, sporting equipment and services). However, there is a lack of data on the proportion of sponsorship associated with "unhealthy" and "healthy" products and no methodology for systematically assessing it. This research aimed to explore this proportion with an Internet survey of sports sponsorship in the New Zealand setting.

Methods

A search methodology was developed to identify Internet-based evidence of sports sponsorship at the national level and at the regional and club level in one specific region (Wellington). The top eight sports for 5-17-year-olds were selected and products and services of sponsors were classified in terms of potential public health impact (using a conservative approach).

Results

Sponsorship of these popular sports was common at the national, regional and club levels (640 sponsors listed on 107 websites overall). Sports sponsorship associated with sponsors' products classified as "unhealthy" (eg, food high in fat and sugar, gambling and alcohol) were over twice as common as sponsorship associated with sponsors' products classified as "healthy" (32.7% (95% CI = 29.1, 36.5) versus 15.5% (95% CI = 12.8, 18.6) respectively). "Gambling" was the most common specific type of sponsorship (18.8%) followed by alcohol (11.3%).

There were significantly more "alcohol" sponsors for rugby, compared to all the other sports collectively (rate ratio (RR) = 2.47; 95% CI = 1.60, 3.79), and for top male sports compared to female (RR = 1.83; 95% CI = 1.05, 3.18). Also there was significantly more "unhealthy food" sponsorship for touch rugby and for "junior" teams/clubs compared to other sports collectively (RR = 6.54; 95% CI = 2.07, 20.69; and RR = 14.72, 95% CI = 6.22, 34.8; respectively). A validation study gave an inter-rater reliability for number of sponsors of 95% (n = 87 sponsors), and an inter-rater reliability of classification and categorisation of 100%.

Conclusion

This study found that the sponsorship of popular sports for young people is dominated by "unhealthy" sponsorship (ie, predominantly gambling, alcohol and unhealthy food) relative to "healthy" sponsorship. Governments may need to consider regulations that limit unhealthy sponsorship and/or adopt alternative funding mechanisms for supporting popular sports.