Effect of health-promoting messages in television food commercials on adolescents' attitudes and consumption: A randomized intervention study

INTRODUCTION

The HAVISA plan is a Spanish government's policy for the promotion of healthy lifestyles via health messages in television food advertisements. This study evaluated the positive or negative impact (health halo effect) of health messages on food choices and predisposition towards healthy habits of Spanish adolescents.

METHODS

Randomized controlled study in 11-14 years old adolescents. The intervention group watched television advertisements for unhealthy foods with HAVISA health messages, while the control group watched the same advertisements without them. A self-administered questionnaire measured participants' attitudes towards the products advertised, to diet and physical activity, and recognition of messages. Afterwards they chose between fruit and unhealthy snacks. The differences between the two groups were then compared.

RESULTS

A total of 27.2% of the control group versus 29.6% of the intervention group chose fruit (p = 0.54). Both groups displayed high desire for (7.24 vs. 7.40, p = 0.29) and intention to consume (6.67 vs. 6.73, p = 0.63) the unhealthy products advertised. There were no differences in perceived healthiness of these foods (4.11 vs. 4.19, p = 0.74), or perceived importance of a healthy diet (3.17 vs. 3.12, p = 0.55) or physical activity (4.53 vs. 4.51, p = 0.73). Desire for vegetables (2.49 vs. 2.66, p = 0.08) and fruit (3.15 vs. 3.30, p = 0.09) were higher in the intervention group, but the differences were not significant. Only 47.6% of participants noticed the presence of health messages; of these, 31% correctly recalled their content.

CONCLUSION

HAVISA health messages changed neither the attitudes nor immediate eating behaviors of adolescents. There was no immediate healthy-lifestyle promoter or adverse health halo effect, probably due to the messages' low prominence. Further research should evaluate the long-term effect of repeated exposure to health messages.

Food Advertising and Prevention of Childhood Obesity in Spain: Analysis of the Nutritional Value of the Products and Discursive Strategies Used in the Ads Most Viewed by Children from 2016 to 2018

In Spain, 40% of children are overweight or obese. Television advertising is a widely acknowledged factor contributing to high-calorie food intake. This study longitudinally correlates some variables involved in childhood obesity prevention strategies in Spain. A mixed-methods approach was used. A quantitative analysis of audience data was conducted to determine the advertising campaigns most viewed by Spanish children from 2016 to 2018. The Nutri-score system was applied to determine the nutritional quality of the food advertised. A content analysis and a study of the discursive strategies used as an advertising ploy was undertaken. The results were examined in relation to the regulatory framework of the Spanish PAOS Code for the co-regulation of food advertising aimed at children. The study shows that Spanish advertising aimed at children mostly advertises very low nutritional value products. Moreover, these campaigns violate the PAOS Code in terms of the use of language in relation to the product, its benefits, and the appearance of popular characters. Our findings suggest a direct association between low nutritional value food ads and discursive strategies based on the intangible and extrinsic characteristics of these products. There remains the need for stricter legislation that takes into consideration the nutritional value of advertised foods and the language used in their hedonistic advertising.

[Food policies to prevent obesity and the main non-transmissible diseases in Spain: where there's a will there's a way]

INTRODUCTION

In Spain, one third of all children and two-thirds of adults suffer from excess weight, a condition that generates a direct excess medical cost of 2000 million Euros. Obesogenic food environments cause obesity by promoting the consumption of sugar-sweetened beverages and ultra-processed foods. Accordingly, we propose five priority policies capable of reversing the epidemic of obesity and related non-communicable diseases through the creation of healthy food environments.

THE POWER (PODER IN SPANISH) OF FOOD POLICIES

Advertising (Publicidad): regulation of unhealthy food and drink advertisements carried by all media and targeted at children, and prohibition of sponsorships of congresses, conferences or sports events and endorsements by scientific associations or health professionals. Supply (Oferta): promotion of a 100% healthy supply of goods on sale in vending machines sited at educational, health and sports centres. Demand (Demanda): levying a tax of at least 20% on sugar-sweetened beverages, accompanied by subsidies or reduced taxes on healthy foods and availability of drinking water free of charge at all public venues and areas. Labelling (Etiquetado): effective application of the Nutri-Score through the use of incentives, regulation and public-tender mechanisms. Reformulation (Reformulación): revising and redrawing reformulation agreements with the industry, setting more ambitious goals and mandatory compliance.

A FINAL THOUGHT

These five proposed interventions, all of which have been successfully applied in other countries, will serve to raise population awareness and have a positive impact on health and the economy, through reducing the health care costs of obesity and enhancing work productivity. These measures should form part of a wide-ranging transformation of the food system, with agri-food policies that foster the sustainable production of healthy foods.