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Salvaleda-Mateu M, Rodríguez-Varela C, Labarta E. Do Popular Diets Impact Fertility? Nutrients 2024; 16:1726. [PMID: 38892663 PMCID: PMC11174414 DOI: 10.3390/nu16111726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Infertility affects 15% of the population in developed countries, and its prevalence is increasing. Fertility can be influenced by different factors. Although key factors like maternal age cannot be changed, there is growing evidence that other modifiable factors, such as diet, can have an impact on fertility. Diet has become increasingly important in recent years for a number of reasons: the new trend toward a healthy lifestyle, the higher prevalence of certain digestive disorders, a lack of time that leads people to consume more prepared and processed food, and personal choice to not eat meat, among others. To meet these needs, several diets have recently become popular, such as the Mediterranean diet, known as the gold standard of health; the DASH diet, known for preventing hypertension; the Western diet, characterized by processed food; the ketogenic diet, characterized by low carbohydrate intake; and the vegetarian diet, which is the choice for people who do not eat meat or animal by-products. Diets present a unique composition characterized by the presence or absence of specific nutrients, which have also been associated with male and female fertility individually. This review assesses the impact of these diets and of macro- and micronutrients on both female and male fertility.
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Affiliation(s)
| | | | - Elena Labarta
- Human Reproduction Department, IVI RMA Valencia, 46015 Valencia, Spain; (C.R.-V.); (E.L.)
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Boyland E, Maden M, Coates AE, Masterson TD, Alblas MC, Bruce AS, Roberts CA. Food and non-alcoholic beverage marketing in children and adults: A systematic review and activation likelihood estimation meta-analysis of functional magnetic resonance imaging studies. Obes Rev 2024; 25:e13643. [PMID: 37766661 DOI: 10.1111/obr.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 07/12/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023]
Abstract
Food marketing impacts the food behaviors of children and adults, but the underpinning neural mechanisms are poorly understood. This systematic review and meta-analysis pooled evidence from neuroimaging studies of exposure to food marketing stimuli (vs. control) on brain activations in children and adults to clarify regions associated with responding. Databases were searched for articles published to March 2022. Inclusion criteria included human functional magnetic resonance imaging (fMRI) studies employing a contrast between a food marketing stimulus and a non-food/non-exposure control, published in English in a peer-reviewed journal, reporting whole brain (not Region of Interest [ROI] only) co-ordinates. Eleven studies met inclusion criteria, of which eight were included in the quantitative synthesis (Activation Likelihood Estimation [ALE] meta-analysis). Food marketing exposures (vs. controls) produced greater activation in two clusters lying across the middle occipital gyrus, lingual gyrus, and cuneus (cluster 1), and the postcentral gyrus, precentral gyrus, and the inferior parietal lobule/supramarginal gyrus (cluster 2). Brain responses to food marketing are most consistently observed in areas relating to visual processing, attention, sensorimotor activity, and emotional processing. Subgroup analyses (e.g., adults vs. children) were not possible because of the paucity of data, and sensitivity analyses highlighted some instability in the clusters; therefore, conclusions remain tentative pending further research.
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Affiliation(s)
- Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Anna E Coates
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Travis D Masterson
- Department of Nutritional Sciences, The Pennsylvania State University, Pennsylvania, USA
| | - Monique C Alblas
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, Kansas, USA
| | - Carl A Roberts
- Department of Psychology, University of Liverpool, Liverpool, UK
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Kontsevaya AV, Imaeva AE, Balanova YA, Breda JJ, Wickramasinghe K, Jewell JM, Abdrakhmanova S, Polupanov AG, Bagci Bosi T, Ergüder T, Drapkina OM, Boyland EJ. Children's exposure to television advertising of unhealthy foods and beverages across four countries of WHO European Region. Public Health Nutr 2023; 26:s32-s40. [PMID: 36912113 PMCID: PMC10801364 DOI: 10.1017/s1368980023000423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 11/02/2022] [Accepted: 02/13/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE To compare the frequency and healthfulness of foods being advertised to children and adolescents in four countries of WHO European region. DESIGN Cross-sectional quantitative study, guided by an adapted version of the WHO protocol. All recorded food advertisements were categorised by categories and as either 'permitted' or 'not permitted' for advertising to children in accordance with WHO Regional Office for Europe Nutrient Profile Model. SETTINGS Four countries: Russia, Turkey, Kazakhstan and Kyrgyzstan. PARTICIPANTS TV channels most popular among children and adolescents. RESULTS Analysis included 70 d of TV broadcasting for all channels, during which time there were 28 399 advertisements. The mean number of advertisements per hour varied from eleven in Turkey and Kazakhstan to eight and two in Russia and Kyrgyzstan. In all countries, the majority of the food and beverages advertised should not be permitted for advertising to children according to the WHO Nutrient Profile Model. The mean number of non-permitted food and beverage advertisements per hour was high in Turkey and Kazakhstan (8·8 and 8·5 ads) compared with Russia (5·1) and Kyrgyzstan (1·9). Turkey was the only country where nutritional information was fully available, and no values were missing that prevented coding for some product categories. CONCLUSIONS Results revealed that children and adolescents in four countries are exposed to a considerable volume of food and beverage advertisements, including sugary products on broadcast television. As such, policymakers should consider protecting youth by developing regulations to restrict these marketing activities within media popular with children.
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Affiliation(s)
- Anna V Kontsevaya
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Asiia E Imaeva
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Department of Epidemiology of Chronic Non-Communicable Diseases, Moscow, Russia
| | - Yulia A Balanova
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Department of Epidemiology of Chronic Non-Communicable Diseases, Moscow, Russia
| | - João J Breda
- World Health Organization, Regional Office for Europe, Moscow, Russia
| | | | - Jo Martin Jewell
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Shynar Abdrakhmanova
- National Center of Public Health under the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | - Andrew G Polupanov
- National Center for Cardiology and Therapy named after academician Mirsaid Mirrakhimov under the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Tulay Bagci Bosi
- Hacettepe University, Department of Public Health, School of Medicine, Ankara, Turkey
| | - Toker Ergüder
- World Health Organization, Country Office in Turkey, Ankara, Turkey
| | - Oksana M Drapkina
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Emma J Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
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Khan AS, Frank T, Swart RE. Child-directed marketing on packaged breakfast cereals in South Africa. Public Health Nutr 2023; 26:2139-2148. [PMID: 37539472 PMCID: PMC10564615 DOI: 10.1017/s1368980023001507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/13/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE Childhood obesity is on the rise in South Africa (SA), and child-directed marketing (CDM) is one of the contributing factors to children's unhealthy food choices. This study assessed CDM on packaged breakfast cereals available in SA supermarkets and their nutritional quality. DESIGN Photographic images were examined in a descriptive quantitative study. A codebook of definitions of CDM was developed for this purpose. REDCap, an online research database, was used for data capturing, and SPSS was used for data analyses including cross-tabulations and one-way ANOVA. SETTING The current study was set in the Western Cape province of SA. SUBJECTS Photographic images of all packaged breakfast cereals sold in major retailers in the Western Cape province of SA in 2019 were studied. RESULTS CDM strategies were classified as direct (to the child) or indirect (through the parent). A total of 222 breakfast cereals were studied, of which 96·9 % had a nutritional or health claim, 95·0 % had illustrations, 75·2 % had product and consumption appeals, 10·8 % had characters, 10·8 % consisted of different appeals, 8·6 % alluded to fantasy and 7·7 % had role models. In breakfast cereals with direct CDM, the protein and fibre content was significantly lower than in breakfast cereals without direct CDM. This study found a significantly higher total carbohydrate and total sugar content in breakfast cereals with direct CDM than those without direct CDM. CONCLUSION CDM was highly prevalent in breakfast cereals sold in SA. Regulations to curb the marketing of packaged foods high in nutrients of concern is recommended.
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Affiliation(s)
- Alice S Khan
- Department of Dietetics and Nutrition, University of the Western Cape, Robert Sobukwe Road, Belville, 7535Cape Town, South Africa
| | - Tamryn Frank
- School of Public Health, University of the Western Cape, Robert Sobukwe Road, Belville, 7535Cape Town, South Africa
| | - Rina Elizabeth Swart
- Department of Dietetics and Nutrition, University of the Western Cape, Robert Sobukwe Road, Belville, 7535Cape Town, South Africa
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Boyland E. Is it ethical to advertise unhealthy foods to children? Proc Nutr Soc 2023; 82:234-240. [PMID: 36606537 DOI: 10.1017/s0029665123000010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The marketing of foods and non-alcoholic beverages (hereafter: food) high in fats, salt and/or sugar (HFSS) has been strongly implicated in the rising levels of childhood obesity worldwide. Multiple ethical concerns arise from the practice of exposing children to such marketing and efforts to monitor and restrict it through regulatory policies. There is considerable evidence that exposure to powerful food marketing messages affects children's food behaviours in ways that are detrimental to good dietary health. Children are particularly vulnerable to being exploited and deceived by food marketing messages based on their cognitive and developmental immaturity. HFSS food marketing also affects numerous child rights enshrined within the UN Convention on the Rights of the Child (of which the UK is a signatory) including the right to the enjoyment of the highest attainable standard of health. The debate has become somewhat polarised between the public health community's evidence-based assertion that all marketing is inherently exploitative and the rebuttal from food and marketing industry stakeholders that provided the marketing is 'accurate and truthful' and there is no ethical need to regulate. This polarisation is reflected in the complexity of policymaking decisions regarding the rationale for mandatory government-led policies or industry self-regulation. There are also ethical considerations inherent in the monitoring of children's food marketing exposure, particularly in the digital sphere, by researchers for the purposes of informing policy design, scope and implementation. This review paper will explore the latest evidence on these issues and consider the implications for public health research, policy, and practice.
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Affiliation(s)
- E Boyland
- Department of Psychology, Institute of Population Health, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK
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Alfraidi A, Alafif N, Alsukait R. The Impact of Mandatory Food-Marketing Regulations on Purchase and Exposure: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1277. [PMID: 37628276 PMCID: PMC10453145 DOI: 10.3390/children10081277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023]
Abstract
(1) Background: Several governments have enforced a series of actions to improve the local food environment and reduce obesity-related diseases in the population by implementing statutory regulations to reduce or ban the marketing of products that are considered unhealthy based on nutrient profile systems or them being high in fat, sugar, and salt (HFSS); (2) Objective: This narrative review is aiming to provide a comprehensive exploration of the available evidence on the impact of identified mandatory regulations restricting food marketing, including advertisements and packages on the exposure and purchase of HFSS food products, to help justify the need for these regulations; (3) Methods: Articles were retrieved by searching electronic databases, including EBSCO Education, PubMed, Scopus, Web of Science, and Google Scholar from 2012 up to December 2022; (4) Results: A total of 12 articles were included in this review. Almost all mandatory food-marketing regulations have evidence in favor of reducing HFSS food purchases and exposure; (5) Conclusions: Protecting children and adolescents from food and beverage marketing through mandatory regulations is a crucial step toward tackling global childhood and adolescent obesity and securing a healthier environment for future generations.
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Affiliation(s)
- Alanoud Alfraidi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (N.A.); (R.A.)
- Department of Clinical Dietitian, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia
| | - Nora Alafif
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (N.A.); (R.A.)
| | - Reem Alsukait
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (N.A.); (R.A.)
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Royo-Bordonada MÁ, Capellán LM, Junquera-Abaitua C, Vioque López J, Felipe Gómez S. Spain facing the challenge of regulating unhealthy food advertising. Lancet 2023; 401:1493. [PMID: 37149297 DOI: 10.1016/s0140-6736(23)00724-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/02/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Miguel Ángel Royo-Bordonada
- National School of Public Health, Institute of Health Carlos III, Ministry of Science and Innovation, Madrid 28029, Spain.
| | - Luisa María Capellán
- Spanish Confederation of Associations of Parents of Students (CEAPA), Madrid, Spain
| | - Cristina Junquera-Abaitua
- Directorate of Awareness-raising and Children's Policies, UNICEF Foundation Spanish Committee, Madrid, Spain
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Boyland E, McGale L, Maden M, Hounsome J, Boland A, Jones A. Systematic review of the effect of policies to restrict the marketing of foods and non-alcoholic beverages to which children are exposed. Obes Rev 2022; 23:e13447. [PMID: 35384238 PMCID: PMC9541016 DOI: 10.1111/obr.13447] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 12/28/2022]
Abstract
This systematic review examined the effectiveness of policies restricting the marketing of foods and/or non-alcoholic beverages to children to inform updated World Health Organization (WHO) guidelines. Databases were searched to March 2020. Inclusion criteria were primary studies of any design assessing implemented policies to restrict food marketing to children (0-19 years). Critical outcomes were exposure to and power of marketing, dietary intake, choice, preference, and purchasing. Important outcomes were purchase requests, dental caries, body weight, diet-related noncommunicable diseases, product change, and unintended consequences. Forty-four observational studies met inclusion criteria; most were moderate quality. Pooling was conducted using vote counting by direction of effect, and GRADE was used to judge evidence certainty. Evidence suggests food marketing policies may result in reduced purchases of unhealthy foods and in unintended consequences favorable for public health. Desirable or potentially desirable (for public health) effects of policies on food marketing exposure and power were also found. Evidence on diet and product change was very limited. The certainty of evidence was very low for four outcomes (exposure, power, dietary intake, and product change) and low for two (purchasing and unintended consequences). Policies can effectively limit food marketing to children; policymakers should prioritize mandatory approaches aligned with WHO recommendations.
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Affiliation(s)
- Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Lauren McGale
- Department of Psychology, University of Liverpool, Liverpool, UK.,Department of Psychology, Edge Hill University, Ormskirk, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Juliet Hounsome
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Angela Boland
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Andrew Jones
- Department of Psychology, University of Liverpool, Liverpool, UK
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Finlay A, Robinson E, Jones A, Maden M, Cerny C, Muc M, Evans R, Makin H, Boyland E. A scoping review of outdoor food marketing: exposure, power and impacts on eating behaviour and health. BMC Public Health 2022; 22:1431. [PMID: 35896996 PMCID: PMC9330687 DOI: 10.1186/s12889-022-13784-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/12/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is convincing evidence that unhealthy food marketing is extensive on television and in digital media, uses powerful persuasive techniques, and impacts dietary choices and consumption, particularly in children. It is less clear whether this is also the case for outdoor food marketing. This review (i) identifies common criteria used to define outdoor food marketing, (ii) summarises research methodologies used, (iii) identifies available evidence on the exposure, power (i.e. persuasive creative strategies within marketing) and impact of outdoor food marketing on behaviour and health and (iv) identifies knowledge gaps and directions for future research. METHODS A systematic search was conducted of Medline (Ovid), Scopus, Science Direct, Proquest, PsycINFO, CINAHL, PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials and a number of grey literature sources. Titles and abstracts were screened by one researcher. Relevant full texts were independently checked by two researchers against eligibility criteria. RESULTS Fifty-three studies were conducted across twenty-one countries. The majority of studies (n = 39) were conducted in high-income countries. All measured the extent of exposure to outdoor food marketing, twelve also assessed power and three measured impact on behavioural or health outcomes. Criteria used to define outdoor food marketing and methodologies adopted were highly variable across studies. Almost a quarter of advertisements across all studies were for food (mean of 22.1%) and the majority of advertised foods were unhealthy (mean of 63%). The evidence on differences in exposure by SES is heterogenous, which makes it difficult to draw conclusions, however the research suggests that ethnic minority groups have a higher likelihood of exposure to food marketing outdoors. The most frequent persuasive creative strategies were premium offers and use of characters. There was limited evidence on the relationship between exposure to outdoor food marketing and eating behaviour or health outcomes. CONCLUSIONS This review highlights the extent of unhealthy outdoor food marketing globally and the powerful methods used within this marketing. There is a need for consistency in defining and measuring outdoor food marketing to enable comparison across time and place. Future research should attempt to measure direct impacts on behaviour and health.
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Affiliation(s)
- Amy Finlay
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK.
| | - Eric Robinson
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Andrew Jones
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, L69 3GB, UK
| | - Caroline Cerny
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
- Obesity Health Alliance, Liverpool, UK
| | - Magdalena Muc
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Rebecca Evans
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Harriet Makin
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
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School Food Environment in Urban Zambia: A Qualitative Analysis of Drivers of Adolescent Food Choices and Their Policy Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127460. [PMID: 35742706 PMCID: PMC9224334 DOI: 10.3390/ijerph19127460] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 02/04/2023]
Abstract
Identifying context specific points for reforming policy to promote healthier food environments and consumer behavior in critical life stages like adolescence is crucial in addressing the double burden of malnutrition. Using a qualitative study design, we conducted 20 focus group discussions with grade 10 pupils from ten secondary schools in Lusaka. Turner’s framework which conceptualizes the food environment into two domains—the external domain (availability, pricing, vendor and product properties, and marketing and regulation of food) and the internal domain (accessibility, affordability, convenience, and desirability of food)—was used to guide thematic data analysis and results interpretation. Adolescents stated their food choices are largely based on personal preference linked to the need for social acceptability among peers. Adolescents felt their food choice is limited to ‘cheap junk foods’ which are affordable and readily available at school. Healthy foods like fruits were said to be inaccessible and unaffordable by the majority of adolescents. Some adolescents stated they were attracted to certain foods by adverts they see on TV and social media. School food environments in urban Lusaka do not support healthy food choices. Policy reforms are required to increase access to affordable healthy food options in schools, and to curb the indiscriminate marketing of unhealthy foods to adolescents.
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Nieto C, Jáuregui A, Contreras-Manzano A, Potvin Kent M, Sacks G, White CM, Pauzé E, Vanderlee L, Thrasher JF, Barquera S, Hammond D. Adults' Exposure to Unhealthy Food and Beverage Marketing: A Multi-Country Study in Australia, Canada, Mexico, the United Kingdom, and the United States. J Nutr 2022; 152:25S-34S. [PMID: 35544288 PMCID: PMC9188858 DOI: 10.1093/jn/nxab449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/10/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Food marketing increases product appeal, purchasing, and consumption, using diverse strategies and locations to reach consumers. OBJECTIVES The aim of this study was to examine differences in adults' self-reported exposure to various marketing strategies (brand and licensed characters, celebrities, and sponsorship of sports and cultural events) and locations (television, radio, and digital media) across 5 countries: Australia, Canada, Mexico, the United Kingdom, and the United States. METHODS We analyzed cross-sectional survey data on self-reported exposure to food marketing strategies and locations collected in 2018 by the International Food Policy Study. Participants (n = 21,678) aged ≥18 years completed an online survey. Exposures to unhealthy food marketing strategies and locations in the prior 30 days were self-reported. Regression models examined differences in marketing exposure and locations across countries. RESULTS The average number of unhealthy food marketing strategies to which participants reported being exposed ranged from 0.5 in the United Kingdom to 2.3 in Mexico. Self-reported exposure to strategies across all countries was highest for brand characters (32%), followed by licensed characters (22%). In total, the reported mean exposure of marketing locations was 1.6 in the prior month. Television was the most prevalent location (44%), followed by digital marketing (32%). Adjusted models indicated that the odds of reporting exposure to marketing strategies and marketing locations were higher for Mexico compared to the rest of the countries. CONCLUSIONS Adults report a variety of exposures to unhealthy food marketing in all countries, but exposure was highest in Mexico. Special attention should be paid to regulating marketing strategies, such as brand characters and licensed characters, and locations, such as television and digital marketing.
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Affiliation(s)
- Claudia Nieto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | | | - Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Geelong, Australia
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Elise Pauzé
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, South Carolina, USA,Center for Population Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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12
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Yau A, Berger N, Law C, Cornelsen L, Greener R, Adams J, Boyland EJ, Burgoine T, de Vocht F, Egan M, Er V, Lake AA, Lock K, Mytton O, Petticrew M, Thompson C, White M, Cummins S. Changes in household food and drink purchases following restrictions on the advertisement of high fat, salt, and sugar products across the Transport for London network: A controlled interrupted time series analysis. PLoS Med 2022; 19:e1003915. [PMID: 35176022 PMCID: PMC8853584 DOI: 10.1371/journal.pmed.1003915] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/14/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Restricting the advertisement of products with high fat, salt, and sugar (HFSS) content has been recommended as a policy tool to improve diet and tackle obesity, but the impact on HFSS purchasing is unknown. This study aimed to evaluate the impact of HFSS advertising restrictions, implemented across the London (UK) transport network in February 2019, on HFSS purchases. METHODS AND FINDINGS Over 5 million take-home food and drink purchases were recorded by 1,970 households (London [intervention], n = 977; North of England [control], n = 993) randomly selected from the Kantar Fast Moving Consumer Goods panel. The intervention and control samples were similar in household characteristics but had small differences in main food shopper sex, socioeconomic position, and body mass index. Using a controlled interrupted time series design, we estimated average weekly household purchases of energy and nutrients from HFSS products in the post-intervention period (44 weeks) compared to a counterfactual constructed from the control and pre-intervention (36 weeks) series. Energy purchased from HFSS products was 6.7% (1,001.0 kcal, 95% CI 456.0 to 1,546.0) lower among intervention households compared to the counterfactual. Relative reductions in purchases of fat (57.9 g, 95% CI 22.1 to 93.7), saturated fat (26.4 g, 95% CI 12.4 to 40.4), and sugar (80.7 g, 95% CI 41.4 to 120.1) from HFSS products were also observed. Energy from chocolate and confectionery purchases was 19.4% (317.9 kcal, 95% CI 200.0 to 435.8) lower among intervention households than for the counterfactual, with corresponding relative reductions in fat (13.1 g, 95% CI 7.5 to 18.8), saturated fat (8.7 g, 95% CI 5.7 to 11.7), sugar (41.4 g, 95% CI 27.4 to 55.4), and salt (0.2 g, 95% CI 0.1 to 0.2) purchased from chocolate and confectionery. Relative reductions are in the context of secular increases in HFSS purchases in both the intervention and control areas, so the policy was associated with attenuated growth of HFSS purchases rather than absolute reduction in HFSS purchases. Study limitations include the lack of out-of-home purchases in our analyses and not being able to assess the sustainability of observed changes beyond 44 weeks. CONCLUSIONS This study finds an association between the implementation of restrictions on outdoor HFSS advertising and relative reductions in energy, sugar, and fat purchased from HFSS products. These findings provide support for policies that restrict HFSS advertising as a tool to reduce purchases of HFSS products.
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Affiliation(s)
- Amy Yau
- Population Health Innovation Lab, Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail: (AY); (SC)
| | - Nicolas Berger
- Population Health Innovation Lab, Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Epidemiology and Public Health, Scientific Institute of Public Health (Sciensano), Brussels, Belgium
| | - Cherry Law
- Population Health Innovation Lab, Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Laura Cornelsen
- Population Health Innovation Lab, Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Robert Greener
- Population Health Innovation Lab, Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Emma J. Boyland
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Thomas Burgoine
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Applied Research Collaboration West, Bristol, United Kingdom
| | - Matt Egan
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Vanessa Er
- Population Health Innovation Lab, Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Amelia A. Lake
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
- Fuse–The Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom
| | - Karen Lock
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Oliver Mytton
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Mark Petticrew
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Claire Thompson
- Centre for Research in Public Health and Community Care, School of Health and Social Work, University of Hertfordshire, Hatfield, United Kingdom
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail: (AY); (SC)
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Abstract
The dynamic development of e-commerce in the foodservice market has been observed in recent years (especially during the COVID-19 pandemic), both in Poland and in other countries. The purpose of the study was to determine the characteristics of e-foodservice customers, identify their motivations for ordering food online and the nutritional consequences of such actions, as well as recognize the influence of consumers’ s-commerce activity on their foodservice market behavior. The study was carried out using the CAWI method on a sample of 1018 adult Poles. With the use of cluster analysis, three consumer segments were distinguished: frequent e-commerce users (221), moderate users (400), and sporadic users (397). The results indicate that frequent users of e-commerce in the foodservice market are slightly more often young and educated men who work full-time, have a higher than average income, and live in a large or medium city. In their own opinions, frequent users are the most concerned about proper nutrition, but despite such declarations, their nutritional quality is inferior to other groups. Compared to other segments, they are the most socially active and show the greatest commitment to s-commerce activity, which influences their purchasing intentions and behaviors.
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Yau A, Adams J, Boyland EJ, Burgoine T, Cornelsen L, de Vocht F, Egan M, Er V, Lake AA, Lock K, Mytton O, Petticrew M, Thompson C, White M, Cummins S. Sociodemographic differences in self-reported exposure to high fat, salt and sugar food and drink advertising: a cross-sectional analysis of 2019 UK panel data. BMJ Open 2021; 11:e048139. [PMID: 33827849 PMCID: PMC8031692 DOI: 10.1136/bmjopen-2020-048139] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To explore sociodemographic differences in exposure to advertising for foods and drinks high in fat, salt and sugar (HFSS) and whether exposure is associated with body mass index (BMI). DESIGN Cross-sectional survey. SETTING UK. PARTICIPANTS 1552 adults recruited to the Kantar Fast Moving Consumer Goods panel for London and the North of England. OUTCOME MEASURES Self-reported advertising exposure stratified by product/service advertised (processed HFSS foods; sugary drinks; sugary cereals; sweet snacks; fast food or digital food delivery services) and advertising setting (traditional; digital; recreational; functional or transport); BMI and sociodemographic characteristics. RESULTS Overall, 84.7% of participants reported exposure to HFSS advertising in the past 7 days. Participants in the middle (vs high) socioeconomic group had higher odds of overall self-reported exposure (OR 1.48; 95% CI 1.06 to 2.07). Participants in the low (vs high) socioeconomic group had higher odds of reporting exposure to advertising for three of five product categories (ORs ranging from 1.41 to 1.67), advertising for digital food delivery services (OR 1.47; 95% CI 1.05 to 2.05), traditional advertising (OR 1.44; 95% CI 1.00 to 2.08) and digital advertising (OR 1.50; 95% CI 1.06 to 2.14). Younger adults (18-34 years vs ≥65 years) had higher odds of reporting exposure to advertising for digital food delivery services (OR 2.08; 95% CI 1.20 to 3.59), digital advertising (OR 3.93; 95% CI 2.18 to 7.08) and advertising across transport networks (OR 1.96; 95% CI 1.11 to 3.48). Exposure to advertising for digital food delivery services (OR 1.40; 95% CI 1.05 to 1.88), digital advertising (OR 1.80; 95% CI 1.33 to 2.44) and advertising in recreational environments (OR 1.46; 95% CI 1.02 to 2.09) was associated with increased odds of obesity. CONCLUSIONS Exposure to less healthy product advertising was prevalent, with adults in lower socioeconomic groups and younger adults more likely to report exposure. Broader restrictions may be needed to reduce sociodemographic differences in exposure to less healthy product advertising.
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Affiliation(s)
- Amy Yau
- Population Health Innovation Lab, Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Jean Adams
- Centre for Diet & Activity Research, University of Cambridge, Cambridge, UK
| | - Emma J Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Thomas Burgoine
- Centre for Diet & Activity Research, University of Cambridge, Cambridge, UK
| | - Laura Cornelsen
- Population Health Innovation Lab, Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Frank de Vocht
- Population Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research Applied Research Collaboration West, Bristol, UK
| | - Matt Egan
- Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Vanessa Er
- Population Health Innovation Lab, Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Amelia A Lake
- Centre for Public Health Research, Teesside University, Middlesbrough, UK
- Centre for Translational Research in Public Health (Fuse), Newcastle upon Tyne, UK
| | - Karen Lock
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Oliver Mytton
- Centre for Diet & Activity Research, University of Cambridge, Cambridge, UK
| | - Mark Petticrew
- Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Claire Thompson
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Martin White
- Centre for Diet & Activity Research, University of Cambridge, Cambridge, UK
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
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15
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Jensen ML, Carpentier FD, Adair L, Corvalán C, Popkin BM, Taillie LS. Examining Chile's unique food marketing policy: TV advertising and dietary intake in preschool children, a pre- and post- policy study. Pediatr Obes 2021; 16:e12735. [PMID: 33105522 PMCID: PMC8073213 DOI: 10.1111/ijpo.12735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/14/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The Chilean government implemented the first phase of a comprehensive marketing policy in 2016, restricting child-directed marketing of products high in energy, total sugars, sodium or saturated fat (hereafter "high-in"). OBJECTIVES To examine the role that high-in TV food advertising had in the effect of the policy on consumption of high-in products between 2016 and 2017. METHODS Dietary data were obtained from 24-hour diet recall measured in 2016 (n = 940) and 2017 (n = 853), pre- and post-policy, from a cohort of 4 to 6 years children. Television use was linked to analyses of food advertisements to derive individual-level estimates of exposure to advertising. A multilevel mediation analysis examined direct and indirect effects of the policy through advertising exposure. RESULTS Children's high-in food consumption and advertising exposure declined significantly from 2016 to 2017 (P < .01). Consumption changes were not significantly mediated by changes in advertising exposure, which might suggest other elements of the Chilean Law potentially driving decreases in consumption to a greater extent than TV ads. CONCLUSIONS Preschoolers' exposure to high-in advertising and consumption of high-in products decreased post-policy. Further research is needed to understand how marketing changes will relate to dietary changes after full implementation of the law and in the long term.
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Affiliation(s)
- Melissa L. Jensen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA
- School of Nutrition, University of Costa Rica, San José, Costa Rica
| | | | - Linda Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Camila Corvalán
- Instituto de Nutrición y Tecnología de Alimentos, Universidad de Chile, Macul, Chile
| | - Barry M. Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA
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16
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Watson WL, Khor PY, Hughes C. Defining unhealthy food for regulating marketing to children-What are Australia's options? Nutr Diet 2021; 78:406-414. [PMID: 33415832 DOI: 10.1111/1747-0080.12658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023]
Abstract
AIM To compare six nutrient profiling models for suitability in food marketing to children regulation. METHODS Products (n = 220) advertised at transport hubs were classified as eligible/ineligible to be advertised to children using an Australian government developed guide (Council of Australian Governments), the Health Star Rating system before and after the modifications made in 2020, World Health Organization Western Pacific Region and Europe nutrient profile criterion and the NOVA food classification system. Agreement between models was determined using Cohen's Kappa. RESULTS The Council of Australian Governments' guide was able to classify more products than the other models (n = 210) and was easy to use as it did not require nutrition information. It agreed most closely with NOVA (moderate agreement). The proportion of foods classified as eligible to be marketed (most strict) was lowest for NOVA (10%), similar for Council of Australian Governments and the World Health Organisation models (16%-17%) and highest for Health Star Rating models (26%-28%). CONCLUSIONS The Council of Australian Governments' guide provides simple, easy to use profiling criteria aligned with Australian dietary advice. Political will is now required to incorporate a profiling model within government-endorsed food marketing regulation.
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Affiliation(s)
- Wendy L Watson
- Cancer Prevention and Advocacy Division, Cancer Council NSW, Woolloomooloo, New South Wales, Australia
| | - Phay Yean Khor
- School of Medicine, The University of Wollongong, Wollongong, New South Wales, Australia
| | - Clare Hughes
- Cancer Prevention and Advocacy Division, Cancer Council NSW, Woolloomooloo, New South Wales, Australia
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17
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Graça P, Gregório M, Freitas M. A Decade of Food and Nutrition Policy in Portugal (2010–2020). PORTUGUESE JOURNAL OF PUBLIC HEALTH 2020. [DOI: 10.1159/000510566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
For the first time, in 2012, the Portuguese Government, through the National Program for the Promotion of Healthy Eating of the Directorate-General for Health, implemented a set of concerted measures for improving the dietary habits, nutritional status and health of the population. Prior to, and since 2007, several epidemiological, social and political circumstances converged, for later enabling the development of a national strategy throughout the decade 2010–2020. This was also supported by specific international guidelines, namely from the World Health Organization and the European Commission. The national strategy objectives have been: (a) To increase the knowledge about the population’s food consumption, its determinants and consequences; (b) to modify the access to certain food items specially in schools, workplaces and public spaces; (c) To inform and empower individuals regarding shopping, preparation and storage of healthy foods, especially amongst those most vulnerable or with a lower income; (d) to identify and promote actions capable of encouraging a healthier diet through the integration of other societal sectors, namely agriculture, sports, environment, education, social security and local authorities; and (e) to better capacitate different professionals who, owing to their roles, may influence nutritional knowledge, attitudes and behaviors. Several actions are described, including the creation of legislation to address these objectives. It is worth noting that one of the biggest challenges to this public policy has been the interventions within the environments where people live. By knowingly being central to food choice determinants, these environmental modifications were also where the stakeholders felt the greatest tensions and difficulties, but also where there are the greatest gains to be made. Solutions to overcome these problems and other perceived difficulties have been proposed here and are considered to be some of the main lessons and achievements throughout this process.
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The potential health impact of restricting less-healthy food and beverage advertising on UK television between 05.30 and 21.00 hours: A modelling study. PLoS Med 2020; 17:e1003212. [PMID: 33048922 PMCID: PMC7553286 DOI: 10.1371/journal.pmed.1003212] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 09/08/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Restrictions on the advertising of less-healthy foods and beverages is seen as one measure to tackle childhood obesity and is under active consideration by the UK government. Whilst evidence increasingly links this advertising to excess calorie intake, understanding of the potential impact of advertising restrictions on population health is limited. METHODS AND FINDINGS We used a proportional multi-state life table model to estimate the health impact of prohibiting the advertising of food and beverages high in fat, sugar, and salt (HFSS) from 05.30 hours to 21.00 hours (5:30 AM to 9:00 PM) on television in the UK. We used the following data to parameterise the model: children's exposure to HFSS advertising from AC Nielsen and Broadcasters' Audience Research Board (2015); effect of less-healthy food advertising on acute caloric intake in children from a published meta-analysis; population numbers and all-cause mortality rates from the Human Mortality Database for the UK (2015); body mass index distribution from the Health Survey for England (2016); disability weights for estimating disability-adjusted life years (DALYs) from the Global Burden of Disease Study; and healthcare costs from NHS England programme budgeting data. The main outcome measures were change in the percentage of the children (aged 5-17 years) with obesity defined using the International Obesity Task Force cut-points, and change in health status (DALYs). Monte Carlo analyses was used to estimate 95% uncertainty intervals (UIs). We estimate that if all HFSS advertising between 05.30 hours and 21.00 hours was withdrawn, UK children (n = 13,729,000), would see on average 1.5 fewer HFSS adverts per day and decrease caloric intake by 9.1 kcal (95% UI 0.5-17.7 kcal), which would reduce the number of children (aged 5-17 years) with obesity by 4.6% (95% UI 1.4%-9.5%) and with overweight (including obesity) by 3.6% (95% UI 1.1%-7.4%) This is equivalent to 40,000 (95% UI 12,000-81,000) fewer UK children with obesity, and 120,000 (95% UI 34,000-240,000) fewer with overweight. For children alive in 2015 (n = 13,729,000), this would avert 240,000 (95% UI 65,000-530,000) DALYs across their lifetime (i.e., followed from 2015 through to death), and result in a health-related net monetary benefit of £7.4 billion (95% UI £2.0 billion-£16 billion) to society. Under a scenario where all HFSS advertising is displaced to after 21.00 hours, rather than withdrawn, we estimate that the benefits would be reduced by around two-thirds. This is a modelling study and subject to uncertainty; we cannot fully and accurately account for all of the factors that would affect the impact of this policy if implemented. Whilst randomised trials show that children exposed to less-healthy food advertising consume more calories, there is uncertainty about the nature of the dose-response relationship between HFSS advertising and calorie intake. CONCLUSIONS Our results show that HFSS television advertising restrictions between 05.30 hours and 21.00 hours in the UK could make a meaningful contribution to reducing childhood obesity. We estimate that the impact on childhood obesity of this policy may be reduced by around two-thirds if adverts are displaced to after 21.00 hours rather than being withdrawn.
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19
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Royo-Bordonada MÁ, Rodríguez-Artalejo F, Bes-Rastrollo M, Fernández-Escobar C, González CA, Rivas F, Martínez-González MÁ, Quiles J, Bueno-Cavanillas A, Navarrete-Muñoz EM, Navarro C, López-García E, Romaguera D, Morales Suárez-Varela M, Vioque J. [Food policies to prevent obesity and the main non-transmissible diseases in Spain: where there's a will there's a way]. GACETA SANITARIA 2019; 33:584-592. [PMID: 31585770 DOI: 10.1016/j.gaceta.2019.05.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 12/12/2022]
Abstract
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.
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Affiliation(s)
| | - Fernando Rodríguez-Artalejo
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Maira Bes-Rastrollo
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España
| | | | - Carlos A González
- Unidad de Nutrición y Cáncer, Instituto Catalán de Oncología, Barcelona, España
| | - Francisco Rivas
- Unidad Municipal de Salud y Consumo, Ayuntamiento de Guadix, Guadix (Granada), España; Grupo de Investigación Aula Internacional de Biomedicina, Ética y Derechos Humanos (GI111), Universidad Nacional de Educación a Distancia, Madrid, España
| | - Miguel Ángel Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Department of Nutrition, Harvard TH Chan School of Public Health, Boston (Massachusetts), USA
| | - Joan Quiles
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Dirección General de Salud Pública, Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, España
| | - Aurora Bueno-Cavanillas
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, España; Instituto de Investigación Biosanitaria de Granada (ibs Granada), Granada, España
| | - Eva M Navarrete-Muñoz
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, ISABIAL-FISABIO, Alicante, España
| | - Carmen Navarro
- Departamento de Ciencias Sociosaniarias, Universidad de Murcia, Murcia, España; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, España
| | - Esther López-García
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Dora Romaguera
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, España
| | - María Morales Suárez-Varela
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Medicina Preventiva y Salud Pública, Ciencias de la Alimentación, Toxicología y Medicina Legal, Facultad de Farmacia, Universitat de Valencia, Valencia, España
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, ISABIAL-FISABIO, Alicante, España
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Kelly B, Boyland E, King L, Bauman A, Chapman K, Hughes C. Children's Exposure to Television Food Advertising Contributes to Strong Brand Attachments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2358. [PMID: 31277287 PMCID: PMC6651128 DOI: 10.3390/ijerph16132358] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 12/16/2022]
Abstract
Children's exposure to unhealthy food marketing is one factor contributing to childhood obesity. The impact of marketing on children's weight likely occurs via a cascade pathway, through influences on children's food brand awareness, emotional responses, purchasing and consumption. Thus, building emotional attachments to brands is a major marketing imperative. This study explored Australian children's emotional attachments to food and drink brands and compared the strength of these attachments to their food marketing exposure, using television viewing as a proxy indicator. A cross-sectional face-to-face survey was conducted with 282 Australian children (8-12 years). Children were asked to indicate their agreement/disagreement with statements about their favourite food and drink brands, as an indicator of the strength and prominence of their brand attachments. Questions captured information about minutes/day of television viewing and the extent that they were exposed to advertising (watched live or did not skip through ads on recorded television). For those children who were exposed to advertisements, their age and commercial television viewing time had significant effects on food and drink brand attachments (p = 0.001). The development of brand attachments is an intermediary pathway through which marketing operates on behavioural and health outcomes. Reducing children's exposure to unhealthy food marketing should be a policy priority for governments towards obesity and non-communicable disease prevention.
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Affiliation(s)
- Bridget Kelly
- Early Start Research Institute, Wollongong, NSW 2522, Australia.
| | - Emma Boyland
- Department of Psychological Sciences, University of Liverpool, Liverpool L3 5TR, UK
| | - Lesley King
- Prevention Research Collaboration, University of Sydney, Sydney, NSW 2006, Australia
| | - Adrian Bauman
- Prevention Research Collaboration, University of Sydney, Sydney, NSW 2006, Australia
| | - Kathy Chapman
- School of Life and Environment Sciences, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
- School of Medicine & Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
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The persuasive effect of advergames promoting unhealthy foods among children: A meta-analysis. Appetite 2018; 129:245-251. [PMID: 30031786 DOI: 10.1016/j.appet.2018.07.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/05/2018] [Accepted: 07/18/2018] [Indexed: 11/20/2022]
Abstract
Multiple studies have examined the effects of advergames promoting unhealthy foods on eating behavior among children. Although the individual results of the existing studies suggest that advergames have a significant influence on (predictors of) eating behavior, a lack of clarity concerning the size of the effect may impede policy actions. Therefore, a meta-analysis was conducted to examine the strength of the effect of playing advergames that promote unhealthy foods on (predictors of) eating behavior among children. Five electronic databases were searched for relevant publications (Web of Science, PsychInfo, Pubmed, JSTOR, and SCOPUS). Fifteen articles were considered eligible for inclusion and analyzed in the meta-analysis. Employing a random-effects model to estimate the composite effect of advergames yielded a small-to-moderate and significant effect of g = 0.30. Results showed that advergames promoting unhealthy foods induced unhealthy eating behavior among children. Although only a limited number of studies were included, this meta-analysis supports public health policy action that seeks to reduce children's exposure to unhealthy digital food marketing. Stricter regulation to protect children against new forms of (online) marketing techniques that promote unhealthy foods should be developed and implemented.
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