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Angelino D, Nucci D, Rabica F, Rota C, Dinu M, Martini D, Gianfredi V. Nutritional quality and level of processing of food items broadcasted on Italian television in advertisements targeted to children. Int J Food Sci Nutr 2024; 75:475-485. [PMID: 38659128 DOI: 10.1080/09637486.2024.2343924] [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: 03/03/2024] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
This study evaluates the nutritional quality and level of processing of food and beverage products advertised on television channels most watched by children, in Italy. Data were collected over 20 non-consecutive days from the five top channels in Italy. A total of 209 food items were analysed using the Nutri-Score and the NOVA classification. Additionally, compliance with nutritional criteria established by the World Health Organisation (WHO) and the EU-PLEDGE was assessed. Results indicate a high proportion of energy-dense and low nutritional quality foods, with 68% falling into less favourable Nutri-Score categories (C, D, and E), and 61% classified as ultra-processed by NOVA classification. When applying WHO and PLEDGE criteria, 71% and 56% of products, respectively, did not meet nutritional standards. This study underscores the low prevalence of nutritionally adequate products in food advertisements targeting children on Italian television, despite differences found based on methodological variations.
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Affiliation(s)
- Donato Angelino
- Department of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy
| | - Daniele Nucci
- SSD Igiene Alimenti e Nutrizione, ATS Brescia, Brescia, Italy
| | - Filippo Rabica
- Department of Pharmaceutical Science, University of Perugia, Perugia, Italy
| | - Cristian Rota
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, Milan, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, Milan, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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2
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Rivera JA, Colchero MA, Pérez-Ferrer C, Barquera S. Perspective: Mexico's Experience in Building a Toolkit for Obesity and Noncommunicable Diseases Prevention. Adv Nutr 2024; 15:100180. [PMID: 38246349 PMCID: PMC10877686 DOI: 10.1016/j.advnut.2024.100180] [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: 10/17/2023] [Revised: 12/15/2023] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
Noncommunicable diseases (NCDs) are a leading cause of death and disability worldwide, with a higher risk of death in low- and middle-income countries. Diet and excess weight are risk factors for NCDs. In Mexico, the prevalence of overweight and obesity increased dramatically in the last 30 y and is among the highest in the world. To address this public health problem, governments and public health professionals have several policy instruments available. In this study, we present the policy instruments currently approved in Mexico, which include fiscal, informational, and authoritative tools that aim to improve the food environment and promote healthy behaviors (taxes, school food guidelines, front-of-pack labeling, marketing regulations, and dietary guidelines). These types of interventions are important in regions like Latin America, where social inequities and poor access to information are common, and individual healthy choices are often limited. These interventions target the environments in which individuals live, study, work, and seek entertainment, while limiting access to unhealthy choices and offering information to promote healthy alternatives. The Mexican experience in design, implementation, and evaluation of policies to improve the food environment can be useful for other low- and middle-income countries facing similar challenges.
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Affiliation(s)
- Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Mónica Arantxa Colchero
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Carolina Pérez-Ferrer
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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3
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Soares Guimarães J, Pauzé E, Potvin Kent M, Barquera S, Jáuregui A, Sacks G, Vanderlee L, Hammond D. The relationship between parent's self-reported exposure to food marketing and child and parental purchasing and consumption outcomes in five countries: findings from the International Food Policy Study. J Nutr Sci 2023; 12:e123. [PMID: 38155804 PMCID: PMC10753451 DOI: 10.1017/jns.2023.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 12/30/2023] Open
Abstract
Food and beverage marketing influences children's food preferences and dietary intake. Children's diets are also heavily influenced by their family environment. The aim of this study was to assess the relationship between parent's self-reported exposure to unhealthy food marketing and a range of outcomes related to children's desire for and intake of unhealthy foods and beverages. The study also sought to examine whether these outcomes varied across different countries. The analysed data are from the International Food Policy Study and were collected in 2018 using an online survey. The sample included 5764 parents of children under 18, living in Australia, Canada, Mexico, the United Kingdom, or the United States. Binary logistic regressions assessed the link between the number of parental exposure locations and children's requests for and parental purchases of unhealthy foods. Generalized ordinal regression gauged the relationship between the number of exposure locations and children's consumption of such items. Interaction terms tested if these associations varied by country. Parental exposure to unhealthy food marketing was positively associated with parents reporting child purchase requests and purchase outcomes; and differed by country. Increased parental exposure to unhealthy food marketing was associated with slightly lower odds of children's weekly consumption of unhealthy foods, and this association varied by country. In conclusion, parental report of a greater range of food marketing exposure was associated with a range of outcomes that would increase children's exposure to unhealthy food products or their marketing. Governments should consider developing more comprehensive restrictions on the marketing of unhealthy foods.
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Affiliation(s)
| | - Elise Pauzé
- School of Interdisciplinary Health Sciences, University of Ottawa, Ottawa, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Simón Barquera
- Center for Nutrition and Health Research, INSP, Cuernavaca, Mexico
| | | | - Gary Sacks
- School of Health and Social Development, Deakin University, Victoria, Australia
| | - Lana Vanderlee
- School of Nutrition, Université of Laval, Quebec City, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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Morales-Juárez A, Monterrubio E, Cosenza-Quintana EL, Zamora I, Jensen ML, Vandevijvere S, Ramírez-Zea M, Kroker-Lobos MF. Unhealthy food advertising on Costa Rican and Guatemalan television: a comparative study. Health Promot Int 2023; 38:7162645. [PMID: 37184579 DOI: 10.1093/heapro/daad028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
This study aimed to exhaustively explore the characteristics of food advertising on TV in Guatemala and Costa Rica. The International Network for Food and Obesity Non-Communicable Diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) methodology was applied. In 2016, we recorded 1440 h of video among 10 TV channels. We used the Pan American Health Organization (PAHO) Nutrient Profile (NP) Model to identify 'critical nutrients', whose excessive consumption is associated with NCDs. We created a nutritional quality score (0 if the product did not exceed any critical nutrient, 1 if the product exceeded one and 2 if it exceeded ≥2). We classified food ads as permitted (score = 0) and not-permitted (score 1 or 2) for marketing. Persuasive marketing techniques were classified as promotional characters (e.g. Batman), premium offers (e.g. toys), brand benefit claims (e.g. tasty) and health-related claims (e.g. nutritious). In Guatemala, foods that exceeded one critical nutrient were more likely to use persuasive marketing techniques, and in Costa Rica were those with an excess of ≥2 critical nutrients, compared with foods without any excess in critical nutrients [Guatemala: promotional characters (odds ratio, OR = 16.6, 95% confidence interval, CI: 5.8, 47.3), premium offers (OR = 3.4, 95% CI: 1.4, 8.2) and health-related claims (OR = 3.5, 95% CI: 2.2, 5.7); Costa Rica: health-related claims (OR = 4.2, 95% CI: 2.0, 8.5)]. In conclusion, Guatemalan and Costa Rican children are exposed to an overabundance of not-permitted food ads on TV. This justifies implementing national policies to reduce exposure to not-permitted food for marketing, including on TV and other media.
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Affiliation(s)
- Analí Morales-Juárez
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Eric Monterrubio
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Emma Lucia Cosenza-Quintana
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Irina Zamora
- School of Public Health, University of Costa Rica, San José, Costa Rica
| | - Melissa L Jensen
- School of Nutrition, University of Costa Rica, San José, Costa Rica
| | - Stefanie Vandevijvere
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Manuel Ramírez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Maria Fernanda Kroker-Lobos
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
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Challenges around Child-Feeding Practices with ‘Comida Chatarra’: A Qualitative Study to Understand the Role of Sociocultural Factors in Caregiver Feeding Decisions. Nutrients 2023; 15:nu15061317. [PMID: 36986041 PMCID: PMC10054330 DOI: 10.3390/nu15061317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/11/2023] Open
Abstract
A massive incorporation of ultra-processed products into young children’s diets worldwide and in Mexico has been documented. The aim of this study is to understand the role of sociocultural factors in principal caregivers’ decisions to give a type of ultra-processed food to children under age five, called ‘comida chatarra’ (‘junk food’ in English), usually includes sugar-sweetened beverages, sweet and salty snacks, and sweet breakfast cereals. We conducted a descriptive, observational qualitative study. The research was conducted in urban and rural communities in two Mexican states. Twenty-four principal caregivers were equally distributed between the two states and types of communities. They were interviewed in person. Phenomenology underpinned this study. Results highlight the preponderant role of culture in food choices and feeding practices with junk food. Local culture influences child-feeding with ultra-processed products through social norms, knowledge, or socially constructed attitudes. These social norms, built in the context of abundant ultra-processed products and omnipresent marketing, ‘justify’ children’s consumption of junk food. They acquire these products from the principal caregivers, family members, and neighbors, among others, who reward and pamper them. These actors also define what amount (small amounts) and when (after meals as snacks) children are given these products. Cultural factors must be considered in the development of effective public policies and programs that aim to change the culture around ultra-processed products among children and avoid their consumption.
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Lei N, Liu Z, Xiang L, Ye L, Zhang J. The extent and nature of television food and non-alcoholic beverage advertising to children during chinese New Year in Beijing, China. BMC Public Health 2022; 22:1417. [PMID: 35883126 PMCID: PMC9316732 DOI: 10.1186/s12889-022-13801-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Exposure to food and non-alcoholic beverage advertisements (F&B ads) on television, which can affect children’s nutrition knowledge, food consumption, diet quality, and purchasing preferences, is one aspect of the obesogenic environment. This aspect has been well-studied and assessed in many countries. In China, however, only few studies have been done in earlier years and all of them were focus on regular days. This study aimed to assess the extent and nature of F&B ads on television (TV) during the public holiday directed towards children aged 4–14 years in Beijing. Method Top 3 channels viewed by children aged 4–14 years in Beijing were selected by TV viewership data, survey, and expert consultation. Each channel was recorded for 7 days (24 h) during the public holiday of the Chinese New Year in 2019. F&B ads were coded and analyzed following the adapted food promotion module of INFORMAS protocol. Three nutrient profile models were used to classify F&B ads as healthy or unhealthy F&B ads. Results Of the 10,082 ads in 504-hour recorded programs, 42.9% were F&B ads. The hourly average ads and F&B ads per channel were 19.8 (SD 15.32) and 8.6 (SD 9.84), while that was higher on the national children’s channel (17.15, SD 12.25) than other channels (p < 0.05). Of F&B ads classified with the three nutrient profile models, more than 55% were unhealthy for children. The categories most frequently advertised were savory snacks, milk drinks, nonpermitted milk drinks, cakes/sweet biscuits, and beverages. Unhealthy F&B ads were more likely to use promotional characters, brand benefit claims, and health claims than permitted F&B ads (p < 0.05). Conclusions Children in Beijing were exposed to a high proportion of unhealthy F&B ads during the Chinese New Year holiday. Our findings support the need to assess and regulate TV F&B ads marketing for children.
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Affiliation(s)
- Nan Lei
- School of Population Medicine and Public Health, Peking Union Medical College / Chinese Academy of Medical Science, 100730, Beijing, China.,Faculty of Medicine, Memorial University of Newfoundland, A1C 5S7, St. John's, Canada
| | - Zechen Liu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 02115, Boston, MA, USA
| | - Lin Xiang
- School of Population Medicine and Public Health, Peking Union Medical College / Chinese Academy of Medical Science, 100730, Beijing, China
| | - Lihong Ye
- School of Population Medicine and Public Health, Peking Union Medical College / Chinese Academy of Medical Science, 100730, Beijing, China
| | - Juan Zhang
- School of Population Medicine and Public Health, Peking Union Medical College / Chinese Academy of Medical Science, 100730, Beijing, China.
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Dikmen D, Bellikci-Koyu E, Isgin-Atici K, Inan-Eroglu E, Akyol A, Ayaz A, Nergiz-Unal R, Buyuktuncer Z. Cross-Sectional Evaluation of Food Items Preferred by Adolescents under the Influence of Television Advertisements. J Res Health Sci 2021; 22:e00539. [PMID: 36511255 PMCID: PMC9315460 DOI: 10.34172/jrhs.2022.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/26/2021] [Accepted: 11/25/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Food and beverage advertisements on television play a significant role in food preferences, especially among children and adolescents. This study aimed to evaluate foods and beverages advertised on television and purchased by adolescents or their families using the World Health Organization (WHO) nutrient profiling model. STUDY DESIGN A cross-sectional study. METHODS This cross-sectional study was performed on 2,699 students (1380 males and 1319 females) aged 11-16 in Ankara, Turkey, in 2015. Socio-demographic characteristics, television-viewing habits, and the tendency to purchase foods and beverages under the influence of TV advertisements were recorded. The body weight and height were measured by the researchers. All reported food and beverage items (n = 284) were evaluated and classified as permitted or not permitted to advertise, according to the WHO nutrient profile model (2015). RESULTS The majority (69.8%) of students were underweight/normal weight, whereas 13.3% and 16.9% were classified as overweight and obese, respectively. A total of 69.6% of adolescents declared that they were influenced by food advertisements, and 66.4% bought those foods. The most purchased products included cakes and sweet biscuits (63.8%), chocolate and confectionery (44.9%), savory snacks (39.6%), and soft drinks (25.4%). Only 8.5% of all the advertised products (n = 284) were permitted to be advertised, according to the WHO nutrient profile model (2015). Dairy products, meat products, grains, fruits and vegetables, soup, and some traditional Turkish foods (e.g., cig kofte and Turkish pizza) were permitted. The permitted products were preferred by only 13.6% of the adolescents. CONCLUSIONS Unhealthy foods are advertised on television for adolescents, and food advertisement management may be an essential strategy to provide healthy food choices.
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Affiliation(s)
- Derya Dikmen
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Ezgi Bellikci-Koyu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey,Izmir Katip Celebi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Izmir, Turkey
| | - Kubra Isgin-Atici
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Elif Inan-Eroglu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey,Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Asli Akyol
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Aylin Ayaz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Reyhan Nergiz-Unal
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Zehra Buyuktuncer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey,Corresponding author: Zehra Buyuktuncer (PhD) Tel.: +90 312 3051094
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Duran AC, Mialon M, Crosbie E, Jensen ML, Harris JL, Batis C, Corvalán C, Taillie LS. [Soluciones relacionadas con el entorno alimentario para prevenir la obesidad infantil en América Latina y en la población latina que vive en Estados Unidos]. Obes Rev 2021; 22 Suppl 5:e13344. [PMID: 34708531 DOI: 10.1111/obr.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Ana Clara Duran
- Núcleo de Estudos e Pesquisas em Alimentação (NEPA), Universidade Estadual de Campinas, Campinas, Brasil.,Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brasil
| | - Melissa Mialon
- Trinity Business School, Trinity College Dublin, Dublín, Irlanda
| | - Eric Crosbie
- School of Community and Health Sciences, University of Nevada, Reno, Nevada, EE. UU
| | - Melissa Lorena Jensen
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, EE. UU.,Escuela de Nutrición, Universidad de Costa Rica, San José, Costa Rica
| | - Jennifer L Harris
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, EE. UU
| | - Carolina Batis
- CONACYT, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Camila Corvalán
- Instituto de Nutricion y Tecnologia de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, Carolina del Norte, EE. UU
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An Assessment of Government Capacity Building to Restrict the Marketing of Unhealthy Food and Non-Alcoholic Beverage Products to Children in the Region of the Americas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168324. [PMID: 34444077 PMCID: PMC8394636 DOI: 10.3390/ijerph18168324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
The Pan American Health Organization (PAHO) Strategic Plan 2020–2025 committed to reduce children’s consumption of energy-dense nutrient-poor food and beverage products high in fat, sugar and salt (HFSS) and promote healthy eating patterns to reduce malnutrition in all forms. This paper describes the capacity-building needs in PAHO’s Member States to restrict the marketing of HFSS food and beverages to children. We asked Ministries of Health officials or national institutes/departmental representatives (n = 35) to complete a 28-item web-based survey (January to July 2020). Capacity-building needs were assessed using an adapted version of the World Health Organization’s government capacity-building framework with three modules: public health infrastructure, policies and information systems. Notable achievements for the PAHO’s Plan of Action were identified. State representatives reported strong infrastructure and information systems; however, policy improvements are needed to increase comprehensive national responses. These include using a constitutional health and human rights approach within the policies, policies that document conflict of interest from non-state actors, and strengthening regulatory oversight for digital media platforms. These findings provide baseline data and we suggest priorities for further action to strengthen national governments’ capacity-building and to accelerate the development, implementation, and monitoring systems to restrict the marketing of HFSS food and non-alcoholic beverages to children in the region of the Americas.
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Guimarães JS, Mais LA, Leite FHM, Horta PM, Santana MO, Martins APB, Claro RM. Abusive advertising of food and drink products on Brazilian television. Health Promot Int 2021; 37:6323908. [PMID: 34279624 PMCID: PMC9053462 DOI: 10.1093/heapro/daab025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In Brazil, any advertising strategies that take advantage of the child's judgment or induce consumers to make harmful health choices are considered abusive. However, the efficacy of restrictions on their use on television (TV) food advertising remains poorly understood. This study analysed the extent and nature of abusive techniques according to national regulations and patterns in their use in food-related ads. Cross-sectional studyrecorded the programming of the three most popular TV channels (6 am-12 am), during eight non-consecutive days, in April 2018. Data collection was based on the INFORMAS protocol and two national regulations. Descriptive analyses were used to describe the types of food ads and abusive techniques used in ultra-processed products (UPP) ads. Principal component analysis was applied to identify patterns of abusive marketing techniques and to relate them to specific food groups. More than 90% of food ads included at least one UPP. Overall, 10.1% of UPP ads targeted children and 57.7% used some kind of abusive technique directed to children and adolescents. Most ads contained messages inducing harmful health choices did not present adequate and clear information about the product and contained more than one type of abusive technique. Four out of five patterns in the use of abusive techniques in UPP ads were specifically directed to children, and fast-food meals were associated with three out of five patterns. The high abusiveness of food advertising in UPP ads should be considered a public health concern given their impact on children's food choices and health.
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Affiliation(s)
- Julia S Guimarães
- Federal University of Minas Gerais (Universidade Federal de Minas Gerais-UFMG), Belo Horizonte, MG, Brazil
| | - Laís A Mais
- Brazilian Institute for Consumer Defense (Instituto Brasileiro de Defesa do Consumidor-Idec), Brazil
| | - Fernanda H M Leite
- Brazilian Institute for Consumer Defense (Instituto Brasileiro de Defesa do Consumidor-Idec), Brazil
| | - Paula M Horta
- Federal University of Minas Gerais (Universidade Federal de Minas Gerais-UFMG), Belo Horizonte, MG, Brazil
| | - Marina O Santana
- Federal University of Minas Gerais (Universidade Federal de Minas Gerais-UFMG), Belo Horizonte, MG, Brazil
| | - Ana P B Martins
- Brazilian Institute for Consumer Defense (Instituto Brasileiro de Defesa do Consumidor-Idec), Brazil
| | - Rafael M Claro
- Federal University of Minas Gerais (Universidade Federal de Minas Gerais-UFMG), Belo Horizonte, MG, Brazil
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Duran AC, Mialon M, Crosbie E, Jensen ML, Harris JL, Batis C, Corvalán C, Taillie LS. Food environment solutions for childhood obesity in Latin America and among Latinos living in the United States. Obes Rev 2021; 22 Suppl 3:e13237. [PMID: 34152071 PMCID: PMC8365715 DOI: 10.1111/obr.13237] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/23/2022]
Abstract
The food environment is a major contributor to unhealthy diets in children and, therefore, to the increasing rates of obesity. Acclaimed by scholars across the world, Latin American countries have been leaders in implementing policies that target different aspects of the food environment. Evidence on the nature and to what extent children are exposed and respond to unhealthy food environments in the region and among Latinos in the United States is, however, deficient. The objective of this review is to use the integrated International Network for Food and Obesity/noncommunicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) framework to create healthy food environment to (i) compare the key elements of childhood obesity-related food environments in Latin America and for Latinos living in the United States; (ii) describe the evidence on solutions to improve childhood obesity-related food environments; and (iii) identify research priorities to inform solutions to fight childhood obesity in these populations. We found that an integrated body of evidence is needed to inform an optimal package of policies to improve food environments to which children in Latin America and Latino children in the United States are exposed and more efficiently translate policy solutions to help curb growing childhood obesity levels across borders.
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Affiliation(s)
- Ana Clara Duran
- Center for Food Studies and Research (NEPA)University of CampinasCampinasBrazil
- Center for Epidemiological Studies in Nutrition and HealthUniversity of São PauloSão PauloBrazil
| | - Melissa Mialon
- Trinity Business SchoolTrinity College DublinDublinIreland
| | - Eric Crosbie
- School of Community and Health SciencesUniversity of NevadaRenoNevadaUSA
| | - Melissa Lorena Jensen
- Rudd Center for Food Policy and ObesityUniversity of ConnecticutHartfordConnecticutUSA
- School of Nutrition, University of Costa RicaSan JoséCosta Rica
| | - Jennifer L. Harris
- Rudd Center for Food Policy and ObesityUniversity of ConnecticutHartfordConnecticutUSA
| | - Carolina Batis
- CONACYT, Health and Nutrition Research CenterNational Institute of Public HealthCuernavacaMexico
| | - Camila Corvalán
- Instituto de Nutricion y Tecnologia de AlimentosUniversity of ChileSantiagoChile
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, and Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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12
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Nutrient profile models a useful tool to facilitate healthier food choices: A comprehensive review. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.01.082] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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13
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Cruz-Casarrubias C, Tolentino-Mayo L, Nieto C, Théodore FL, Monterrubio-Flores E. Use of advertising strategies to target children in sugar-sweetened beverages packaging in Mexico and the nutritional quality of those beverages. Pediatr Obes 2021; 16:e12710. [PMID: 32783401 DOI: 10.1111/ijpo.12710] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/23/2020] [Accepted: 07/14/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND A product package can be a powerful marketing tool to persuade and attract consumers at the point-of-sale. Evidence shows that most advertised products have low nutritional quality. Currently, Mexico has incorporated advertising regulations on food and beverage packaging. OBJECTIVES To analyze the advertising strategies used to target children on packaging and to assess the nutritional quality of sugar-sweetened beverages available in the Mexican market. METHODS Photographs of 2380 beverages available in retail stores in Mexico City from January to March 2017 were analyzed. Beverages were classified as displaying child-directed strategies or nondirected strategies. Nutrition quality was evaluated using the Pan American Health Organization nutrient profile model. RESULTS The use of characters was the most frequent strategy among beverages with child-directed strategies (82.0%). The evaluation of nutrition quality found that 88.0% (P < .001) of sugar-sweetened beverages with child-directed strategies were excessive in free sugars and 56.9% (P < .001) contained other sweeteners. Beverages with more than two advertising strategies have the highest proportion of excessive free sugars (93.4%, 95% CI 82.8-98.6). CONCLUSIONS The use of characters and other visual strategies were frequently used in the packaging of sugar-sweetened beverages with child-directed strategies. In addition, these beverages are excessive in free sugars and contain a large number of products with other sweeteners.
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Affiliation(s)
- Carlos Cruz-Casarrubias
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Lizbeth Tolentino-Mayo
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Claudia Nieto
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Florence L Théodore
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Eric Monterrubio-Flores
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Taillie LS, Busey E, Stoltze FM, Dillman Carpentier FR. Governmental policies to reduce unhealthy food marketing to children. Nutr Rev 2021; 77:787-816. [PMID: 31329232 DOI: 10.1093/nutrit/nuz021] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Reducing children's exposure to food marketing is an important obesity prevention strategy. This narrative review describes current statutory regulations that restrict food marketing; reviews available evidence on the effects of these regulations; and compares policy design elements in Chile and the United Kingdom. Currently, 16 countries have statutory regulations on unhealthy food marketing to children. Restrictions on television advertising, primarily during children's programming, are most common. Schools are also a common setting for restrictions. Regulations on media such as cinema, mobile phone applications, print, packaging, and the internet are uncommon. Eleven evaluations of policies in 4 jurisdictions found small or no policy-related reductions in unhealthy food advertising, in part because marketing shifted to other programs or venues; however, not all policies have been evaluated. Compared with the United Kingdom, Chile restricts marketing on more products, across a wider range of media, using more marketing techniques. Future research should examine which elements of food marketing policy design are most effective at reducing children's exposure to unhealthy food marketing.
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Affiliation(s)
- Lindsey Smith Taillie
- UNC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily Busey
- UNC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Fernanda Mediano Stoltze
- UNC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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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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Cosenza-Quintana EL, Morales-Juárez A, Ramirez-Zea M, Vandevijvere S, Kroker-Lobos MF. Overabundance of unhealthy food advertising targeted to children on Guatemalan television. Health Promot Int 2020; 35:1331-1340. [PMID: 32060503 PMCID: PMC7785310 DOI: 10.1093/heapro/daaa002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
To assess, for the first time, the extent (by hour channel) and nature (e.g. persuasive marketing techniques (PMT) and health-related claims) of unhealthy food advertisements (ads) targeted at children (3–11 years) on the six most-watched television (TV) channels in Guatemala. We recorded 864 h of video on the six most popular channels featuring children’s programmes. We classified food and beverage ads as permitted or non-permitted for marketing to children, according to the 2015 World Health Organisation (WHO) nutrient profile. Furthermore, we also analysed PMT (i.e. premium offers, promotional characters, brand benefit claims) and health-related claims. Most food ads (85%) were non-permitted to be marketed to children. Non-permitted food ads were six times more likely, either on weekdays or weekends, for all programme and channel categories compared with permitted food ads. There was no difference in the frequency of non-permitted food ads between peak and non-peak hours, weekend and weekdays or children and non-children programmes. PMT and health-related claims were present in all food ads (5.3 ± 1.9 techniques/claims per ad). There is a need to regulate food ads on TV channels featuring children’s programmes in Guatemala as a result of a high frequency of non-permitted food ads and extensive use of PMT together with health-related claims.
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Affiliation(s)
- Emma Lucia Cosenza-Quintana
- Research Centre for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama (INCAP), 1188 Calzada Roosevelt 6-25 zona 11, Guatemala City, Guatemala
| | - Analí Morales-Juárez
- Research Centre for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama (INCAP), 1188 Calzada Roosevelt 6-25 zona 11, Guatemala City, Guatemala
| | - Manuel Ramirez-Zea
- Research Centre for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama (INCAP), 1188 Calzada Roosevelt 6-25 zona 11, Guatemala City, Guatemala
| | - Stefanie Vandevijvere
- School of Population Health, University of Auckland, 1142 24 Symonds Street, Auckland, New Zealand
| | - Maria F Kroker-Lobos
- Research Centre for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama (INCAP), 1188 Calzada Roosevelt 6-25 zona 11, Guatemala City, Guatemala
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Abstract
OBJECTIVE Previous studies from European countries noted that food products promoted on TV for children did not comply with international guidelines, including the World Health Organization European Nutrient Profile Model (WHO-ENPM) and the EU Pledge Nutrition Criteria (EU-PNC, an initiative developed by leading food companies). We aim to provide new data from Italy. DESIGN Evaluation of Italian TV advertisements. Data on nutritional values for food product advertised were compared with nutritional standards issued by the WHO-ENPM and the EU-PNC. SETTING In total, 180 h of TV programmes from six Italian channels, 2016-2017. PARTICIPANTS Eight hundred and ten consecutive advertisements during children's programmes. RESULTS Out of 810 advertisements, 90 (11·1 %) referred to food products. Among these, 84·5 % of the foods promoted did not meet the WHO-ENPM and 55·6 % the EU-PNC guidelines. Advertisements promoting sweet and salty snacks (i.e. ≥ 70 % of all foods) v. other food products showed higher non-compliance with both the WHO-ENPM (OR: 73·8; 95 % CI: 4·09, 1330) and the EU-PNC (OR: 9·21; 95 % CI: 2·82, 30·1). CONCLUSIONS In Italy, most food advertisements during children's programmes are not compliant with European nutritional standards. Almost all the advertisements for snacks do not meet international guidelines. As the WHO-ENPM guidelines do not propose standards for all the food products, including meals, there is an urgent need to define independent and easy-to-read guidelines for food advertisements targeting children. As a first step towards the complete ban of food advertisements targeting children recommended by other researchers, these guidelines should be enforced by all the TV broadcasts.
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Role of different nutrient profiling models in identifying targeted foods for front-of-package food labelling in Brazil. Public Health Nutr 2020; 24:1514-1525. [PMID: 32515717 PMCID: PMC8025091 DOI: 10.1017/s1368980019005056] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: To compare the degree of strictness and agreement of different nutrient profiling models (NPM) used to identify which foods would be required to show front-of-package (FOP) warning labels. Design: Using data of 11 434 packaged foods found in the five largest food retailers in Brazil, we used two published NPM: the Pan American Health Organization (PAHO) model and the NPM used in the Chilean nutritional FOP labelling policy, and compared them with a NPM proposed by the Brazilian National Health Surveillance Agency (Anvisa). The proportion of foods that would be required to show FOP warning labels was calculated overall and by food category. We also tested whether a modified version of the PAHO NPM would behave similarly to the original version. Setting: Brazil. Results: Two-thirds of the packaged products (62 %) would receive FOP warning labels under the PAHO NPM, as compared with 45 % of products using the proposed Anvisa NPM and 41 % if the Chilean NPM was applied. The PAHO NPM identified more foods high in critical nutrients such as sweetened dairy and non-dairy beverages, canned vegetables and convenience foods. Overall agreement between models was considered good with kappa coefficient ranging from 0·57 to 0·92 but was lower for some food categories. Conclusions: We found variations in the degree of strictness and agreement between assessed NPM. The PAHO NPM identified more foods and beverages high in sugar which are among the top contributors to sugar and energy intake in Brazil.
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Nutritional Quality of Hidden Food and Beverage Advertising Directed to Children: Extent and Nature of Product Placement in Mexican Television Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093086. [PMID: 32365478 PMCID: PMC7246833 DOI: 10.3390/ijerph17093086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/18/2020] [Accepted: 04/19/2020] [Indexed: 11/30/2022]
Abstract
(1) Background: Nutrient-poor, energy-dense food and beverage (F&B) advertisements influence children’s food preferences, consumption, and purchase requests, contributing to overweight and obesity. Objective: To characterize the nutritional quality of F&B advertised by product placement (PP) in Mexican television programs with the highest audience ratings for children. (2) Methods: A total of 48 h of television programs between December 2016 and January 2017 during the hours with the highest ratings for children were analyzed. Nutritional quality was assessed through the Mexican Ministry of Health (MMH-NPM), the World Health Organization Regional Office for Europe (WHO-Europe), and the Pan American Health Organization nutrient profile models (PAHO-NPM). (3) Results: A total of 119 F&B were broadcast, of which more than 60% were unhealthy according to the three nutritional models. Reality shows and movies presented the most PP advertising. The food category most frequently advertised was sugar-sweetened beverages (41.2%). F&B advertised in children’s programs had a higher content of energy, total fat, and saturated fat (p < 0.01). (4) Conclusion: The MMH-NPM was the most permissive and the PAHO-NPM was the strictest for evaluating nutritional quality. Mexico must strengthen the regulation of advertising to protect children from its negative effects on health.
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Aceves B, Ingram M, Nieto C, de Zapien JG, Rosales C. Non-communicable disease prevention in Mexico: policies, programs and regulations. Health Promot Int 2020; 35:409-421. [PMID: 31006024 PMCID: PMC7313413 DOI: 10.1093/heapro/daz029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Non-communicable diseases (NCD), such as diabetes and cardiovascular disease, have become a leading cause of the death in Mexico. The federal government has addressed this issue through developing NCD prevention plans, regulations and policies (PRPs) that seek to address social and environmental factors, which was led by the National Institute of Public Health and Ministry of Health in concert with various non-governmental organizations. This review aims to synthesize and summarize national NCD prevention PRPs addressing social and environmental factors passed from 2010 to 2016, and to assess the extent to which these efforts successfully addressed factors contributing to the epidemic. In total nine federal NCD prevention PRPs were identified from a scan that examined executive and legislative PRPs, which identified five documents. A scoping review was conducted for evaluation studies and reports corresponding to these PRPs. The majority of PRPs focused on nutrition, specifically the access and promotion of food. Studies and reports demonstrated that taxation on energy-dense low-nutrient foods and sugar-sweetened beverages were the most effective. Other PRPs had various issues with implementation, mostly related to adherence and resources available. Overall, there lacked evidence of evaluative work on several NCD prevention PRPs, specifically assessing implementation and effectiveness. Additionally, PRPs did not sufficiently address integration of clinical, social, environmental approaches and access to physical activity. While the Mexican federal government has taken the initial steps to address the multifactorial causes of NCD, firm political commitment and investment of significant resources are still needed.
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Affiliation(s)
- Benjamin Aceves
- University of Arizona, Mel and Enid Zuckerman College of Public Health, 1296 N. Martin, Tucson, AZ 85724, USA
| | - Maia Ingram
- University of Arizona, Mel and Enid Zuckerman College of Public Health, 1296 N. Martin, Tucson, AZ 85724, USA
| | - Claudia Nieto
- Instituto Nacional de Salud Pública, Centro de Investigación en Nutrición y Salud, 7a Cerrada de Fray Pedro de Gante 50, Tlalpan, Sección XVI, 14080 Ciudad de México, CDMX, Mexico
| | - Jill Guernsey de Zapien
- University of Arizona, Mel and Enid Zuckerman College of Public Health, 1296 N. Martin, Tucson, AZ 85724, USA
| | - Cecilia Rosales
- University of Arizona, Mel and Enid Zuckerman College of Public Health, 1296 N. Martin, Tucson, AZ 85724, USA
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Leite FHM, Mais LA, Ricardo CZ, Andrade GC, Guimarães JS, Claro RM, Duran ACDFL, Martins APB. Nutritional quality of foods and non-alcoholic beverages advertised on Brazilian free-to-air television: a cross-sectional study. BMC Public Health 2020; 20:385. [PMID: 32209067 PMCID: PMC7092551 DOI: 10.1186/s12889-020-08527-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/16/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Evidence shows that foods marketed on television are often low-nutrient-dense foods associated with poor nutritional diet quality, obesity and non-communicable diseases. However, little research has been undertaken in Brazil around this issue. This study assessed the nutritional profile of foods and non-alcoholic beverages advertised on Brazilian television by applying the Pan American Health Organization (PAHO) and the World Health Organization (WHO/Europe) nutrient profiling models. METHODS Cross-sectional study based on the International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support (INFORMAS) protocol. A total of 432 h on the three major Brazilian free-to-air TV channels was recorded from April 1st to 30th 2018. Recordings were done for eight non-consecutive and randomly selected days from 6 am to 12 am (midnight). All food-related ads were coded using a systematic approach and classified according to the PAHO and the WHO/Europe nutrient profile models as "eligible"/"not eligible" for marketing restrictions. Absolute and relative frequencies were used to describe absolute numbers and proportions of food and beverage advertisements. The nutritional profile of foods was compared by day, time of the day and types of TV program. For each advertisement, the parent company of promoted food products, supermarkets and restaurants was identified. RESULTS A total of 1610 food and beverage ads were broadcast, representing 18.1% of the total ads shown on selected channels. Over 80.0% of all foods and beverages advertised on Brazilian TV channels did not meet the PAHO and the WHO/Europe nutritional quality standards and were considered eligible for marketing restrictions. The proportion of unhealthy food ads was significantly higher on weekends, in the afternoon, and during soap operas programming. Altogether, 10 transnational and local food and beverage companies, two large international fast food chains and two of Brazil's largest supermarket retailers accounted for almost 90% of all unhealthy food ads shown. CONCLUSIONS The findings of the present study indicate a high exposure of the Brazilian population to unhealthy food marketing and an inefficient enforcement of existing regulations. Further research to monitor population exposure to unhealthy food marketing and understand the policy inertia that is preventing policy progress, is highly recommended.
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Affiliation(s)
- Fernanda Helena Marrocos Leite
- Center for Epidemiological Research in Nutrition and Health (Nupens), University of São Paulo, Avenida Dr. Arnaldo, 715, São Paulo, Brazil.
| | - Laís Amaral Mais
- Brazilian Institute for Consumer Defense (Idec), Rua Doutor Costa Júnior, 543, Água Branca, São Paulo, Brazil
| | - Camila Zancheta Ricardo
- Center for Epidemiological Research in Nutrition and Health (Nupens), University of São Paulo, Avenida Dr. Arnaldo, 715, São Paulo, Brazil
| | - Giovanna Calixto Andrade
- Center for Epidemiological Research in Nutrition and Health (Nupens), University of São Paulo, Avenida Dr. Arnaldo, 715, São Paulo, Brazil
| | - Julia Soares Guimarães
- Health Sciences Department, University of Ottawa, 3-71 Rue Papineau, Gatineau, Quebec, Canada
| | - Rafael Moreira Claro
- Nutrition Department, Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Clara da Fonseca Leitão Duran
- Center for Epidemiological Research in Nutrition and Health (Nupens), University of São Paulo, Avenida Dr. Arnaldo, 715, São Paulo, Brazil.,Center for Food Studies, University of Campinas, Avenida Albert Einstein, 291, Campinas, São Paulo, Brazil
| | - Ana Paula Bortoletto Martins
- Center for Epidemiological Research in Nutrition and Health (Nupens), University of São Paulo, Avenida Dr. Arnaldo, 715, São Paulo, Brazil.,Brazilian Institute for Consumer Defense (Idec), Rua Doutor Costa Júnior, 543, Água Branca, São Paulo, Brazil
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García-Chávez CG, Rivera JA, Monterrubio-Flores E, Rodríguez-Ramírez S. Dietary patterns are associated with obesity in Mexican schoolchildren. Eur J Clin Nutr 2020; 74:1201-1209. [PMID: 32152510 DOI: 10.1038/s41430-020-0598-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 02/20/2020] [Accepted: 02/25/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The prevalence of overweight and obesity in Mexican schoolchildren has increased in the past three decades. Dietary pattern approaches to assess diet have been used to study the relation between nutrition and chronic conditions. OBJECTIVE The objective of this study is to analyze the association between dietary patterns (DP) and overweight and obesity in Mexican schoolchildren. METHODS We analyzed information from schoolchildren who participated in the National Health and Nutrition Survey 2012 (ENSANUT-2012). Dietary information was obtained through a 24-h recall of 2751 children (5-11 year). Foods were classified into 33 groups, and the DPs were identified by cluster analysis (k-means method). Weight and height were measured to estimate the body mass index (BMI), by classifying overweight if the Z score was >1 and ≤2 standard deviations (SD), and obesity when the Z score was >2SD. To analyze the association, a Poisson regression model was used, adjusting by age, region, area of residence, socioeconomic status (SES), and the survey design. RESULTS Four DPs were identified: "Traditional", "Industrialized", "Varied", and "Modern". The "Modern" DP was associated with obesity (PR = 1.7) (p < 0.05) compared with the "Traditional" DP. CONCLUSIONS The "Modern" DP could be influencing the development of obesity in Mexican schoolchildren. The promotion of healthy food and public health strategies to those food groups that should be discouraged are necessary to reverse the obesity epidemic in Mexican children.
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Affiliation(s)
- Claudia Gabriela García-Chávez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública., Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, México
| | - Juan A Rivera
- Dirección General, Instituto Nacional de Salud Pública., Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, México
| | - Eric Monterrubio-Flores
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública., Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, México
| | - Sonia Rodríguez-Ramírez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública., Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, México.
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Rincón-Gallardo Patiño S, Rajamohan S, Meaney K, Coupey E, Serrano E, Hedrick VE, da Silva Gomes F, Polys N, Kraak V. Development of a Responsible Policy Index to Improve Statutory and Self-Regulatory Policies that Protect Children's Diet and Health in the America's Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020495. [PMID: 31941054 PMCID: PMC7013653 DOI: 10.3390/ijerph17020495] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/06/2020] [Accepted: 01/09/2020] [Indexed: 01/15/2023]
Abstract
In 2010, 193 Member States of the World Health Organization (WHO) endorsed World Health Assembly Resolution WHA63.14 to restrict the marketing of food and beverage products high in fat, sugar and salt (HFSS) to children to prevent obesity and non-communicable diseases (NCDs). No study has examined HFSS marketing policies across the WHO regional office countries in the Americas. Between 2018 and 2019, a transdisciplinary team examined policies to restrict HFSS food and beverage product marketing to children to develop a responsible policy index (RESPI) that provides a quality score based on policy characteristics and marketing techniques. After designing the RESPI, we conducted a comprehensive literature review through October 2019 to examine policies in 14 countries in the WHO Americans Region. We categorized policies (n = 38) as either self-regulatory or statutory and calculated the RESPI scores, ranked from 0 (lowest) to 10 (highest). Results showed Brazil, Canada, Chile, and Uruguay had the highest RESPI scores associated with statutory policies that restricted point of sale, cartoon, licensed media characters and celebrities; and HFSS products in schools and child care settings, and broadcast and print media. Policymakers can use the RESPI tool to evaluate marketing policies within and across geopolitical boundaries to protect children's diet and health.
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Affiliation(s)
- Sofía Rincón-Gallardo Patiño
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (E.S.); (V.E.H.); (V.K.)
- Correspondence: ; Tel.: +1-540-831-9719
| | - Srijith Rajamohan
- Advanced Research Computing, Information Technology, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (S.R.); (N.P.)
| | - Kathleen Meaney
- School of Visual Arts, College of Architecture and Urban Studies, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Eloise Coupey
- Department of Marketing, Pamplin College of Business, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Elena Serrano
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (E.S.); (V.E.H.); (V.K.)
| | - Valisa E. Hedrick
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (E.S.); (V.E.H.); (V.K.)
| | - Fabio da Silva Gomes
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, World Health Organization, Washington, DC 20037, USA;
| | - Nicholas Polys
- Advanced Research Computing, Information Technology, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (S.R.); (N.P.)
| | - Vivica Kraak
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (E.S.); (V.E.H.); (V.K.)
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Chemas-Velez MM, Gómez LF, Velasquez A, Mora-Plazas M, Parra DC. Scoping review of studies on food marketing in Latin America: Summary of existing evidence and research gaps. Rev Saude Publica 2020; 53:107. [PMID: 31967201 PMCID: PMC6924973 DOI: 10.11606/s1518-8787.2019053001184] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 05/09/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To document the evidence about marketing of ultra-processed foods and "non-alcoholic" beverages in Latin America. METHODS We performed a structured search of quantitative and qualitative studies in PubMed, SciELO and LILACS, published between January 2000 and May 2017 and conducted in Latin America. We conducted a quality assessment following a standardized tool and a thematic analysis to identify key typologies of marketing across studies. RESULTS Out of 521 studies screened by title and abstract, we included 36 in this review; 27 of them analyzed television advertisement. Other marketing channels studied were food packaging, point of sale and outdoor advertisement. Studies found television advertises foods and beverages that are mostly ultraprocessed foods and have low nutritional value, particularly those promoted during children's programming. We also observed children have a literal interpretation of images printed on food packaging, so this can be deceiving. Several studies also found proximity to unhealthy foods may increase their consumption. Finally, the thematic analysis identified the following typologies of food marketing: a) television advertisement, b) food packaging marketing, c) marketing strategies at points of sale and d) other marketing strategies. We found almost no advertisements for unprocessed or minimally processed foods such as fruits and vegetables. We did not find any studies on digital marketing conducted in the region. CONCLUSIONS This review found that the main channel of food marketing was television advertising. This synthesis provides insights to the challenges unhealthy eating represents to the public health of Latin America and identifies knowledge gaps to guide future research.
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Affiliation(s)
- Maria Manuela Chemas-Velez
- Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Preventiva y Social. Bogotá, Colombia
| | - Luis F Gómez
- Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Preventiva y Social. Bogotá, Colombia
| | - Alcides Velasquez
- University of Kansas. Department of Communication Studies. Lawrence, KS, USA
| | - Mercedes Mora-Plazas
- Universidad Nacional de Colombia. Facultad de Medicina. Departamento de Nutrición Humana. Bogotá, Colombia
| | - Diana C Parra
- Washington University in St. Louis. School of Medicine. Program of Physical Therapy. St. Louis, USA
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Vandevijvere S, Mackay S, D'Souza E, Swinburn B. The first INFORMAS national food environments and policies survey in New Zealand: A blueprint country profile for measuring progress on creating healthy food environments. Obes Rev 2019; 20 Suppl 2:141-160. [PMID: 31483561 DOI: 10.1111/obr.12850] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/13/2019] [Accepted: 02/26/2019] [Indexed: 12/30/2022]
Abstract
The International Network for Food and Obesity/NCDs Research, Monitoring and Action Support aims to benchmark national food environments. This study proposes a blueprint country profile to measure progress on creating healthy food environments, based on the results of the first, comprehensive survey in New Zealand (NZ). We assessed the implementation of national food environment policies and food industry commitments to improve population nutrition and the strength and comprehensiveness of public sector settings' nutrition policies. The healthiness of the packaged food supply, including health-related labelling, was evaluated. Food environments were measured in 833 schools, 204 supermarkets, 1500 takeaway outlets, 28 hospitals, 70 sport centres, and around all NZ schools. Food swamps, defined as areas with high relative density of unhealthy food outlets, were identified, and food marketing to children on television, websites, social media and packages, in magazines, and in and around schools was measured. The cost differential between healthy and current household diets was calculated for different population groups. NZ's food environment profile is largely unhealthy, and there are inequalities in access to healthy food environments. It is anticipated that the proposed country profile can help other countries tackle unhealthy food environments through increasing accountability of governments and the industry.
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Affiliation(s)
- Stefanie Vandevijvere
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Erica D'Souza
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Boyd Swinburn
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
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The food environment in Latin America: a systematic review with a focus on environments relevant to obesity and related chronic diseases. Public Health Nutr 2019; 22:3447-3464. [PMID: 31666140 DOI: 10.1017/s1368980019002891] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Food environments may be contributing to the rapid increase in obesity occurring in most Latin American (LA) countries. The present study reviews literature from LA that (i) describes the food environment and policies targeting the food environment (FEP); and (ii) analytic studies that investigate associations between the FEP and dietary behaviours, overweight/obesity and obesity related chronic diseases. We focus on six dimensions of the FEP: food retail, provision, labelling, marketing, price and composition. DESIGN Systematic literature review. Three databases (Web of Science, SciELO, LILACS) were searched, from 1 January 1999 up to July 2017. Two authors independently selected the studies. A narrative synthesis was used to summarize, integrate and interpret findings. SETTING Studies conducted in LA countries. PARTICIPANTS The search yielded 2695 articles of which eighty-four met inclusion criteria. RESULTS Most studies were descriptive and came from Brazil (61 %), followed by Mexico (18 %) and Guatemala (6 %). Studies were focused primarily on retail/provision (n 27), marketing (n 16) and labelling (n 15). Consistent associations between availability of fruit and vegetable markets and higher consumption of fruits and vegetables were found in cross-sectional studies. Health claims in food packaging were prevalent and mostly misleading. There was widespread use of marketing strategies for unhealthy foods aimed at children. Food prices were lower for processed relative to fresh foods. Some studies documented high sodium in industrially processed foods. CONCLUSIONS Gaps in knowledge remain regarding policy evaluations, longitudinal food retail studies, impacts of food price on diet and effects of digital marketing on diet/health.
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Storcksdieck genannt Bonsmann S, Robinson M, Wollgast J, Caldeira S. The ineligibility of food products from across the EU for marketing to children according to two EU-level nutrient profile models. PLoS One 2019; 14:e0213512. [PMID: 31644591 PMCID: PMC6808307 DOI: 10.1371/journal.pone.0213512] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 02/23/2019] [Indexed: 01/04/2023] Open
Abstract
Background A variety of nutrient profiling models have been developed to restrict food marketing to children. Previous assessments have shown substantial differences in terms of model strictness and agreement, but EU-wide data on how leading products in the various national markets perform against these health-minded nutrition criteria are unavailable. Objective To evaluate the nutritional composition of the pre-packaged food offer in selected categories sold at scale in the EU using criteria of two nutrient profile models intended to restrict food marketing to children. Methods The nutrient profile models of the private-sector EU Pledge and of the World Health Organization's Regional Office for Europe were applied to a commercial database with sales and nutritional information of 2691 pre-packaged products from five product categories (breakfast cereals, ready meals, processed meat, processed seafood, and yoghurts) and 20 EU countries. This study describes the criteria not met, the product ineligibility rates, and the distances to the various criteria thresholds. Findings Between 48% (EU Pledge) and 68% (WHO Europe) of the 2691 products analysed were found to be ineligible for marketing to children. The criteria thresholds most often not met were those for total sugars (in breakfast cereals, yoghurts), salt (in processed meat, processed seafood, ready meals), and fibre (in breakfast cereals). Total and saturated fat criteria also played a substantial role in rendering yoghurt products ineligible, and the energy criterion did so for ready meals. Interpretation A large number of food products selling at scale in the EU do not meet the criteria of two EU-level nutrient profile models intended to restrict food marketing to children. Given the considerable market share of many such products, they are likely to be consumed widely and in some cases regularly, including by children, even without being marketed to them. Nutrient profile models could serve as benchmarking tools for monitoring and evaluating food product reformulation efforts.
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Affiliation(s)
| | | | - Jan Wollgast
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Sandra Caldeira
- European Commission, Joint Research Centre (JRC), Ispra, Italy
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Television food and beverage marketing to children in Costa Rica: current state and policy implications. Public Health Nutr 2019; 22:2509-2520. [PMID: 31109393 DOI: 10.1017/s1368980019000776] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To examine the frequency of television (TV) food and beverage advertisements (F&B ads) to which children (4-11 years) are likely exposed and the nutrient profile of products advertised. DESIGN TV broadcasting between September and November 2016 was recorded (288 h of children's programming; 288 h of family programming) resulting in 8980 advertisements, of which 1862 were F&B ads. Of those, 1473 could be classified into one of the seventeen food groups, and into permitted/non-permitted according to the WHO-EU nutrient profile model. Persuasive marketing techniques used were also identified. SETTING TV programming was recorded for four weekdays and four weekend days, between 06.00 and 00.00 hours (576 total hours), for four channels (two national and two cable), in Costa Rica. RESULTS Mean (sd) number of F&B ads/h was greater in cable than national channels (3·7 (0·4) v. 2·8 (0·4), P < 0·05) and during children's peak viewing hours (4·4 (0·4) v. 2·9 (0·3)). Of F&B ads classified with WHO-EU nutrient profile model (n 1473, 71·1 %), 91·1 % were non-permitted to be marketed to children. Categories most frequently advertised were ready-made/convenience foods (16 %), chocolates/confectionery/desserts (15 %), breakfast cereals (14 %), beverages (15 %), edible ices (9 %) and salty snacks (8 %). Non-permitted F&B ads were more likely to use promotional characters, brand benefit claims, and nutrition and health claims than permitted F&B ads. CONCLUSIONS Children watching popular TV channels in Costa Rica are exposed to a high number of unhealthy F&B ads daily. Our findings help justify the need for regulatory actions by national authorities.
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Medina C, Jáuregui A, Campos-Nonato I, Barquera S. [Prevalence and trends of physical activity in children and adolescents: results of the Ensanut 2012 and Ensanut MC 2016]. SALUD PUBLICA DE MEXICO 2019; 60:263-271. [PMID: 29746743 DOI: 10.21149/8819] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 04/09/2018] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To describe the prevalence and trends of physical activity (PA) in children and adolescents from Ensanut 2012 and Ensanut MC 2016. MATERIALS AND METHODS Physical activity levels were obtained from the Health Behaviour in School-aged Children (HBSC) and the International Physical Activity (IPAQ) questionnaires for children and adolescents respectively. RESULTS More than 80% of the children and 35% of the adolescents in Mexico do not meet the PA recom¬mendations. From 2012-2016, girls and schoolchildren in the rural area showed an increase in participation in organized activities and sports. CONCLUSIONS The prevalence of PA is low in children and adolescents and the trend has not improved in the last six years.
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Assessment of the Canadian Children's Food and Beverage Advertising Initiative's Uniform Nutrition Criteria for Restricting Children's Food and Beverage Marketing in Canada. Nutrients 2018; 10:nu10070803. [PMID: 29932134 PMCID: PMC6073317 DOI: 10.3390/nu10070803] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/13/2018] [Accepted: 06/19/2018] [Indexed: 12/30/2022] Open
Abstract
Imposing governmental restrictions on the marketing of unhealthy foods and beverages to children is a demanded policy action since in Canada, this remains self-regulated by the voluntary, industry-led Canadian Children’s Food and Beverage Advertising Initiative (CAI) whose participants pledge to only advertise products that satisfy its Uniform Nutrition Criteria to children. This study evaluated the stringency of this nutrient profiling (NP) model for restricting child-directed food and beverage marketing in Canada. Data was obtained from the University of Toronto Food Label Information Program (FLIP) 2013 database, providing nutritional information for 15,342 packaged products which were evaluated using the CAI Uniform Nutrition Criteria. Products with child-directed packaging and those from CAI participating companies were identified. Of the n = 15,231 products analyzed, 25.3% would be allowed and 57.2% would be restricted from being marketed to children according to the CAI Criteria. Additionally, 17.5% of products lacked criteria by which to evaluate them. Child-directed products represented 4.9% of all products; however, 74.4% of these would be restricted from being marketed to children under CAI standards. Products from CAI participating companies represented 14.0% of all products and 33.3% of child-directed products; 69.5% of which would be restricted from being marketed to children. These results indicate that if the CAI was mandatory and covered a broader range of advertising platforms, their Uniform Nutrition Criteria would be relatively stringent and could effectively restrict children’s marketing in Canada.
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Contreras-Manzano A, Jáuregui A, Velasco-Bernal A, Vargas-Meza J, Rivera JA, Tolentino-Mayo L, Barquera S. Comparative Analysis of the Classification of Food Products in the Mexican Market According to Seven Different Nutrient Profiling Systems. Nutrients 2018; 10:E737. [PMID: 29880737 PMCID: PMC6024607 DOI: 10.3390/nu10060737] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 05/31/2018] [Accepted: 06/04/2018] [Indexed: 01/08/2023] Open
Abstract
Nutrient profiling systems (NPS) are used around the world. In some countries, the food industry participates in the design of these systems. We aimed to compare the ability of various NPS to identify processed and ultra-processed Mexican products containing excessive amounts of critical nutrients. A sample of 2544 foods and beverages available in the Mexican market were classified as compliant and non-compliant according to seven NPS: the Pan American Health Organization (PAHO) model, which served as our reference, the Nutrient Profiling Scoring Criterion (NPSC), the Mexican Committee of Nutrition Experts (MCNE), the Health Star Rating (HSR), the Mexican Nutritional Seal (MNS), the Chilean Warning Octagons (CWO) 2016, 2018 and 2019 criteria, and Ecuador's Multiple Traffic Light (MTL). Overall, the proportion of foods classified as compliant by the HSR, MTL and MCNE models was similar to the PAHO model. In contrast, the NPSC, the MNS and the CWO-2016 classified a higher amount of foods as compliant. Larger differences between NPS classification were observed across food categories. Results support the notion that models developed with the involvement of food manufacturers are more permissive than those based on scientific evidence. Results highlight the importance of thoroughly evaluating the underlying criteria of a model.
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Affiliation(s)
- Alejandra Contreras-Manzano
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
| | - Alejandra Jáuregui
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
| | - Anabel Velasco-Bernal
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
| | - Jorge Vargas-Meza
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
| | - Juan A Rivera
- National Institute of Public Health, Cuernavaca 62100, Mexico.
| | - Lizbeth Tolentino-Mayo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
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Galvan-Portillo M, Sánchez E, Cárdenas-Cárdenas LM, Karam R, Claudio L, Cruz M, Burguete-García AI. Dietary patterns in Mexican children and adolescents: Characterization and relation with socioeconomic and home environment factors. Appetite 2018; 121:275-284. [DOI: 10.1016/j.appet.2017.11.088] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/07/2017] [Accepted: 11/09/2017] [Indexed: 01/22/2023]
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Allemandi L, Castronuovo L, Tiscornia MV, Ponce M, Schoj V. Food advertising on Argentinean television: are ultra-processed foods in the lead? Public Health Nutr 2018; 21:238-246. [PMID: 28745262 PMCID: PMC10260822 DOI: 10.1017/s1368980017001446] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 03/26/2017] [Accepted: 05/26/2017] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To describe the number of processed and ultra-processed food (PUPF) advertisements (ads) targeted to children on Argentinean television (TV), to analyse the advertising techniques used and the nutritional quality of the foods advertised, and to determine the potential exposure of children to unhealthy food advertising in our country. DESIGN Five free-to-air channels and the three most popular children's cable networks were recorded from 07.00 to 22.00 hours for 6 weeks. Ads were classified by target audience, type of product, advertised food categories and advertising strategies used. The NOVA system was used to classify food products according to industrial food processing level. Nutritional quality was analysed using the Pan American Health Organization's nutrient profile model. SETTING Buenos Aires, Argentina. Results are considered applicable to most of the country. SUBJECTS The study did not involve human subjects. RESULTS Of the sample of food ads, PUPF products were more frequently advertised during children's programmes (98·9 %) v. programmes targeted to the general audience (93·7 %, χ 2=45·92, P<0·01). The top five food categories were desserts, dairy products, non-alcoholic sugary beverages, fast-food restaurants, and salty snacks. Special promotions and the appearance of cartoon characters were much more frequent in ads targeting children. Argentinean children are estimated to be exposed to sixty-one ads for unhealthy PUPF products per week. CONCLUSIONS Our study showed that Argentinean children are exposed to a high number of unhealthy PUPF ads on TV. The Argentinean Government should build on this information to design and implement a comprehensive policy to reduce exposure to unhealthy food marketing that includes TV and other communication channels and places.
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Affiliation(s)
- Lorena Allemandi
- Department of Food Policy, Fundación InterAmericana del Corazón Argentina (FIC-Argentina), Arévalo 2364 – 1 ‘A’, Buenos Aires C1425DBR, Argentina
| | - Luciana Castronuovo
- Department of Food Policy, Fundación InterAmericana del Corazón Argentina (FIC-Argentina), Arévalo 2364 – 1 ‘A’, Buenos Aires C1425DBR, Argentina
| | - M Victoria Tiscornia
- Department of Food Policy, Fundación InterAmericana del Corazón Argentina (FIC-Argentina), Arévalo 2364 – 1 ‘A’, Buenos Aires C1425DBR, Argentina
| | - Miguel Ponce
- Fundación InterAmericana del Corazón Argentina (FIC-Argentina), Buenos Aires, Argentina
| | - Veronica Schoj
- Fundación InterAmericana del Corazón Argentina (FIC-Argentina), Buenos Aires, Argentina
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Labonté MÈ, Poon T, Mulligan C, Bernstein JT, Franco-Arellano B, L'Abbé MR. Comparison of global nutrient profiling systems for restricting the commercial marketing of foods and beverages of low nutritional quality to children in Canada. Am J Clin Nutr 2017; 106:1471-1481. [PMID: 29070562 DOI: 10.3945/ajcn.117.161356] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 10/02/2017] [Indexed: 11/14/2022] Open
Abstract
Background: The Canadian government recently committed to introduce legislation to restrict the commercial marketing of unhealthy foods and beverages to children.Objective: We compared the degree of strictness and agreement between nutrient profile (NP) models relevant to marketing restrictions by applying them in the Canadian context.Design: With the use of data from the University of Toronto 2013 Food Label Information Program (n = 15,342 prepackaged foods), 4 NP models were evaluated: the Food Standards Australia New Zealand-Nutrient Profiling Scoring Criterion (FSANZ-NPSC), the WHO Regional Office for Europe (EURO) model, the Pan American Health Organization (PAHO) model, and a modified version of the PAHO model (Modified-PAHO), which did not consider the extent of food processing because the application of this characteristic was prone to ambiguity. The number and proportion of foods that would be eligible for marketing to children was calculated with the use of each model, overall and by food category.Results: The Modified-PAHO and PAHO models would permit only 9.8% (95% CI: 9.4%, 10.3%) and 15.8% (95% CI: 15.3%, 16.4%) of foods, respectively, followed by the EURO model [29.8% (95% CI: 29.0%, 30.5%)]. In contrast, the FSANZ-NPSC would consider almost half of prepackaged foods as eligible for marketing to children [49.0% (95% CI: 48.2%, 49.8%)]. Cross-classification analyses showed that only 8.1% of foods would be eligible based on all models (e.g., most pastas without sauce). Subanalyses showed that each model would be more stringent when evaluating food items that specifically target children on their package (n = 747; from 1.9% of foods eligible under Modified-PAHO to 24.2% under FSANZ-NPSC).Conclusions: The degree of strictness and agreement vary greatly between NP models applicable to marketing restrictions. The discrepancies between models highlight the importance for policy makers to carefully evaluate the characteristics underlying such models when trying to identify a suitable model to underpin regulations restricting the marketing of unhealthy foods to children.
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Affiliation(s)
- Marie-Ève Labonté
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Theresa Poon
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christine Mulligan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jodi T Bernstein
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Nieto-Orozco C, Chanin Sangochian A, Tamborrel Signoret N, Vidal González E, Tolentino-Mayo L, Vergara-Castañeda A. Percepción sobre el consumo de alimentos procesados y productos ultraprocesados en estudiantes de posgrado de la Ciudad de México. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jbhsi.2018.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Nieto C, Rincon-Gallardo Patiño S, Tolentino-Mayo L, Carriedo A, Barquera S. Characterization of Breakfast Cereals Available in the Mexican Market: Sodium and Sugar Content. Nutrients 2017; 9:nu9080884. [PMID: 28813010 PMCID: PMC5579677 DOI: 10.3390/nu9080884] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/27/2017] [Accepted: 08/03/2017] [Indexed: 12/31/2022] Open
Abstract
Preschool Mexican children consume 7% of their total energy intake from processed breakfast cereals. This study characterized the nutritional quality and labelling (claims and Guideline Daily Amount (GDA)) of the packaged breakfast cereals available in the Mexican market. Photographs of all breakfast cereals available in the 9 main food retail chains in the country were taken. The nutrition quality of cereals was assessed using the United Kingdom Nutrient Profiling Model (UKNPM). Claims were classified using the International Network for Food and Obesity/non-communicable Diseases Research, Monitoring and Action Support (INFORMAS) taxonomy and the GDA was defined according to the Mexican regulation, NOM-051. Overall, a total of 371 different breakfast cereals were analysed. The nutritional profile showed that 68.7% were classified as “less healthy”. GDAs and claims were displayed more frequently on the “less healthy” cereals. Breakfast cereals within the “less healthy” category had significantly higher content of energy, sugar and sodium (p < 0.001). Most of the claims were displayed in the “less healthy” cereals (n = 313). This study has shown that there is a lack of consistency between the labelling on the front of the pack and the nutritional quality of breakfast cereals.
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Affiliation(s)
- Claudia Nieto
- Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca C.P 62100, Morelos, Mexico.
| | | | - Lizbeth Tolentino-Mayo
- Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca C.P 62100, Morelos, Mexico.
| | - Angela Carriedo
- London School of Hygiene & Tropical Medicine, Keppel St, Bloomsbury, London WC1E 7HT, UK.
| | - Simón Barquera
- Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca C.P 62100, Morelos, Mexico.
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Corvalán C, Garmendia ML, Jones-Smith J, Lutter CK, Miranda JJ, Pedraza LS, Popkin BM, Ramirez-Zea M, Salvo D, Stein AD. Nutrition status of children in Latin America. Obes Rev 2017; 18 Suppl 2:7-18. [PMID: 28741907 PMCID: PMC5601284 DOI: 10.1111/obr.12571] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 05/03/2017] [Indexed: 12/30/2022]
Abstract
The prevalence of overweight and obesity is rapidly increasing among Latin American children, posing challenges for current healthcare systems and increasing the risk for a wide range of diseases. To understand the factors contributing to childhood obesity in Latin America, this paper reviews the current nutrition status and physical activity situation, the disparities between and within countries and the potential challenges for ensuring adequate nutrition and physical activity. Across the region, children face a dual burden of undernutrition and excess weight. While efforts to address undernutrition have made marked improvements, childhood obesity is on the rise as a result of diets that favour energy-dense, nutrient-poor foods and the adoption of a sedentary lifestyle. Over the last decade, changes in socioeconomic conditions, urbanization, retail foods and public transportation have all contributed to childhood obesity in the region. Additional research and research capacity are needed to address this growing epidemic, particularly with respect to designing, implementing and evaluating the impact of evidence-based obesity prevention interventions.
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Affiliation(s)
- C Corvalán
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - M L Garmendia
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - J Jones-Smith
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | | | - J J Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - L S Pedraza
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - B M Popkin
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama, Guatemala
| | - D Salvo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico.,Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Austin, TX, USA
| | - A D Stein
- Hubert Department of Global Health of the Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Regulation of food marketing to children: are statutory or industry self-governed systems effective? Public Health Nutr 2017; 20:761-764. [DOI: 10.1017/s1368980017000465] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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