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Liem DG, Woo YC. Encouraging online consumers into making better food choices: The power of nature exposure on healthy food choices. Appetite 2024; 199:107382. [PMID: 38723667 DOI: 10.1016/j.appet.2024.107382] [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: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND online environments can influence food desire and choices. We tested if online calming nature and stressful street environments can affect desire for healthy and unhealthy foods. METHOD we asked 238 participants (40 ± 14 yrs) to rate their desire (100 mm VAS) for 7 low calorie nutrient rich foods (Healthy) and 7 high calorie nutrient poor foods (Unhealthy), and perceived stress (state anxiety in STAI), before and after imagining themselves in a control, nature park, or busy street condition. RESULTS participants who imagined themselves being in a nature park had a significant higher desire for Healthy foods, than participants in the busy street condition (p < 0.05). Participants in the busy street condition decreased their desire for Healthy foods after they imagined themselves in a busy street (p < 0.05)). However, perceived stress did not impact the association between condition and desire for low calorie foods nor high calorie foods. CONCLUSION this study suggests that online environments can have an impact on healthy food desires, which could be of importance for the increased number of food choices which are made in online environments.
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Affiliation(s)
- Djin Gie Liem
- Deakin University, CASS Food Research Centre, Australia.
| | - Yu Chu Woo
- Deakin University, CASS Food Research Centre, Australia.
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2
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Foláyan MO, de Barros Coelho EMR, Feldens CA, Gaffar B, Virtanen JI, Kemoli A, Duangthip D, Sun IG, Masumo RM, Vukovic A, Al-Batayneh OB, Mfolo T, Schroth RJ, El Tantawi M. A scoping review on the associations between early childhood caries and sustainable cities and communities using the sustainable development goal 11 framework. BMC Oral Health 2024; 24:751. [PMID: 38943110 PMCID: PMC11214204 DOI: 10.1186/s12903-024-04521-1] [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: 09/14/2023] [Accepted: 06/23/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Early childhood caries (ECC) is a multifactorial disease in which environmental factors could play a role. The purpose of this scoping review was to map the published literature that assessed the association between the Sustainable Development Goal (SDG) 11, which tried to make cities and human settlements safe, inclusive, resilient and sustainable, and ECC. METHODS This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In July 2023, a search was conducted in PubMed, Web of Science, and Scopus using tailored search terms related to housing, urbanization, waste management practices, and ECC. Studies that solely examined ECC prevalence without reference to SDG11 goals were excluded. Of those that met the inclusion criteria, a summary highlighting the countries and regions where the studies were conducted, the study designs employed, and the findings were done. In addition, the studies were also linked to relevant SDG11 targets. RESULTS Ten studies met the inclusion criteria with none from the African Region. Six studies assessed the association between housing and ECC, with findings suggesting that children whose parents owned a house had lower ECC prevalence and severity. Other house related parameters explored were size, number of rooms, cost and building materials used. The only study on the relationship between the prevalence of ECC and waste management modalities at the household showed no statistically significant association. Five studies identified a relationship between urbanization and ECC (urbanization, size, and remoteness of the residential) with results suggesting that there was no significant link between ECC and urbanization in high-income countries contrary to observations in low and middle-income countries. No study assessed the relationship between living in slums, natural disasters and ECC. We identified links between ECC and SDG11.1 and SDG 11.3. The analysis of the findings suggests a plausible link between ECC and SDG11C (Supporting least developed countries to build resilient buildings). CONCLUSION There are few studies identifying links between ECC and SDG11, with the findings suggesting the possible differences in the impact of urbanization on ECC by country income-level and home ownership as a protective factor from ECC. Further research is needed to explore measures of sustainable cities and their links with ECC within the context of the SDG11.
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Affiliation(s)
- Morẹ́nikẹ́ Oluwátóyìn Foláyan
- Early Childhood Caries Advocacy Group, Winnipeg, Canada.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Elisa Maria Rosa de Barros Coelho
- Department of Pediatric Dentistry, Lutheran University of Brazil, Canoas, Brazil
- Department of Pediatric Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Alberto Feldens
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Pediatric Dentistry, Lutheran University of Brazil, Canoas, Brazil
| | - Balgis Gaffar
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Jorma I Virtanen
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Arthur Kemoli
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Paediatric Dentistry and Orthodontics, University of Nairobi, Nairobi, Kenya
| | - Duangporn Duangthip
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Ray M Masumo
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Ana Vukovic
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ola B Al-Batayneh
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Tshepiso Mfolo
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Community Health, University of Pretoria, Pretoria, South Africa
| | - Robert J Schroth
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Maha El Tantawi
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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3
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Boyland E, Spanakis P, O'Reilly C, Christiansen P. Associations between everyday exposure to food marketing and hunger and food craving in adults: An ecological momentary assessment study. Appetite 2024; 196:107241. [PMID: 38307297 DOI: 10.1016/j.appet.2024.107241] [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: 07/11/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/04/2024]
Abstract
Food marketing in television and digital media negatively affects appetitive sensations and eating behaviour in children, but effects are less well understood for outdoor food advertising and adults. This research used Ecological Momentary Assessment (EMA) to explore associations between exposures to food advertising in various contexts (television, digital, outdoors) and adults' hunger and craving for highly advertised food categories. Over one week, participants provided ratings of cravings for types of food (fast food, soft drinks, snacks/confectionery, other) and hunger on a smartphone app up to six times per day when they saw a food advertisement (reactive assessment) and at random intervals (random assessment). Fifty-four participants (70.4 % female; 21.24 ± 3.84 years) provided 1223 assessments (24.7 % reactive, 75.3 % random). Data were analysed in R using multilevel multivariable linear regression models. Participants reported feeling hungrier (X2(1) = 5.85, p = .016, ΔAIC = 3.9) and having stronger cravings (X2(1) = 20.64, p < .001, ΔAIC = 318.6) after seeing food advertisements vs. random assessments. This was driven by greater hunger following television advertising exposure vs. random assessments (β = 1.58, SE = 0.61, p = .010, 95 %CIs 0.38 to 2.78), food advertising via digital devices or outdoors was not associated with hunger. Participants experienced stronger craving after seeing a food advertisement on television (β = 0.52, SE = 0.19, p = .006, 95 %CIs 0.15 to 0.89), outdoors (β = 0.39, SE = 0.12, p < .001, 95 % CIs 0.16 to 0.62) and in digital media (β = 0.36, SE = 0.14, p = .012, 95 % CIs 0.08 to 0.64), vs. random assessments. Cravings were (largely) specific to the advertised food category. EMA can be effective for assessing food marketing associations in adults. The current study provides evidence that food marketing is associated with hunger and craving in adults, which may, with replication, have implications for public health policy.
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Affiliation(s)
- Emma Boyland
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Panagiotis Spanakis
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Connor O'Reilly
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Paul Christiansen
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
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4
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Rodrigues MB, de Paula Matos J, Oliveira Santana M, Martins APB, Claro RM, Horta PM. Exposure and power of TV food advertising during the COVID-19 pandemic in Brazil: a content analysis. BMC Public Health 2024; 24:618. [PMID: 38408942 PMCID: PMC10898037 DOI: 10.1186/s12889-024-17870-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 01/24/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND With the COVID-19 pandemic and the restrictions imposed to contain the spread of SARS-CoV-2, the Brazilian population has increased the time spent at home and watching television (TV). Since food advertising exposure is a key driver of food choices, this study described the content of food advertisements (ads) on Brazilian TV during the COVID-19 pandemic. METHODS This is an exploratory study. A total of 684 h of TV programming comprised of three free-to-air channels and two pay-per-view channels was recorded from 06 a.m. to 12 a.m. for eight non-consecutive days in June 2020. A content analysis of all the food-related ads was carried out. The data collection process followed INFORMAS Protocol for TV food advertising monitoring. RESULTS The sample was composed of 7,083 ads, 752 (10.6%) of which were food-related and 487 (6.9%) were promoting ultra-processed foods. The content analysis indicated seven thematic categories, all of them with reference to the COVID-19 pandemic: brand and product differentials (79.8%); visual and sound effects (70.2%); thematic campaigns (56.0%); digitization (22.9%); convenience (16.5%); economic benefits (11.9%); and commensality and social interaction (6.1%). Ads content varied according to the day of the week, the time of the day, the length of the ad, and the channel type. CONCLUSIONS The thematic of food advertising on Brazilian TV during the COVID-19 pandemic is aligned with the country's health crisis context and varied during the programming.
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Affiliation(s)
- Michele Bittencourt Rodrigues
- Department of Nutrition, Federal University of Minas Gerais (UFMG), Av. Alfredo Balena 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Juliana de Paula Matos
- Department of Nutrition, Federal University of Minas Gerais (UFMG), Av. Alfredo Balena 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Marina Oliveira Santana
- Department of Nutrition, Federal University of Minas Gerais (UFMG), Av. Alfredo Balena 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Paula Bortoletto Martins
- Department of Nutrition, School of Public Health, University of São Paulo (USP), Av. Dr. Arnaldo, 715 - Cerqueira César, 01246-904, São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), Av. Dr. Arnaldo, 715 - Cerqueira César, 01246-904, São Paulo, São Paulo, Brazil
| | - Rafael Moreira Claro
- Department of Nutrition, Federal University of Minas Gerais (UFMG), Av. Alfredo Balena 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo (USP), Av. Dr. Arnaldo, 715 - Cerqueira César, 01246-904, São Paulo, São Paulo, Brazil
| | - Paula Martins Horta
- Department of Nutrition, Federal University of Minas Gerais (UFMG), Av. Alfredo Balena 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil.
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McKevitt S, White M, Petticrew M, Summerbell C, Vasiljevic M, Boyland E, Cummins S, Laverty AA, Millett C, de Vocht F, Junghans C, Vamos EP. Characterizing restrictions on commercial advertising and sponsorship of harmful commodities in local government policies: a nationwide study in England. J Public Health (Oxf) 2023; 45:878-887. [PMID: 37608490 PMCID: PMC10687598 DOI: 10.1093/pubmed/fdad155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/05/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Commercial advertising and sponsorship drive the consumption of harmful commodities. Local authorities (LAs) have considerable powers to reduce such exposures. This study aimed to characterize local commercial policies across all English LAs. METHODS We conducted a census of all English LAs (n = 333) to identify local commercial policies concerning advertising and sponsorship of tobacco, alcohol, less healthy foods and gambling, through online searches and Freedom of Information requests. We explored policy presence, commodity frequency and type, and associations with LA characteristics (region, urban/rural and deprivation). RESULTS Only a third (106) of LAs in England had a relevant policy (32%). These included restrictions on tobacco (91%), gambling (79%), alcohol (74%) and/or less healthy foods (24%). Policy prevalence was lowest in the East of England (22%), North East (25%) and North West (27%), higher in urban areas (36%) than rural areas (28%) and lower in the least (27%) compared with the most (38%) deprived areas. Definitions in policies varied, particularly for alcohol and less healthy foods. CONCLUSIONS English LAs currently underutilize their levers to reduce the negative impacts of harmful commodity industry marketing, particularly concerning less healthy foods. Standardized guidance, including clarity on definitions and application, could inform local policy development.
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Affiliation(s)
- Sarah McKevitt
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Martin White
- MRC Epidemiology Unit, School of Clinical Sciences, University of Cambridge, Cambridge, UK
| | - Mark Petticrew
- Department of Public Health, Environments & Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Carolyn Summerbell
- Centre for Translational Research in Public Health, Fuse, Newcastle, UK
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Milica Vasiljevic
- Centre for Translational Research in Public Health, Fuse, Newcastle, UK
- Department of Psychology, Durham University, Durham, UK
| | - Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration Northwest London (NIHR ARC), London, UK
| | - Cornelia Junghans
- NIHR Applied Research Collaboration Northwest London (NIHR ARC), London, UK
| | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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6
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Antrum CJ, Waring ME, Cohen JF, Stowers KC. Within-store fast food marketing: The association between food swamps and unhealthy advertisement. Prev Med Rep 2023; 35:102349. [PMID: 37593352 PMCID: PMC10428106 DOI: 10.1016/j.pmedr.2023.102349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023] Open
Abstract
Previous studies have linked food consumption outside the home and fast food to poor diet quality and living within a food swamp to an increased likelihood of obesity. A growing amount of research has linked food marketing to food choice. Still, limited information is available on how this dynamic may work within fast food establishments and if the marketing strategies used may vary by neighborhood food swamp status. Utilizing the Environment Assessment (EAT) Tool, we examined the within-store marketing environment of fast food restaurants to understand the factors potentially influencing food choice. A cross-sectional study design surveyed fast food outlets (n = 170) for unhealthy advertisements. Each fast-food outlet was assigned an FSI score based on its geographic location and proximity to unhealthy outlets. Outlets were assessed for associations between food swamp status and unhealthy advertisements. Poisson Regression was performed to assess the relationship between unhealthy advertisements and FSI score. Low FSI had a mean unhealthy advertisement score of 36.79 (11.06). Moderate and High FSI had mean unhealthy advertisement scores of 33.03 (14.67) and 31.71 (12.63), respectively. The number of unhealthy advertisements did not differ by food swamp categories (Moderate FSI IRR: 0.90, 95% CI: 0.74-1.09; High FSI IRR: 0.86, 95% CI: 0.73-1.01 vs. low FSI). Differences in marketing environments by food swamp status were not observed. Future research should examine other factors of the food swamp environment and additional factors such as television or social media to understand its association with food choice.
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Affiliation(s)
- Curtis Jalen Antrum
- Department of Allied Health Sciences, University of Connecticut, 258 Mansfield Rd., Storrs, CT 06269, USA
| | - Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, 258 Mansfield Rd., Storrs, CT 06269, USA
| | - Juliana F.W. Cohen
- School of Nursing and Health Sciences, Merrimack College, 315 Turnpike St, North Andover, MA 01845, USA
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Kristen Cooksey Stowers
- Department of Allied Health Sciences, University of Connecticut, 258 Mansfield Rd., Storrs, CT 06269, USA
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7
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Allman-Farinelli M. Nutritional Strategies to Prevent Weight Gain and Obesity. Nutrients 2023; 15:4180. [PMID: 37836463 PMCID: PMC10574331 DOI: 10.3390/nu15194180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
It has now been 25 years since the World Health Organisation (Geneva, Switzerland) drew attention to the obesity epidemic (later becoming a pandemic) [...].
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Affiliation(s)
- Margaret Allman-Farinelli
- Sydney Nursing School, Faculty of Medicine and Health and Charles Perkins Centre D17, University of Sydney, Camperdown, NSW 2006, Australia
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8
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Ruggles PR, Thomas JE, Poulos NS, Pasch KE. School-Level Socioeconomic Status and Nutrient Content of Outdoor Food/Beverage Advertisements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6730. [PMID: 37754591 PMCID: PMC10530988 DOI: 10.3390/ijerph20186730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/01/2023] [Accepted: 09/03/2023] [Indexed: 09/28/2023]
Abstract
We examined if areas around schools with more students of lower socioeconomic status (SES) have more total food/beverage advertisements and/or more advertisements with poorer nutritional content as compared to areas around schools with fewer students with lower SES. All outdoor food/beverage advertisements within a half-mile radius of 47 middle and high schools in the United States were objectively documented in 2012 and coded for nutritional content. The total number of advertisements and the macronutrient and micronutrient contents (total calories, fat (g), protein (g), carbohydrate (g), sugar (g), and sodium (mg)) of food and beverage items depicted in the advertisements were calculated. In total, 9132 unique advertisements were recorded, with 3153 ads displaying food and beverages that could be coded for nutrient content. Schools located in areas of lower SES (≥60% students receiving free/reduced-price lunch) had significantly more advertisements displaying food and beverages that could be coded for nutrient content (z = 2.01, p = 0.04), as well as advertisements that contained more sodium (z = 2.20, p = 0.03), as compared to schools located in areas of higher SES. There were no differences in calorie, fat, protein, carbohydrate, or sugar content. Policies to reduce the prevalence of outdoor food and beverage advertising are warranted.
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Affiliation(s)
- Phoebe R. Ruggles
- Department of Kinesiology & Health Education, University of Texas at Austin, Austin, TX 78712, USA
| | - Jacob E. Thomas
- Department of Kinesiology & Health Education, University of Texas at Austin, Austin, TX 78712, USA
| | - Natalie S. Poulos
- School of Community and Rural Health, Heath Science Center, The University of Texas at Tyler, Tyler, TX 78708, USA
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Keryn E. Pasch
- Department of Kinesiology & Health Education, University of Texas at Austin, Austin, TX 78712, USA
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Lake AA, Moore HJ, Cotton M, O'Malley CL. Opportunities to improve population health: possibilities for healthier food environments. Proc Nutr Soc 2023; 82:264-271. [PMID: 37057804 DOI: 10.1017/s0029665123002677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
The recent Covid-19 pandemic highlighted stark social inequalities, notably around access to food, nutrition and to green or blue space (i.e. outdoor spaces with vegetation and water). Consequently, obesity is socio-economically patterned by this inequality; and while the environmental drivers of obesity are widely acknowledged, there is currently little upstream intervention. We know that living with obesity contributes to increasing health inequalities, and places healthcare systems under huge strain. Our environment could broadly be described obesogenic, in the sense of supporting unhealthful eating patterns and sedentary behaviour. Evidence points to the existence of nearly 700 UK obesity policies, all of which have had little success. Obesity prevention and treatment has focused on educational and behavioural interventions targeted at individual consumers. A more sustainable approach would be to try and change the environments that promote less healthy eating and high energy intake as well as sedentary behaviour. Approaches which modify the environment have the potential to assist in the prevention of this complex condition. This review paper focuses on the role of wider food environments or foodscapes. While there is an imperfect evidence base relating to the role of the foodscape in terms of the obesity crisis, policy, practice, civic society and industry must work together and take action now, in areas where current evidence suggests change is required. Despite the current cost-of-living crisis, shaping the foodscape to better support healthful eating decisions has the potential to be a key aspect of a successful obesity prevention intervention.
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Affiliation(s)
- Amelia A Lake
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Helen J Moore
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Matthew Cotton
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Claire L O'Malley
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
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10
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Boyland E. Is it ethical to advertise unhealthy foods to children? Proc Nutr Soc 2023; 82:234-240. [PMID: 36606537 DOI: 10.1017/s0029665123000010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The marketing of foods and non-alcoholic beverages (hereafter: food) high in fats, salt and/or sugar (HFSS) has been strongly implicated in the rising levels of childhood obesity worldwide. Multiple ethical concerns arise from the practice of exposing children to such marketing and efforts to monitor and restrict it through regulatory policies. There is considerable evidence that exposure to powerful food marketing messages affects children's food behaviours in ways that are detrimental to good dietary health. Children are particularly vulnerable to being exploited and deceived by food marketing messages based on their cognitive and developmental immaturity. HFSS food marketing also affects numerous child rights enshrined within the UN Convention on the Rights of the Child (of which the UK is a signatory) including the right to the enjoyment of the highest attainable standard of health. The debate has become somewhat polarised between the public health community's evidence-based assertion that all marketing is inherently exploitative and the rebuttal from food and marketing industry stakeholders that provided the marketing is 'accurate and truthful' and there is no ethical need to regulate. This polarisation is reflected in the complexity of policymaking decisions regarding the rationale for mandatory government-led policies or industry self-regulation. There are also ethical considerations inherent in the monitoring of children's food marketing exposure, particularly in the digital sphere, by researchers for the purposes of informing policy design, scope and implementation. This review paper will explore the latest evidence on these issues and consider the implications for public health research, policy, and practice.
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Affiliation(s)
- E Boyland
- Department of Psychology, Institute of Population Health, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK
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11
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Scott LJ, Toumpakari Z, Nobles J, Sillero-Rejon C, Jago R, Cummins S, Blake S, Horwood J, Vocht FD. Assessing exposure to outdoor advertisement for products high in fat, salt and sugar (HFSS); is self-reported exposure a useful exposure metric? BMC Public Health 2023; 23:668. [PMID: 37041569 PMCID: PMC10088263 DOI: 10.1186/s12889-023-15567-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/30/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Exposure to advertising of unhealthy commodities such as fast-food and gambling is recognised as a risk factor for developing non-communicable diseases. Assessment of the impact of such advertisement and the evaluation of the impact of any policies to restrict such advertisements on public health are reliant on the quality of the exposure assessment. A straightforward method for assessing exposure is to ask people whether they noticed any such advertisements in their neighbourhoods. However, the validity of this method is unclear. We assessed the associations between measured exposure to outdoor advertising, self-reported exposure, and self-reported consumption. METHODS We collected exposure information in January-March 2022 using two methods: (i) through a resident survey investigating advertising and consumption of unhealthy products, distributed across Bristol and neighbouring South Gloucestershire, and (ii) through in-person auditing. Self-reported exposure was obtained from the resident survey (N = 2,560) and measured exposure from photos obtained for all Council owned advertisement sites (N = 973 bus stops). Both data sources were geographically linked at lower-super-output-area level. Reporting ratios (RRs), 95% confidence intervals (CIs), and Cohen's kappas, are presented. RESULTS 24% of advertisements displayed food and/or drink advertising. Bristol respondents in neighbourhoods displaying food/drink adverts were more likely to also report seeing these adverts compared to those in neighbourhoods without food/drink adverts (59% vs. 51%, RR = 1.15, 95%CI 1.01-1.31). There was no such association in South Gloucestershire (26% vs. 32%, RR = 0.82, 95%CI 0.58-1.14). Respondents in both Bristol and South Gloucestershire who recalled seeing advertising for unhealthy food and drink products were more likely to consume them (e.g. for fast-food: 22% vs. 11%, RR = 2.01, 95%CI 1.68-2.42). There was no such association between measured food and drink adverts in respondents' local areas and self-reported consumption of HFSS product (90.1% vs. 90.7%, RR = 0.99, 95%CI 0.96-1.03). CONCLUSIONS Self-reported outdoor advertisement exposure is correlated with measured exposure, making this a useful methodology for population studies. It has the added advantage that it correlates with consumption. However, given that measurement error can be significant and self-reported exposure is known to be susceptible to various biases, inferences from studies using this exposure metric should be made with caution.
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Affiliation(s)
- Lauren J Scott
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Zoi Toumpakari
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - James Nobles
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Carlos Sillero-Rejon
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Russell Jago
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Steven Cummins
- Faculty of Public Health and Policy, London School of Hygiene and tropical medicine, London, UK
| | - Sarah Blake
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Jeremy Horwood
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Frank de Vocht
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
- Population health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- NIHR ARC West, 9th Floor, Whitefriars Lewins Mead Bristol, Bristol, BS1 2NT, UK.
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