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Noonan RJ. Extrinsic goals benefit capitalism but not well-being. Rethinking the economy's goal for a healthier future. Health Promot Int 2024; 39:daae090. [PMID: 39322425 PMCID: PMC11424164 DOI: 10.1093/heapro/daae090] [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] [Indexed: 09/27/2024] Open
Abstract
The dramatic rise in non-communicable diseases around the world but notably in high-income countries like the UK is a manifestation of a global economic system-capitalism-that prioritizes wealth over health. A decade ago, the former WHO Director-General, Margaret Chan highlighted how 'efforts to prevent non-communicable diseases go against the business interests of powerful economic operators' [United Nations. (2013) Take Action for the Sustainable Development Goals. https://www.un.org/sustainabledevelopment/sustainable-development-goals/ (last accessed 16 February 2024)]. While there is a growing literature on how politics and economics influence population health-for better or worse-less attention has been given to exploring how economic systems like capitalism influence people's psychological well-being. To fill this gap, the following article examines how the continued pursuit of economic growth under capitalism (neoliberal free-market forms especially) impacts well-being through challenging basic psychological needs for security, autonomy, competence and relatedness. In doing so, I hope to shed important light on the sources and possible solutions to our growing health and social problems, and stimulate a conversation on how to achieve a healthier future for us all.
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Affiliation(s)
- Robert J Noonan
- Faculty of Health and Wellbeing, University of Bolton, Deane Road, Bolton BL3 5AB, UK
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Taillie LS, Bercholz M, Popkin B, Rebolledo N, Reyes M, Corvalán C. Decreases in purchases of energy, sodium, sugar, and saturated fat 3 years after implementation of the Chilean food labeling and marketing law: An interrupted time series analysis. PLoS Med 2024; 21:e1004463. [PMID: 39331649 PMCID: PMC11432892 DOI: 10.1371/journal.pmed.1004463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 08/19/2024] [Indexed: 09/29/2024] Open
Abstract
BACKGROUND In 2016, Chile implemented a multiphase set of policies that mandated warning labels, restricted food marketing to children, and banned school sales of foods and beverages high in nutrients of concern ("high-in" foods). Chile's law, particularly the warning label component, set the precedent for a rapid global proliferation of similar policies. While our initial evaluation showed policy-linked decreases in purchases of high-in, a longer-term evaluation is needed, particularly as later phases of Chile's law included stricter nutrient thresholds and introduced a daytime ban on advertising of high-in foods for all audiences. The objective is to evaluate changes in purchases of energy, sugar, sodium, and saturated fat purchased after Phase 2 implementation of the Chilean policies. METHODS AND FINDINGS This interrupted time series study used longitudinal data on monthly food and beverage purchases from 2,844 Chilean households (138,391 household-months) from July 1, 2013 until June 25, 2019. Nutrition facts panel data from food and beverage packages were linked at the product level and reviewed by nutritionists. Products were considered "high-in" if they contained added sugar, sodium, or saturated fat and exceeded nutrient or calorie thresholds. Using correlated random-effects models and an interrupted time series design, we estimated the nutrient content of food and beverage purchases associated with Phase 1 and Phase 2 compared to a counterfactual scenario based on trends during a 36-month pre-policy timeframe. Compared to the counterfactual, we observed significant decreases in high-in purchases of foods and beverages during Phase 2, including a relative 36.8% reduction in sugar (-30.4 calories/capita/day, 95% CI -34.5, -26.3), a 23.0% relative reduction in energy (-51.6 calories/capita/day, 95% CI -60.7, -42.6), a 21.9% relative reduction in sodium (-85.8 mg/capita/day, 95% CI -105.0, -66.7), and a 15.7% relative reduction in saturated fat (-6.4 calories/capita/day, 95% CI -8.4, -4.3), while purchases of not-high-in foods and drinks increased. Reductions in sugar and energy purchases were driven by beverage purchases, whereas reductions in sodium and saturated fat were driven by foods. Compared to the counterfactual, changes in both high-in purchases and not high-in purchases observed in Phase 2 tended to be larger than changes observed in Phase 1. The pattern of changes in purchases was similar for households of lower versus higher socioeconomic status. A limitation of this study is that some results were sensitive to the use of shorter pre-policy time frames. CONCLUSIONS Compared to a counterfactual based on a 36-month pre-policy timeframe, Chilean policies on food labeling, marketing, and school food sales led to declines in nutrients of concern during Phase 2 of implementation, particularly from foods and drinks high in nutrients of concern. These declines were sustained or even increased over phases of policy implementation.
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Affiliation(s)
- Lindsey Smith Taillie
- University of North Carolina at Chapel Hill, Carolina Population Center and Gillings School of Global Public Health, Department of Nutrition, Chapel Hill, North Carolina, United States of America
| | - Maxime Bercholz
- University of North Carolina at Chapel Hill, Carolina Population Center and Gillings School of Global Public Health, Department of Nutrition, Chapel Hill, North Carolina, United States of America
| | - Barry Popkin
- University of North Carolina at Chapel Hill, Carolina Population Center and Gillings School of Global Public Health, Department of Nutrition, Chapel Hill, North Carolina, United States of America
| | - Natalia Rebolledo
- CIAPEC, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Marcela Reyes
- CIAPEC, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Camila Corvalán
- CIAPEC, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
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Harris JL, Taillie LS. More than a Nuisance: Implications of Food Marketing for Public Health Efforts to Curb Childhood Obesity. Annu Rev Public Health 2024; 45:213-233. [PMID: 38109516 DOI: 10.1146/annurev-publhealth-090419-102616] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Fifteen years ago, public health experts urged industry, governments, and advocates to take action to dramatically improve the unhealthy food-marketing environment surrounding children in order to address the global childhood obesity crisis. Since then, research has confirmed that food marketing to children has far-reaching negative effects on their diets and health, takes advantage of adolescent vulnerabilities, and contributes to health disparities. In addition, digital marketing has profoundly changed young people's engagement with brands. Moreover, reliance on industry self-regulation as a solution has proven ineffective. Government-led policies have been more successful, but they remain limited in scope and challenging to adopt and implement. New approaches are necessary to increase public and policy maker awareness that food marketing is more than a nuisance, that it threatens the long-term health of children and adolescents worldwide, and that meaningful governmental action is urgently required to curtail industry's negative impact on young people's well-being.
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Affiliation(s)
- Jennifer L Harris
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, Connecticut, USA;
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
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Bassi S, Bahl D, Gopal S, Sethi V, Backholer K, Gavaravarapu SM, Babu GR, Ghosh-Jerath S, Bhatia N, Aneja K, Kataria I, Mishra P, De Wagt A, Arora M. Are advertising policies affirmative in restricting the marketing of foods high in fat, salt and sugar (HFSS) in India?: evidence from SWOT Analysis. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 21:100315. [PMID: 38361596 PMCID: PMC10866952 DOI: 10.1016/j.lansea.2023.100315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/29/2023] [Accepted: 10/19/2023] [Indexed: 02/17/2024]
Abstract
The regulatory Indian environment for advertising high fat, salt, and sugar (HFSS) foods and non-alcoholic beverages, on various media was reviewed. Identified national-level policies were categorised as mandatory or self-regulatory based on legal content. For each mandatory regulation, Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was undertaken to determine how existing policies could be strengthened to safeguard children from unhealthy food advertisements. Thirteen policies (nine mandatory; four self-regulatory) relevant to advertising in India were identified. Of the nine mandatory policies, Guidelines for Prevention of Misleading Advertisements and Endorsements for Misleading Advertisements, 2022, is the only policy that restricts HFSS food advertisements to children across all media. There are key shortfalls, including limited scope of 'child-targeted' advertisements and lack of criteria to define HFSS foods. A robust regulatory framework is needed to protect children from HFSS food marketing, not just what is 'directed' at them, with clear evidence-based food classification criteria.
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Affiliation(s)
| | | | | | - Vani Sethi
- UNICEF, Regional Office for South Asia, Kathmandu, Nepal
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia
| | | | - Giridhara R. Babu
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | | | | | - Ishu Kataria
- Center for Global Noncommunicable Diseases, RTI International, New Delhi, India
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Mediano Stoltze F, Correa T, Corvalán Aguilar CL, Taillie LS, Reyes M, Dillman Carpentier FR. Beverage industry TV advertising shifts after a stepwise mandatory food marketing restriction: achievements and challenges with regulating the food marketing environment. Public Health Nutr 2023; 27:e26. [PMID: 38148176 PMCID: PMC10830373 DOI: 10.1017/s1368980023002872] [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: 01/23/2023] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE Sugar-sweetened beverages (SSB) are heavily advertised globally, and SSB consumption is linked to increased health risk. To reduce unhealthy food marketing, Chile implemented a regulation for products classified as high in energies, sugar, saturated fat or sodium, starting with a 2016 ban on child-targeted advertising of these products and adding a 06.00-22.00 daytime advertising ban in 2019. This study assesses changes in television advertising prevalence of ready-to-drink beverages, including and beyond SSB, to analyse how the beverage industry shifted its marketing strategies across Chile's implementation phases. DESIGN Beverage advertisements were recorded during two randomly constructed weeks in April-May of 2016 (pre-implementation) through 2019 (daytime ban). Ad products were classified as 'high-in' or 'non-high-in' according to regulation nutrient thresholds. Ads were analysed for their programme placement and marketing content. SETTING Chile. RESULTS From pre-regulation to daytime ban, child-targeted, daytime and total ads decreased by 51·8 percentage points (p.p.), 51·5 p.p. and 61·8 p.p. for high-in products and increased by 62·9 p.p., 54·9 p.p. and 61·8 p.p. for non-high-in products (Ps < 0·001). Additionally, total ready-to-drink beverage ads increased by 5·4 p.p. and brand-only ads (no product shown) by 7 p.p. CONCLUSIONS After the regulation implementation, 'high-in' ads fell significantly, but 'non-high-in' ads rose and continued using strategies targeting children and being aired during daytime. Given research showing that advertising one product can increase preferences for a different product from that same brand and product categories, broader food marketing regulation approaches may be needed to protect children from the harmful effects of food marketing.
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Affiliation(s)
- Fernanda Mediano Stoltze
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
- School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Teresa Correa
- School of Communication, Diego Portales University, Santiago, Chile
| | | | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Marcela Reyes
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
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Dillman Carpentier FR, Stoltze FM, Popkin BM. Comprehensive mandatory policies are needed to fully protect all children from unhealthy food marketing. PLoS Med 2023; 20:e1004291. [PMID: 37747882 PMCID: PMC10575484 DOI: 10.1371/journal.pmed.1004291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 10/13/2023] [Indexed: 09/27/2023] Open
Abstract
The World Health Organization (WHO) have released a new guideline, "Policies to protect children from the harmful impact of food marketing" [1] which recommends the development of comprehensive laws to reduce children's exposure to unhealthy food marketing. This new guideline extends previous recommendations [2] to limit the adverse effects of unhealthy food marketing on the health of the world's children. We consider here whether these new recommendations go far enough.
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Affiliation(s)
| | | | - Barry M. Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
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Figueira M, Araújo J, Gregório MJ. Monitoring Food Marketing Directed to Portuguese Children Broadcasted on Television. Nutrients 2023; 15:3800. [PMID: 37686832 PMCID: PMC10490328 DOI: 10.3390/nu15173800] [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: 07/12/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Children are massively exposed to food marketing through television and other forms of media. Marketing strategies promote unhealthy eating behaviours and contribute to childhood obesity. The main aim of this study was to assess the potential exposure and power of food advertisements aimed at children, broadcasted on Portuguese television. Television data was recorded for two weekdays and two weekend days between 6 am and 10 pm during November 2021 from four free-access Portuguese television channels. Data was analysed according to the World Health Organization television protocol and Portuguese Legislation. We identified 5272 advertisements, of which 11.2% were for food and beverages (n = 590). Most advertised food categories for children and adolescents were chocolate and bakery products (42.0%), soft drinks (26.7%), and yoghurt (16.0%), and none met the nutritional profile outlined by the national legislation. Unhealthier food advertisements targeting youth were shown in children's non-peak time and morning during news and entertainment programmes. Product uniqueness, humour, and fun were the most frequent primary persuasive techniques. Most advertisements showed a high use of brand logos, product images, and premium offers. In conclusion, Portuguese children and adolescents are potentially exposed to large numbers of unhealthy food advertisements on television, despite marketing regulation and restriction policies.
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Affiliation(s)
- Marta Figueira
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (M.F.); (J.A.)
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
| | - Joana Araújo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (M.F.); (J.A.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica—Unidade de Epidemiologia, Faculdade de Medicina da Universidade do Porto, 4200-450 Porto, Portugal
| | - Maria João Gregório
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- Direção-Geral da Saúde, 1049-005 Lisboa, Portugal
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