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Potvin Kent M, Bagnato M, Remedios L, Soares Guimarães J, Gillis G, Soto C, Hatoum F, Pritchard M. Child and adolescent exposure to unhealthy food marketing across digital platforms in Canada. BMC Public Health 2024; 24:1740. [PMID: 38951838 PMCID: PMC11218052 DOI: 10.1186/s12889-024-19094-5] [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: 12/08/2023] [Accepted: 06/10/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Children and adolescents are exposed to a high volume of unhealthy food marketing across digital media. No previous Canadian data has estimated child exposure to food marketing across digital media platforms. This study aimed to compare the frequency, healthfulness and power of food marketing viewed by children and adolescents across all digital platforms in Canada. METHODS For this cross-sectional study, a quota sample of 100 youth aged 6-17 years old (50 children, 50 adolescents distributed equally by sex) were recruited online and in-person in Canada in 2022. Each participant completed the WHO screen capture protocol where they were recorded using their smartphone or tablet for 30-min in an online Zoom session. Research assistants identified all instances of food marketing in the captured video footage. A content analysis of each marketing instance was then completed to examine the use of marketing techniques. Nutritional data were collected on each product viewed and healthfulness was determined using Health Canada's 2018 Nutrient Profile Model. Estimated daily and yearly exposure to food marketing was calculated using self-reported device usage data. RESULTS 51% of youth were exposed to food marketing. On average, we estimated that children are exposed to 1.96 marketing instances/child/30-min (4067 marketing instances/child/year) and adolescents are exposed to 2.56 marketing instances/adolescent/30-min (8301 marketing instances/adolescent/year). Both children and adolescents were most exposed on social media platforms (83%), followed by mobile games (13%). Both age groups were most exposed to fast food (22% of marketing instances) compared to other food categories. Nearly 90% of all marketing instances were considered less healthy according to Health Canada's proposed 2018 Nutrient Profile Model, and youth-appealing marketing techniques such as graphic effects and music were used frequently. CONCLUSIONS Using the WHO screen capture protocol, we were able to determine that child and adolescent exposure to the marketing of unhealthy foods across digital media platforms is likely high. Government regulation to protect these vulnerable populations from the negative effects of this marketing is warranted.
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Affiliation(s)
- Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada.
| | - Mariangela Bagnato
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada
| | - Lauren Remedios
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada
| | | | - Grace Gillis
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada
| | - Carolina Soto
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada
| | - Farah Hatoum
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Meghan Pritchard
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada
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Vaillancourt C, Ahmed M, Kirk S, Labonté MÈ, Laar A, Mah CL, Minaker L, Olstad DL, Potvin Kent M, Provencher V, Prowse R, Raine KD, Schram A, Zavala-Mora D, Rancourt-Bouchard M, Vanderlee L. Food environment research in Canada: a rapid review of methodologies and measures deployed between 2010 and 2021. Int J Behav Nutr Phys Act 2024; 21:18. [PMID: 38373957 PMCID: PMC10875887 DOI: 10.1186/s12966-024-01558-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: 01/24/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024] Open
Abstract
Numerous research methodologies have been used to examine food environments. Existing reviews synthesizing food environment measures have examined a limited number of domains or settings and none have specifically targeted Canada. This rapid review aimed to 1) map research methodologies and measures that have been used to assess food environments; 2) examine what food environment dimensions and equity related-factors have been assessed; and 3) identify research gaps and priorities to guide future research. A systematic search of primary articles evaluating the Canadian food environment in a real-world setting was conducted. Publications in English or French published in peer-reviewed journals between January 1 2010 and June 17 2021 and indexed in Web of Science, CAB Abstracts and Ovid MEDLINE were considered. The search strategy adapted an internationally-adopted food environment monitoring framework covering 7 domains (Food Marketing; Labelling; Prices; Provision; Composition; Retail; and Trade and Investment). The final sample included 220 articles. Overall, Trade and Investment (1%, n = 2), Labelling (7%, n = 15) and, to a lesser extent, Prices (14%, n = 30) were the least studied domains in Canada. Among Provision articles, healthcare (2%, n = 1) settings were underrepresented compared to school (67%, n = 28) and recreation and sport (24%, n = 10) settings, as was the food service industry (14%, n = 6) compared to grocery stores (86%, n = 36) in the Composition domain. The study identified a vast selection of measures employed in Canada overall and within single domains. Equity-related factors were only examined in half of articles (n = 108), mostly related to Retail (n = 81). A number of gaps remain that prevent a holistic and systems-level analysis of food environments in Canada. As Canada continues to implement policies to improve the quality of food environments in order to improve dietary patterns, targeted research to address identified gaps and harmonize methods across studies will help evaluate policy impact over time.
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Affiliation(s)
- Caroline Vaillancourt
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Sara Kirk
- School of Health and Human Performance, Dalhousie University, 6230 South Street, Kjipuktuk (Halifax), NS, B3H 4R2, Canada
| | - Marie-Ève Labonté
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, 5850 College Street, Halifax, NS, B3H 4R2, Canada
| | - Leia Minaker
- School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3T1, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Véronique Provencher
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, 11405 87 Ave Northwest, Edmonton, AB, T6G 1C9, Canada
| | - Ashley Schram
- School of Regulation and Global Governance (RegNet), ANU College of Asia & the Pacific, The Australian National University, 8 Fellows Road, Canberra, Australian Capital Territory, 2600, Australia
| | - Daniela Zavala-Mora
- Science Library, Université Laval, 1045 Avenue de La Médecine, Québec, QC, G1V 0A6, Canada
| | - Maryka Rancourt-Bouchard
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada.
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Reeve E, Bell C, Sacks G, Mounsey S, Waqa G, Peeters A, Thow AM. Lessons for strengthening policymaking for obesity and diet-related noncommunicable disease prevention: A narrative synthesis of policy literature from the Western Pacific Region. Obes Rev 2024; 25:e13651. [PMID: 37905309 DOI: 10.1111/obr.13651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/28/2023] [Accepted: 09/09/2023] [Indexed: 11/02/2023]
Abstract
Obesity and diet-related noncommunicable diseases (NCDs) have a profound impact on individuals, households, health care systems, and economies in low- and middle- income countries (LMICs), with the Western Pacific Region experiencing some of the highest impacts. Governments have committed to improving population diets; however, implementation challenges limit effective policy action. We undertook meta-narrative synthesis of the academic literature and used theories of policymaking and implementation to synthesize current knowledge of issues affecting the adoption and implementation of policies to prevent obesity and diet-related NCDs in LMICs in the Western Pacific Region. We found that political leadership and management of food and nutrition policies often diluted following policy adoption, and that nutrition and health advocates find it difficult to enforce policy compliance from actors outside their sectors. Opportunities for strengthening implementation of food and nutrition policies in the Western Pacific include (1) improved and earlier engagement between health policymakers and implementing agencies; (2) focusing on the need for increased accountability from governments, including through effective engagement and organization of actor networks, knowledge sharing, and in highlighting where stronger action is required; and (3) identifying and building the strategic capacities of policy actors in framing, advocacy, coalition-building, knowledge translation, and leadership.
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Affiliation(s)
- Erica Reeve
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Colin Bell
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Sarah Mounsey
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Gade Waqa
- Pacific Research Centre for Prevention of Obesity and Non-Communicable Disease (C-POND), Fiji National University, Suva, Fiji
| | - Anna Peeters
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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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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Potvin Kent M, Guimaraes JS, Bagnato M, Remedios L, Pauzé E, Pritchard M, Wu D, L'Abbé M, Mulligan C, Vergeer L, Weippert M. Broadcast Television Is Not Dead: Exposure of Children to Unhealthy Food and Beverage Advertising on Television in Two Policy Environments (Ontario and Quebec). An Observational Study. J Nutr 2023; 153:268-278. [PMID: 36913461 DOI: 10.1016/j.tjnut.2022.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/07/2022] [Accepted: 09/26/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Food marketing can influence children's dietary behaviors. In Canada, Quebec banned commercial advertising to children under the age of 13 y in 1980, whereas advertising to children is self-regulated by industry in the rest of the country. OBJECTIVES The objective of this study was to compare the extent and power of food and beverage advertising on television to children (age: 2-11 y) in two different policy environments (Ontario and Quebec). METHODS Advertising data for 57 selected food and beverage categories were licensed from Numerator for Toronto and Montreal (English and French markets) from January to December 2019. The 10 most popular stations for children (age: 2-11 y) and a subset of child-appealing stations were examined. Exposure to food advertisements (ads) was based on gross rating points. A content analysis of food ads was conducted, and the healthfulness of ads was assessed using Health Canada's proposed nutrient profile model. Descriptive statistics were tabulated for the frequency of and exposure to ads. RESULTS On average, children were exposed to 3.7 to 4.4 food and beverage ads per day, exposure to fast-food advertising was highest (670.7-550.6 ads per year), advertising techniques were used frequently, and the majority (>90%) of advertised products were classified as unhealthy. On the top 10 stations, French children in Montreal were most exposed to unhealthy food and beverage advertising (712.3 ads per year), although they were exposed to fewer child-appealing advertising techniques compared with those in other markets. On the child-appealing stations, French children in Montreal were least exposed to food and beverage advertising (43.6 ads per year per station) and child-appealing advertising techniques compared with the other groups. CONCLUSIONS The Consumer Protection Act appears to positively impact exposure to child-appealing stations; yet, it does not sufficiently protect all children in Quebec and requires strengthening. Federal-level regulations restricting unhealthy advertising are needed to protect children across Canada.
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Affiliation(s)
- Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada.
| | - Julia Soares Guimaraes
- School of Interdisciplinary Health Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Canada
| | - Mariangela Bagnato
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Lauren Remedios
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Elise Pauzé
- School of Interdisciplinary Health Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Canada
| | - Meghan Pritchard
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - David Wu
- Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada
| | - Mary L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Christine Mulligan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Laura Vergeer
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Madyson Weippert
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada
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Boyland E, McGale L, Maden M, Hounsome J, Boland A, Jones A. Systematic review of the effect of policies to restrict the marketing of foods and non-alcoholic beverages to which children are exposed. Obes Rev 2022; 23:e13447. [PMID: 35384238 PMCID: PMC9541016 DOI: 10.1111/obr.13447] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 12/28/2022]
Abstract
This systematic review examined the effectiveness of policies restricting the marketing of foods and/or non-alcoholic beverages to children to inform updated World Health Organization (WHO) guidelines. Databases were searched to March 2020. Inclusion criteria were primary studies of any design assessing implemented policies to restrict food marketing to children (0-19 years). Critical outcomes were exposure to and power of marketing, dietary intake, choice, preference, and purchasing. Important outcomes were purchase requests, dental caries, body weight, diet-related noncommunicable diseases, product change, and unintended consequences. Forty-four observational studies met inclusion criteria; most were moderate quality. Pooling was conducted using vote counting by direction of effect, and GRADE was used to judge evidence certainty. Evidence suggests food marketing policies may result in reduced purchases of unhealthy foods and in unintended consequences favorable for public health. Desirable or potentially desirable (for public health) effects of policies on food marketing exposure and power were also found. Evidence on diet and product change was very limited. The certainty of evidence was very low for four outcomes (exposure, power, dietary intake, and product change) and low for two (purchasing and unintended consequences). Policies can effectively limit food marketing to children; policymakers should prioritize mandatory approaches aligned with WHO recommendations.
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Affiliation(s)
- Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Lauren McGale
- Department of Psychology, University of Liverpool, Liverpool, UK.,Department of Psychology, Edge Hill University, Ormskirk, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Juliet Hounsome
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Angela Boland
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Andrew Jones
- Department of Psychology, University of Liverpool, Liverpool, UK
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Ogundijo DA, Tas AA, Onarinde BA. Factors influencing the perception and decision‐making process of consumers on the choice of healthier foods in the United Kingdom: a systematic review using narrative synthesis. Int J Food Sci Technol 2022. [DOI: 10.1111/ijfs.15478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Daniel A. Ogundijo
- National Centre for Food Manufacturing University of Lincoln Holbeach PE12 7LD UK
| | - Ayten A. Tas
- National Centre for Food Manufacturing University of Lincoln Holbeach PE12 7LD UK
| | - Bukola A. Onarinde
- National Centre for Food Manufacturing University of Lincoln Holbeach PE12 7LD UK
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Pauzé E, Potvin Kent M. Children's measured exposure to food and beverage advertising on television in Toronto (Canada), May 2011-May 2019. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2021; 112:1008-1019. [PMID: 34129214 PMCID: PMC8651920 DOI: 10.17269/s41997-021-00528-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/08/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Exposure to unhealthy food advertising is a known determinant of children's poor dietary behaviours. The purpose of this study was to quantify and characterize Canadian children's exposure to food advertising on broadcast television and examine trends over time. METHODS Objectively measured advertising exposure data for 19 food categories airing on 30 stations broadcast in Toronto were licenced for May 2011 and May 2019. Using ad ratings data, the average number of food advertisements viewed by children aged 2-11 years, overall, by food category and by type of television station (child-appealing, adolescent-appealing and generalist stations), was estimated per time period. RESULTS In May 2019, children viewed an average of 136 food advertisements on television, 20% fewer than in May 2011. More than half of advertisements viewed in May 2019 promoted unhealthy food categories such as fast food (43% of exposure), candy (6%), chocolate (6%) and regular soft drinks (5%) and only 17% of their total exposure occurred on child-appealing stations. Between May 2011 and May 2019, children's exposure increased the most, in absolute terms, for savory snack foods (+7.2 ad exposures/child), fast food (+5.4) and regular soft drinks (+5.3) with most of these increases occurring on generalist stations. CONCLUSION Canadian children are still exposed to advertisements promoting unhealthy food categories on television despite voluntary restrictions adopted by some food companies. Statutory restrictions should be adopted and designed such that children are effectively protected from unhealthy food advertising on both stations intended for general audiences and those appealing to younger audiences.
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Affiliation(s)
- Elise Pauzé
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario, K1G 5Z3, Canada
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario, K1G 5Z3, Canada.
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Lauber K, Hunt D, Gilmore AB, Rutter H. Corporate political activity in the context of unhealthy food advertising restrictions across Transport for London: A qualitative case study. PLoS Med 2021; 18:e1003695. [PMID: 34473694 PMCID: PMC8412307 DOI: 10.1371/journal.pmed.1003695] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 06/14/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diets with high proportions of foods high in fat, sugar, and/or salt (HFSS) contribute to malnutrition and rising rates of childhood obesity, with effects throughout the life course. Given compelling evidence on the detrimental impact HFSS advertising has on children's diets, the World Health Organization unequivocally supports the adoption of restrictions on HFSS marketing and advertising. In February 2019, the Greater London Authority introduced novel restrictions on HFSS advertising across Transport for London (TfL), one of the most valuable out-of-home advertising estates. In this study, we examined whether and how commercial actors attempted to influence the development of these advertising restrictions. METHODS AND FINDINGS Using requests under the Freedom of Information Act, we obtained industry responses to the London Food Strategy consultation, correspondence between officials and key industry actors, and information on meetings. We used an existing model of corporate political activity, the Policy Dystopia Model, to systematically analyse arguments and activities used to counter the policy. The majority of food and advertising industry consultation respondents opposed the proposed advertising restrictions, many promoting voluntary approaches instead. Industry actors who supported the policy were predominantly smaller businesses. To oppose the policy, industry respondents deployed a range of strategies. They exaggerated potential costs and underplayed potential benefits of the policy, for instance, warning of negative economic consequences and questioning the evidence underlying the proposal. Despite challenging the evidence for the policy, they offered little evidence in support of their own claims. Commercial actors had significant access to the policy process and officials through the consultation and numerous meetings, yet attempted to increase access, for example, in applying to join the London Child Obesity Taskforce and inviting its members to events. They also employed coalition management, engaging directly and through business associations to amplify their arguments. Some advertising industry actors also raised the potential of legal challenges. The key limitation of this study is that our data focused on industry-policymaker interactions; thus, our findings are unable to present a comprehensive picture of political activity. CONCLUSIONS In this study, we identified substantial opposition from food and advertising industry actors to the TfL advertising restrictions. We mapped arguments and activities used to oppose the policy, which might help other public authorities anticipate industry efforts to prevent similar restrictions in HFSS advertising. Given the potential consequences of commercial influence in these kinds of policy spaces, public bodies should consider how they engage with industry actors.
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Affiliation(s)
- Kathrin Lauber
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, United Kingdom
- * E-mail:
| | - Daniel Hunt
- Independent Researcher and Freelance Health Policy Consultant, Bath, United Kingdom
| | - Anna B. Gilmore
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, United Kingdom
| | - Harry Rutter
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, United Kingdom
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
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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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Pinto A, Pauzé E, Roy-Gagnon MH, Dubois L, Potvin Kent M. The targeting of preschoolers, children, adolescents and adults by the Canadian food and beverage industry on television: a cross-sectional study. Appl Physiol Nutr Metab 2020; 46:651-660. [PMID: 33320731 DOI: 10.1139/apnm-2020-0621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Unhealthy food advertising can negatively impact children's food preferences and nutritional health. In Canada, only companies participating in the self-regulatory Children's Food and Beverage Advertising Initiative (CAI) commit to limiting unhealthy food advertising to children. We analyzed food advertising from 182 Canadian television stations in 2018. A principal component analysis explored patterns of advertising by 497 food companies and their targeting of preschoolers, children, adolescents, and adults. Chi-square analyses tested differences in the volume of advertising between target age groups by heavily advertising food companies and by CAI-participating and non-participating companies. In 2018, Maple Leaf Foods, Boulangerie St-Méthode, Exceldor Foods, Goodfood Market and Sobeys advertised most frequently during preschooler-programming. General Mills, Kellogg's, the Topps Company, Parmalat and Post Foods advertised most frequently during child-programming, while Burger King, McDonald's, General Mills, Kellogg's and Wendy's advertised most frequently during adolescent-programming. CAI-participating companies were responsible for over half of the food advertising broadcast during programs targeted to children (55%), while they accounted for less than half of the food advertising aired during programs targeting preschoolers (24%), adolescents (41%) and adults (42%). Statutory food advertising restrictions are needed to limit food companies' targeting of young people on television in Canada. Novelty: Advertising from fast food restaurant chains dominated television programming targeted to adolescents in 2018. Advertising from breakfast cereal, candy, and snack manufacturers dominated television programming targeted at children in 2018. Over 100 Canadian and transnational companies contravened broadcast restrictions on advertising to preschoolers in 2018.
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Affiliation(s)
- A Pinto
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - E Pauzé
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - M-H Roy-Gagnon
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - L Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - M Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
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12
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Rowbotham S, Astell-Burt T, Barakat T, Hawe P. 30+ years of media analysis of relevance to chronic disease: a scoping review. BMC Public Health 2020; 20:364. [PMID: 32192448 PMCID: PMC7083065 DOI: 10.1186/s12889-020-8365-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic, non-communicable diseases are a significant public health priority, requiring action at individual, community and population levels, and public and political will for such action. Exposure to media, including news, entertainment, and advertising media, is likely to influence both individual behaviours, and attitudes towards preventive actions at the population level. In recent years there has been a proliferation of research exploring how chronic diseases and their risk factors are portrayed across various forms of media. This scoping review aims to map the literature in this area to identify key themes, gaps, and opportunities for future research in this area. METHODS We searched three databases (Medline, PsycINFO and Global Health) in July 2016 and identified 499 original research articles meeting inclusion criteria: original research article, published in English, focusing on media representations of chronic disease (including how issues are framed in media, impact or effect of media representations, and factors that influence media representations). We extracted key data from included articles and examined the health topics, media channels and methods of included studies, and synthesised key themes across studies. RESULTS Our findings show that research on media portrayals of chronic disease increased substantially between 1985 and 2016. Smoking and nutrition were the most frequent health topics, and television and print were the most common forms of media examined, although, as expected, research on online and social media channels has increased in recent years. The majority of studies focused on the amount and type of media coverage, including how issues are framed, typically using content analysis approaches. In comparison, there was much less research on the influences on and consequences of media coverage related to chronic disease, suggesting an important direction for future work. CONCLUSIONS The results highlight key themes across media research of relevance to chronic disease. More in-depth syntheses of studies within the identified themes will allow us to draw out the key patterns and learnings across the literature.
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Affiliation(s)
- Samantha Rowbotham
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, Australia. .,The Australian Prevention Partnership Centre, Sydney, Australia.
| | - Thomas Astell-Burt
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, Australia.,Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, University of Wollongong, Wollongong, Australia.,School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China.,National Institute of Environmental Health, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Tala Barakat
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, Australia.,The Australian Prevention Partnership Centre, Sydney, Australia
| | - Penelope Hawe
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, Australia.,The Australian Prevention Partnership Centre, Sydney, Australia.,O'Brien Institute of Public Health, University of Calgary, Calgary, Canada
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13
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Pinto A, Pauzé E, Mutata R, Roy-Gagnon MH, Potvin Kent M. Food and Beverage Advertising to Children and Adolescents on Television: A Baseline Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1999. [PMID: 32197390 PMCID: PMC7142724 DOI: 10.3390/ijerph17061999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/11/2020] [Accepted: 03/14/2020] [Indexed: 11/16/2022]
Abstract
The progressive rise in Canadian child obesity has paralleled trends in unhealthy food consumption. Industry has contributed to these trends through aggressive food and beverage marketing in various media and child settings. This study aimed to assess the extent of food and beverage advertising on television in Canada and compare the frequency of food advertising broadcasted during programs targeted to preschoolers, children, adolescents and adults. Annual advertising from 2018 was drawn from publicly available television program logs. Food and beverage advertisement rates and frequencies were compared by, target age group, television station, month and food category, using linear regression modelling and chi-square tests, in SAS version 9.4. Rates of food and beverage advertising differed significantly between the four target age groups, and varied significantly by television station and time of the year, in 2018. The proportion of advertisements for food and beverage products was significantly greater during preschooler-, child-, and adult-programming [5432 (54%), 142,451 (74%) and 2,886,628 (48%), respectively; p < 0.0001] compared to adolescent-programming [27,268 (42%)]. The proportion of advertisements promoting fast food was significantly greater among adolescent-programming [33,475 (51%), p < 0.0001] compared to other age groups. Legislation restricting food and beverage advertising is needed in Canada as current self-regulatory practices are failing to protect young people from unhealthy food advertising and its potential negative health effects.
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Affiliation(s)
| | | | | | | | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
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14
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Mulligan C, Christoforou AK, Vergeer L, Bernstein JT, L’Abbé MR. Evaluating the Canadian Packaged Food Supply Using Health Canada's Proposed Nutrient Criteria for Restricting Food and Beverage Marketing to Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041250. [PMID: 32075224 PMCID: PMC7068661 DOI: 10.3390/ijerph17041250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/05/2020] [Accepted: 02/11/2020] [Indexed: 01/16/2023]
Abstract
Federally mandated restrictions on food and beverage marketing to kids (M2K) have been re-introduced as a national public health priority in Canada by the newly elected government, following the failure to implement a similar policy first proposed in 2016. This study examined the extent to which Canadian packaged foods, including products already displaying M2K on the packaging, would be permitted to be marketed, based on the nutrient criteria for marketing restrictions defined by Health Canada (in December 2018) as part of the previous policy proposal. Products from the University of Toronto Food Label Information Program 2013 database (n = 15,200) were evaluated using Health Canada’s published criteria: thresholds for sodium, sugars and saturated fats that products cannot exceed in order to be M2K. The proportion of products exceeding no thresholds (i.e., permitted to be M2K), the number of thresholds exceeded, and the proportion exceeding each individual threshold were calculated overall and in the subsample of products displaying M2K on the packaging (n = 747). Overall, 18.0% of products would be permitted to be M2K, versus 2.7% of products displaying M2K. Sodium was the most exceeded threshold overall (57.5% of products), whereas sugars was the most exceeded by products displaying M2K (80.1%). Only 4.7% of all products versus 10.4% of products displaying M2K exceeded all three thresholds. These results highlight the importance of reintroducing federal regulations restricting M2K in Canada and including marketing on product packaging in the regulatory scope.
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Affiliation(s)
- Christine Mulligan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (C.M.); (A.K.C.); (L.V.); (J.T.B.)
| | - Anthea K. Christoforou
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (C.M.); (A.K.C.); (L.V.); (J.T.B.)
| | - Laura Vergeer
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (C.M.); (A.K.C.); (L.V.); (J.T.B.)
| | - Jodi T. Bernstein
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (C.M.); (A.K.C.); (L.V.); (J.T.B.)
| | - Mary R. L’Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (C.M.); (A.K.C.); (L.V.); (J.T.B.)
- Correspondence: ; Tel.: +1-416-946-7545
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15
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Vandenbrink D, Pauzé E, Potvin Kent M. Strategies used by the Canadian food and beverage industry to influence food and nutrition policies. Int J Behav Nutr Phys Act 2020; 17:3. [PMID: 31992304 PMCID: PMC6988317 DOI: 10.1186/s12966-019-0900-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 12/11/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Unhealthy food environments contribute to the rising rates of obesity and diet-related diseases. To improve the Canadian nutritional landscape, Health Canada launched the Healthy Eating Strategy in October 2016 which involved several initiatives including the restriction of unhealthy food marketing to children, the reduction of sodium in the food supply and the introduction of front-of-package labelling. Subsequently, various stakeholders engaged in discussions with Health Canada. This study sought to describe the interactions between Health Canada and industry and non-industry stakeholders and to identify the strategies used by industry to influence food and nutrition policy in Canada. METHODS Documents such as correspondences and presentations exchanged in interactions between Health Canada and stakeholders regarding the Healthy Eating Strategy were obtained from Health Canada's Openness and Transparency website. The participating stakeholders of each interaction and the topics discussed were determined and described quantitatively. A directed content analysis was then conducted to identify the strategies employed by industry to influence policy. This was guided by a previously developed coding framework that was adapted during analysis. RESULTS A total of 208 interactions concerning the Healthy Eating Strategy occurred between October 2016 and June 2018. Of the interactions for which documents were received (n = 202), 56% involved industry stakeholders, 42% involved non-industry stakeholders and 2% involved both. Industry stakeholders were more likely to initiate interactions with Health Canada (94% of their interactions) than non-industry stakeholders (49%). Front-of-package labelling was the most frequently discussed topic by industry stakeholders (discussed in 49% interactions involving industry) while non-industry stakeholders most frequently discussed the Healthy Eating Strategy as a whole (discussed in 37% of interactions involving non-industry). A wide variety of strategies were used by industry in their attempts to influence policy. Those most frequently identified included: "framing the debate on diet- and public health-related issues", "promoting deregulation", "shaping the evidence base", "stressing the economic importance of industry", and "developing and promoting alternatives to proposed policies". CONCLUSION Industry stakeholders are highly active in their attempts to influence Canadian nutritional policies. Policymakers and public health advocates should be aware of these strategies so that balanced and effective food and nutrition policies can be developed.
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Affiliation(s)
- D Vandenbrink
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | - E Pauzé
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Room 207F, Ottawa, Ontario, K1G 5Z3, Canada
| | - M Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Room 301J, Ottawa, Ontario, K1G 5Z3, Canada.
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16
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Maximova K, Raine KD, Czoli C, O'Loughlin J, Minkley J, Tisdale K, Bubela T. Monitoring progress toward United Nations commitments: characteristics of Canadian legislation to promote tobacco control, physical activity and healthy eating. A descriptive study. CMAJ Open 2019; 7:E745-E753. [PMID: 31836632 PMCID: PMC6910139 DOI: 10.9778/cmajo.20190049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Legal interventions are important mechanisms for chronic disease prevention. Since Canadian laws to promote physical activity and healthy eating are growing, we compared the characteristics of legal interventions targeting physical activity and healthy eating with tobacco control laws, which have been extensively described. METHODS We reviewed 718 federal, provincial and territorial laws promoting tobacco control, physical activity and healthy eating captured in the Prevention Policies Directory between spring 2010 and September 2017. We characterized the legislation with regard to its purpose, tools to accomplish the purpose, responsible authorities, target location, level of coerciveness and provisions for enforcement. RESULTS Two-thirds (67.9%) of tobacco control legislation had a primary chronic disease prevention purpose (explicit in 5.3% of documents and implicit in 62.6%), and 29.5% had a secondary chronic disease prevention purpose. One-quarter (27.0%) of physical activity legislation had a primary chronic disease prevention purpose (explicit in 8.8% of documents and implicit in 18.1%), and 53.0% had a secondary chronic disease prevention purpose. In contrast, 69.3% of healthy eating legislation had no chronic disease prevention purpose. Tobacco control legislation was most coercive (restrict or eliminate choice), and physical activity and healthy eating legislation was least coercive (provide information or enable choice). Most tobacco control legislation (85.8%) included provisions for enforcement, whereas 47.4% and 24.8% of physical activity and healthy eating laws, respectively, included such provisions. Patterns in responsible authorities, target populations, settings and tools to accomplish its purpose (e.g., taxation, subsidies, advertising limits, prohibitions) also differed between legislation targeting tobacco control versus physical activity and healthy eating. INTERPRETATION Legislative approaches to promote physical activity and healthy eating lag behind those for tobacco control. The results serve as a baseline for building consensus on the use of legislation to support approaches to chronic disease prevention to reduce the burden of chronic disease in Canadians.
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Affiliation(s)
- Katerina Maximova
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - Kim D Raine
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - Christine Czoli
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - Jennifer O'Loughlin
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - John Minkley
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - Kendall Tisdale
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - Tania Bubela
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
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17
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Knai C, Petticrew M, Mays N, Capewell S, Cassidy R, Cummins S, Eastmure E, Fafard P, Hawkins B, Jensen JD, Katikireddi SV, Mwatsama M, Orford J, Weishaar H. Systems Thinking as a Framework for Analyzing Commercial Determinants of Health. Milbank Q 2018; 96:472-498. [PMID: 30277610 PMCID: PMC6131339 DOI: 10.1111/1468-0009.12339] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Policy Points: Worldwide, more than 70% of all deaths are attributable to noncommunicable diseases (NCDs), nearly half of which are premature and apply to individuals of working age. Although such deaths are largely preventable, effective solutions continue to elude the public health community. One reason is the considerable influence of the “commercial determinants of health”: NCDs are the product of a system that includes powerful corporate actors, who are often involved in public health policymaking. This article shows how a complex systems perspective may be used to analyze the commercial determinants of NCDs, and it explains how this can help with (1) conceptualizing the problem of NCDs and (2) developing effective policy interventions.
Context The high burden of noncommunicable diseases (NCDs) is politically salient and eminently preventable. However, effective solutions largely continue to elude the public health community. Two pressing issues heighten this challenge: the first is the public health community's narrow approach to addressing NCDs, and the second is the involvement of corporate actors in policymaking. While NCDs are often conceptualized in terms of individual‐level risk factors, we argue that they should be reframed as products of a complex system. This article explores the value of a systems approach to understanding NCDs as an emergent property of a complex system, with a focus on commercial actors. Methods Drawing on Donella Meadows's systems thinking framework, this article examines how a systems perspective may be used to analyze the commercial determinants of NCDs and, specifically, how unhealthy commodity industries influence public health policy. Findings Unhealthy commodity industries actively design and shape the NCD policy system, intervene at different levels of the system to gain agency over policy and politics, and legitimize their presence in public health policy decisions. Conclusions It should be possible to apply the principles of systems thinking to other complex public health issues, not just NCDs. Such an approach should be tested and refined for other complex public health challenges.
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Affiliation(s)
- Cécile Knai
- London School of Hygiene and Tropical Medicine
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18
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Vergeer L, Vanderlee L, Potvin Kent M, Mulligan C, L'Abbé MR. The effectiveness of voluntary policies and commitments in restricting unhealthy food marketing to Canadian children on food company websites. Appl Physiol Nutr Metab 2018; 44:74-82. [PMID: 30273499 DOI: 10.1139/apnm-2018-0528] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Marketing unhealthy foods and beverages to children (M2K) fosters poor dietary patterns, increasing obesity and noncommunicable disease risk. Federal restrictions on M2K have been under development in Canada since 2016; however, at present, M2K is mostly self-regulated by food companies. This study aimed to compare M2K on Canadian websites of food companies with and without voluntary policies or commitments in this area. A systematic content analysis of company websites was conducted in spring/summer 2017 for major packaged food (n = 16), beverage (n = 12), and restaurant chain (n = 13) companies in Canada. M2K policies were sourced from company websites and published corporate documents. Sixteen companies (43%) reported national and/or global M2K policies, while 21 companies (57%) had no published policies. The websites of Canadian companies (n = 154) were scanned for child-directed products and marketing; type and frequency of marketing techniques were recorded. Child-directed marketing appeared on 19 websites of 12 companies (32%), including 9 companies with M2K policies. Websites featured products with unconventional flavours, colours, shapes, or child-oriented packaging, and used promotional characters, contests, games, activities, or lettering and graphics appealing to children. The nutritional quality of products marketed to children was evaluated using a nutrient profile model developed by Health Canada for proposed M2K regulations. Of the 217 products marketed to children, 97% exceeded Health Canada's proposed ∼5% Daily Value threshold for saturated fat, sodium, and/or sugars, 73% of which were products from 9 companies with policies. These findings highlight the limitations of self-regulation in restricting M2K on food company websites, reinforcing the need for government regulations.
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Affiliation(s)
- Laura Vergeer
- a Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Lana Vanderlee
- a Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Monique Potvin Kent
- b School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Christine Mulligan
- a Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Mary R L'Abbé
- a Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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19
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Potvin Kent M, Smith JR, Pauzé E, L'Abbé M. The effectiveness of the food and beverage industry's self-established uniform nutrition criteria at improving the healthfulness of food advertising viewed by Canadian children on television. Int J Behav Nutr Phys Act 2018; 15:57. [PMID: 29929539 PMCID: PMC6013888 DOI: 10.1186/s12966-018-0694-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 06/14/2018] [Indexed: 12/04/2022] Open
Abstract
Background Food and beverage marketing has been identified as an environmental determinant of childhood obesity. The purpose of this study is to assess whether the Uniform Nutrition Criteria established and implemented by companies participating in the self-regulatory Canadian Children’s Food and Beverage Advertising Initiative (CAI) had an impact on the healthfulness of food and beverage advertising during television programming with a high share of children in the viewing audience. Methods Data on food advertising were licensed from Numeris for 27 television stations for Toronto for May 2013 and May 2016 (i.e. before and after the implementation of the nutrition criteria). First, television programs that had a child audience share of ≥35% (when the nutrition criteria applied) were identified. Ten percent of these programs were randomly selected and included in the study. After identifying the food and beverage ads that aired during these programs, the nutritional information of advertised products was collected and their healthfulness was assessed using the Pan-American Health Organization (PAHO) and UK Nutrient Profile Models (NPM). The healthfulness of CAI products advertised in May 2013 and 2016 was compared using Chi-square tests. Results Although in May 2016, products advertised by CAI companies were more likely to be categorized as healthier by the UK NPM (21.5% versus 6.7%, χ2(1) = 12.1,p = 000) compared to those advertised in May 2013, the frequency of advertised products considered less healthy in May 2016 remained very high (78.5%) and comparable to that of products advertised by companies not participating in the CAI (80.0% categorized as less healthy). Furthermore, in both May 2013 and May 2016, 99–100% of CAI advertisements featured products deemed excessive in either fat (total, saturated, trans), sodium or free sugars according to the PAHO NPM. Conclusions Despite modest improvements noted after the implementation of the CAI’s Uniform Nutrition Criteria, the healthfulness of most products advertised during programs with a high share of children in the viewing audience remains poor. Mandatory regulations are needed.
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Affiliation(s)
- Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Cres., Room 301J, Ottawa, ON, K1G5Z3, Canada.
| | - Jennifer R Smith
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Cres., Room 301J, Ottawa, ON, K1G5Z3, Canada
| | - Elise Pauzé
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Cres., Room 301J, Ottawa, ON, K1G5Z3, Canada
| | - Mary L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
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20
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Prowse R. Food marketing to children in Canada: a settings-based scoping review on exposure, power and impact. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 37:274-292. [PMID: 28902477 DOI: 10.24095/hpcdp.37.9.03] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Food marketing impacts children's food knowledge, behaviours and health. Current regulations in Canada focus on restricting promotional aspects of food marketing with little-to-no consideration of the places where children experience food. Understanding food marketing in children's everyday settings is necessary to protect children. This scoping review describes the current literature on food marketing to children in Canada by setting. METHODS The author searched databases for Canadian research on children's exposure to food marketing, and the power and impact of food marketing to children (2-17 years) across settings, and on how current regulations may mediate the effect of food marketing on children. Peer-reviewed studies in English, published between 2000 and 2016, were included. RESULTS Twenty-five studies documented children's exposure to food marketing and its power and/or impact on them in homes (via television, or online) (n = 12), public schools (n = 1), grocery stores (n = 8), fast food restaurants (n = 2), and in general (n = 2). Research trends suggest that unhealthy foods are targeted at children using multiple promotional techniques that overlap across settings. Several research gaps exist in this area, leading to an incomplete, and potentially underestimated, picture of food marketing to children in Canada. Available evidence suggests that current Canadian approaches have not reduced children's exposure to or the power of food marketing in these settings, with the exception of some positive influences from Quebec's statutory regulations. CONCLUSION The settings where children eat, buy or learn about food expose them to powerful, often unhealthy food marketing. The current evidence suggests that "place" may be an important marketing component to be included in public policy in order to broadly protect children from unhealthy food marketing. Organizations and communities can engage in settings-based health promotion interventions by developing their own marketing policies that address the promotion and place of unhealthy food and beverages.
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Affiliation(s)
- Rachel Prowse
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Barquera S, Hernández-Barrera L, Rothenberg SJ, Cifuentes E. The obesogenic environment around elementary schools: food and beverage marketing to children in two Mexican cities. BMC Public Health 2018; 18:461. [PMID: 29625608 PMCID: PMC5889561 DOI: 10.1186/s12889-018-5374-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 03/26/2018] [Indexed: 12/02/2022] Open
Abstract
Background Unhealthy environments and food advertisements are major determinants of childhood obesity. Recent regulation has banned unhealthy foods from schools in Mexico. However, currently there is no regulation limiting exposure to food marketing around schools. Thus, our objective was to analyze the characteristics of food advertising practices around 60 elementary schools in two cities and to evaluate compliance with the Pan American Health Organization (PAHO) recommendations and the local food industry self-regulatory marketing code. Methods Data were collected during the period of October 2012 to March 2013. A random sample of elementary schools was selected from two Mexican cities. Using geographic information systems, we drew a 100-m-diameter buffer around each school. Trained personnel obtained photographs to assess the locations and types of food advertisements. Our results were stratified by school type and by indicators of compliance with the PAHO and industry recommendations. We developed a multivariate negative binomial regression model to determine factors predicting the number of advertisements around schools. Results The number of advertisements was significantly higher around public schools than around private schools (6.5 ± 5.6 vs. 2.4 ± 3.5, p < 0.05). Printed posters were the most common type of marketing medium (97%), showing mostly sugar-sweetened beverages, sweet breads, candies, and bottled water. Promotions, such as special prices or gifts, were included on 30% of printed posters. Food advertising practices were often in compliance with industry recommendations (83%) but not with those from the PAHO (32%) (p < 0.001). Conclusion Our results support the importance of monitoring the obesogenic environment and identifying policy tools to protect children from food marketing not only inside schools but also around them, particularly in lower income communities.
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Affiliation(s)
- Simón Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Lucia Hernández-Barrera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Stephen J Rothenberg
- Center for Research in Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Enrique Cifuentes
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
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Marketing techniques in television advertisements of food and drinks directed at children in Spain, 2012. Int J Public Health 2018; 63:733-742. [DOI: 10.1007/s00038-018-1085-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 02/18/2018] [Accepted: 02/19/2018] [Indexed: 11/27/2022] Open
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The effectiveness of self-regulation in limiting the advertising of unhealthy foods and beverages on children's preferred websites in Canada. Public Health Nutr 2018; 21:1608-1617. [PMID: 29433594 DOI: 10.1017/s1368980017004177] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess the effectiveness of the self-regulatory Canadian Children's Food and Beverage Advertising Initiative (CAI) in limiting advertising of unhealthy foods and beverages on children's preferred websites in Canada.Design/Setting/SubjectsSyndicated Internet advertising exposure data were used to identify the ten most popular websites for children (aged 2-11 years) and determine the frequency of food/beverage banner and pop-up ads on these websites from June 2015 to May 2016. Nutrition information for advertised products was collected and their nutrient content per 100 g was calculated. Nutritional quality of all food/beverage ads was assessed using the Pan American Health Organization (PAHO) and UK Nutrient Profile Models (NPM). Nutritional quality of CAI and non-CAI company ads was compared using χ 2 analyses and independent t tests. RESULTS About 54 million food/beverage ads were viewed on children's preferred websites from June 2015 to May 2016. Most (93·4 %) product ads were categorized as excessive in fat, Na or free sugars as per the PAHO NPM and 73·8 % were deemed less healthy according to the UK NPM. CAI-company ads were 2·2 times more likely (OR; 99 % CI) to be excessive in at least one nutrient (2·2; 2·1, 2·2, P<0·001) and 2·5 times more likely to be deemed less healthy (2·5; 2·5, 2·5, P<0·001) than non-CAI ads. On average, CAI-company product ads also contained (mean difference; 99 % CI) more energy (141; 141·1, 141·4 kcal, P<0·001, r=0·55), sugar (18·2; 18·2, 18·2 g, P<0·001, r=0·68) and Na (70·0; 69·7, 70·0 mg, P<0·001, r=0·23) per 100 g serving than non-CAI ads. CONCLUSIONS The CAI is not limiting unhealthy food and beverage advertising on children's preferred websites in Canada. Mandatory regulations are needed.
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Reeve E, Thow AM, Bell C, Engelhardt K, Gamolo-Naliponguit EC, Go JJ, Sacks G. Implementation lessons for school food policies and marketing restrictions in the Philippines: a qualitative policy analysis. Global Health 2018; 14:8. [PMID: 29361951 PMCID: PMC5781266 DOI: 10.1186/s12992-017-0320-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The school environment can enhance children's skills, knowledge and behaviours in relation to healthy eating. However, in many countries, unhealthy foods are commonly available in schools, and children can be exposed to aggressive marketing by the food industry. Taking the perspective of policymakers, this study aimed to identify barriers and enablers to effective school food policy development and implementation in the Philippines. METHODS In May 2016, semi-structured interviews were conducted with 21 policymakers and stakeholders involved in school food policymaking and implementation in the Philippines. The Health Policy Analysis Triangle was used to identify interview questions and to guide the thematic analysis. These included the political and socio-environmental context, strengths and limitations of existing policy content, roles and behaviours of actors, implementation processes, policy outcomes, and opportunities to improve policy coherence. RESULTS The Department of Education's policy 'Orders' represented a relatively strong policy framework for the education sector of the Philippines. However, a lack of human and financial resources for implementation, planning, and policy enforcement limited the impact of the policy on the healthiness of school food provision. Ambiguity in policy wording allowed a wide interpretation of the foods eligible to be provided in schools, and led to difficulties in effective monitoring and enforcement. Food companies used existing relationships with schools to promote their brands and compromise the establishment of a stronger food policy agenda. We found a motivated group of actors engaging in policy-oriented learning and advocating for a stronger policy alternative so as to improve the school food environment. CONCLUSIONS The adoption of policy mechanisms being used to promote healthy dietary practices in the school setting will be strengthened by more robust implementation planning processes, and resources to support implementation and enforcement. Policymakers should ensure policy language clearly and unequivocally promotes healthier food and beverage options. Steps should be taken to achieve policy coherence by ensuring the objectives of one agency or institution are not undermining that of any others. Where there is reliance on the private sector for school resources, safeguards should be established to protect against conflicts of interest.
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Affiliation(s)
- Erica Reeve
- Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention Centre for Population Health Research School of Health & Social Development, Faculty of Health, Melbourne, Victoria 3218 Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy, The University of Sydney, Sydney, NSW 2006 Australia
| | - Colin Bell
- Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention Centre for Population Health Research School of Health & Social Development, Faculty of Health, Melbourne, Victoria 3218 Australia
| | - Katrin Engelhardt
- Formerly of the Division of NCD and Health through the Life-Course, The World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | | | - John Juliard Go
- Philippines Country Office, Western Pacific Regional Office of the World Health Organization, Manila, Philippines
| | - Gary Sacks
- Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention Centre for Population Health Research School of Health & Social Development, Faculty of Health, Melbourne, Victoria 3218 Australia
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Evaluation of compliance with the Spanish Code of self-regulation of food and drinks advertising directed at children under the age of 12 years in Spain, 2012. Public Health 2017; 150:121-129. [DOI: 10.1016/j.puhe.2017.05.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/05/2017] [Accepted: 05/22/2017] [Indexed: 11/21/2022]
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Théodore FL, Tolentino-Mayo L, Hernández-Zenil E, Bahena L, Velasco A, Popkin B, Rivera JA, Barquera S. Pitfalls of the self-regulation of advertisements directed at children on Mexican television. Pediatr Obes 2017; 12:312-319. [PMID: 27135300 DOI: 10.1111/ijpo.12144] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 03/21/2016] [Accepted: 04/04/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are no academic studies that characterize advertisements directed at children from the companies that signed the self-regulation. OBJECTIVE The aim of this paper was to assess the extent and nature of food advertisements and the persuasive techniques used to market unhealthy food and beverages (UFB) to children, by signatory companies of self-regulation. METHODS From December 2012 to April 2013, 600 h of programming were recorded on the four broadcast public television channels in Mexico with the highest rating nationwide. Marketing aimed at children directly (broadcast on children's programmes or advertisements with a specific appeal to children) or indirectly (aimed at other target audiences with messages or scenes that link children to the product) were considered. RESULTS About 74.9% (2148) of the total food and beverage advertisements tried to influence children directly and indirectly. Companies, which had signed the self-regulation, focused 92.7% of their advertisements on UFB. Of the total number, 23.9% were aimed at children, 7.1% at adolescents, 12.5% at parents and 56.2% at the general public. Most of these advertisements were broadcast on movies (29.8%), cartoons (18%), soap operas (17.6%), entertainment shows (17.2%) and sports programs (6.4%). CONCLUSION Despite the self-regulation of television marketing, children were surrounded by UFB advertisements. Signatory companies influence children indirectly by targeting other audiences and by marketing during family television programs, which are also watched by children.
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Affiliation(s)
- F L Théodore
- Center for Research in Nutrition and Health, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - L Tolentino-Mayo
- Center for Research in Nutrition and Health, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - E Hernández-Zenil
- Center for Research in Nutrition and Health, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - L Bahena
- Center for Research in Nutrition and Health, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - A Velasco
- Center for Research in Nutrition and Health, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - B Popkin
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J A Rivera
- Center for Research in Nutrition and Health, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - S Barquera
- Center for Research in Nutrition and Health, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
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Buse K, Tanaka S, Hawkes S. Healthy people and healthy profits? Elaborating a conceptual framework for governing the commercial determinants of non-communicable diseases and identifying options for reducing risk exposure. Global Health 2017; 13:34. [PMID: 28619031 PMCID: PMC5472958 DOI: 10.1186/s12992-017-0255-3] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/02/2017] [Indexed: 11/10/2022] Open
Abstract
Background Non-communicable diseases (NCDs) represent a significant threat to human health and well-being, and carry significant implications for economic development and health care and other costs for governments and business, families and individuals. Risks for many of the major NCDs are associated with the production, marketing and consumption of commercially produced food and drink, particularly those containing sugar, salt and transfats (in ultra-processed products), alcohol and tobacco. The problems inherent in primary prevention of NCDs have received relatively little attention from international organizations, national governments and civil society, especially when compared to the attention paid to secondary and tertiary prevention regimes (i.e. those focused on provision of medical treatment and long-term clinical management). This may in part reflect that until recently the NCDs have not been deemed a priority on the overall global health agenda. Low political priority may also be due in part to the complexity inherent in implementing feasible and acceptable interventions, such as increased taxation or regulation of access, particularly given the need to coordinate action beyond the health sector. More fundamentally, governing determinants of risk frequently brings public health into conflict with the interests of profit-driven food, beverage, alcohol and tobacco industries. Materials We use a conceptual framework to review three models of governance of NCD risk: self-regulation by industry; hybrid models of public-private engagement; and public sector regulation. We analyse the challenges inherent in each model, and review what is known (or not) about their impact on NCD outcomes. Conclusion While piecemeal efforts have been established, we argue that mechanisms to control the commercial determinants of NCDs are inadequate and efforts at remedial action too limited. Our paper sets out an agenda to strengthen each of the three governance models. We identify reforms that will be needed to the global health architecture to govern NCD risks, including to strengthen its ability to consolidate the collective power of diverse stakeholders, its authority to develop and enforce clear measures to address risks, as well as establish monitoring and rights-based accountability systems across all actors to drive measurable, equitable and sustainable progress in reducing the global burden of NCDs.
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Affiliation(s)
| | | | - Sarah Hawkes
- Institute for Global Health, University College London, London, UK.
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Elliott C, Den Hoed RC. Do apples need an Elmo sticker? Children’s classification of unprocessed edibles. CRITICAL PUBLIC HEALTH 2016. [DOI: 10.1080/09581596.2016.1262942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Charlene Elliott
- Department of Communication, Media and Film, University of Calgary, Calgary, Canada
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Sadeghirad B, Duhaney T, Motaghipisheh S, Campbell NRC, Johnston BC. Influence of unhealthy food and beverage marketing on children's dietary intake and preference: a systematic review and meta-analysis of randomized trials. Obes Rev 2016; 17:945-59. [PMID: 27427474 DOI: 10.1111/obr.12445] [Citation(s) in RCA: 246] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 05/27/2016] [Accepted: 05/31/2016] [Indexed: 12/25/2022]
Abstract
Marketing of foods and beverages high in fat, sugar and salt are suggested to contribute to poor dietary behaviours in children and diet-related diseases later in life. This systematic review and meta-analysis of randomized trials aimed to assess the effects of unhealthy food and beverage marketing on dietary intake (grams or kilocalories) and dietary preference (preference score or percentage of participants who selected specific foods/beverages) among children 2 to 18 years of age. We searched MEDLINE, EMBASE and PsycINFO up to January 2015 for terms related to advertising, unhealthy foods or beverages among children. Randomized trials that assessed the effects of unhealthy food and beverage marketing compared with non-dietary advertisement or no advertisement in children were considered eligible. Two authors independently extracted information on study characteristics and outcomes of interest and assessed risk of bias and the overall quality of evidence using grade methodology. Meta-analysis was conducted separately for dietary intake and preference using a random-effects model. We identified 29 eligible studies, of which 17 studies were included for meta-analysis of dietary preference and nine for meta-analysis of dietary intake. Almost half of the studies were at high risk of bias. Our meta-analysis showed that in children exposed to unhealthy dietary marketing, dietary intake significantly increased (mean difference [MD] = 30.4 kcal, 95% confidence interval [CI] 2.9 to 57.9, and MD = 4.8 g, 95%CI 0.8 to 8.8) during or shortly after exposure to advertisements. Similarly, children exposed to the unhealthy dietary marketing had a higher risk of selecting the advertised foods or beverages (relative risk = 1.1, 95%CI 1.0 to 1.2; P = 0.052). The evidence indicates that unhealthy food and beverage marketing increases dietary intake (moderate quality evidence) and preference (moderate to low quality evidence) for energy-dense, low-nutrition food and beverage. Unhealthy food and beverage marketing increased dietary intake and influenced dietary preference in children during or shortly after exposure to advertisements. © 2016 World Obesity.
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Affiliation(s)
- B Sadeghirad
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.,Systematic Overviews through advancing Research Technology (SORT), Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - T Duhaney
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - S Motaghipisheh
- Modeling in Health Research Center Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - N R C Campbell
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.,Departments of Medicine, Physiology and Pharmacology and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada
| | - B C Johnston
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. .,Systematic Overviews through advancing Research Technology (SORT), Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada. .,Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. .,Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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Barquera S, Pedroza-Tobias A, Medina C. Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease. Curr Opin Lipidol 2016; 27:329-44. [PMID: 27389629 PMCID: PMC4947537 DOI: 10.1097/mol.0000000000000320] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW There are today 11 mega-countries with more than 100 million inhabitants. Together these countries represent more than 60% of the world's population. All are facing noncommunicable chronic disease (NCD) epidemic where high cholesterol, obesity, diabetes, and cardiovascular diseases are becoming the main public health concerns. Most of these countries are facing the double burden of malnutrition where undernutrition and obesity coexist, increasing the complexity for policy design and implementation. The purpose of this study is to describe diverse sociodemographic characteristics of these countries and the challenges for prevention and control in the context of the nutrition transition. RECENT FINDINGS Mega-countries are mostly low or middle-income and are facing important epidemiologic, nutrition, and physical activity transitions because of changes in food systems and unhealthy lifestyles. NCDs are responsible of two-thirds of the 57 million global deaths annually. Approximately, 80% of these are in low and middle-income countries. Only developed countries have been able to reduce mortality rates attributable to recognized risk factors for NCDs, in particular high cholesterol and blood pressure. SUMMARY Mega-countries share common characteristics such as complex bureaucracies, internal ethnic, cultural and socioeconomic heterogeneity, and complexities to implement effective health promotion and education policies across population. Priorities for action must be identified and successful lessons and experiences should be carefully analyzed and replicated.
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Affiliation(s)
- Simon Barquera
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Beyond Food Promotion: A Systematic Review on the Influence of the Food Industry on Obesity-Related Dietary Behaviour among Children. Nutrients 2015; 7:8565-76. [PMID: 26501319 PMCID: PMC4632434 DOI: 10.3390/nu7105414] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 10/08/2015] [Indexed: 01/08/2023] Open
Abstract
An increased consumption of energy-dense, nutrient-poor food and beverages as a result of a changing obesogenic environment contributes substantially to the increasing prevalence of childhood overweight and obesity. This paper reviews the nature and extent of food industry influences which expose children to commercial influences and thus might affect unhealthy dietary behaviour and finally contributes to obesity. A systematic search of nine electronic databases (including PubMed, PsycINFO, EconLit) and reference lists of original studies and reviews using key search terms identified 1900 articles. Of these only thirty-six articles met the inclusion and quality criteria. A narrative synthesis of the reviewed studies revealed six key obesogenic environments by which the food industry possibly influences obesity-related dietary behaviours in young children. These were schools, retailers, mass media “television”, mass media “internet”, home and promotional campaigns. Identifying these obesogenic environments is critical for monitoring and controlling the food industry, the development of effective environmental-level interventions to prevent childhood overweight and obesity and to identify knowledge gaps to be addressed in future research to support informed decisions of policy makers.
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Raine KD. Reducing the economic burden of chronic disease requires major investment in public health. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2015; 106:e167-e170. [PMID: 26285185 PMCID: PMC6972109 DOI: 10.17269/cjph.106.5214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 07/24/2015] [Accepted: 07/23/2015] [Indexed: 06/04/2023]
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Chambers SA, Freeman R, Anderson AS, MacGillivray S. Reducing the volume, exposure and negative impacts of advertising for foods high in fat, sugar and salt to children: A systematic review of the evidence from statutory and self-regulatory actions and educational measures. Prev Med 2015; 75:32-43. [PMID: 25735606 DOI: 10.1016/j.ypmed.2015.02.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 02/18/2015] [Accepted: 02/21/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE To identify and review evidence on 1) the effectiveness of statutory and self-regulatory actions to reduce the volume, exposure or wider impact of advertising for foods high in fat, sugar and salt (HFSS) to children, and 2) the role of educational measures. DESIGN/METHODOLOGY/APPROACH A systematic review of three databases (Medline, CINAHL and PsycINFO) and grey literature was carried out. Relevant evidence included studies evaluating advertising bans and restrictions, advertising literacy programmes and parental communication styles. Relevant media included TV, internet, radio, magazines and newspaper advertising. No studies were excluded based on language or publication date. FINDINGS Forty-seven publications were included: 19 provided evidence for the results of statutory regulation, 25 for self-regulation, and six for educational approaches. Outcome measures varied in approach, quality and results. Findings suggested statutory regulation could reduce the volume of and children's exposure to advertising for foods HFSS, and had potential to impact more widely. Self-regulatory approaches showed varied results in reducing children's exposure. There was some limited support for educational measures. DISCUSSION Consistency in measures from evaluations over time would assist the development and interpretation of the evidence base on successful actions and measures to reduce the volume, exposure and impact of advertising for foods HFSS to children.
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Affiliation(s)
- Stephanie A Chambers
- Oral Health and Health Research Group, Dental Health Services Research Unit, University of Dundee, Dundee Dental School, Park Place, Dundee DD1 4HN, United Kingdom; Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom.
| | - Ruth Freeman
- Oral Health and Health Research Group, Dental Health Services Research Unit, University of Dundee, Dundee Dental School, Park Place, Dundee DD1 4HN, United Kingdom.
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom.
| | - Steve MacGillivray
- Social Dimensions of Health Institute, University of Dundee, Airlie Place, Dundee DD1 4HJ, United Kingdom.
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Effertz T, Garlichs D, Gerlach S, Müller MJ, Pötschke-Langer M, Prümel-Philippsen U, Schaller K. Wirkungsvolle Prävention chronischer Krankheiten. PRAVENTION UND GESUNDHEITSFORDERUNG 2015. [DOI: 10.1007/s11553-014-0483-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Elliott C. Food as people: Teenagers' perspectives on food personalities and implications for healthy eating. Soc Sci Med 2014; 121:85-90. [DOI: 10.1016/j.socscimed.2014.09.044] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/20/2014] [Accepted: 09/24/2014] [Indexed: 11/30/2022]
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Bhatnagar N, Kaur R, Dudeja P. Food marketing to children in India: comparative review of regulatory strategies across the world. Indian J Pediatr 2014; 81:1187-92. [PMID: 24854368 DOI: 10.1007/s12098-014-1480-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 04/30/2014] [Indexed: 11/25/2022]
Abstract
Food marketing directed to children is an issue of concern in the present day society. Revolution in food industry, increasing globalization and boom in information technology has introduced various types of food products and the way they are placed in front of likely consumers. This has resulted in rising trend of obesity and switch from communicable to non-communicable diseases, which is not cost effective for nation as a whole. Multinational companies have targeted children as a naïve audience to boost their sales. In-ethical practice of misleading claims in the advertisements is instrumental in many cases. Food marketing to children has been assumed a public health threat since times of yore. World Health Organization has resolutions and recommendations on this subject. Member countries, including India are a signatory to this declaration. However, much needs to be done to counter these multinational food giants. Regulations and policies need to be enforced at national and institutional levels. Parents must be educated; schools and social organizations to be made proactive on this aspect.
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Affiliation(s)
- Nidhi Bhatnagar
- Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India,
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Campbell N, Pipe A, Duhaney T. Calls for Restricting the Marketing of Unhealthy Food to Children: Canadian Cardiovascular Health Care and Scientific Community Get Ignored by Policy Makers. What Can They Do? Can J Cardiol 2014; 30:479-81. [DOI: 10.1016/j.cjca.2013.11.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 11/25/2013] [Accepted: 11/26/2013] [Indexed: 11/25/2022] Open
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Smithers LG, Lynch JW, Merlin T. Industry self-regulation and TV advertising of foods to Australian children. J Paediatr Child Health 2014; 50:386-92. [PMID: 24372719 DOI: 10.1111/jpc.12488] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2013] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study is to examine the amount of non-core (unhealthy) food advertising currently on Australian television (i) during children's programmes and viewing times; (ii) since the introduction of food industry self-regulatory initiatives in 2009; and (iii) whether advertising differs according to signatory status to industry initiatives. METHODS We systematically searched PubMed, Embase.com and JSTOR (media/marketing) databases; grey literature; and reference lists of relevant articles for studies published since 2009 that reported on food advertising on Australian television. RESULTS The title and abstract of 316 articles were screened, yielding 25 articles considered potentially eligible, of which eight met the pre-defined selection criteria. Meta-analysis was not possible because of temporal and methodological differences across studies. The advertising of non-core foods was found to be negligible during programmes with a C-(children's) classification but ranged from 1.5 to 6.5/h during children's peak viewing times. From 2006 to 2011, non-core food advertising decreased by 0.18 advertisements per hour every year, whereas fast food advertising increased by 0.09/h; however, these analyses are based on one study with only five time points. During children's viewing times, signatories to industry initiatives advertise non-core foods at higher rates than non-signatories. CONCLUSIONS Although it is not possible to determine whether advertising has changed since the industry initiatives were introduced, signatories to the initiatives continue to advertise non-core foods at times when many children watch television. Future efforts to reduce children's exposure to food advertising should be focused on advertising during children's peak viewing times rather than by programme classifications.
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Affiliation(s)
- Lisa G Smithers
- School of Population Health, University of Adelaide, Adelaide, South Australia, Australia
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Jenkin G, Madhvani N, Signal L, Bowers S. A systematic review of persuasive marketing techniques to promote food to children on television. Obes Rev 2014; 15:281-93. [PMID: 24433359 DOI: 10.1111/obr.12141] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/17/2013] [Accepted: 12/04/2013] [Indexed: 12/30/2022]
Abstract
The ubiquitous marketing of energy-dense, nutrient-poor food and beverages is a key modifiable influence on childhood dietary patterns and obesity. Much of the research on television food advertising is focused on identifying and quantifying unhealthy food marketing with comparatively few studies examining persuasive marketing techniques to promote unhealthy food to children. This review identifies the most frequently documented persuasive marketing techniques to promote food to children via television. A systematic search of eight online databases using key search terms identified 267 unique articles. Thirty-eight articles met the inclusion criteria. A narrative synthesis of the reviewed studies revealed the most commonly reported persuasive techniques used on television to promote food to children. These were the use of premium offers, promotional characters, nutrition and health-related claims, the theme of taste, and the emotional appeal of fun. Identifying and documenting these commonly reported persuasive marketing techniques to promote food to children on television is critical for the monitoring and evaluation of advertising codes and industry pledges and the development of further regulation in this area. This has a strong potential to curbing the international obesity epidemic besieging children throughout the world.
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Affiliation(s)
- G Jenkin
- Health Promotion and Policy Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
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Potvin Kent M, Wanless A. The influence of the Children's Food and Beverage Advertising Initiative: change in children's exposure to food advertising on television in Canada between 2006-2009. Int J Obes (Lond) 2014; 38:558-62. [PMID: 24418894 DOI: 10.1038/ijo.2014.4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 11/25/2013] [Accepted: 01/01/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess whether children's exposure to television food/beverage advertising has changed since the implementation of the self-regulatory Canadian Children's Food and Beverage Advertising Initiative (CAI). DESIGN Data on 11 advertised food/beverage categories (candy, chocolate bars, cookies, portable snacks, cheese, yogurt, cereal, juices, soft drinks, diet soft drinks and fast food) were purchased from Nielsen Media Research for May 2006, 2009 and 2011 for the broadcasting markets of Toronto and Vancouver. The number of advertisements aired on 27 television stations between 0600 hours-1200 hours was determined in Toronto and Vancouver for May 2006, 2009 and 2011 and the percentage change in the number of spots between May 2006 and May 2011 on all stations, on children's specialty stations and on generalist stations was then calculated. The average number food/beverage spots seen by children aged 2-11 was determined for May 2006 and 2009 and the percentage change was calculated. RESULTS On children's specialty channels, a 4.5% decrease in total spots aired was observed while spots aired on generalist stations increased by 44% (Toronto) and 45% (Vancouver). On all stations, children's total average exposure to food/beverage advertising increased by 16.8% in Toronto and 6.4% in Vancouver between 2006 and 2009. Significant increases were seen in snacks and yogurt in both cities, and in fast food in Toronto. On children's specialty channels, children's exposure to the food/beverage categories considered increased by 5.4% in Toronto and by 2.5% in Vancouver. CONCLUSIONS Despite improvements in the volume of spots on children's specialty channels, children's exposure to food and beverage advertising has increased since the implementation of the CAI. The current self-regulatory system is failing to protect children from food marketing high in fat, sugar and sodium on television. Government regulation needs to be considered.
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Affiliation(s)
- M Potvin Kent
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - A Wanless
- Independent Consultant, Gatineau, QC, Canada
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Royo-Bordonada MA, Martínez-Huedo MA. Evaluation of compliance with the self-regulation agreement of the food and drink vending machine sector in primary schools in Madrid, Spain, in 2008. GACETA SANITARIA 2014; 28:65-8. [DOI: 10.1016/j.gaceta.2013.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 05/10/2013] [Accepted: 05/27/2013] [Indexed: 11/16/2022]
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Galbraith-Emami S, Lobstein T. The impact of initiatives to limit the advertising of food and beverage products to children: a systematic review. Obes Rev 2013; 14:960-74. [PMID: 23845093 DOI: 10.1111/obr.12060] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 05/24/2013] [Accepted: 05/24/2013] [Indexed: 11/28/2022]
Abstract
In response to increasing evidence that advertising of foods and beverages affects children's food choices and food intake, several national governments and many of the world's larger food and beverage manufacturers have acted to restrict the marketing of their products to children or to advertise only 'better for you' products or 'healthier dietary choices' to children. Independent assessment of the impact of these pledges has been difficult due to the different criteria being used in regulatory and self-regulatory regimes. In this paper, we undertook a systematic review to examine the data available on levels of exposure of children to the advertising of less healthy foods since the introduction of the statutory and voluntary codes. The results indicate a sharp division in the evidence, with scientific, peer-reviewed papers showing that high levels of such advertising of less healthy foods continue to be found in several different countries worldwide. In contrast, the evidence provided in industry-sponsored reports indicates a remarkably high adherence to voluntary codes. We conclude that adherence to voluntary codes may not sufficiently reduce the advertising of foods which undermine healthy diets, or reduce children's exposure to this advertising.
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Lee Y, Yoon J, Chung SJ, Lee SK, Kim H, Kim S. Effect of TV food advertising restriction on food environment for children in South Korea. Health Promot Int 2013; 32:25-34. [DOI: 10.1093/heapro/dat078] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Martins APB, Levy RB, Claro RM, Moubarac JC, Monteiro CA. Participacao crescente de produtos ultraprocessados na dieta brasileira (1987-2009). Rev Saude Publica 2013; 47:656-65. [DOI: 10.1590/s0034-8910.2013047004968] [Citation(s) in RCA: 225] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 09/09/2013] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO Estimar tendências temporais do consumo domiciliar de itens alimentícios no Brasil, levando em conta a extensão e o propósito do seu processamento industrial. MÉTODOS Os dados analisados são provenientes de Pesquisa de Orçamentos Familiares realizadas no Brasil em 1987-1988, 1995-1996, 2002-2003 e 2008-2009. Foram analisadas amostras probabilísticas dos domicílios das áreas metropolitanas em todos os períodos mencionados e, nas duas amostras mais recentes, a abrangência foi nacional. As unidades de análise foram registros de aquisições de agregados de domicílios. Os itens alimentícios foram divididos segundo extensão e propósito de seu processamento industrial em: alimentos in natura ou minimamente processados, ingredientes culinários processados e produtos alimentícios prontos para consumo, processados ou ultraprocessados. A quantidade adquirida de cada item foi convertida em energia. Estimaram-se a disponibilidade diária total per capita de calorias e a contribuição dos grupos de alimentos em cada pesquisa. Calcularam-se estimativas por quintos de renda para as pesquisas nacionais. Variações temporais foram testadas por teste de diferença de médias e modelos de regressão linear. RESULTADOS Houve aumento significativo da participação de produtos prontos para o consumo (de 23,0% para 27,8% das calorias), graças ao aumento no consumo de produtos ultraprocessados (de 20,8% para 25,4%) entre 2002-2003 e 2008-2009. Houve redução significativa na participação de alimentos e de ingredientes culinários nesse período. O aumento da participação de produtos ultraprocessados ocorreu em todos os estratos de renda. Observou-se aumento uniforme da participação calórica de produtos prontos para o consumo em áreas metropolitanas, novamente à custa de produtos ultraprocessados e acompanhada por reduções na participação de alimentos in natura ou minimamente processados quanto de ingredientes culinários. CONCLUSÕES Produtos ultraprocessados apresentam participação crescente na dieta brasileira, evidenciada desde a década de 1980 nas áreas metropolitanas e confirmada para todo o País na década de 2000.
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Elliott C, Cook B. Not so great: ten important myths about food advertising targeted to children in Canada. Child Obes 2013; 9:286-91. [PMID: 23777270 DOI: 10.1089/chi.2013.0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Rising rates of childhood obesity have led to a greater concern over the impact of food advertising on children's health. Although public policy interventions seek to mitigate the impact of advertising on children, several pervasive myths often sidetrack effective discussions. This Perspective outlines and responds to ten common myths.
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Affiliation(s)
- Charlene Elliott
- Department of Communication and Culture, University of Calgary, Calgary, Alberta, Canada.
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The epidemic of childhood obesity in the Americas must be stopped: Governmental and PAHO leadership are crucial. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2013; 3:S15-7. [PMID: 27152156 DOI: 10.1038/ijosup.2013.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Pan American Health Organization's approach to preventing child obesity is built on (1) documenting and monitoring the problem and its social and economic impacts; (2) advocating for prevention and control policies through the life-course, within and outside of the health sector; (3) leading initiatives on healthy diet and active living and educating policy makers and the public about obesogenic environments, including policies to reduce the marketing of food and beverages to children; (4) enabling healthy environments for daily life activities, especially for children in schools and community settings; (5) strengthening capacity for integrated management of obesity and noncommunicable diseases with emphasis on primary health care; and (6) mobilizing partners and resources to combat the problem.
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Raine KD, Lobstein T, Landon J, Kent MP, Pellerin S, Caulfield T, Finegood D, Mongeau L, Neary N, Spence JC. Restricting marketing to children: consensus on policy interventions to address obesity. J Public Health Policy 2013; 34:239-53. [PMID: 23447026 PMCID: PMC3644621 DOI: 10.1057/jphp.2013.9] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Obesity presents major challenges for public health and the evidence is strong. Lessons from tobacco control indicate a need for changing the policy and environments to make healthy choices easier and to create more opportunities for children to achieve healthy weights. In April 2011, the Alberta Policy Coalition for Chronic Disease Prevention convened a consensus conference on environmental determinants of obesity such as marketing of unhealthy foods and beverages to children. We examine the political environment, evidence, issues, and challenges of placing restrictions on marketing of unhealthy foods and beverages within Canada. We recommend a national regulatory system prohibiting commercial marketing of foods and beverages to children and suggest that effective regulations must set minimum standards, monitor compliance, and enact penalties for non-compliance.
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Affiliation(s)
- Kim D Raine
- Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada.
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Bogart WA. Law as a tool in "the war on obesity": useful interventions, maybe, but, first, what's the problem? THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2013; 41:28-41. [PMID: 23581655 DOI: 10.1111/jlme.12003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This article explores the effectiveness of legal interventions to promote healthier eating/drinking and exercise in responding to obesity. Undue emphasis on weight loss and prevention of excess gain have largely been failures and have fueled prejudice against fat people. A major challenge lies in shifting norms: away from stigmatization of the obese and towards more nutritious eating/drinking and increased activity with acceptance of bodies in all shapes and sizes. Part of the enormity of this challenge lies in the complex effects of law and its relationship with norms, including unintended consequences of regulation. To illustrate such complications, the paper examines two interventions and the actual effects that they have produced (or could under differing conditions): junk food taxes, particularly on SSBs (sugar sweetened beverages), and restriction of advertising to children, especially the ban in Quebec.
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Adopting and implementing nutrition guidelines in recreational facilities: tensions between public health and corporate profitability. Public Health Nutr 2012; 16:815-23. [PMID: 23149122 DOI: 10.1017/s1368980012004818] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Little is known about how public entities can partner with industry to achieve public health goals. We investigated industry's perspective of factors that influenced their adoption and implementation of voluntary, government-issued nutrition guidelines (Alberta Nutrition Guidelines for Children and Youth, ANGCY) in recreational facilities. DESIGN In-depth semi-structured interviews were conducted. Data were analysed using directed content analysis. SETTING Food services in recreational facilities. SUBJECTS Seven managers from industry participated; five from companies that had adopted and implemented the ANGCY (adopters) in recreational facilities and two from companies that had not (non-adopters). RESULTS Industry views nutrition guidelines through the lens of profitability. Non-adopters were unwilling to implement the ANGCY for fear of sacrificing short-term profitability, whereas adopters adhered to them in an attempt to position themselves for long-term profitability. Adopters faced barriers including few resources, no training, complex guidelines, low availability of and demand for ANGCY-compliant products, competitive pressures and substantial declines in revenue. Managers believed widespread voluntary adoption of the ANGCY was unlikely without government incentives and/or a mandate, as the environmental context for voluntary action was poor. All managers supported government-mandated implementation of the ANGCY to level the playing field upon which companies compete. CONCLUSIONS Public-private partnerships in recreational facilities can embrace public health goals in the short term, provided industry perceives potential for long-term financial gain. Widespread uptake of voluntary nutrition guidelines in this setting is unlikely, however, as market mechanisms do not encourage industry to sell and promote healthier options. Government legislation may therefore be warranted.
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