A rapid review of the evidence for children’s TV and online advertisement restrictions to fight obesity.
Prev Med Rep 2022;
26:101717. [PMID:
35141122 PMCID:
PMC8814640 DOI:
10.1016/j.pmedr.2022.101717]
[Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 01/11/2022] [Accepted: 01/23/2022] [Indexed: 12/31/2022] Open
Abstract
The relationship between obesity and exposure to food advertising meets all criteria commonly used to demonstrate the presence of a causal relationship in epidemiology.
Younger children (≤8 years of age) are more susceptible to the impacts of food marketing, in terms of quantity and quality of calories consumed, than older children and adults, although emerging evidence suggests that adolescents (10–19 years) may be most susceptible to the impacts of online advertisements.
Children from socio-economically disadvantaged and ethnic minority backgrounds are disproportionately exposed to unhealthy food advertisements.
Statutory regulation is a potentially cost-effective policy option, in terms of healthcare savings outweighing the costs of implementing the policy. However, advertising restrictions must be accompanied by community-based interventions that address other causes of poor diet and sedentary behaviour; this is because online and TV advertisements represent one small dimension in the wider obesogenic environment.
Voluntary bans are ineffective. Exposure to unhealthy food advertising is similar before and after the introduction of voluntary food advertisements.
The World Health Organisation has urged all governments to address rising rates of obesity by implementing population-based interventions, such as restrictions on the marketing to children of unhealthy food and beverage items. However, the relationship between unhealthy food advertisements and childhood obesity is disputed by industry-sponsored reports, which recommend promoting physical activity and weight loss campaigns rather than policies to limit exposure to advertisements. We aimed to elucidate this debate by providing a narrative review of the evidence on the relationship between unhealthy TV and online food advertisements, short-term food consumption and childhood obesity. We also examined the impact of unhealthy food advertisements on vulnerable groups and identified which policy interventions are supported by current evidence.
We conducted a rapid overview of reviews published since 2006. From a synthesis of 18 reviews meeting the inclusion criteria, we conclude that exposure to unhealthy TV and online food advertising is a contributing factor to childhood obesity. Evidence of a relationship between exposure to unhealthy food advertisements and childhood obesity was evident at all stages of the causal pathway, including a clear dose-response relationship. The evidence base was particularly strong for children aged 3–12 years of age and for children from socio-economically disadvantaged and minority ethnic backgrounds.
The introduction of statutory regulation is a potentially cost-effective policy option, in terms of healthcare savings outweighing the costs of implementing the policy, although voluntary codes were shown to be ineffective, with exposure to unhealthy food advertisements similar in countries before and after their introduction. Food advertising, however, is just one factor in the wider obesogenic environment and further advertising restrictions must be implemented alongside population-based interventions that aim to address systemic causes of poor diet.
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