Tackling food marketing to children in a digital world: trans-disciplinary perspectives. Children’s rights, evidence of impact, methodological challenges, regulatory options and policy implications for the WHO European Region

There is unequivocal evidence that childhood obesity is influenced by marketing of foods and non-alcoholic beverages high in saturated fat, salt and/or free sugars (HFSS), and a core recommendation of the WHO Commission on Ending Childhood Obesity is to reduce children’s exposure to all such marketing. As a result, WHO has called on Member States to introduce restrictions on marketing of HFSS foods to children, covering all media, including digital, and to close any regulatory loopholes. This publication provides up-to-date information on the marketing of foods and non-alcoholic beverages to children and the changes that have occurred in recent years, focusing in particular on the major shift to digital marketing. It examines trends in media use among children, marketing methods in the new digital media landscape and children’s engagement with such marketing. It also considers the impact on children and their ability to counter marketing as well as the implications for children’s rights and digital privacy. Finally the report discusses the policy implications and some of the recent policy action by WHO European Member States

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

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

Evaluating implementation of the WHO set of recommendations on the marketing of foods and non-alcoholic beverages to children: Progress, challenges and guidance for next steps in the WHO European Region

This paper describes the status of the implementation of the WHO Set of Recommendations on the Marketing of Foods and Non-alcoholic Beverages to Children (2010). The Set of Recommendations, adopted by the World Health Assembly, urges Member States to reduce the impact on children of the marketing of energy-dense, highly processed foods and beverages that are high in saturated fats, trans fats, free sugars and/or salt (HFSS). A growing body of independent monitoring and research indicates that existing policies and regulations are markedly insufficient to address the continuing challenges in this field. This report identifies loopholes, ongoing challenges, and factors that Member States need to consider to effectively limit the harmful impact that HFSS food marketing has on children, their health and their rights. Policies and regulations tend to use narrow definitions and criteria (they frequently apply to pre-digital media only, to younger children and not to adolescents, and to “child-directed” media, rather than those with the greatest child audiences), and they almost never address the complex challenges of crossborder marketing. This situation can be explained, in part, by the strong scrutiny and opposition that countries have faced from parts of the private sector, and by weak self-regulatory schemes. As a result, and in order to ensure that States uphold their legal obligations to protect the child’s right to health and related rights, the World Health Assembly requested that WHO provides additional technical support to Member States in implementing the Set of Recommendations. This report identifies challenges States need to address

Who's Feeding the Kids Online? Digital food marketing to children in Ireland: Advertisers’ tactics, children’s exposure and parents’ awareness

Obesity in children and young people is a global health challenge. The widespread marketing of unhealthy foods (food and non-alcoholic drinks high in fat, sugar and salt, or HFSS) plays a causal role in unhealthy eating and obesity. Food and eating is typically presented as an issue of ‘choice’. However, this disregards the fact that current obesogenic environments use many tactics to promote unhealthy foods, interfering with people’s ability to make good choices. This study examined: 1. Content appealing to children and young people on websites of top food and drink retail brands in Ireland 2. Marketing techniques on Facebook: Pages of food brands that have the highest reach among young teens, the first such study of which we are aware 3. Parents’ awareness of digital food marketing to their children in an online, two-stage survey with digital marketing examples and open-ended response options

Negotiating healthy trade in Australia: health impact assessment of the proposed Trans-Pacific Partnership Agreement

Drawing on leaked texts of potential provisions of the proposed Trans-Pacific Partnership Agreement, this health impact assessment found the potential for negative impacts in the cost of medicines, tobacco control policies, alcohol control policies, and food labeling. Overview The Centre for Health Equity Training Research and Evaluation (CHETRE) has been working with a group of Australian academics and non-government organisations interested in the health of the Australian population to carry out a health impact assessment (HIA) on the Trans-Pacific Partnership Agreement (TPP) negotiations. In the absence of official publicly available drafts of the trade agreement, the health impact assessment drew on leaked texts of potential provisions and formulated policy scenarios based on high priority health policies that could be affected by the TPP. The HIA found the potential for negative impacts in each of the four areas under investigation: the cost of medicines; tobacco control policies; alcohol control policies; and food labeling. In each of these areas, the HIA report traces the relevant proposed provisions through to their likely effects on the policy scenarios onto the likely impact on the health of Australians, focusing particularly on vulnerable groups in the Australian community. The report makes a number of recommendations to DFAT regarding the TPP provisions and to the Australian Government regarding the TPP negotiating process

Can Law Improve Prevention and Treatment of Cancer?

The December 2011 issue of Public Health (the Journal of the Royal Society for Public Health) contains a symposium entitled: Legislate, Regulate, Litigate? Legal approaches to the prevention and treatment of cancer. This symposium explores the possibilities for using law and regulation – both internationally and at the national level – as the policy instrument for preventing and improving the treatment of cancer and other leading non-communicable diseases (NCDs). In this editorial, we argue that there is an urgent need for more legal scholarship on cancer and other leading NCDs, as well as greater dialogue between lawyers, public health practitioners and policy-makers about priorities for law reform, and feasible legal strategies for reducing the prevalence of leading risk factors. The editorial discusses two important challenges that frequently stand in the way of a more effective use of law in this area. The first is the tendency to dismiss risk factors for NCDs as purely a matter of individual \u27personal responsibility\u27; the second is the fact that effective regulatory responses to risks for cancer and NCDs will in many cases provoke conflict with the tobacco, alcohol and food industries. After briefly identifying some of the strategies that law can deploy in the prevention of NCDs, we briefly introduce each of the ten papers that make up the symposium

Taxing food: implications for public health nutrition

AIM: To set out a policy analysis of food taxes as a way of influencing food consumption and behaviour. DESIGN: The study draws on examples of food taxes from the developed world imposed at national and local levels. Studies were identified from a systemised search in six databases with criteria designed to identity articles of policy relevance. RESULTS: The dominant approach identified from the literature was the imposition of food taxes on food to raise general revenue, such as Value Added Tax in the European Union. Food taxes can be applied in various ways, ranging from attempts to directly influence behaviour to those which collect taxes for identified campaigns on healthy eating through to those applied within closed settings such as schools. There is a case for combining taxes of unhealthy foods with subsidies of healthy foods. The evidence from the literature concerning the use and impact of food taxes on food behaviour is not clear and those cases identified are mainly retrospective descriptions of the process. Many food taxes have been withdrawn after short periods of time due to industry lobbying. CONCLUSIONS FOR POLICY: Small taxes with the clear purpose of promoting the health of key groups, e.g. children, are more likely to receive public support. The focus of many tax initiatives is unclear; although they are generally aimed at consumers, another focus could be food manufacturers, using taxes and subsidies to encourage the production of healthier foods, which could have an effect at a population level. Further consideration needs to be given to this aspect of food taxes. Taxing food (and subsidies) can influence food behaviour within closed systems such as schools and the workplace

Reducing Obesity: Policy Strategies From the Tobacco War

Outlines the impact of obesity on health, healthcare costs, and productivity. Reviews successful policy interventions to reduce tobacco use and considers whether excise or sales tax, labeling requirements, and advertising bans could lower obesity rates

Corporate political activity in the context of unhealthy food advertising restrictions across Transport for London:A qualitative case study

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

The case for and against the regulation of food marketing directed towards children

Authoritative and comprehensive reviews of studies on the nature and extent of food marketing to children indicate that children are exposed to high levels of food marketing and that the \u27marketed diet\u27 typically comprises energy-dense, micronutirent-poor foods. However, the implication of causality between marketing, product exposures and childhood obesity is not universally accepted. A vigorous discussion rages about appropriate policy responses to children\u27s exposure to food marketing. The advocacy by many health and consumer groups for tighter government restrictions on food marketing is juxtaposed to the views held by many in the food and advertising industries. Pivotal in this debate is the role of evidence in policy decisions and the appropriateness of industry self-regulation versus government intervention in food marketing. This chapter will explore the dietary and health implications of children\u27s exposure to unhealthy food marketing and present arguments for and against regulations to restrict this marketing