Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Chapter 15
Box 15.1 The findings of r eviews
in r elation to the e xtent and
n ature of f ood p romotion
• Food dominates advertising to children.
• Five product categories dominate this advertising
(soft drinks, pre - sugared cereals, confectionery,
snacks and fast - food restaurants).
• The advertised diet contrasts dramatically with the
recommended diet.
• Children engage with and enjoy this “ unhealthy ”
advertising.
The findings in relation to the effects were that:
• Food promotion influences children ’ s nutritional
knowledge, food preferences, purchasing and purchase
- related behavior, consumption, and diet and
health status.
• The extent of the influence is difficult to determine
(though advertising is independent of other factors).
• Food promotion affects both total category sales
and brand switching.
Source : Food Standards Agency, 2003 4
pre - sweetened breakfast cereals). Furthermore, the
influence is independent of other influencing variables
such as parental behavior or pricing.
The review was updated for WHO in 2006 5 and
2009, 6 taking in a global perspective. The updates
showed that, while the more complex studies have all
been undertaken in developed countries, children
respond to advertising in much the same way across
the globe. In fact, there is reason to believe that young
people in poorer countries may be even more vulnerable
to food promotion than their wealthier peers,
because they are less advertising literate and associate
developed countries ’ brands with desirable attributes
of life. They also provide a key entry point for multinationals
because they are more flexible and responsive
than their parents.
Following on from the first systematic review,
research by the UK ’ s regulatory body for the communications
industries, which includes broadcast
advertising (Ofcom), also concluded that TV advertising
influences children ’ s food behaviors and that
restrictions on TV advertising were, therefore, warranted.
7 These were phased in during 2007 – 8 and
limited the advertising of high fat, salt, sugar ( HFSS )
foods (as defined by using the UK ’ s nutrient profiling
system) on children ’ s TV programming and dedicated
children ’s channels.
Concerns were raised that the restrictions would
accelerate the trend for marketing spend to shift from
broadcast advertising to alternative (unregulated)
marketing channels. There is evidence to support this
in the initial Department of Health evaluation 8 of the
regulations, which show that a 41% decrease in HFSS
television advertising to children is offset by a 42%
increase in press advertising, and 11% increase in
radio, cinema and internet advertising. In addition, a
number of recent studies in the UK and internationally
have analysed the content of food and beverage
marketing in these other media, including children ’ s
websites,
9 – 11 children ’s magazines, 12 in-store promotions
13 and direct mailings 14 and found that HFSS
foods continue to predominate.
There has also been substantial research on parental
responses to the influence of marketing on their children.
There is a growing and consistent body of evidence
that parents perceive food marketing as a driver
of children ’ s food requests, and that it acts both as a
barrier to their efforts to encourage healthy food
choices and a source of parent – child conflict. 15,16
In summary then, the power of marketing to
encourage unhealthy behavior is well established. It is
becoming clear, however, that it can also push in the
opposite direction. Tobacco control provides some
interesting insights into how restrictions on commercial
marketing can be combined with proactive social
marketing.
Tobacco c ontrol:
t en m arketing l essons
In 1954, when Richard Doll first published his research
on British GPs showing the lethal qualities of tobacco,
some 80% of UK men smoked and women were
enthusiastically catching them up. 17 Today cigarettes
are used by fewer than a quarter of the UK population,
and in other countries this proportion is well under a
fifth.
Dietary behaviors and stakeholder responses are
still in 1954. The full enormities of the pandemic of
diet and inactivity - related non - communicable chronic
diseases are just now being appreciated. Two things
are already certain, however: the toll will continue to
rise to at least match that from tobacco, 18,19 and public
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