Preventing Childhood Obesity - Evidence Policy and Practice.pdf

The role of policy in preventing childhood obesity
Box 24.2 Ignoring the evidence —
food marketing to children
Food marketing to children
There is strong evidence that marketing works, especially
when it is specifically targeted at children and
takes advantage of their credulity. 22 – 24 There is also
strong evidence that the types of food and beverages
marketed to children are overwhelmingly energy -
dense and nutrient - poor. Furthermore, there is strong
evidence that a high intake of energy - dense foods
promotes unhealthy weight gain. Included in the evidence
mix is the concept of “ indirect evidence ” , 21
which states that there is direct evidence that marketing
influences children ’ s eating patterns but this is
proprietary information not public information.
However, based on their own direct evidence, food
companies continue to invest billions of dollars in marketing
to children so one can indirectly infer the broad
findings of the proprietary studies showing the influence
of marketing on children ’ s diets.
In spite of this weight of evidence (and support from
parents, professionals and the general public), policy
responses are few. A few examples of policies banning
food marketing to children exist but it is far less than
expected, given the likely cost – effectiveness of such
an intervention. 25 The reason, of course, is the vigorous
pressure from the food and advertising industries
on politicians not to create policies that restrict their
ability to target children. Food marketing to children
is a classic case of the pressure from vested interests
outweighing both the evidence and public and professional
calls for a tough policy response.
services in the departments of health and hospitals),
and giving the responsibility to senior ministers.
Indeed, with food prices rising, potential food
shortages looming, and food - related disease costs
escalating, a stand - alone Ministry for Food may be
warranted.
There are many possible policies that could be
included in a policy backbone for obesity prevention
and below we have outlined some of the key policies
that could be major contributors to obesity prevention
efforts.
Regulations to reduce food marketing to children:
This is such a touchstone issue for obesity prevention
that little progress is likely to be made at a population
level while there is such an enormous marketing effort
Box 24.3 Important features for a
successful policy - making process
Political will: The level of support from senior politicians
is probably the single most important determinant
of successful policy - making. These may be
expressed in a commitment through high - level
policy strategy documents.
Policy - making structure: Is the structure cross -
departmental or even cross - sectoral? Does it have
high level authority to make decisions or recommendations?
Does it have the responsibility (jurisdiction)
to implement the policies? Does it have the
capability (expertise) and capacity (resources) to
create, implement and evaluate the policies?
Policy - relevant evidence: It is important that a broad
definition of evidence is taken and preferably, that
the modeling of the costs and benefits of the policy
options have been done.
Policy development process: While there is a tendency
for some government policies to be hatched in
secrecy to maximize their “ announceability ” , this
process leaves little room for consultation with the
key stakeholders. Ideally, for maximum buy - in and
expert input, consultation needs to be an intrinsic
part of the process.
(over $10 billion/year in the USA alone) 23 undermining
the health promotion efforts of the rest of society.
Not only are bans on marketing obesogenic foods to
children probably one of the single most effective and
cost - saving strategies a government could implement,25
but they also send a very strong message to
society about what is appropriate and inappropriate
food for children.
Food service policies: Government departments and
government - funded organizations reach virtually
everyone — they are large employers, they include
many child settings, such as schools and preschools,
and they feed large numbers of people in settings such
as hospitals and prisons. If healthy food service policies
were required of all these organizations, it would
have a significant effect on actual food eaten as well as
sending loud messages to a large proportion of the
population about healthy food choices. Even if the
food eaten in these settings is a minor proportion of
the total annual food consumption, which is often the
case for schools, 26 they can have a “ lighthouse ” effect
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