Search

Objective: To assess associations between self-reported advertising exposure to foods high in fats, salt and sugar and household purchases of energy, nutrients and specific product categories., Design: A cross-sectional design was used. Advertising exposure data were gathered using a questionnaire administered to the main shopper of each household, and purchase data from supermarkets and other stores for these households were accessed for a 4-week period during February 2019., Setting: Households in London and the North of England., Participants: Representative households ( N 1289) from the Kantar Fast Moving Consumer Goods Panel. Main shoppers were predominantly female (71 %), with a mean age of 54 years (±13)., Results: Linear regression models identified that exposure to foods high in fats, salt and sugar advertising through traditional mediums (including broadcast and print), but not digital, transport, recreational or functional mediums, was associated with greater purchases of energy (9779 kcal; 95 % CI 3515, 16 043), protein (416 g; 95 % CI 161, 671), carbohydrate (1164 g; 95 % CI 368, 1886) and sugar (514 g; 95 % CI 187, 841). Generalised linear models showed that individuals who reported exposure to sugary drink advertising were more likely to purchase sugary drinks (1·16; 95 % CI 2·94, 4·99) but did not purchase more energy or nutrients from sugary drinks. There was no evidence of associations between exposure to advertising for sugary cereals or sweet snacks and purchases from these categories., Conclusions: There was a strong influence of traditional advertising and sugar-sweetened beverage advertising on household food and drink purchases, thus supporting the need for advertising restrictions across traditional formats and for sugary drinks specifically.

Issue Addressed: The pervasive promotion of energy-dense, nutrient-poor food and drinks undermines efforts by adolescents and their parent/carers to maintain a nutritious diet during a crucial developmental period. This study examined the association between awareness of food and drink advertisements and adolescents' dietary behaviours and intake., Methods: A sample of Australian secondary students aged 12-17 years (N = 8763) self-reported their awareness of food and drink advertisements across seven settings, whether they had tried a new product or asked a parent/carer to purchase a product they had seen advertised, and their consumption of various unhealthy food and drink types. Analyses used multilevel mixed-effects generalised linear models adjusted for school-level clustering, socio-demographic factors and television viewing., Results: Students with higher advertising awareness were more likely to have tried a new product they had seen advertised (adjusted prevalence ratio [APR] = 1.62, 95% CI = 1.51-1.73, p < .001) and asked their parent/carer to buy an advertised product (APR = 1.62, 95% CI = 1.51-1.73, p < .001) at least once in the past month. As advertising awareness increased, so too did students' likelihood of reporting these dietary behaviours. A high unhealthy food intake was more commonly reported among students with higher advertising awareness (APR = 1.45, 95% CI = 1.32-1.58, p < .001), as was a high unhealthy drink intake (APR = 1.29, 95% CI = 1.18-1.42, p < .001)., Conclusions: Australian adolescents are vulnerable to the persuasive effects of food and drink marketing. SO WHAT?: Greater restrictions on the way the food and drink industry can market their products to adolescents are needed to better support them in developing and maintaining positive dietary behaviours., (© 2024 Australian Health Promotion Association.)

Despite the prevalence of digital food marketing to teenagers and its potential impact on food preferences and consumption, little is known about the specific food advertisements teenagers see in Canada and how they perceive them. Further, few studies consult teenagers directly about their perceptions of teen-specific food marketing content. To shed light on such issues, this study examines perceptions of food marketing and self-reported media use of Canadian teenagers via an online survey. Four hundred and sixty-four teenagers (ages 13-17) participated. Overall, teenagers identified Instagram and TikTok as the most popular social media platforms. The top food or beverage brands that teens felt specifically targeted them were McDonald's, Starbucks, Coca-Cola and Tim Hortons, while Instagram was deemed the most important media platform when it comes to teen-targeted food marketing. Teens deemed "celebrity" and "visual style" as the most important (food and beverage) advertising techniques when it comes to persuading teenagers to buy. Overall, the study provides insights into teen media use and brand preference, including the brands teens feel target them most directly and what they consider to be salient in terms of the food advertising they see. It also provides valuable details for researchers seeking to further identify and measure elements of teen-targeted food marketing.

Objective: To establish the relationship between the marketing strategies and nutritional quality of foods and beverages promoted in television food advertisements (TV ads) seen by Colombian child audiences overall and based on child gender and socio-economic strata (SES)., Design: A quantitative content analysis of marketing appeals was combined with nutritional data of the food products advertised and matched with TV audience ratings data for each food and beverage ads for Colombian children between 4 and 11 years., Setting: All beverages and foods TV ads cable or over-the-air channels in Colombia in 2017., Participants: N/A., Results: Compared with rational appeals (e.g. freshness, health or nutrition messages), emotional appeals (referencing or depicting human senses or emotions, e.g. using cartoons to suggest fun) were more frequently used in the TV ads most viewed by Colombian children. Female children and children in lower SES tended to be more exposed to emotional appeals in TV ads than their male or higher SES counterparts. Furthermore, TV ads using more emotional appeals tended to be for products high in problematic nutrients., Conclusion: The findings of this study highlight the need to implement statutory measures to reduce the deleterious effect of food marketing on children.

Background: Through the Children's Food and Beverage Advertising Initiative (CFBAI), U.S. food companies pledge to only advertise healthier products in children's television (TV) programming, but previous research shows that highly advertised products do not qualify as nutritious according to independent nutrition criteria. In 2020, the CFBAI implemented stricter nutrition criteria for products that may be advertised to children, but the potential impact of these changes has not been assessed. This observational study evaluates (1) improvements in energy and individual nutrient composition of products that companies indicated may be advertised to children (i.e., CFBAI-listed products) in 2020 versus 2017, (2) amount of advertising on children's TV for CFBAI-listed versus other products in 2021, and 3) the nutrition quality of advertised versus non-advertised CFBAI-listed products., Methods: Data include energy, saturated fat, sodium, and sugar content and overall nutrition quality (Nutrition Profile Index [NPI] scores) of CFBAI-listed products in 2017 (n = 308) and 2020 (n = 245). Nielsen data provided total ad spending and children's exposure to ads on children's TV channels for all foods and beverages in 2021., Results: From 2017 to 2021, energy, saturated fat and sugar declined for CFBAI-listed products in three of six food categories (yogurt, sweet and salty snacks). Although CFBAI-listed products accounted for 79% of food ads viewed by children on children's TV channels, just 50% of CFBAI-listed food and 36% of drink brands were advertised on children's TV. Moreover, advertised products were significantly less nutritious than non-advertised CFBAI-listed products., Conclusion: Despite revised nutrition standards and improvements in nutrient content of some product categories, participating companies continued to primarily advertise nutritionally poor food and beverages on children's TV. CFBAI companies have not delivered on their promises to advertise healthier products to children., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Food marketing has long been recognized to influence children's food preferences and consumption patterns, yet only in recent years have teenagers been recognized as a uniquely vulnerable audience for food marketing appeals. Marketing pressures on teenagers around food promotion continue to intensify, yet little is known about the marketing channels and specific persuasive appeals targeting this audience. Given this research gap, this participatory research study engages teenagers to capture the food marketing targeting them and to identify its persuasive "power" and platforms of exposure. Using a specially designed mobile app called GrabFM! (Grab Food Marketing!) teenagers (ages 13-17, n = 309) identified and tagged examples of teen-targeted food marketing in their physical and digital environments over a 7-day period. Results reveal that: 1) digital platforms dominate teen-targeted food marketing, with over three quarters of the ads found on Instagram, Snapchat, TikTok, ad YouTube; 2) branded beverages, fast food, and candy/chocolate comprise the majority (72%) of ads; and 3) the most powerful techniques for attracting teens attention are visual style, special offer and theme. In 40% of advertisements submitted, teenagers used only one indicator to identify "teen-targeted", although older teenagers (ages 15-17) were more likely to report multiple indicators per ad. This study provides important insights into the platforms targeting teenagers (and their relative importance), the food products endorsed, and the specific appeals that teenagers find persuasive. For the purposes of monitoring, it is helpful to know that digital platforms comprise the majority of teen-directed food promotions, and that the Big Food brands have been joined by countless smaller players to sell food to teens., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: Children are frequently exposed to unhealthy food marketing on digital media. This marketing contains features that often appeal to children, such as cartoons or bold colours. Additional factors can also shape whether marketing appeals to children. In this study, in order to assess the most important predictors of child appeal in digital food marketing, we used machine learning to examine how marketing techniques and children's socio-demographic characteristics, weight, height, BMI, frequency of screen use and dietary intake influence whether marketing instances appeal to children., Design: We conducted a pilot study with thirty-nine children. Children were divided into thirteen groups, in which they evaluated whether food marketing instances appealed to them. Children's agreement was measured using Fleiss' kappa and the S score. Text, labels, objects and logos extracted from the ads were combined with children's variables to build four machine-learning models to identify the most important predictors of child appeal., Setting: Households in Calgary, Alberta, Canada., Participants: 39 children aged 6-12 years., Results: Agreement between children was low. The models indicated that the most important predictors of child appeal were the text and logos embedded in the food marketing instances. Other important predictors included children's consumption of vegetables and soda, sex and weekly hours of television., Conclusions: Text and logos embedded in the food marketing instances were the most important predictors of child appeal. The low agreement among children shows that the extent to which different marketing strategies appeal to children varies.

Background: As childhood obesity rates continue to rise, health organizations have called for regulations that protect children from exposure to unhealthy food marketing. In this study, we evaluate the impact of child-based versus time-based restrictions of "high-in" food and beverage advertising in Chile, which first restricted the placement of "high-in" advertisements (ads) in television attracting children and the use of child-directed content in high-in ads and, second, banned high-in ads from 6am-10pm. "High-in" refers to products above regulation-defined thresholds in energy, saturated fats, sugars, and/or sodium. High-in advertising prevalence and children's exposure to high-in advertising are assessed., Methods: We analyzed a random stratified sample of advertising from two constructed weeks of television at pre-regulation (2016), after Phase 1 child-based advertising restrictions (2017, 2018), and after the Phase 2 addition of a 6am-10pm high-in advertising ban (2019). High-in ad prevalence in post-regulation years were compared to prior years to assess changes in prevalence. We also analyzed television ratings data for the 4-12 year-old child audience to estimate children's ad exposure., Results: Compared to pre-regulation, high-in ads decreased after Phase 1 (2017) by 42% across television (41% between 6am-10pm, 44% from 10pm-12am) and 29% in programs attracting children (P < 0.01). High-in ads further decreased after Phase 2, reaching a 64% drop from pre-regulation across television (66% between 6am-10pm, 56% from 10pm-12am) and a 77% drop in programs attracting children (P < 0.01). High-in ads with child-directed ad content also dropped across television in Phase 1 (by 41%) and Phase 2 (by 67%), compared to pre-regulation (P < 0.01). Except for high-in ads from 10pm-12am, decreases in high-in ads between Phase 1 (2018) and Phase 2 were significant (P < 0.01). Children's high-in ad exposure decreased by 57% after Phase 1 and by 73% after Phase 2 (P < 0.001), compared to pre-regulation., Conclusions: Chile's regulation most effectively reduced children's exposure to unhealthy food marketing with combined child-based and time-based restrictions. Challenges remain with compliance and limits in the regulation, as high-in ads were not eliminated from television. Yet, having a 6am-10pm ban is clearly critical for maximizing the design and implementation of policies that protect children from unhealthy food marketing., (© 2023. The Author(s).)

Food marketing is currently a multi-billion dollar industry. High levels of child-targeted food marketing, including on food packaging, suggests the need for media literacy skills to navigate persuasive techniques on food products. Evidence-based educational content on the topic of Media Literacy & Food Marketing (MLFM) was developed for children in Grades 3 to 9. This MLFM content has been taught to thousands of Canadian children across Canada, both in-person and virtually. This Practice Note highlights key strategies and lessons from implementing the program, and provides valuable insights into effective methods for empowering children's critical thinking around food promotion.

Background: Food and beverage promotion is a contributor to children's dietary behaviours, and ultimately, downstream health consequences. Broadcast television remains an important source of such advertising. The objective of this study was to examine and compare children and adolescent's exposure to food advertising on television in Canada over an entire year in a self-regulatory environment., Methods: Television advertising data for 57 selected food and beverage categories were licensed from Numerator for 36 stations in Toronto, for 2019. The estimated average number of advertisements viewed by children aged 2-11 and adolescents aged 12-17 was determined overall, by food category, and by marketing technique. The healthfulness of advertisements was also assessed using Health Canada's Nutrient Profile Model., Results: Overall in 2019, children viewed 2234.4 food ads/person/yr while adolescents viewed 1631.7 ads, exposure for both groups stemmed primarily from stations with general appeal, and both age groups were exposed to a range of powerful marketing techniques. Exposure to advertising for restaurants, snacks, breakfast food and candy and chocolate was high among both age groups and the healthfulness of most advertised products was considered poor. Adolescents were exposed to 36.4% more food products classified as unhealthy, had higher exposure to all marketing techniques examined, and were exposed to substantially more child-related marketing techniques compared to children., Conclusion: Children and adolescents were heavily exposed to food advertisements on television in 2019. Despite current self-regulatory policies, children's exposure to unhealthy food and beverages remains high. Differences in exposure to food advertisements by food category and healthfulness may suggest that adolescents are being disproportionately targeted by food companies as a result of self-regulatory marketing restrictions., (© 2023. The Author(s).)

Background: Exposure to food and non-alcoholic beverage advertisements (F&B ads) on television, which can affect children's nutrition knowledge, food consumption, diet quality, and purchasing preferences, is one aspect of the obesogenic environment. This aspect has been well-studied and assessed in many countries. In China, however, only few studies have been done in earlier years and all of them were focus on regular days. This study aimed to assess the extent and nature of F&B ads on television (TV) during the public holiday directed towards children aged 4-14 years in Beijing., Method: Top 3 channels viewed by children aged 4-14 years in Beijing were selected by TV viewership data, survey, and expert consultation. Each channel was recorded for 7 days (24 h) during the public holiday of the Chinese New Year in 2019. F&B ads were coded and analyzed following the adapted food promotion module of INFORMAS protocol. Three nutrient profile models were used to classify F&B ads as healthy or unhealthy F&B ads., Results: Of the 10,082 ads in 504-hour recorded programs, 42.9% were F&B ads. The hourly average ads and F&B ads per channel were 19.8 (SD 15.32) and 8.6 (SD 9.84), while that was higher on the national children's channel (17.15, SD 12.25) than other channels (p < 0.05). Of F&B ads classified with the three nutrient profile models, more than 55% were unhealthy for children. The categories most frequently advertised were savory snacks, milk drinks, nonpermitted milk drinks, cakes/sweet biscuits, and beverages. Unhealthy F&B ads were more likely to use promotional characters, brand benefit claims, and health claims than permitted F&B ads (p < 0.05)., Conclusions: Children in Beijing were exposed to a high proportion of unhealthy F&B ads during the Chinese New Year holiday. Our findings support the need to assess and regulate TV F&B ads marketing for children., (© 2022. The Author(s).)

Food marketing to children is ubiquitous and persuasive. It primarily promotes foods of poor nutritional quality, influences children's food preferences and habits, and is a factor in childhood obesity. Given that food marketing relentlessly targets children in traditional/digital media and the built environment, children need critical media literacy skills that build their understanding of food marketing's persuasive effects. However, little research connects media literacy with food marketing and health, including effective strategies for teaching and evaluating such programming for children. This perspective presents the outcomes of a stakeholder meeting on best practices in teaching and evaluation on media literacy and food marketing to children. Strategies for promoting critical thinking (teaching content, teaching practices, teaching supports, and parent/caregiver involvement), and strategies for measuring critical thinking (program effectiveness and broader long-term impacts) were identified. These include, among other things, the need to capture the range of marketing formats and current food promotion trends , to include inquiry-based and co-creation activities , and to support ongoing media literacy development . Overall, these strategies suggest useful criteria for media literacy programming related to food marketing, and highlight the importance of media literacy for giving children the skills to navigate a complex food environment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Elliott, Truman, Nelson, Scheibe, Hudders, De Jans, Brisson-Boivin, McAleese, Johnson, Walker and Ellison.)

Objectives: The study objectives were to examine: (1) adolescents' media viewing habits, (2) associations with media viewing and self-reported exposure to unhealthy food and beverage advertising and (3) differences in trends among younger and older adolescents in six high and upper middle-income countries., Design: Repeat cross-sectional online survey., Setting: Australia, Canada, Chile, Mexico, the United Kingdom (UK) and the United States of America (USA)., Participants: Respondents to the International Food Policy Study who provided information on all variables of interest in November-December 2019 aged 10-17 years (n=9171)., Outcome Measures: Self-reported exposure to screen-based media (screen time by media channel), use of social media platforms and self-reported location and frequency of exposure to unhealthy food and beverage advertising., Results: The average amount of time spent in front of various screens ranged from 7.6 hours to 10.2 hours across countries per week day, which may include possible viewing of multiple media channels simultaneously. Overall, Instagram was the most popular social media platform (52%-68% by country), followed by Facebook (42%-79%) and Snapchat (28%-52%). The percentage of respondents who self-reported having seen unhealthy food advertisements in the past 30 days was highest on television (43%-69%), followed by digital media (27%-60%) and gaming applications (10%-17%). Self-reported daily exposure to advertising varied between countries for sugary drinks (10%-43%) and fast food (19%-44%) and was positively associated with self-reported screen time. Self-reported exposure to screen-based media and social media platforms differed by sociodemographic characteristics and was higher among older adolescents than younger adolescents., Conclusions: The important amount of time spent on screen-based media reported by adolescents and large percentage of adolescents reporting social media usage, coupled with high rates of self-reported advertising exposure, support the need for policies to restrict marketing of unhealthy food and beverages appealing to adolescents on screen-based media., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Unhealthy food marketing influences attitudes, preferences, and consumption of unhealthy foods, leading to excess weight gain. Outdoor advertising is highly visible (often displayed on publicly owned assets), but the evidence supporting regulation is unclear. This systematic scoping review of academic and grey literature aimed to (1) describe potential health and economic impacts of implementing government-led policies that restrict unhealthy food advertising in outdoor spaces or on public assets (including studies examining prevalence of advertising, associations with health outcomes and interventional studies); (2) identify and describe existing policies; and (3) identify factors perceived to have influenced policy implementation. Thirty-six academic studies were eligible for inclusion. Most reported on prevalence of unhealthy food advertising, demonstrating high prevalence around schools and in areas of lower socioeconomic position. None examined health and economic impacts of implemented policies. Four jurisdictions were identified with existing regulations; five had broader marketing or consumer protection policies that captured outdoor food marketing. Facilitators of policy implementation included collaboration, effective partnerships, and strong political leadership. Barriers included lobbying by food, media, and advertising industries. Implementation of food marketing policies in outdoor spaces and on public assets is feasible and warranted. Strong coalitions and leadership will be important to drive the policy agenda forward., (© 2021 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Objective: To describe US adults' levels of support, neutrality and opposition to restricting junk food advertising to children on social media and explore associations with socio-demographic and health-related characteristics., Design: In 2020-2021, we used cross-sectional data from the National Cancer Institute's 2020 Health Information National Trends Survey to estimate the prevalence of opinions towards advertising restrictions and correlates of neutrality and opposition using weighted multivariable logistic regression., Setting: United States., Participants: Adults aged 18+ years., Results: Among the analytic sample (n 2852), 54 % of adults were neutral or opposed to junk food advertising restrictions on social media. The odds of being neutral or opposed were higher among Non-Hispanic Black adults (v. non-Hispanic White; OR: 2·03 (95 % CI 1·26, 3·26)); those completing some college (OR: 1·68 (95 % CI 1·20, 2·34)) or high school or less (OR: 2·62 (95 % CI 1·74, 3·96)) (v. those with a college degree); those who were overweight (v. normal weight; OR: 1·42 (95 % CI: 1·05, 1·93)) and those reporting a moderate (OR: 1·45 (95 % CI 1·13, 1·88)) or conservative (OR: 1·71 (95 % CI 1·24, 2·35)) political viewpoint (v. liberal). Having strong (v. weaker) weight and diet-related cancer beliefs was associated with 53 % lower odds of being neutral or opposed to advertising restrictions (OR: 0·47 (95 % CI 0·36, 0·61))., Conclusions: The current study identified subgroups of US adults for whom targeted communication strategies may increase support for policies to improve children's food environment.

Online food delivery (OFD) platforms guarantee access to food during the coronavirus disease 2019 (COVID-19) pandemic when commercial food establishments are closed and access to food retail is controlled. The present study aimed to describe the advertisements published in an OFD platform in Brazilian capitals, during the 13th and 14th weeks of the pandemic. Data collection occurred on 1 d of the week and 1 d of the weekend and during lunch and dinner time. A random sample of 25 % of the advertisements (n 1754) published in this period was classified in accordance with the presence of food groups and to the use of marketing strategies. Sandwiches, ultra-processed beverages, traditional meals or pasta were the most common food groups shown in the advertisements. Free delivery prevailed in advertisements of ice cream, candies or salty packages snacks and pizza (P < 0·01). Combos were more frequently shown in the advertising of natural juices or smoothies, ultra-processed beverages, sandwiches and pizzas (P < 0·01). Messages about healthiness were more seen among natural juices or smoothies, vegetables and traditional meals and pasta advertisements (P < 0·01) and less seen in sandwiches (P = 0·02) and pizza advertisements (P < 0·01). Economy messages were rare in advertisements of traditional meals or pasta (P < 0·01) and more common in ultra-processed beverages (P = 0·03) and ice cream, candies or salty packages snacks (P < 0·01) advertisements. The OFD platform promoted unhealthy eating during the COVID-19 pandemic in Brazil due to the expressive presence of unhealthy foods advertising.

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.

Background: Marketing of unhealthy foods and beverages is recognized as a contributing factor to the global increase in overweight and obesity, particularly among children. Such marketing negatively affects children's dietary preferences, food choices, purchasing requests, and consumption patterns. Given that little is known about food marketing in Africa, including in Uganda, monitoring children's exposure to food marketing is essential to generate evidence on the problem and develop meaningful policy responses. The aim of this study was to describe the food and beverage marketing environment surrounding schools in urban and peri-urban areas of Kampala city., Methods: Outdoor advertising around 25 randomly sampled primary and secondary schools within a radius of 250 m of each school was mapped. Information on size, setting, type, and position of the advertisements and the healthiness of the foods and beverages promoted was collected using the INFORMAS Outdoor Advertising Protocol. The occurrence of advertising was described using frequencies, median, and density per 100m 2 ., Results: A total of 1034 branded advertisements were identified around the schools. Of these, 86% featured unhealthy products, 7% healthy products, and 7% miscellaneous products. The most advertised products were sugar-sweetened beverages and alcoholic beverages (51 and 23%, respectively). Schools in the urban area were surrounded by more unhealthy ads than those in the peri-urban areas (median of 45 vs 24 advertisements)., Conclusion: The widespread extent of unhealthy food and beverage advertisements around primary and secondary schools highlights the need for food marketing regulation in Uganda, in line with the World Health Organization's recommendations, to ensure that young people are protected from unhealthy food marketing.

Background: The Chilean government implemented the first phase of a comprehensive marketing policy in 2016, restricting child-directed marketing of products high in energy, total sugars, sodium or saturated fat (hereafter "high-in")., Objectives: To examine the role that high-in TV food advertising had in the effect of the policy on consumption of high-in products between 2016 and 2017., Methods: Dietary data were obtained from 24-hour diet recall measured in 2016 (n = 940) and 2017 (n = 853), pre- and post-policy, from a cohort of 4 to 6 years children. Television use was linked to analyses of food advertisements to derive individual-level estimates of exposure to advertising. A multilevel mediation analysis examined direct and indirect effects of the policy through advertising exposure., Results: Children's high-in food consumption and advertising exposure declined significantly from 2016 to 2017 (P < .01). Consumption changes were not significantly mediated by changes in advertising exposure, which might suggest other elements of the Chilean Law potentially driving decreases in consumption to a greater extent than TV ads., Conclusions: Preschoolers' exposure to high-in advertising and consumption of high-in products decreased post-policy. Further research is needed to understand how marketing changes will relate to dietary changes after full implementation of the law and in the long term., (© 2020 World Obesity Federation.)

Purpose of Review: Given the need to limit unhealthy food marketing to children, more information is required around strategies for its monitoring. Child-directed food packaging, in particular, requires special consideration: packaging drives decision-making at the point-of-sale and is a powerful means of capturing children's attention. This review examines and summarizes literature that monitors the "power" (persuasive techniques) of packaging, in order to assess what these broader strategies contribute to monitoring child-targeted packaged foods., Recent Findings: Eleven relevant studies on monitoring (spanning food, tobacco, and cannabis packaging) were examined. Strategies regarding the precise measurement indicators, accurate data collection and management, and time trends analysis were identified; from this, a set of criteria for monitoring the power of packaging in retail settings was proposed. Examining literature on the monitoring of the "power" of packaging reveals the paucity of research in this area. This review details how packaging features can be effectively tracked in different contexts and over time.

Objectives: Data on gender representation in food and beverage advertisements may allow for a better understanding of how the food industry is targeting different audiences based on gender. Nonetheless, scant research on food and beverage print advertising with a gender approach has been conducted. Therefore, we sought to assess the prevalence of gender focus in print advertisements found inside corner stores in two cities: Guatemala City, Guatemala, and Lima, Peru., Data Description: We developed two complementary datasets as part of the study: (1) a dataset of digital photographs of 200 food and beverage print advertisements found in corner stores located near schools (100 ads per country selected according to criteria such as product type, image quality, and uniqueness); (2) a quantitative dataset with data of the content analysis of these photographs. We employed 19 variables to record the general information and gender assessment of the ads. These datasets should allow scholars and public officials to identify gender-specific marketing strategies of the food industry that might impact children's and adolescents' nutrition differently.

The consumer food environment is changing: an extensive variety of foods are now available in most markets, offering palatability, convenience and novelty. However, little is known about the availability and advertising of food items within food outlets, especially among developing countries. The present study examined these dimensions in 281 food outlets located around eighteen primary healthcare services in Belo Horizonte, Brazil, in 2013. These establishments were classified as large-chain supermarkets; specialised fruits and vegetable (F&V) markets; and local grocery stores, convenience stores or bakeries. Availability of F&V, availability of ultra-processed foods (UPF) and food advertising were compared across the food outlet categories by applying the χ test. Almost 60 % of the food outlets were specialised F&V markets, 21⋅4 % were large-chain supermarkets and 19⋅2 % were local grocery stores, convenience stores or bakeries. Almost 80 % contained at least eight types of fruits and vegetables, and 60 % contained UPF. Food advertisement was absent in 59⋅8 % of the food outlets, 19⋅6 % were advertising only F&V and 17⋅4 % were advertising only UPF. Higher F&V availability was noted inside specialised F&V markets and large-chain supermarkets than local grocery stores, convenience stores or bakeries. Advertising of F&V was more common within specialised F&V markets. However, large-chain supermarkets and local grocery stores, convenience stores or bakeries contained more frequent UPF food advertising isolated: 38⋅3 and 35⋅2 %, respectively. Therefore, the availability and advertising of food items within food outlets around primary healthcare services are different according to the type of food outlet.2 test. Almost 60 % of the food outlets were specialised F&V markets, 21⋅4 % were large-chain supermarkets and 19⋅2 % were local grocery stores, convenience stores or bakeries. Almost 80 % contained at least eight types of fruits and vegetables, and 60 % contained UPF. Food advertisement was absent in 59⋅8 % of the food outlets, 19⋅6 % were advertising only F&V and 17⋅4 % were advertising only UPF. Higher F&V availability was noted inside specialised F&V markets and large-chain supermarkets than local grocery stores, convenience stores or bakeries. Advertising of F&V was more common within specialised F&V markets. However, large-chain supermarkets and local grocery stores, convenience stores or bakeries contained more frequent UPF food advertising isolated: 38⋅3 and 35⋅2 %, respectively. Therefore, the availability and advertising of food items within food outlets around primary healthcare services are different according to the type of food outlet., (© The Author(s) 2020.)

Objectives: This study investigated the use of persuasive advertising strategies in ultra-processed food (UPF) advertisements broadcast on the three most popular free-to-air television channels in Brazil., Methods: The programming of the selected channels was recorded on eight non-consecutive days from April 2018 (6:00 am-12:00 am). Information from each advertising piece was collected through an electronic questionnaire based on the INFORMAS protocol. Food products were classified according to the NOVA classification system. Marketing strategies were investigated in UPF advertisements and stratified into three groups. Principal component analysis was used to identify patterns of strategies. Linear regression models were employed to investigate the association between the patterns and food groups., Results: In total, 90.77% of the food-related advertisements contained at least one UPF, and 96% of them included one or more persuasive advertising strategies. Five advertising patterns were identified and associated with the UPF food groups., Conclusions: The results showed that food advertising on Brazilian free television is marked by UPF, with the predominant use of persuasive advertising strategies, demonstrating a lack of enforcement of the current regulatory legislation in the country.

Child-targeted food marketing is a significant public health concern, prompting calls for its regulation. Product packaging is a powerful form of food marketing aimed at children, yet no published studies examine the range of literature on the topic or the "power" of its marketing techniques. This study attempts such a task. Providing a systematic scoping review of the literature on child-targeted food packaging, we assesses the nutritional profile of these foods, the types of foods examined, and the creative strategies used to attract children. Fifty-seven full text articles were reviewed. Results identify high level trends in methodological approaches (content analysis, 38%), outcomes measured (exposure, 44%) and with respect to age. Studies examining the nutritional profile of child-targeted packaged foods use various models, classifying from anywhere from 41% to 97% of products as unhealthy. Content analyses track the prevalence of child-targeted techniques (cartoon characters as the most frequently measured), while other studies assess their effectiveness. Overall, this scoping review offers important insights into the differences between techniques tracked and those measured for effectiveness in existing literature, and identifies gaps for future research around the question of persuasive power-particularly when it comes to children's age and the specific types of techniques examined., Competing Interests: The authors declare no conflict of interest.

: Background: To determine how many adolescents follow food/beverage brands on Instagram and Twitter, and examine associations between brands' youth-targeted marketing practices and percentages of adolescent followers., Methods: We purchased data from Demographics Pro to characterize the demographics of Twitter and Instagram users who followed 27 of the most highly advertised fast food, snack, and drink brands in 2019. We used one-sample t -tests to compare percentages of adolescent followers of the selected brands' accounts versus all social media accounts, independent samples t -tests to compare followers of sugary versus low-calorie drink brands, and linear regression to examine associations between youth-targeted marketing practices and the percentages of adolescent followers., Results: An estimated 6.2 million adolescents followed the selected brands. A higher percentage of adolescents followed the selected brands' accounts (9.2%) compared to any account on Twitter (1.2%) ( p < 0.001), but not Instagram. A higher percentage of adolescents followed sugary (7.9%) versus low-calorie drink brands (4.3%) on Instagram ( p = 0.02), but we observed the opposite pattern for adults on Twitter and Instagram. Television advertising expenditures were positively associated with percentages of adolescent followers of the selected brands on Twitter ( p = 0.03), but not Instagram., Conclusions: Food and sugary drink brands maintain millions of adolescent followers on social media., Competing Interests: The authors declare no conflict of interest.

Background: Children are inhabitants of a media-rich environment rife in extensive, sophisticated, and persistent techniques that are used to market unhealthy food. Exposure is known to influence children's attitudes, choices, and consumption, yet further research is required to explore the influence of contemporary techniques within online games., Objective: To explore the influence of modern advertising on children's attitudes, choices, and consumption, techniques (ie, banner advertising, advergame, and rewarded video advertising) were used to promote an unfamiliar confectionery brand within an online game., Design: A between-subjects randomized experimental study., Participants/setting: Children (aged 7 to 12 years [n=156]) were recruited in New South Wales, Australia, between September and November 2017., Intervention: Children were required to play a 4-minute online game, complete some questionnaires, and choose one snack to consume afterward. Children were randomly assigned to one of four conditions: a control group with no advertising, and three experimental conditions that promoted an unfamiliar confectionery brand via a banner advertisement, advergame, or rewarded video advertisement., Main Outcome Measures: Questionnaires included the assessment of attitudes to the test brand before and after the game, enjoyment of the game, and children's awareness of advertising. Food choice was recorded and food consumption was measured by weighing the snack in grams, which was translated into kilocalories., Statistical Analyses Performed: Statistical tests included analyses of variance, Kruskal-Wallis test, and χ 2 test., Results: Attitudes toward the perception of fun (P=0.06) and taste (P=0.21) of the test brand were not influenced by condition. Children who were exposed to the rewarded video advertising chose the test brand significantly more than children in the other three conditions (P<0.002). Condition did not influence overall energy intake measured in grams (P=0.78) or kilocalories (P=0.46)., Conclusions: Children's choice of the test brand was significantly influenced by the rewarded video advertising condition (compared with control, banner advertising, and advergame conditions). This technique is prevalent across online and application games that children play yet the effects of using rewarded video advertising to promote food brands have not been explored from a public health perspective. This study contributes to the understanding of modern strategies used to market unhealthy foods to children., (Copyright © 2020 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objective: To examine the frequency of television (TV) food and beverage advertisements (F&B ads) to which children (4-11 years) are likely exposed and the nutrient profile of products advertised., Design: TV broadcasting between September and November 2016 was recorded (288 h of children's programming; 288 h of family programming) resulting in 8980 advertisements, of which 1862 were F&B ads. Of those, 1473 could be classified into one of the seventeen food groups, and into permitted/non-permitted according to the WHO-EU nutrient profile model. Persuasive marketing techniques used were also identified., Setting: TV programming was recorded for four weekdays and four weekend days, between 06.00 and 00.00 hours (576 total hours), for four channels (two national and two cable), in Costa Rica., Results: Mean (sd) number of F&B ads/h was greater in cable than national channels (3·7 (0·4) v. 2·8 (0·4), P < 0·05) and during children's peak viewing hours (4·4 (0·4) v. 2·9 (0·3)). Of F&B ads classified with WHO-EU nutrient profile model (n 1473, 71·1 %), 91·1 % were non-permitted to be marketed to children. Categories most frequently advertised were ready-made/convenience foods (16 %), chocolates/confectionery/desserts (15 %), breakfast cereals (14 %), beverages (15 %), edible ices (9 %) and salty snacks (8 %). Non-permitted F&B ads were more likely to use promotional characters, brand benefit claims, and nutrition and health claims than permitted F&B ads., Conclusions: Children watching popular TV channels in Costa Rica are exposed to a high number of unhealthy F&B ads daily. Our findings help justify the need for regulatory actions by national authorities.

Children's favourite food and beverage brands use various tactics to foster positive associations and loyalty. This brand-consumer dynamic is frequently influenced by the use of implicit techniques and emotional appeals. Few studies have used physiological methods to examine the connections that brands build with children and the influence this has on their automatic responses. These techniques are potentially less prone to bias than behavioural or cognitive methods. This is the first study to explore the implicit response that children have to images of their favourite food and beverage brands using skin conductance responses as a marker of arousal. Australian children aged 8-11 years ( n = 48) were recruited. Images of the participants' favourite branded food and beverage products, alongside images of the same products unpackaged, their family and friends, and neutral objects were presented in a randomised order with a standard timed interval between images. Children were significantly more aroused by branded images of their favourite food and beverage products than by their unpackaged counterparts ( p < 0.042, d = 0.4). The physiological response to the branded products was similar to the response to the children's family and friends ( p = 0.900, d = -0.02). These findings suggest that children may have an implicit connection to their favourite branded products.

Evidence demonstrating links between exposure to unhealthy food marketing, poor eating behaviours and paediatric obesity has led to calls for regulatory change in many countries, including the UK. However no official monitoring system exists to inform international debate on food advertising policy. This study systematically explores food advertising on UK television in 2010 (post-regulation) and compare this to 2008 (mid-regulation) to assess if food adverts improved in nutritional quality after implementation of regulations. Television was recorded between 6 a.m. and 10 p.m. for one weekday and one weekend day during 6 months of 2010 across 13 commercial television channels popular with children. These data were directly compared with previously published data for 2008. Food and beverages were the third most frequently advertised product type (11.9% of all ads), a decrease of 0.9% from 2008 (12.8%). Non-core food commercials decreased (down 2.2-53.8%) and core food advertising increased (up 0.5-18.6%). Fast food items were the third most frequently advertised food product (15.4%, up 3.5% from 2008). During peak children's viewing times, 17.0% of all commercials were for food, an increase of 4.7% from non-peak children's viewing times and fewer core (-0.9%) and more non-core (+0.5%) foods were advertised at these times. Despite statutory regulation, frequency and balance of food commercials (core, non-core and miscellaneous) remained relatively static over the 2 years. Children are still exposed to high amounts of unhealthy food advertising on television. Continued monitoring of television food advertising remains crucial and policymakers should examine the comparative efficacy of other restrictions., (© The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Objective: In the light of Chile's comprehensive new restriction on unhealthy food marketing, we analyse food advertising on Chilean television prior to the first and final phases of implementation of the restriction., Design: Content analysis of marketing strategies of 6976 advertisements, based on products' nutritional quality. Statistical analysis of total and child audience reached using television ratings data., Setting: Advertising from television aired between 06.00 and 00.00 hours during two random composite weeks across April-May 2016 from the four broadcast and four cable channels with the largest youth audiences., Results: Food ads represented 16 % of all advertising; 34 % of food ads featured a product high in energy, saturated fats, sugars and/or salt (HEFSS), as defined by the initial regulation. HEFSS ads were seen by more children and contained more child-directed marketing strategies than ads without HEFSS foods. If HEFSS advertising was restricted only in programmes where 20 % are children aged 4-12 years, 31 % of children's and 8 % of the general audience's HEFSS advertising exposure would be reduced. The newest 06.00-22.00 hours restriction captures 80 % of all audience exposure., Conclusions: HEFSS advertising was seen by a large proportion of children before Chile's regulation. Chile's first implementation based on audience composition should reduce a third of this exposure and its second restriction across the television day should eliminate most of the exposure. The current study is a crucial first step in evaluating how Chile's regulation efforts will impact children's diets and obesity prevalence.

Objective: The World Health Organization has recommended that advertising of unhealthy food to children decrease in quantity (exposure) and efficacy (power). The degree to which marketing practices align with these recommendations varies across countries. The purpose of this study is to describe the television food marketing landscape that children experience in the South Asian country of Nepal., Research Methods & Procedures: Commercials from 57hours of television were recorded from three channels during hours that children's programming was played. In a content analysis of 1,203 food commercials, researchers coded commercials for nutrition content, product category and marketing appeal type., Results: Principal findings of this study were that nearly 21% of airtime during children's programming was dedicated to commercials, and 55% of that was dedicated to foods. Over 70% of food commercials aired advertised foods with excessive amounts of saturated fat, sugar, and/or sodium; nearly half of the commercials (47.7%) featured products that contained excess sugar. The most prevalent food types shown were ice cream and popsicles (20.7%), energy/nutritional supplements (20.6%), and candy (14.7%). Additionally, the three most commonly occurring marketing appeals featured highly-efficacious strategies for persuading children-animated effects (83.2%), movie, cartoon, animated, or costumed characters (36.8%), and television/movie tie-ins (16.5%)., Conclusion(s): Results from this study suggest that many television commercials shown in Nepal do not meet WHO recommendations for advertising foods to children. This is likely to negatively impact the diet and health of the next generation of Nepalis., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Unhealthy food marketing to children is a key risk factor for childhood obesity. Online video platforms have surpassed television as the primary choice for screen viewing among children but the extent of food marketing through such media is relatively unknown. We aimed to examine food and beverage advertisements (ads) encountered in YouTube videos targeting children in Malaysia., Methods: The social media analytics site SocialBlade.com was used to identify the most popular YouTube videos (n = 250) targeting children. Ads encountered while viewing these videos were recorded and analyzed for type of product promoted and ad format (video vs. overlay). Food and beverage ads were further coded based on food category and persuasive marketing techniques used., Results: In total 187 ads were encountered in sampled videos. Food and beverage ads were the most common at 38% (n=71), among which 56.3% (n = 40) promoted noncore foods. Ads for noncore foods were more commonly delivered as video rather than overlay ads. Among ads promoting noncore foods, the most commonly employed persuasive marketing techniques found were taste appeal (42.3%), uniqueness/novelty (32.4%), the use of animation (22.5%), fun appeal (22.5%), use of promotional characters (15.5%), price (12.7%), and health and nutrition benefits (8.5%)., Conclusions: Similar to television, unhealthy food ads predominate in content aimed toward children on YouTube. Policies regulating food marketing to children need to be extended to cover online content in line with a rapidly-evolving digital media environment. Service providers of social media can play a part in limiting unhealthy food advertising to children.

Objectives: To analyse marketing techniques used in television advertisements of food and drinks (AFDs) directed to children, and their nutritional quality., Methods: This is a cross-sectional study of television AFDs directed to children in Spain over 7 days in 2012. Primary appeal, persuasive and nutritional marketing techniques, and links to Internet were registered. The foods were classified according to their nutritional quality using an international codification system and the UK nutrient profile model. Frequency of AFDs using marketing techniques and percentages for unhealthy products were calculated., Results: Taste and fun were the main primary appeals used. Persuasive and nutritional marketing techniques and links to Internet were used in 61%, 68.5% and 65.2% of AFDs, respectively. These techniques were more common during weekdays, enhanced protection time slots and on channels with particular appeal to children. More than two-thirds of AFDs using these techniques were for unhealthy products, reaching 96.2% of AFDs with premium offers and gifts., Conclusions: There is an extensive use of marketing techniques in television AFDs directed to children in Spain. Most products advertised were unhealthy, so stronger governmental regulations are required.

Monitoring the creative content within food marketing to children is strongly advocated by public health authorities, but few studies address the prevalence of health-related messaging in television adverts. Food and beverage adverts ( n = 18,888 in 2008, n = 6664 in 2010) from UK television channels popular with children were coded and analyzed. Physical-activity depiction displayed an 18.8 percentage point increase from 2008 (4.4%) to 2010 (23.2%). Of the food adverts containing physical-activity depiction in 2010, 81.1% were for non-core foods. The appearance of health claims in food adverts in 2010 increased 4.1 percentage points from 2008 levels (20.7% to 24.8%) where the majority of food adverts featuring health and nutrition claims were for non-core foods (58.3%). Health-related (e.g., health/nutrition, weight loss/diet) appeals were used in 17.1% of food adverts during peak child-viewing times, rising to 33.0% of adverts shown on dedicated children's channels in 2010. Implicit (physical activity) and explicit (health claims) health messages are increasingly prevalent in UK television food advertising viewed by children, and are frequently used to promote unhealthy foods. Policy makers in the UK should consider amendments to the existing statutory approach in order to address this issue., Competing Interests: Rosa Whalen, Emma Boyland and Simon Child declare that they have no conflicts of interest. Halford’s research was funded through grants by MRC, EUFW7, BBSRC, ERSC, California Prune Board and Ingredion and the University has a partnership with American Beverage Association (ABA). The University is paid for consultancy on health, weight management and appetite control expertise by the food and beverage, commercial weight management, pharmaceutical and ingredient sectors. No personal consultancies are taken. The laboratory has studentships funded through BBSRC and ESRC with Unilever, Coca-Cola and Tate & Lyle. Those related to eating behaviour focus on the potential benefits of dietary fibre in appetite and weight control. There has been and is no industry involvement in any of the health policy related research the laboratory has conducted over the past 12 years.

Previous studies indicated that television (TV) advertising is associated with higher rates of obesity. The rate of obesity and overweight continues to rise in mainland China, bringing into question whether TV advertising to young audiences might be partly to blame. This study investigated messaging delivered through TV advertisements regarding healthy and unhealthy foodstuffs. A total of 42 major food brands and 480 advertisements were analysed for content in this study. The results showed that the majority of TV spots advertised products with poor nutritional content and had a potential to mislead audiences concerning products' actual nutritional value. The tactics of repetition and appeals of premium offerings on food brands have a potential to influence the purchase intentions. Additional qualitative observation involving the social bond, social context and cultural factors pertaining to mood alterations were highlighted. The discussion addressed product attributes reflected by culture and the implicit messages of marketing claims may increase the risk of obesity. Thus, public health policymakers and researchers were encouraged to act urgently to evaluate the obesity risks of unhealthy food advertised in the media and to support healthy foods., Competing Interests: The authors declare no conflicts of interest.

Objective: To comprehensively assess the extent, nature and impact of unhealthy food advertising targeted to children on New Zealand television., Design: Four weekdays and four weekend days were randomly selected over the period June-August 2015. Programming was recorded from 06.00 to 00.00 hours (midnight), for a total of 432 h. Audience ratings were used to identify children's peak viewing times., Setting: New Zealand., Subjects: The three major free-to-air channels., Results: The majority of foods advertised (n 1807) were unhealthy; 68·5 % of food advertisements included at least one food not permitted to be marketed to children according to the WHO nutrient profiling model. The mean hourly rate of unhealthy food advertising was 9·1 (sd 5·2). One-third of unhealthy food advertisements included a promotional character and one-third a premium offer. About 88 % of unhealthy food advertisements were shown during children's peak viewing times. If unhealthy food advertisements were to be restricted during times when at least 25 % of children are watching television, this would reduce the average unhealthy food advertising impact by 24 % during weekdays and 50 % during weekend days, and if the WHO instead of the current nutrient profiling model were used to restrict unhealthy food advertising to children, the average impact would be reduced by 24 % during weekdays and 29 % during weekend days., Conclusions: Current self-regulation is ineffective in protecting children from exposure to unhealthy food advertising on television. The WHO nutrient profiling model needs to be used to restrict unhealthy food advertising, especially during children's peak viewing times.

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., Competing Interests: Rachel Prowse has no financial relationships that may pose a conflict of interest.

Objectives: This was a two-part descriptive study designed to (1) assess the marketing themes and sugar content of beverages promoted in outdoor advertisements (ads) within a portion of Accra, Ghana and (2) quantify the types of ads that appeared along the Accra-Cape Coast Highway., Setting: A 4.7 km 2 area of Accra, Ghana and a 151 km region along the highway represented the target areas for collecting photos of outdoor beverage ads., Primary and Secondary Outcome Measures: Number and types of beverage ads, sugar content of beverage products featured in ads and marketing themes used in ads., Design: Two researchers photographed outdoor beverage ads in a 4.7 km 2 area of Accra and used content analysis to assess marketing themes of ads, including the portrayal of children, local culture, music, sports and health. Researchers also recorded the number and type of ads along a 151 km stretch of the Accra-Cape Coast Highway. Researchers assessed the added sugar content to determine which beverages were sugar-sweetened beverages (SSBs)., Results: Seventy-seven photographed ads were analysed. Seventy-three per cent (72.7%) of ads featured SSBs, and Coca-Cola accounted for 59.7% of ads. Sixty-five per cent (64.9%) of all ads featured sodas, while 35.1% advertised energy drinks, bottled or canned juice drinks and coffee-based, milk-based and water-based beverages. Thirteen per cent (13%) of ads featured children and 5.2% were located near schools or playgrounds. Nine per cent (9.1%) of ads contained a reference to health and 7.8% contained a reference to fitness/strength/sport. Along the Accra-Cape Coast Highway, Coca-Cola accounted for 60% of branded ads., Conclusion: This study demonstrates the frequency of outdoor SSB ads within a 4.7 km 2 area of Accra, Ghana. Coca-Cola was featured in the majority of ads, and the child-targeted nature of some ads indicates a need to expand the Children's Food and Beverage Advertising Initiative pledge to reduce child-targeted marketing on a global scale., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: Over-consuming unhealthful foods and beverages contributes to pediatric obesity and associated diseases. Food marketing influences children's food preferences, choices, and intake., Objective: To examine whether adding licensed media characters to healthful food/beverage packages increases children's attention to and preference for these products. We hypothesized that children prefer less- (vs more-) healthful foods, and pay greater attention to and preferentially select products with (vs without) media characters regardless of nutritional quality. We also hypothesized that children prefer more-healthful products when characters are present over less-healthful products without characters., Design: On a computer, participants viewed food/beverage pairs of more-healthful and less-healthful versions of similar products. The same products were shown with and without licensed characters on the packaging. An eye-tracking camera monitored participant gaze, and participants chose which product they preferred from each of 60 pairs., Participants/setting: Six- to 9-year-old children (n=149; mean age=7.36, standard deviation=1.12) recruited from the Twin Cities, MN, area in 2012-2013., Main Outcome Measures: Visual attention and product choice., Statistical Analyses Performed: Attention to products was compared using paired-samples t tests, and product choice was analyzed with single-sample t tests. Analyses of variance were conducted to test for interaction effects of specific characters and child sex and age., Results: Children paid more attention to products with characters and preferred less-healthful products. Contrary to our prediction, children chose products without characters approximately 62% of the time. Children's choices significantly differed based on age, sex, and the specific cartoon character displayed, with characters in this study being preferred by younger boys., Conclusions: Results suggest that putting licensed media characters on more-healthful food/beverage products might not encourage all children to make healthier food choices, but could increase selection of healthy foods among some, particularly younger children, boys, and those who like the featured character(s). Effective use likely requires careful demographic targeting., (Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objective: In 2006, food industry self-regulatory efforts aimed to balance the mix of food advertisements to limit children's exposure to unhealthy food products. An update to these efforts proposed to eliminate all unhealthy advertisements during peak child viewing times and implement uniform nutrition criteria by December, 2013. Marketing techniques are not currently addressed in self-regulatory efforts. The food industry's pledge prompted researchers to conduct a content analysis to assess nutritional quality and presence of persuasive marketing techniques in child-directed food and beverage advertisements., Study Design: Content analysis., Methods: 32 h of children's television programming were recorded in February, 2013. Three independent coders assessed the nutritional content of food and beverage advertisements using the UK Nutrition Profiling System and assessed presence of persuasive techniques (PTs) using a rating form developed for this study., Results: Overall, 13.75% of advertisements promoted a food or beverage product. Most food advertisements, 54.6%, represented unhealthy products and 95.48% of food advertisements contained at least one PT. The number of PTs was not significantly different for healthy (M = 4.98, SD = 2.07) and unhealthy food advertisements (M = 4.66, SD = 1.82) however food advertisements aimed at children used significantly more PTs (M = 5.5, SD = 1.43) than those targeting adults (M = 1.52, SD = 1.54), t (153) = 11.738, P < 0.0001. Saturday morning children's programming showed significantly fewer food advertisements compared to weekday morning children's programming., Conclusions: While a majority of food-related advertisements represented unhealthy items, advertisements airing during Saturday morning programming featured fewer food advertisements overall and were more frequently for healthier items compared to weekdays. Industry self-regulation may not be effective for reducing overall unhealthy ad exposure but may play a role in reduced exposure on weekends. Despite policy efforts, additional changes are needed to improve ad exposure experienced by children with a focus on addressing the persistent use of persuasive marketing techniques in food advertising intended for children., (Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

The essential adaptive food selection behavior of young children has become increasingly medicalized as a kind of disease-the "picky-eating" syndrome in Hong Kong. The researcher used the multiple case studies approach with data collected from in-depth interviews and advertisements to examine the process of the medicalization of picky-eating disorder, which demonstrates how an essential adaptive human behavior can be redefined by the market and medical system as a deviant, abnormal behavior that needs to be eliminated and how the resulting health risks can be resolved by modern medicine produced by this pharmaceutical nexus.

Objective: To investigate how food commercials influence children's food choices., Study Design: Twenty-three children ages 8-14 years provided taste and health ratings for 60 food items. Subsequently, these children were scanned with the use of functional magnetic resonance imaging while making food choices (ie, "eat" or "not eat") after watching food and nonfood television commercials., Results: Our results show that watching food commercials changes the way children consider the importance of taste when making food choices. Children did not use health values for their food choices, indicating children's decisions were largely driven by hedonic, immediate rewards (ie, "tastiness"); however, children placed significantly more importance on taste after watching food commercials compared with nonfood commercials. This change was accompanied by faster decision times during food commercial trials. The ventromedial prefrontal cortex, a reward valuation brain region, showed increased activity during food choices after watching food commercials compared with after watching nonfood commercials., Conclusion: Overall, our results suggest watching food commercials before making food choices may bias children's decisions based solely on taste, and that food marketing may systematically alter the psychological and neurobiologic mechanisms of children's food decisions., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Reducing the extent and persuasive power of marketing unhealthy foods to children worldwide are important obesity prevention goals. Research is limited to understand how brand mascots and cartoon media characters influence children's diet. We conducted a systematic review of five electronic databases (2000-2014) to identify experimental studies that measured how food companies' mascots and entertainment companies' media characters influence up to 12 diet-related cognitive, behavioural and health outcomes for children under 12 years. Eleven studies met the inclusion criteria. Studies used 21 unique popular media characters, but no brand mascots. Results suggest that cartoon media character branding can positively increase children's fruit or vegetable intake compared with no character branding. However, familiar media character branding is a more powerful influence on children's food preferences, choices and intake, especially for energy-dense and nutrient-poor foods (e.g. cookies, candy or chocolate) compared with fruits or vegetables. Future research should use a theoretically grounded conceptual model and larger and more diverse samples across settings to produce stronger findings for mediating and moderating factors. Future research can be used to inform the deliberations of policymakers, practitioners and advocates regarding how media character marketing should be used to support healthy food environments for children., (© 2014 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.)

Background: Food marketing contributes to childhood obesity. Food companies commonly place display advertising on children's web sites, but few studies have investigated this form of advertising., Objectives: Document the number of food and beverage display advertisements viewed on popular children's web sites, nutritional quality of advertised brands and proportion of advertising approved by food companies as healthier dietary choices for child-directed advertising., Methods: Syndicated Internet exposure data identified popular children's web sites and food advertisements viewed on these web sites from July 2009 through June 2010. Advertisements were classified according to food category and companies' participation in food industry self-regulation. The percent of advertisements meeting government-proposed nutrition standards was calculated., Results: 3.4 billion food advertisements appeared on popular children's web sites; 83% on just four web sites. Breakfast cereals and fast food were advertised most often (64% of ads). Most ads (74%) promoted brands approved by companies for child-directed advertising, but 84% advertised products that were high in fat, sugar and/or sodium. Ads for foods designated by companies as healthier dietary choices appropriate for child-directed advertising were least likely to meet independent nutrition standards., Conclusions: Most foods advertised on popular children's web sites do not meet independent nutrition standards. Further improvements to industry self-regulation are required., (© 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.)

Background: Food advertising on television (TV) is well known to influence children's purchasing requests and models negative food habits in Western countries. Advertising of unhealthy foods is a contributor to the obesogenic environment that is a key driver of rising rates of childhood obesity. Children in developing countries are more at risk of being targeted by such advertising, as there is a huge potential for market growth of unhealthy foods concomitant with poor regulatory infrastructure. Further, in developing countries with multi-ethnic societies, information is scarce on the nature of TV advertising targeting children., Objectives: To measure exposure and power of TV food marketing to children on popular multi-ethnic TV stations in Malaysia., Design: Ethnic-specific popular TV channels were identified using industry data. TV transmissions were recorded for each channel from November 2012 to August 2013 (16 hr/day) for randomly selected weekdays and weekend days during normal days and repeated during school holidays (n=88 days). Coded food/beverage advertisements were grouped into core (healthy), non-core (non-healthy), or miscellaneous (unclassified) food categories. Peak viewing time (PVT) and persuasive marketing techniques were identified., Results: Non-core foods were predominant in TV food advertising, and rates were greater during school holidays compared to normal days (3.51 vs 1.93 food ads/hr/channel, p<0.001). During normal days' PVT, the ratio of non-core to core food advertising was higher (3.25 food ads/hr/channel), and this more than trebled during school holidays to 10.25 food ads/hr/channel. Popular channels for Indian children had the lowest rate of food advertising relative to other ethnic groups. However, sugary drinks remained a popular non-core product advertised across all broadcast periods and channels. Notably, promotional characters doubled for non-core foods during school holidays compared to normal days (1.91 vs 0.93 food ads/hr/channel, p<0.001)., Conclusions: This study highlights non-core food advertising, and predominantly sugary drinks are commonly screened on Malaysian TV channels. The majority of these sugary drinks were advertised by multinational companies, and this observation warrants regulatory attention.

Evidence suggests that exposure to advertising of unhealthy foods may contribute to increased rates of obesity in children. This study examined the extent to which television stations marketed unhealthy foods to children during after-school programming aired over one week in La Ceiba, Honduras. Content analysis was performed on four television stations, including one broadcast station and three cable networks. Eighty hours of programming were recorded and analyzed. Advertised products were categorized as food or non-food items, with food items further classified as healthy or unhealthy. Advertisements were coded as those aimed at children, adults, or both, and chi-square tests were used to compare the proportion of unhealthy advertisements by target audience. A total of 2271 advertisements aired during the observation period, with 1120 marketing products (49.3%). Of those, 397 (35.4%) promoted foods-30.2% were for healthy foods and 69.8% for unhealthy foods. The unhealthy foods were all advertised on cable networks and not the broadcast station. Children appeared to be targeted more than adults in advertisements for unhealthy foods (92.1%, p<0.001). Cable television programming during after-school hours advertised primarily unhealthy foods. Exposure to these advertisements may promote consumption of unhealthy foods by children, increasing their risk of obesity., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Purpose: This study aims to examine adolescents' social media environment connected to unhealthy food marketing. As social media have become a ubiquitous part of young people's everyday lives, marketers have also shifted their focus to these channels. Literature on this phenomenon is still scarce and often takes a quite narrow view of the role of marketing in social media. Furthermore, the experiences of the adolescents are seldom considered. Design/methodology/approach: Using a sociocultural approach and netnographic methodology, this study presents findings from a research project conducted in Finland. The data consist of both social media material and focus group interviews with adolescents. Findings: The findings elaborate on unhealthy food marketing to adolescents in social media from two perspectives: sociocultural representations of unhealthy foods in social media marketing and social media influencers connecting with adolescents. Originality/value: The study broadens and deepens the current understanding of unhealthy food marketing to adolescents taking place in social media. The study introduces a novel perspective to the topic by looking at it as a sociocultural phenomenon. [ABSTRACT FROM AUTHOR]

Objective: Sugar-sweetened beverages (SSB) are heavily advertised globally, and SSB consumption is linked to increased health risk. To reduce unhealthy food marketing, Chile implemented a regulation for products classified as high in energies, sugar, saturated fat or sodium, starting with a 2016 ban on child-targeted advertising of these products and adding a 06.00–22.00 daytime advertising ban in 2019. This study assesses changes in television advertising prevalence of ready-to-drink beverages, including and beyond SSB, to analyse how the beverage industry shifted its marketing strategies across Chile's implementation phases. Design: Beverage advertisements were recorded during two randomly constructed weeks in April-May of 2016 (pre-implementation) through 2019 (daytime ban). Ad products were classified as 'high-in' or 'non-high-in' according to regulation nutrient thresholds. Ads were analysed for their programme placement and marketing content. Setting: Chile. Results: From pre-regulation to daytime ban, child-targeted, daytime and total ads decreased by 51·8 percentage points (p.p.), 51·5 p.p. and 61·8 p.p. for high-in products and increased by 62·9 p.p., 54·9 p.p. and 61·8 p.p. for non-high-in products (Ps < 0·001). Additionally, total ready-to-drink beverage ads increased by 5·4 p.p. and brand-only ads (no product shown) by 7 p.p. Conclusions: After the regulation implementation, 'high-in' ads fell significantly, but 'non-high-in' ads rose and continued using strategies targeting children and being aired during daytime. Given research showing that advertising one product can increase preferences for a different product from that same brand and product categories, broader food marketing regulation approaches may be needed to protect children from the harmful effects of food marketing. [ABSTRACT FROM AUTHOR]

Numerous studies have characterised the establishments registered with meal delivery apps (MDA) in several countries. However, little evidence is available regarding these platforms in Latin America (LA). The purpose of this study is to characterise food establishments registered with an MDA in nine LA cities. The establishments (n 3339) were characterised by the following keyword groups: 'Typical cuisine', 'Meat and fish', 'Snacks', 'Breakfast', 'Desserts' and 'Healthy'. In addition, we identified the marketing strategies present in the establishments' advertisements: photos, discounts and free delivery. Mexico City had the highest number of establishments registered with MDA (773), followed by Bogotá (655), Buenos Aires (567) and São Paulo (454). There is a direct relationship between the number of inhabitants of the cities and the number of the registered establishments. 'Snacks' was the keyword group most used by establishments in five of the nine cities. Establishments in two cities were most often characterised by the terms 'Typical cuisine' (Mexico City and Santiago de Chile) and 'Meats and fish' (Quito and San Jose). Photos were present in the advertisements of at least 84·0 % of the establishments. In addition, at least 40 % of establishments in Montevideo, Bogotá, São Paulo, Lima and Santiago de Chile offered discounts. Free delivery was present in at least 50 % of establishments in Quito, San Jose, Mexico City, Santiago de Chile and Lima. Photos were also the most common marketing strategy used by the establishments classified in all groups of keywords, while free delivery and discounts differed among them. [ABSTRACT FROM AUTHOR]